Mediating Role of Social Health in the Relationship of Parenting Stress and Child-parent Interaction with Health-related Quality of Life in Parents of Children with Specific Learning Disorder

Document Type : Original Article

Authors

Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran

Abstract

Background: Health-related quality of life (HRQOL) can predict the amount and impact of the disease, damages, and inabilities; moreover, it can assess an individual's psychological health.
 
Objectives: The present study aimed to assess the mediating role of social health in the relationship of parenting stress and child-parent interaction with HRQOL in parents of children with a specific learning disorder (SLD).
 
Methods: This descriptive-correlational study was conducted using path analysis. The study population comprised all parents of children with SLD in Andimeshk in 2020-21, among whom 174 parents were selected via convenience sampling. The research instruments included the SF-36 Questionnaire (Weber, 1992), Parenting Stress Index (Abidin, 1992), Child-Parent Relationship Scale (Pianta, 1994), and Keyes's Social Health Questionnaire (Keyes, 1998). The proposed model was evaluated using path analysis with AMOS software (version 25).
 
Results: The results pointed to a significant relationship between child-parent interaction and HRQOL (β=0.204, P=0.004), social health and HRQOL (β=0.383, P<0.001), parenting stress and social health (β=-0.561, P<0.001), as well as child-parent interaction and social life (β=0.152, P=0.016). Furthermore, the indirect paths of parenting stress and HRQOL mediated by social health (P<0.001), as well as the relationship between child-parent interaction and the HRQOL mediated by social health (P=0.021), were all significant.
 
Conclusion: The final model achieved a desirable good fit; therefore, this model could be considered an important step in understanding effective factors in the HRQOL in parents of children with SLD.

Keywords


Copyright © 2024, Razavi International Journal of Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Shah HR, Sagar JKV, Somaiya MP, Nagpal JK. Clinical Practice Guidelines on Assessment and Management of Specific Learning Disorders. Indian J Psychiatry. 2019;61(Suppl 2):211-225. doi:10.4103/psychiatry.IndianJPsychiatry_564_18
https://doi.org/10.4103/psychiatry.IndianJPsychiatry_564_18
PMid:30745697 PMCid:PMC6345134
 
2. Holt S, Yuill N. Tablets for two: How dual tablets can facilitate other-awareness and communication in learning disabled children with autism. International Journal of Child-Computer Interaction. 2017;11:72-82. doi:10.1016/j.ijcci.2016.10.005
https://doi.org/10.1016/j.ijcci.2016.10.005
 
3. Hashemi Razini H, Maghsoodloonejad F. The Comparison of Divided, Sustained and Selective Attention in Children with Attention Deficit Hyperactivity Disorder, Children with Specific Learning Disorder and Normal Children. Razavi International Journal of Medicine. 2017;5(4).e12523. doi:10.5812/rijm.12523
https://doi.org/10.5812/rijm.12523
 
4. Fernández T, Bosch-Bayard J, Harmony T, Caballero MI, Díaz-Comas L, Galán L, et al. Neurofeedback in Learning Disabled Children: Visual versus Auditory Reinforcement. Applied Psychophysiology and Biofeedback. 2016;41(1):27-37. doi.org/10.1007/s10484-015-9309-6
https://doi.org/10.1007/s10484-015-9309-6
PMid:26294269
 
5. Matteucci MC, Scalone L, Tomasetto C, Cavrini G, Selleri P. Health-related quality of life and psychological wellbeing of children with Specific Learning Disorders and their mothers. Research in Developmental Disabilities. 2019;87:43-53. doi:10.1016/j.ridd.2019.02.003
https://doi.org/10.1016/j.ridd.2019.02.003
PMid:30772705
 
6. Ohnemus D, Neighbors K, Rychlik K, Venick RS, Bucuvalas JC, Sundaram SS, et al. Health-Related Quality of Life and Cognitive Functioning in Pediatric Liver Transplant Recipients. Liver Transpl. 2020;26(1):45-56. doi:10.1002/lt.25634
https://doi.org/10.1002/lt.25634
PMid:31509650
 
7. Bahreini I, Bakhtiarpour S, Ehteshamzadeh P, Heidari A. Structural model of health-related quality of life in diabetic patients based on mental well-being and quality
 
of sleep mediated by self-care behaviors. Razavi International Journal of Medicine. 2021;9(2):87-92. doi:10.30483/rijm.2021.254212.1059
 
8. Hordijk J, Verbruggen S, Vanhorebeek I, Van den Berghe G, Utens E, Joosten K, et al. Health-related quality of life of children and their parents 6 months after
 
children's critical illness. Qual Life Res. 2020;29(1):179-89. doi:10.1007/s11136-019-02347-x
https://doi.org/10.1007/s11136-019-02347-x
PMid:31691884 PMCid:PMC6962289
 
