ABSTRACT
The birth of a baby is usually anticipated with great excitement and expectations of a future filled with happiness and success. This exuberance may become muted with the birth of a handicapped child. It does not matter if the handicap is blindness, retardation or a physical abnormality. The family into which this child is born will change in many ways. The long term out come of handicapped condition depends on family adjustment, and coping strategies which in the long run often are equal to or of greater importance than the technical and medical procedures. Mothers of handicapped children who may experience additional stressors such as unmet service needs and financial problems would inevitably lead to pathology and mal-adaptation pattern of coping. Mothers who use mal-adaptive coping strategies have feeling of disappointment, high level of stress, depression, low level of confidence, marital dis adjustement, as well as difficult in relationship and reduced social contact. Mothers who are successfully coping with having a handicapped child, are able to effectively mobilize their internal and external resources, to deal with the special needs of their child and have a high quality of life, regardless of the disability. Nurses have a great responsibility in helping the mothers to use an effective coping strategies that enable them to take care of their handicapped child while still maintaining their own satisfactory lives. Assessment of the coping strategies helps the nurse to identify the unique way for managing the mothers stress. Assessment of facilitators and inhibitors to the coping and quality of life in mothers of handicapped children allows the descripition from a new point of view, giving valuable information for improving the families health care and for resource allocation. Hence the purpose of this research is to assess the coping strategies and the quality of life among mothers with handicapped child, and to identify the facilitators and inhibitors to the coping. The study was conducted at Jameyat Fatat, Al-Khalig, Female Special Education Center, and the out patient department of King Fahed Hospital, Kingdom of Saudi Arabia. The subjects of this study consisted of one hundred and twenty mothers that have one handicapped child between 6 and 13 years of age. Three tools were used in this study, The Personal and demographic characteristics, The Coping Inventory for Stressful Situations [CISS]. And the Quality-of-life scale [QOL]. In addition, an interview was conducted using open-ended questions to elicit the facilitators and inhibitors to effective coping. The study revealed that more than half of the mothers used emotional coping strategies [53.3%], followed by problem-focus coping [29.08%] then avoidance coping strategies [20.8%]. The mean score for quality of life among the mothers of handicapped child is relatively low [Mean=59.4 +/- 31.19]. The study also showed that mothers who used problem-focus coping strategies have higher quality of life than the mothers who utilized emotional or avoidance as a way of coping. The present study indicate that mothers reported "Faith in God" and "Husband's support and understanding" as the most important facilitator for coping, this is followed by, "physical support from, family, friend, neighbors, and relatives". "The presence of maid servant", "Financial support", " Professional support", were reported next. The most common inhibiting for coping reported by the mothers are "Lack of acceptance of the handicapped child by others", "Financial constraints", and "Problems related to professionals"