Mental health of parents having children with physical disabilities.

BACKGROUND: Parents of children with disabilities play an essential role in the successful rehabilitation of their children. However, the high level of care required may affect the mental health of the parents and consequently contribute to an unfavorable rehabilitation outcome in their children. The aims of this study are to investigate the mental health of parents of children with physical disabilities and to elucidate the factors affecting parental mental health. METHOD: This was a cross-sectional study. Ninety-one parents of children with physical disabilities who visited the outpatient rehabilitation clinics of a tertiary hospital were invited to join the study. Data from the parents and children were recorded during face-to-face interviews. Parental- perceived stress was assessed using the simplified Parenting Stress Index (PSI/SF). Parental mental health was evaluated as the main outcome measure using the 12-item version of the Chinese Health Questionnaire (CHQ-12). RESULTS: Forty parents (44%) were categorized as psychiatric cases on the CHQ. Child-related factors that negatively affected parental mental health were poor walking ability (p < 0.05), dependency on others to perform activities of daily life (ADL) (p < 0.01), and younger age (p < 0.05). Parent-related factors that negatively affected parental mental health were low income (p < 0.05), no religious beliefs (p < 0.01), high level of parental distress (p < 0.01), parent-child dysfunctional interaction (p < 0.01), and having difficult child (p < 0.05). The most significant predictor of overall parental mental health in multivariate analysis was found to be parental distress. CONCLUSIONS: Parents of children with physical disabilities were at risk of poor mental health. Perceived parental distress is the most important factor affecting parental mental health. Strategies to reduce parental stress should be developed to prevent deterioration of parental mental health.

Regional survey of assistive devices use by children with physical disabilities in southern Taiwan.

BACKGROUND: Despite increasing use of assistive devices (ADs) by physically disabled (PD) children, the use rate, number, effects and related services have seldom been studied. Understanding AD utilization is helpful in improving the related services. This study describes the usage of ADs by children with physical disabilities (PDs). METHODS: This regional survey enrolled children with PDs. The children's parents or primary caregivers filled out structured questionnaires regarding the children's use of and need for ADs, the benefits and problems associated with the ADs and related services. RESULTS: In total, 224 ADs were used by 124 children (1.79 ADs per child). The most commonly used ADs were orthoses (n = 77, 62.10%), mobility aids (n = 51, 41.13%), and aids for therapy and training (n = 21, 16.94%). The degree of disability, age, gender, diagnosis and rehabilitation training location were not associated with the number of ADs used. Most children (n = 103, 83.06%) benefited from ADs, and 93 (75%) children had been evaluated prior to buying ADs. Eighty three (66.94%) parents paid for the Ads, and 108 (87.10%) parents acquired information from rehabilitation professionals. Forty one (40.20%) parents were satisfied with the services of local suppliers; 119 (95.97%) parents had applied to their local government for financial support; 82 (68.91%) parents were not satisfied with the application procedures or the amount of support they received. CONCLUSION: Although parents of PD children favored the usage of ADs, they needed additional information. We suggest that policies and strategies are needed to reduce barriers to ADs utilization, enhance insurance coverage and improve ease of using the services.

Fitting a bilateral transhumeral amputee with utensil prostheses and their functional assessment 10 years later: a case report.

Traumatic transhumeral amputations resulting from electric burn injury are uncommon and present a significant rehabilitation challenge. Compensating for loss of fine, coordinated function of the upper extremities with prostheses is difficult medically, technologically, psychologically, and socially. We followed up a patient with traumatic bilateral transhumeral amputation who was fitted with specially designed bilateral low-temperature utensil prostheses for 10 years. A bilateral utensil prosthesis consists of 2 thermoplastic sockets, an elastic harness, 2 utensil holders, and several different utensils. The characteristics of utensil prostheses are low cost, quick fabrication, and responsiveness to a patient's needs. Ten years after the patient's first prosthesis fitting, he still used these specially designed prostheses. By using these devices and his feet, the patient has regained independence in most activities of daily living and gained a new working skill.

Comparing stress levels of parents of children with cancer and parents of children with physical disabilities.

AIM: To evaluate whether parental stress differs between parents of children with physical disabilities and parents of children with cancer. METHODS: Parents (92 with disabled children and 89 with children with cancer) were recruited to complete the measures of the Parenting Stress Index/Short Form. RESULTS: Diagnostic group differences were found across the parenting stress measures used in this study. The parents of children with cancer experienced significantly higher levels of stress compared with the parents of disabled children. The mean scores of each subscale (PD, PCDI, and DC) and total score scales in both groups approached were above the 90th percentile of Abidin's normative sample (PD = 36, PCDI = 27, DC = 36, Total = 91), except for the PD and DC subscales in the disabled children group, which approached the 90th percentile. CONCLUSION: The results of the study suggest that most of the parents in our sample should be referred for more in-depth diagnostic study and professional counseling in stress management. Therefore, a normative score on the PSI/SF for Taiwanese parents with healthy children should be established to identify whether differences exist between parents whose children are healthy and those whose children have been diagnosed with a chronic illness.