Effects of Continuous Care Model on Mental Health in Mothers of Children with Cerebral Palsy: A Randomized Clinical Trial

Abstract

Background: Cerebral palsy is a leading cause of disability among children, and most of these children depend on their care provider or parents all the time. Mothers of these children spend a great amount of time taking care of them, which could have adverse effects on their mental health. Objectives: The present study was conducted to investigate the impact of the continuous care model (CCM) on the mental health of mothers with children suffering from cerebral palsy. Methods: This randomized clinical trial was performed among 80 mothers of hospitalized children with cerebral palsy. Subjects were randomly divided into the two groups of intervention and control. In the intervention group, the CCM was administered to the mothers up to eight weeks after discharge, and for the control group, only routine nursing education was provided to the mothers at hospital discharge. Before and one and eight weeks after the intervention, in both groups, the mothers' mental health was assessed using the General Health Questionnaire. Data were analyzed using SPSS version 21 through descriptive and inferential statistics. Results: The mean age of the mothers was 33.2 ± 2.1 years and 34.3 ± 2.2 years in the intervention and control groups, respectively. In the intervention group, the CCM had a positive effect on the mental health of mothers one and two months after discharge from hospital compared to before the intervention (P = 0.04, P = 0.02, respectively); however, in the control group, the mean score of mothers' mental health was decreased over time. No significant relationship was found between mental health and the demographic characteristics of the mothers (i.e., age, education, participation in any child caring programs, having anxiety, having any other children with cerebral palsy, and experiencing depression due to having a child with cerebral palsy) (P > 0.05). Conclusions: The CCM had a positive effect on the mental health of mothers of children with cerebral palsy. Thus, this intervention might be useful, but further studies are needed about the cost effectiveness of this intervention and its long-term impact on a larger sample.

Effect of family-centered care interventions on well-being of caregivers of children with cerebral palsy: a systematic review

“…All the studies are randomized controlled trials, of which thirteen studies involved children with CP, 6,[27][28][29][30][31][32][33][34][35][36][37][38] two studies involved infants at high risk of CP, 39,40 and lastly, one study involved both children diagnosed or at high risk of CP. 41 Four studies were located in Australia, 30,33,39,40 two in Iran, 6,35 and one each in the United Kingdom, 34 Tanzania, 27 Netherlands, 41 Norway, 32 Brazil, 29 Canada, 31 Denmark, 28 Turkey, 37 Thailand, 36 and Bangladesh. 38 In five studies 30,33,35,37,38,32 the interventions directly targeted the caregivers while in the remaining studies, the interventions targeted the caregiver indirectly by focussing on improvement in child-related outcomes.…”

“…Only two studies incorporated only one FCC component-Enabling and partnership, 31,32 whereas the remaining studies involved multiple FCC components in their intervention. 6,[27][28][29][30][33][34][35][36][37][38][39][40][41] The interventions targeted different needs of the caregiver such as social or informational support. Various modes of delivering the intervention such as online or offline platforms, actively through discussions, or passively through mailing child-related information reports were utilized.…”

“…Risk of bias of included studies. Risk of bias was low (green) in six studies, 6,29,30,32,36,40 unclear (yellow) in five studies, 28,35,[37][38][39] and high (red) in five studies. 27,31,33,34,41 Table 2.…”

“…33 'Information provision', 'Enabling and partnership', and 'Respectful and supportive care' Five studies were included in this category. 6,35,37,38,40 Four studies involved children diagnosed with CP, in the age group of 1-16 years, 6,35,37,38 from all GMFCS levels and one study included infants with high-risk CP (age 3 to 10 months). 40 In the study by Kahjoogh et al ( 2019), 6 goal setting was done for all caregivers using the COPM (one goal for themselves and two goals for their child) prior to randomization.…”

Selected Topics on Infant Feeding

“…COVID-19 is an infectious disease that was declared a public health emergency of international concern by the WHO [54]. Their main concern is whether breastfeeding by mothers infected with COVID-19 is safe, and whether the virus or antibodies can be transmitted from mother to baby through milk [55].…”