9. Sosnowski R, Kulpa M, Ziętalewicz U, Wolski JK, Nowakowski R, Bakuła R, et al. Basic issues concerning health-related quality of life. Cent European J Urol. 2017;70(2):206-11. doi:10.5173/ceju.2017.923
https://doi.org/10.5173/ceju.2017.923
 
10. Hsiao Y-J. Parental Stress in Families of Children with Disabilities. Intervention in School and Clinic. 2018;53(4):201-205. doi:10.1177/1053451217712956
https://doi.org/10.1177/1053451217712956
 
11. Bonifacci P, Storti M, Tobia V, Suardi A. Specific Learning Disorders: A Look Inside Children's and Parents' Psychological Well-Being and Relationships. J Learn Disabil. 2016;49(5):532-545. doi:10.1177/0022219414566681
https://doi.org/10.1177/0022219414566681
PMid:25609675
 
12. Ceballos PL, Lin Y-W, Bratton SC, Lindo N. Effects of Parenting Programs on Latina Mothers' Parental Stress and Their Children's Internalizing Behavioral Problems. Journal of Child and Adolescent Counseling. 2019;5(1):73-88. doi:10.1080/23727810.2018.1556983
https://doi.org/10.1080/23727810.2018.1556983
 
13. Craig F, Operto FF, De Giacomo A, Margari L, Frolli A, Conson M, et al. Parenting stress among parents of children with Neurodevelopmental Disorders. Psychiatry Res. 2016;242:121-9. doi:10.1016/j.psychres.2016.05.016
https://doi.org/10.1016/j.psychres.2016.05.016
PMid:27280521
 
14. Zyga O, Dimitropoulos A. Preliminary Characterization of Parent-Child Interaction in Preschoolers With Prader-Willi Syndrome: The Relationship Between Engagement and Parental Stress. Am J Intellect Dev Disabil. 2020;125(1):76-84. doi:10.1352/1944-7558-125.1.76
https://doi.org/10.1352/1944-7558-125.1.76
PMid:31877257
 
15. Johansson M, Benderix Y, Svensson I. Mothers' and fathers' lived experiences of postpartum depression and parental stress after childbirth: a qualitative study. Int J Qual Stud Health Well-being. 2020;15(1):1722564. /doi:10.1080/17482631.2020.1722564
https://doi.org/10.1080/17482631.2020.1722564
PMid:31990637 PMCid:PMC7034451
 
16. Zeng S, Hu X, Zhao H, Stone-MacDonald AK. Examining the relationships of parental stress, family support and family quality of life: A structural equation modeling approach. Research in Developmental Disabilities. 2020;96:103523. doi:10.1016/j.ridd.2019.103523
https://doi.org/10.1016/j.ridd.2019.103523
PMid:31785472
 
17. Ben-Naim S, Gill N, Laslo-Roth R, Einav M. Parental Stress and Parental Self-Efficacy as Mediators of the Association Between Children's ADHD and Marital Satisfaction. J Atten Disord. 2019;23(5):506-516. doi:10.1177/1087054718784659
https://doi.org/10.1177/1087054718784659
PMid:29985090
 
18. Pisula E, Porębowicz-Dörsmann A. Family functioning,
 
parenting stress and quality of life in mothers and fathers of Polish children with high functioning autism or
 
Asperger syndrome. PLoS One. 2017;12(10):e0186536. doi:10.1371/journal.pone.0186536
https://doi.org/10.1371/journal.pone.0186536
PMid:29036188 PMCid:PMC5643111
 
19. Miranda A, Tárraga R, Fernández MI, Colomer C, Pastor G. Parenting Stress in Families of Children with Autism Spectrum Disorder and ADHD. Exceptional Children. 2015;82(1):81-95. doi:10.1177/0014402915585479
https://doi.org/10.1177/0014402915585479
 
20. Condy EE, Factor RS, Swain DM, Strege MV, Scarpa A. Maternal Affect During a Challenging Mother-Child Interaction: The Effects of Broad Autism Phenotype and Respiratory Sinus Arrhythmia Reactivity in Mothers of Children with and Without Autism Spectrum Disorder. J Autism Dev Disord. 2019;49(12):4891-4900. doi:10.1007/s10803-019-04198-4
https://doi.org/10.1007/s10803-019-04198-4
PMid:31473950
 
21. Konijnenberg C, Sarfi M, Melinder A. Mother-child interaction and cognitive development in children prenatally exposed to methadone or buprenorphine. Early Hum Dev. 2016;101:91-97. doi:10.1016/j.earlhumdev.2016.08.013
https://doi.org/10.1016/j.earlhumdev.2016.08.013
PMid:27614330
 
