Efeitos da pandemia: percepção de estresse e apoio em famílias com filhos com desenvolvimento atípico / Pandemic' effects: perception of stress and support in families with children with atypical development

A pandemia da COVID-19 exigiu medidas de proteção que repercutiram no modo de vida das famílias. Os impactos podem ter sido mais intensos em famílias com crianças com deficiência ou transtorno global do desenvolvimento (TGD) que necessitam de cuidados e estímulos específicos. O objetivo deste estudo foi analisar o impacto do isolamento social na percepção de estresse, estresse parental e apoio social percebido por mães e pais de crianças com deficiência/TGD. Trata-se de um estudo transversal com 37 participantes, em duas fases independentes de coleta de dados (F1; F2). Utilizou-se instrumentos autoaplicáveis disponibilizados em um Formulário Google: Questionário Sociodemográfico; Questionário sobre percepção da influência do isolamento social na dinâmica familiar; Escala de Estresse Percebido; Escala de Estresse Parental e Escala de Apoio Social. Observou-se que a percepção de estresse em F2 foi significativamente maior que em F1 e em famílias com mais de um filho (p

The COVID-19 pandemic required protect actions with quarantine and social distancing, which had an impact on families' lifestyle. The impacts of the pandemic may have been even more intense in families of children with disabilities or pervasive developmental disorder (PDD) who need specific care. This study aims to analyze the impact of the social distancing situation on the perception of stress, parental stress and perceived social support by mothers and fathers of children with disabilities/PDD with 11 years old or more, and associations between these variables. This is a cross-sectional study with 37 participants in two independent phases. The following self-administered instruments were available in a Google Form: Sociodemographic Questionnaire; Questionnaire on the perception of the influence of social distancing resulting from the pandemic on family dynamics; Perceived Stress Scale; Parental Stress Scale and Social Support Scale. There was a significatively higher stress perception between mothers in Phase 2 (P2>P1) and higher stress among families with more than one child. Most mothers referred social support, an increase in the stress perception with children care and stress comparing the phases. This study demonstrated the importance of social support to parents' adaptation in stress increasing related to pandemic situation

Parenting a Child with Autism Spectrum Disorder: A Qualitative Study

Background: Research in India has seldom studied caregivers’ perceptions, experiences, and needs for information and personal support after an autism spectrum disorder (ASD) diagnosis. Objectives: The objectives of the study were to understand the perceived barriers for obtaining a diagnosis and the perspectives and experiences of parents of children with autism. Materials and Methods: Parents with a diagnosed ASD child (within a year of diagnosis) in the 3–8 years range were recruited from the Pediatric Psychology and Neurodevelopmental Clinic from a tertiary care teaching hospital in North India. An interview guide elicited information about experiences regarding obtaining an ASD diagnosis, perceived barriers and facilitators, reactions to diagnosis, postdiagnostic family and community experiences, and stress experienced by parents. Qualitative responses were analyzed using thematic analysis. Participants were recruited till there was a saturation of themes. The ethics clearance was provided by the institutional review board. Results: Twenty-eight caregivers of children with ASD were recruited for the study. Overall, nine themes were identified from the qualitative analysis of the interviews: two before diagnosis (delayed help?seeking and experiences with healthcare), one at the time of diagnosis disclosure (heightened emotional response to diagnosis), and six themes after the diagnosis (increased stress, behavioral challenges, deterioration in family relationships, negative attitudes of the family, seeking support, and moving forward with hope for the future). Conclusions: There are several barriers and gaps in the autism-related available services in the country, and there is a need to provide inclusive, supportive, culturally sensitive, and family-centered model of care for parents raising children with ASD.

