Depression, anxiety and stress among caregivers of adolescents with cerebral palsy in rural Bangladesh

Power, Rosalie; Muhit, Mohammad; Heanoy, Eamin; Karim, Tasneem; Galea, Claire; Badawi, Nadia; Khandaker, Gulam

doi:10.1080/09638288.2019.1692378

Cited by 17 publications

(25 citation statements)

References 34 publications

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“…Research on parents of children with CP focuses mainly on the impact of care on the health of parents as well as on assessment HRQOL. A review of the related literature and published findings shows that parents of children with CP tend to present a higher level of distress and poorer mental health [6,21,37,38,39,40], and that anxiety and depression are the most common mental health disorders [1,6,41,42]. However, the determinants of anxiety and depression are still not fully understood, therefore the related research needs to be continued.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Anxiety and Depression in Polish Primary Parental Caregivers of Children with Cerebral Palsy Compared to a Control Group, as well as Identification of Selected Predictors

Gugała

Penar-Zadarko

Pięciak-Kotlarz

et al. 2019

IJERPH

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Background: Taking care of a child with Cerebral Palsy (CP) may be linked with adverse effects in the parents’ physical and mental health. The causes of anxiety and depression symptoms associated with childcare are still not fully understood. Aim: To assess the intensity of anxiety and depression symptoms in parents of children with CP compared to a control group and to identify selected mental health predictors. Design and Methods: Data were collected from 301 respondents, including 190 parents of children with CP (study group) and 111 parents taking care of children developing normally (control group). Intensity of anxiety and depression was rated using the Hospital Anxiety and Depression Scale (HADS) scale. Gross Motor Function Classification System for Cerebral Palsy (GMFCS), Sense of Coherence Scale (SOC-29), Berlin Support Social Scales (BSSS) scales and a specially designed questionnaire were used to assess the predictors. The investigated variables included the children’s and the parents’ characteristics, as well as environmental factors. The analyses applied Spearman’s rank correlation coefficient, M(SD) as well as multiple regression. Results: The level of anxiety and depression was clearly higher in the parents of children with CP–the mean levels of anxiety and depression in the study group and the controls amounted to 8.1 vs. 4.7 and 6.8 vs. 3.7, respectively. The factors associated with intensity of anxiety and depression in the parents of children with CP included lack of social support, mainly perceived and received support, unsatisfying parental health status, poor economic status of the family, as well as difficult living conditions, sense of coherence, loneliness, the parent’s gender, and the child’s intellectual disability. Conclusions: Identification of significant anxiety and depression predictors, understood as modifiable factors, should be considered in determining and planning comprehensive support for a child with CP and his/her primary parental caregiver.

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Section: Discussionmentioning

confidence: 99%

Assessment of Anxiety and Depression in Polish Primary Parental Caregivers of Children with Cerebral Palsy Compared to a Control Group, as well as Identification of Selected Predictors

Gugała

Penar-Zadarko

Pięciak-Kotlarz

et al. 2019

IJERPH

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“…DASS-21 is a 21-item standardized self-report questionnaire designed to measure the negative related emotional states of 'depression', 'anxiety' and 'stress'. Caregiver mental health scores for this sample are available in Power, Muhit [20].…”

Section: Caregiver Mental Health: Depression Anxiety and Stress Scalmentioning

confidence: 99%

“…We have explored factors either informed by previous research or considered relevant to the research context including priority areas of the sustainable development goals of which Bangladesh is an adoptee [19]. Moreover, mental health is a significant issue among adolescents with CP and caregivers in rural Bangladesh [6,20] and are included as potential determinants in our analysis. We also explore proxies of socio-economic status related to housing infrastructure due to their potential impact on adolescent wellbeing in the study context.…”

Section: Introductionmentioning

confidence: 99%

What predicts the proxy-reported health-related quality of life of adolescents with cerebral palsy in Bangladesh?

et al. 2020

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Background: The health-related quality of life (HRQoL) of adolescents with CP in low and middle-income countries is often poor, as is the case in Bangladesh. This exploratory study examined what factors predict the proxy-reported HRQoL of adolescents with CP in rural Bangladesh, a typical low-and middle-income country (LMIC). Methods: Adolescents with CP (10 to 18y) were identified using the Bangladesh Cerebral Palsy Register. HRQoL was assessed using the Cerebral Palsy Quality of Life-Teens proxy-report questionnaire (CPQoL-Teens), adolescent mental health using the Strengths and Difficulty Questionnaire (SDQ) and caregiver mental health using the Depression, Anxiety and Stress Scale (DASS-21). Theoretical and statistical interests (i.e. bivariate analysis, p < 0.05) identified potential predictors which were entered into hierarchical multiple linear regression (HMLR) models in order of clinical significance; HMLR related adolescent clinical characteristics, adolescent and caregiver mental health and proxies of socioeconomic status to CPQoL-Teens dimensions. Results: One hundred fifty-four adolescents with CP (mean age 15y 1mo, SD 1y 8mo, female 31.2%) participated in this study. Twenty-four factors were identified to explore for relationship to adolescent proxy-reported HRQoL. Fifteen of the factors correlated to one or more CPQoL-Teens dimension; strongest correlation was between 'feelings about functioning' and motor impairment (r = 0.545). Nine were predictive of CPQoL-Teens dimensions; adolescent sex, school attendance, severity of motor impairment, hearing and speech impairment, mother's education, primary caregiver depression and stress, and having a sanitary latrine at home resulting in score changes of between 0.79 (95% CI 0.24 to 1.35) to 35.1 (95% CI 6.03 to 64.22). Conclusions: Many of the factors predicting the proxy-reported HRQoL of adolescents with CP are amenable to intervention, and have the potential to improve adolescent wellbeing. Several determinants are priorities of the sustainable development goals (SDGs); these findings should inform resource prioritization to improve the wellbeing of adolescents with CP in Bangladesh and other LMICs.

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“…Interventions for children with CP are also strongly linked to caregiver wellbeing [42]. This has been evidenced in studies from LMICs including Bangladesh and Ghana [43,44]. The findings from a study in Zimbabwe have previously also reported that caregivers of children with CP had poor health-related quality of life; high levels of depression, anxiety and stress; and felt overwhelmed by the economic burden and their caregiving role [45].…”

Section: Discussionmentioning

confidence: 95%

Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

et al. 2021

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We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

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Depression, anxiety and stress among caregivers of adolescents with cerebral palsy in rural Bangladesh

Cited by 17 publications

References 34 publications

Assessment of Anxiety and Depression in Polish Primary Parental Caregivers of Children with Cerebral Palsy Compared to a Control Group, as well as Identification of Selected Predictors

Assessment of Anxiety and Depression in Polish Primary Parental Caregivers of Children with Cerebral Palsy Compared to a Control Group, as well as Identification of Selected Predictors

What predicts the proxy-reported health-related quality of life of adolescents with cerebral palsy in Bangladesh?

Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

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