22. Tzuriel D, Caspi R. Intervention for peer mediation and
 
mother-child interaction: The effects on children's
 
mediated learning strategies and cognitive modifiability. Contemporary Educational Psychology. 2017;49:302-23. doi:10.1016/j.cedpsych.2017.03.005
https://doi.org/10.1016/j.cedpsych.2017.03.005
 
23. Tripathy P, Nair N, Sinha R, Rath S, Gope RK, Rath S, et al. Effect of participatory women's groups facilitated by Accredited Social Health Activists on birth outcomes in rural eastern India: a cluster-randomised controlled trial. The Lancet Global Health. 2016;4(2):e119-e28. doi:10.1016/S2214-109X(15)00287-9
https://doi.org/10.1016/S2214-109X(15)00287-9
PMid:26823213
 
24. Magnezi R, Grosberg D, Novikov I, Ziv A, Shani M, Freedman LS. Characteristics of patients seeking health information online via social health networks versus general Internet sites: a comparative study. Inform Health Soc Care. 2015;40(2):125-138. doi:10.3109/17538157.2013.879147
https://doi.org/10.3109/17538157.2013.879147
PMid:24475937
 
25. He AJ, Wu S. Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives. Appl Health Econ Health Policy. 2017;15(6):707-716. doi:10.1007/s40258-016-0254-1
https://doi.org/10.1007/s40258-016-0254-1
PMid:27333794
 
26. Prazeres F, Santiago L. Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: a multicentre cross-sectional study. Health Qual Life Outcomes. 2016;14(1):156. doi:10.1186/s12955-016-0559-7
https://doi.org/10.1186/s12955-016-0559-7
PMid:27835995 PMCid:PMC5106778
 
27. Lu J, Yu Z, Zhang X, Wu M, Lin S, Zhu Y, et al. Association between social health status and health-related quality of life among community-dwelling elderly in Zhejiang. Health Qual Life Outcomes. 2020;18(1):110. doi:10.1186/s12955-020-01358-4
https://doi.org/10.1186/s12955-020-01358-4
PMid:32345322 PMCid:PMC7189640
 
28. Kuhn J, Ford K, Dawalt LS. Brief Report: Mapping Systems of Support and Psychological Well-Being of Mothers of Adolescents with Autism Spectrum Disorders. J Autism Dev Disord. 2018;48(3):940-946. doi:10.1007/s10803-017-3381-0
https://doi.org/10.1007/s10803-017-3381-0
PMid:29164438
 
29. Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305(6846):160-4. doi:10.1136/bmj.305.6846.160
https://doi.org/10.1136/bmj.305.6846.160
PMid:1285753 PMCid:PMC1883187
 
30. Fallahzade H, Balanian S. Evaluation of SF-36 Questionnaire Dimensions in Quality of Life of Postmenopausal
 
Women Referring to Yazd City Health Centers in 2019. The Journal of Toloo-e-behdasht. 2021;19(5):78-93. doi:10.18502/tbj.v19i5.5169
https://doi.org/10.18502/tbj.v19i5.5169
 
31. Abidin, RR. The determinants of parenting behavior. Journal of Clinical Child Psychology. 1992;21: 407-412. doi:10.1207/s15374424jccp2104_12
https://doi.org/10.1207/s15374424jccp2104_12
 
32. Mohammadipour S, Dasht Bozorgi Z, Hooman F. The Role of Mental Health of Mothers of Children with Learning Disabilities in the Relationship Between Parental Stress, Mother-child Interaction, and Children's Behavioral Disorders. Journal of Client-Centered Nursing Care. 2021;7(2):149-158. doi:10.32598/JCCNC.7.2.362.1
https://doi.org/10.32598/JCCNC.7.2.362.1
 
33. Dyer WJ, Kaufman R, Fagan J. Father-child closeness and conflict: Validating measures for nonresident fathers. J Fam Psychol. 2017;31(8):1074-1080. doi:10.1037/fam0000384
https://doi.org/10.1037/fam0000384
PMid:29309190
 
34. Fereydooni A, Heidari AR, Eftekhar Saadi Z, Ehteshamzadeh P, Pasha R. Comparison of Effectiveness of Mindfulness and Happiness Training in Promoting Parent-Child Interaction Case Study: Mothers of Anxious Preschool Children in Shahrekord 2018. J Community Health Research. 2020;9(1):37-45. doi:10.18502/jchr.v9i1.2573
https://doi.org/10.18502/jchr.v9i1.2573
 
35. Corey Lee MK. Social Well-Being. Social Psychology Quarterly. 1998;61(2):121-40. doi:10.2307/2787065
https://doi.org/10.2307/2787065
 
36. Sharbatiyan, M. The Semantic Components Reflecting the link between Social Capital and the Rate Social health of the Benefit of Students of Payam Noor University, Mashhad. Sociological Studies of Youth. 2011;2(5):149-174. http://ssyj.baboliau.ac.ir/article_536037.html