Estrés parental y dedicación a la educación virtual de sus hijos en padres del oriente peruano

Introducción: Los niveles de estrés parental aumentaron durante la temporada de educación virtual de sus hijos. Esto hace que los padres se sientan desbordados ante las demandas propias del rol paterno, promoviendo sentimientos negativos sobre sí mismos o sobre sus hijos. Por lo tanto, se pretende determinar la relación entre estrés parental y dedicación a la educación virtual de sus hijos en padres de la ciudad de Tingo María, Perú. Métodos: Es un estudio de diseño no experimental transversal descriptivo de alcance correlacional. En la recolección de datos se utilizó los instrumentos: Escala de Estrés Parental y el Cuestionario Dedicación a la Educación Virtual de sus Hijos, en la cual participaron 356 padres de familia de 18 a 59 años (Me=37; DE=7.49) de la Amazonía peruana dedicados a la agricultura. Resultados: Donde se encontró que no existe relación entre estrés parental y dedicación a la educación virtual de los hijos (rho = -0.096; p = 0.071). Sin embargo, se encontró una relación altamente significativa entre las dimensiones recompensas parentales (rho = 0.384; p=0.000) y factores estresantes (rho = -0.270; p = 0.000) con la variable dedicación a la educación virtual con un tamaño del efecto moderado y pequeño respectivamente. Así mismo, se encontró diferencias significativas entre el estrés parental según el estado civil (U= 12056.0, p<0.05, d= 1.703) y la dedicación a la educación virtual de los hijos según la edad (U=3360.0, p<0.05, d= 1.343). Conclusión: En los padres que participaron en el estudio, a mayores factores estresantes menor es la dedicación a la educación virtual de sus hijos y un incremento de recompensa parental aumentó la dedicación a la educación virtual de sus hijos. Estudios posteriores pueden explorar la relación de estas variables en padres con otras condiciones socioeconómicas y en muestras representativas de otras regiones.

Background: The parental stress levels increased during their children's virtual education season. This makes parents feel overwhelmed by the demands of the parental role, promoting negative feelings about themselves or their children. Therefore, the aim is to determine the relationship between parental stress and dedication to the virtual education of their children in parents from the city of Tingo Maria, Peru. Methods: It is a cross-sectional descriptive non-experimental design study with a correlational scope. The instruments used in the data collection were: The parental Stress Scale and the Questionnaire Dedication to the Virtual Education of their Children, in which 356 parents aged 18 to 59 years (Me=37; SD=7.49) from the Peruvian Amazon dedicated to agriculture participated. Results: Where it was found that there is no relationship between parental stress and dedication to the virtual education of children (rho = -0.096; p = 0.071). However, a highly significant relationship was found between the dimensions of parental rewards (rho = 0.384; p=0.000) and stress factors (rho = -0.270; p = 0.000) with the variable dedication to virtual education with moderate effect size and small respectively. Likewise, significant differences were found between parental stress according to marital status (U= 12056.0, p<0.05, d= 1.703) and children's dedication to virtual education according to age (U=3360.0, p<0.05, d= 1.343). Conclusions: In the parents who participated in the study, the greater the stressors, the lower the dedication to their children's virtual education, and an increase in parental reward increased the dedication to their children's virtual education. Further studies can explore the relationship of these variables in parents with other socioeconomic conditions and representative samples from other regions.

Parental Stress and Coping Attitudes in Autism Spectrum Disorder Children: A Survey during Movement Control Order period amid COVID-19 Pandemic

@#Introduction: Parents with autistic children are more susceptible of developing stress due to genuine challenges in treasuring them. During the world pandemic disaster of COVID-19 emergency, the challenge is far greater than expected as movement control order restricted them to seek for help and resources as the country adopting strict isolation measurement to restrain COVID-19 virus infection. This survey was conducted online to determine the prevalence of stress, independent predictor and assessing coping style that help to overcome them. Methods: This was a cross-sectional study using Facebook platform. The survey was posted into Autisme Malaysia group for 2 weeks duration from 17th June until 30th June 2020. Stress was measured using Malay version of Perceived Stress Scale (PSS-10) and coping style using Brief COPE questionnaire. Independent t-test was used to determine coping style associated with stress and multiple logistic regression for independent stress predictor. Results: The mean age of respondents was 38.9 years old with mean child’s age was 8.6 years old. Majority of respondents were female, Malay, and married couples with 83.1% of the caregivers were having stress. The independent predictor for stress were age of the caregivers and the level of education. The approach style of coping was significantly associated with stress. Conclusion: The pandemic has directly and indirectly contributed to stress prevalence among caregivers of children with autism. Hence, the right coping style should be embraced and empowered to parents for healthier stress therapy. Our findings recommended that coping style of informational support, behavioural disengagement, religion and acceptance as dynamic model of coping style.

