Levels, Correlates, and Predictors of Stress and Caregiver Burden among Caregivers of Children with Cerebral Palsy in Nigeria

Abstract

Cerebral palsy (CP) is a major cause of physical disability in childhood. Caregivers are often subjected to both stress and burden due to prolonged care. This article assesses levels, correlates, and predictive factors of stress and caregiver burden among primary caregivers of children with CP. A hospital-based descriptive cross-sectional study was conducted in three tertiary hospitals within the Osun State, Nigeria. Two hundred and nine caregivers were interviewed with both the Parental Stress Scale and Caregiver Difficulty Scale to assess for stress and burden of caregivers, respectively. Data were collected and analyzed using Statistical Program for Social Sciences for Windows version 22 (SPSS Inc., Chicago, Illinois, United States) with alpha set at p < 0.05. Two hundred and nine children with CP aged 12 months to 12 years were seen during the 6-month period. Mothers constituted 87.1% of the total caregivers. The mean (standard deviation [SD]) stress seen in caregivers was 44.8 ± 10.1, while the mean (SD) caregiver burden was 45.2 ± 13.4. Both these scores were above the minimum score of 42, which signifies high psychosocial stress and burden. Multivariate linear regression was used to assess associations between clinical and sociodemographic and each of stress and caregivers' burden. Severity of CP and level of education were the most important predictors of stress, while severity of CP, level of education, and male child were the most important predictors of caregivers' burden. Caregivers' burden and stress are known to result in negative outcomes. Identifying factors that can predict caregivers' burden and stress could help develop an early intervention strategy to minimize these negative effects while promoting caregivers' psychosocial well-being.

Factors associated with caregiver burden among family caregivers of children with cerebral palsy: a systematic review

“…Caregiver factors were grouped into five categories, including caregiver demographics, emotional functioning, physical functioning, overall health and social functioning. Caregiver demographical factors included age, 8 12 14 15 21 23 gender, 21 educational level, 14 15 21 23 monthly income, 14 15 21 23 number of caregiver, 15 socioeconomic status, 21 geographical area, 23 mother employment, 19 additional helper 14 and daily caring time. 12 Emotional functioning factors included anxiety, 15 20 24 depression, 12 14 15 17 20 22 24 mental health, 12 22 25 26 perceived stress, 20 26 beliefs of rehabilitation, 8 perceived self-efficacy 8 17 and experiential avoidance.…”

“…Children factors were grouped into five categories, including children demographics, disease related, behavioural functioning, overall health and social environment. Children demographical factors included age, 8 12 14 15 21 23 gender, 14 15 21 23 going to nursery/school, 19 residence, 19 birth order, 21 number of children, 14 15 23 number of disabled child 15 and body mass index. 12 Disease-related factors included type of CP, 21 23 severity of CP, 12 14 17 21 tube/intravenous nutrition, 19 aetiology, 21 additional physical illness, 14 associated conditions 21 23 and functional impairments.…”

“…Children demographical factors included age, 8 12 14 15 21 23 gender, 14 15 21 23 going to nursery/school, 19 residence, 19 birth order, 21 number of children, 14 15 23 number of disabled child 15 and body mass index. 12 Disease-related factors included type of CP, 21 23 severity of CP, 12 14 17 21 tube/intravenous nutrition, 19 aetiology, 21 additional physical illness, 14 associated conditions 21 23 and functional impairments. 23 This category was included in 5 of the 15 studies.…”

“…Seven instruments were used to measure caregiver burden: Zarit Burden Interview (n=7) 12 14-19 ; Caregiver Difficulties Scale (n=4) [20][21][22][23] ; Caregiver Burden Scale (n=1) 24 ; The Revised Burden Measure (n=1) 25 ; The Burden Interview (n=1) 26 ; Daily Parenting Tasks Checklist-Parenting Burden (n=1) 27 ; Viriyaprasart's questionnaire about burden of care (n=1). 8…”

The Chinese version of the Caregiver Difficulties Scale: Psychometric evaluation

“…Consequently, the long‐term care and therapeutic intervention are indispensability part in children development (Sadowska et al, 2020). Parenting children with CP can be stressful and may threats to parent–child relationship and family function (Omole et al, 2019; Raina et al, 2005). Considerable evidence exists that caregiver of a child with cerebral palsy has experienced light to moderate burden and simultaneously also suffering from anxiety, depression, fatigue, pain and poorer sleep (Albayrak et al, 2019; Farajzadeh et al, 2020).…”