Relationship between parental stress and attitude towards cochlear implantation outcomes in children in an Indian context

ABSTRACT Purpose The study was aimed to investigate the relationship between parental stress and attitude of parents towards the outcomes of cochlear implantation in an Indian scenario. Methods A total of 59 parents of children with cochlear implantation participated in the study. The outcomes of cochlear implant was measured using Parental attitudes of various aspects of cochlear implantation questionnaire and parental stress was measured using parental stress scale. The questionnaires were circulated to participants and data was collected in the form of e-survey. Results The present study showed that the parental stress level was similar among mothers and fathers. Further, the parental attitude towards communication abilities of children and education were positively correlated with the duration of cochlear implantation. Finally, a significant positive correlation was found between the parental stress and the parental attitude towards communication abilities of children and social skills. Conclusion The present study showed a positive relationship between parental stress and parental attitude towards the outcomes of cochlear implantation for aspects of communication abilities and social skills.

Qualidade da Coparentalidade e o Estresse em Pais de Crianças com Paralisia Cerebral / Coparenting Quality and Stress in Parents of Children with Cerebral Palsy

RESUMO: O objetivo deste artigo foi verificar a associação entre a qualidade da coparentalidade e o estresse em pais de crianças com paralisia cerebral (PC). Trata-se de um estudo transversal e descritivo. Foram incluídos 81 pais de crianças com até 12 anos de idade diagnosticadas com PC. Os instrumentos utilizados foram Inventário sociodemográfico, Escala de classificação funcional motora grossa, Índice de estresse parental e Questionário de coparentalidade submetidos na Técnica de Análise de Correspondência (ANCOR). Altos níveis de estresse total estão associados a elevados índices de estresse nas subescalas sofrimento parental, interação disfuncional pai e filho e criança difícil. Os pais avaliados no Questionário de Coparentalidade com baixa cooperação foram registrados com elevados índices de estresse na subescala sofrimento parental. Os dados mostraram relação significativa entre a qualidade da coparentalidade e o nível de estresse em pais de crianças com PC.

ABSTRACT: The aim of this paper is to verify the association between quality of co-parenting and stress in parents of children with cerebral palsy (CP). This is a cross-sectional and descriptive study. Eighty-one parents of children up to twelve years old diagnosed with CP were included. The instruments used were Sociodemographic Inventory, Gross Motor Functional Rating Scale, Parental Stress Index and Coparenting Questionnaire. High levels of total stress are associated with stress levels in parent distress sub-items, dysfunctional parent-child interaction, and difficult child. The parents evaluated in the Coparenting Questionnaire with low cooperation were registered with high levels of stress in the subscale parental suffering. The data showed a significant relationship between the quality of coparenting and the level of stress in parents of children with CP.

usencia de asociación entre estrés parental y caries temprana de la infancia en preescolares / Absence of association between parental stress and early childhood caries in preschoolers

RESUMEN: La caries temprana de infancia (CTI) es un problema de salud pública. Los determinantes de CTI pueden ser biológicos, conductuales y psicosociales, siendo estos últimos los menos estudiados. El objetivo de este estudio es establecer la asociación entre estrés parental y CTI. Se realizó un estudio de corte transversal en niños de 3 a 5 años que asisten a jardines infantiles de INTEGRA en la ciudad de Temuco, Chile. La variable dependiente fue índice ceod; la variable independiente fue estrés parental, medida a través de la versión en español del Parenting Stress Index, versión corta (PSI-sf). El cuestionario fue entregado al cuidador principal del niño. Posteriormente, se realizaron los exámenes clínicos a los preescolares por investigadores calibrados. Las variables de control fueron sexo, estado civil, nivel socioeconómico, higiene oral y dieta cariogénica. Se realizó un análisis descriptivo con las características sociodemográficas. El test exacto de Fisher, la prueba ttest y ANOVA fueron utilizados para determinar asociación entre las variables de estudio (nivel de significancia p<0,05). Fueron incluidos 202 preescolares (105 niños y 97 niñas) con edad promedio de 3,3 (SD 0,6). Los cuidadores principales fueron mayoritariamente mujeres (91,0 %). El 48,5 % de los padres presentaron nivel de estrés adecuado y sólo un 18,3 % presentaron nivel de estrés clínicamente significativo. La prevalencia de caries fue un 69,8 %. No se encontró asociación entre alto nivel de estrés o estrés clínicamente significativo e índice ceod (p>0.05). Los padres que reportaron una peor salud de sus hijos o quienes no realizaban higiene oral, presentaron significativamente un mayor índice ceod (p<0,01). Los ingresos económicos y la composición familiar mostraron estar asociados a mayor índice ceod (p<0,05). Este estudio no mostró asociación significativa entre CTI y estrés parental.

ABSTRACT: Early childhood caries (ECC) is a public health problem. ECC determinants can be biological, behavioral and psychosocial, the latter being the least studied. The aim of this study is to establish the association between parental stress and ECC. A cross-sectional study was carried out with children from 3 to 5 years of age who attend INTEGRA kindergartens in Temuco, Chile, The dependent variable was dmft index. The independent variable was parental stress, measured by the Spanish version of the Parenting Stress Index, short form (PSI-sf). The questionnaire was given to the main caregiver of the child. Subsequently, preschooler clinical examinations were performed by calibrated researchers. Control variables were sex, marital status, socioeconomic level, oral hygiene and cariogenic diet of the preschooler. A descriptive analysis was carried out with the sociodemographic characteristics. Fisher's exact test, t test and ANOVA test were used to determine association between the study variables. The level of significance was p <0.05. Two hundred and two preschoolers were included (105 boys and 97 girls); the average age was 3.3 (SD 0.6). The main caregivers were mostly women, (91.0 %). Forty eight point five percent of parents presented an adequate level of stress and only 18.3 % presented a clinically significant level of stress. The prevalence of caries was 69.8 %. No association was found between high level of stress or clinically significant stress and dmft index (p> 0.05). Parents who reported worse health of their children, or who did not perform oral hygiene with their children presented a significantly higher dmft index (p <0.01). The economic income and the family composition showed to be significantly associated to a higher dmft index (p<0,05). This study showed no significant association between early childhood caries and parental stress.

Estresse parental percebido na gestação e na maternidade / Perceived parental stress in pregnancy and motherhood

O estresse parental é considerado fator de risco para o desenvolvimento e bem-estar infantil e para dinâmica familiar. Promover o desenvolvimento infantil saudável, garantir que todas as necessidades sejam atendidas e educar a criança pode ser um desafio para as famílias. O objetivo foi identificar o estresse parental e os fatores relacionados para mulheres durante a gestação e no primeiro mês de vida do bebê. Estudo descritivo de corte longitudinal, realizado com mulheres que tiveram gestação de risco habitual, no terceiro trimestre da gestação em 2017 e 2018, cadastradas em unidades com Estratégia Saúde da Família de um município brasileiro de médio porte. Foram realizadas entrevistas em domicílio, com a utilização de genograma e ecomapa e aplicação da Escala de Estresse Parental. Participaram 121 mulheres, com idade entre 18 a 40 anos. A maior parte possuía entre 11 e 13 anos de estudo, brancas, trabalhava em casa, possuía um companheiro que residia no mesmo domicílio, com planejamento da gestação e a realização do número preconizado de consultas no pré-natal. A escala aplicada na gestação mostrou que 82 participantes (67,8%) tinham algum estresse e 39 (32,2%) nenhum estresse na gestação. No primeiro mês de vida do bebê, em relação ao desequilíbrio no papel materno, 58 (47,9%) apresentaram alto nível de estresse parental e 63 (52,1%) baixo nível de estresse parental. O estresse parental alto foi correlacionado com a presença de estresse na gestação e menor número de gestações planejadas. Houve também associação entre receber auxílio do governo e o nível de estresse parental alto. A estrutura familiar foi heterogênea com diversos arranjos familiares. Foi predominante as mulheres que moravam com companheiros e filhos. O genograma e o ecomapa foram facilitadores na identificação de condições estressantes. Tais resultados sugerem que são fundamentais as ações para identificar precocemente e reduzir o estresse parental, com destaque para a atuação dos profissionais junto as famílias no contexto da atenção primária à saúde. Na atuação da/o Enfermeira/o há diversas oportunidades para otimizar as boas práticas parentais, propiciar o processo de criação de vínculo parental com o bebê no planejamento familiar, na gestação, no pré-natal e após o nascimento, em consultas de puerpério, salas de vacinação, visitas domiciliares, entre outras, a partir de observação, diálogos e avaliação das situações vivenciadas pelas figuras parentais. Assim, para além da preocupação com a sobrevivência das crianças, é necessário oferecer apoio qualificado aos cuidadores e famílias para produzir resultados na trajetória de desenvolvimento humano, o que implica ações para reduzir o estresse parental.

Parental stress is considered a risk factor for child development, wellbeing and family dynamics. Raising a child, promoting his/her healthy development and ensuring that all needs of a child are met can be a challenge for families. This study's objective was to identify parental stress and related factors among women during pregnancy and after the infants' first month of life. This descriptive, longitudinal study carried out with women in the third trimester of low-risk pregnancies in 2017 and 2018, receiving care provided by family health strategy units of a medium-sized Brazilian city. Interviews were held at the participants' homes and the Genograms, Ecomaps and Parental Stress Scale was used. A total of 121 women, aged between 18 and 40 years old, participated in the study. Most had between 11 and 13 years of schooling, were Caucasians, homemakers or worked from home, had a partner living in the same home, pregnancy planning and had the recommended number of prenatal consultations. The scale applied during pregnancy showed that 82 participants (67,8%) experienced some level of stress, while 39 (32,2%) reported no stress during pregnancy. At the infants' first month of life, 58 (47,9%) presented a high level of parental stress and 63 (52,1%) presented a low level of parental stress. High parental stress was correlated with the presence of stress during pregnancy and a lower number of planned pregnancies. There was also an association between receiving government assistance and high level of parental stress. The family structure was heterogeneous with several family arrangements. Women living with partners and children predominated. The genogram and the ecomap facilitated the identification of stressful conditions. These results suggest actions are needed for early identification and intervention in parental stress, especially actions performed by workers delivering care to families within the context of primary health care. In the role of the Nurse there are several opportunities to optimize good parenting practices, promote the process of creating a parental bond with the baby in family planning, during pregnancy, in prenatal care and after birth, in postpartum consultations, vaccination rooms, home visits, among others, from observation, dialogues and evaluation of situations experienced by parental figures. Thus, in addition to the concern for children, it is necessary to offer qualified support to caregivers and families to produce results in the trajectory of human development, or that implies actions to reduce parents' stress.

Parental Stress among Parents of Children with Type 1 Diabetes Mellitus: A Review

@#This review provides an overview of the evidence which concerns the parental stress of children with type 1 diabetes mellitus. Articles for this review were collected using the Science Direct, CINAHL, PsycINFO, Medline, Scopus, EBSCO, Springer, Ovid, PubMed, Google Scholar, and Cochrane Library. In total, 38 articles were relevant to this review. The findings of the reviewed studies provide an exciting opportunity to advance our knowledge for a different aspect of parental stress which is related to the disease and predictor’s factor contributes to parental stress. This review sheds new light on developing the educational programs to reduce the level of parental stress and to help them to cope positively with this disease.

Validación de "The Parental Stressor Scale Infant Hospitalization modificado, al español" en una unidad cuidados intensivos pediátricos / Validation of "The Parental Stressor Scale Infant Hospitalization modified, to Spanish" in a pediatric intensive care unit

INTRODUCCIÓN: Las unidades de cuidados intensivos son conocidas como ambientes de alto estrés para los familiares, este puede ser mayor cuando el paciente es un hijo/hija y los padres deben enfrentar la enfermedad y el ambiente hospitalario. El instrumento "The Parental Stressor Scale Infant Hospitali zation (PSSIH), es una herramienta utilizada para medir estresores en Unidades de Cuidados Intensivos Pediátricos (UCIP), sin embargo, la escala no está validada en Chile. El objetivo de este estudio es validar y adaptar culturalmente el instrumento "The Parental Stressor Scale Infant Hospitalization modificado" en madres/padres de niños hospitalizados en la UCIP de un Hospital Universitario. MÉTODO: Estudio instrumental de validación. Luego de traducir y contratraducir la versión en inglés del instrumento, un grupo de 10 profesionales expertos evaluó la adaptación al español. Luego 10 padres/ madres de niños hospitalizados en la UCIP evaluaron la comprensión del instrumento. Las propiedades psicométricas del instrumento fueron evaluadas utilizando un análisis factorial exploratorio y alfa de Cronbach. RESULTADOS: Se aplicó en una muestra de 221 padres/madres la versión chilena del "PSSIH modificado", tuvo mínimas modificaciones semánticas y los jueces expertos consideraron adecuado el instrumento, por lo que no fue necesario borrar ningún ítem. Se eligió la solución de 3 dimensiones, que explicaron el 48,89% de la varianza total del instrumento. El alfa de Cronbach fue de 0,885, 0,902 y 0,703 respectivamente para cada dimensión. CONCLUSIÓN: El PSSIH modificado ha demostrado ser un instrumento confiable y valido en una muestra de niños chilenos hospitalizados en una Unidad de Cuidados Intensivos Pediátricos de un hospital universitario , cuyo nombre en español es "Escala de Evaluación de Estresores Parentales en niños hospitalizados en Unidades de Cuidados Intensivos Pediátricos" (EEEP - UCIP).

INTRODUCTION: Intensive care units are known as high-stress environments for family members, this can be higher when the patient is a son or daughter and the parents must face the disease along with everything that the hospital environment implies. The Parental Stressor Scale Infant Hospitalization (PSSIH) instrument is a tool used to measure stressors in Pediatric Intensive Care Units (PICU), however, the scale is not validated in Chile. The objective of this study is to culturally validate and adapt the instrument "the modified Parental Stressor Scale Infant Hospitalization" in mothers/fathers of hospitalized children in the PICU of a University Hospital. METHOD: Instrumental validation study. After translating and counter-translating the English version of the instrument, a group of 10 expert professionals evaluated the Spanish adaptation. Then, 10 parents of hospitalized children in the PICU evaluated the understanding of the instrument. The psychometric properties of the instrument were evaluated using exploratory factorial analysis and Cronbach's alpha. RESULTS: The Chilean version of the "modified PSSIH" was applied to a sample of 221 parents, with minimal semantic modifications and the expert judges considered the instrument adequate, therefore, it was not necessary to delete any item. The 3-dimensional solution was chosen, which explained 48.89% of the total instrument variance. The Cronbach's alpha was 0.885, 0.902, and 0.703 respectively for each dimension. CONCLUSION: The modified PSSIH has proved to be a reliable and valid instrument in a sample of Chilean children hospitalized in a Pediatric Intensive Care Unit of a university hospital. The name in Spanish of the scale is "Escala de Evaluación de Estresores Parentales en niños hospitalizados en Unidades de Cuidados Intensivos Pediátricos" (EEEP - UCIP).

Propuesta de programa psicoeducativo de estrategias de afrontamiento ante el estrés de crianza dirigido a padres y representantes / Proposal for a psychoeducational program of coping strategies for parenting stress addressed to parents and parents representatives

Esta investigación tuvo como propósito realizar la propuesta de un programa psicoeducativo para desarrollar estrategias de afrontamiento de estrés de crianza dirigido a los padres y representante de la consulta de Psicología Infantil del Hospital Militar Dr. José Ángel Álamo. La muestra estuvo conformada por 40 sujetos que asistían con sus hijos a la consulta en el periodo enero-febrero del 2018. La presencia de estrés de crianza y estrategias de afrontamiento se evaluó a través de aplicación de un cuestionario modificado, usando el Test de Estrés Parental (Abidin) y el Test de Estrategias de Afrontamiento (Carver). 54% de los participantes tenían un funcionamiento psicológico inadecuado, 65% reportaron ausencia de recursos personales y 53% de los sujetos señalan que está presente el apoyo familiar y social. En la mayoría de los participantes están presentes estrategias adecuadas de afrontamiento tales como resolución de problemas, búsqueda de apoyo social, reevaluación, regulación afectiva y búsqueda de información. El estudio de factibilidad proporcionó resultados favorables para diseñar un programa psicoeducativo que incluya estrategias de afrontamiento del estrés de crianza bajo la modalidad de cuatro talleres vivenciales teórico­prácticos que le brinden herramientas a los padres para entender la naturaleza de su rol, el neurodesarrollo de los niños y estrategias de disciplina positiva(AU)

The purpose of this research was to propose a psychoeducational program to develop parenting stress strategies for parents and parent's representative of children that attend the children's psychology office of the Hospital Militar Dr. José Ángel Álamo. The sample included 40 subjects that attended the consult in the January-February 2018 period. In the diagnostic phase, the presence of parenting stress and coping strategies was determined through the application of a modified questionnaire using the Parental Stress Test (Abidin) and the Coping Strategies Test (Carver). The results showed that 54% of participants had an inadequate psychological functioning, 65% had absence of personal resources and 53% had social and family support The majority of subjects had adequate coping strategies which included conflict resolution, search for social support, reevaluation, afective regulation and search for information. The feasibility study provided favorable results to design a psychoeducational program to develop coping stress strategies in the form of four (04) theoretical-practical workshops which will provide parents with tools to understand the nature of their role, the neurodevelopment of children and positive discipline strategies(AU)

Levantamento Sistemático dos Focos de Estresse Parental em Cuidadores de Crianças com Síndrome de Down / Systematic Review of Parental Stress Outbreaks in Caregivers of Children with Down Syndrome

RESUMO: A chegada de uma criança com Síndrome de Down (SD) requer uma readaptação familiar, demandando esforços em relação aos cuidados diários ou às rotinas terapêuticas e escolares. Os objetivos deste estudo foram compreender quais são os principais focos de estresse parental em cuidadores de crianças com SD e identificar quem são os cuidadores principais dessas crianças. Trata-se de uma revisão de literatura de abordagem qualitativa, que utilizou como referencial teórico pesquisas empíricas publicadas a partir de 2010, encontradas nos portais Google Acadêmico, Scielo e Psicologia.PT, e nos periódicos: Interação em Psicologia, CEPE UEG e Ata CIAIQ 2016. Inicialmente, foram identificadas 23 pesquisas, utilizando-se os descritores Síndrome de Down, estresse e cuidadores. Após filtragem, cinco passaram para revisão final. O resultado evidencia que o estresse parental está relacionado a três fatores - à deficiência, ao desenvolvimento da criança e ao papel do cuidador. Os principais focos de estresse foram o impacto do diagnóstico; medo da discriminação e preconceito; falta de autonomia da criança; sobrecarga emocional do cuidador; preocupação com a sexualidade; baixa escolaridade paterna; mães que não podem trabalhar; e crianças mais velhas. As mães apresentaram os níveis mais elevados de estresse. A divisão familiar equilibrada em relação aos cuidados com a criança com SD, além de um acompanhamento psicológico familiar, são alternativas para reduzir os níveis de estresse e garantir saúde física e mental aos cuidadores. Conclui-se que os focos de estresse parental são diversos e causam abalo emocional, dificuldades de aceitação e adaptação familiar.

ABSTRACT: The arrival of a child with Down Syndrome (DS) requires a family readaptation, demanding efforts in relation to daily care or therapeutic and school routines. The aims of this study were to understand what the main sources of parental stress in caregivers of children with DS are and identify who the main caregivers of these children are. This is a literature review of a qualitative approach that used a theoretical framework of empirical researches published as of 2010, found in the Google Scholar, Scielo and Psychology.PT portals, and in the journals: Interação em Psicologia, CEPE UEG e Ata CIAIQ 2016. Initially, 23 researches were identified, through the use of the descriptors Down syndrome, stress and caregivers. After filtering, five works were selected for a final review. The result shows that parental stress is related to three factors - disability, development of the child and the role of the caregiver. The main stress outbreaks were the impact of the following diagnosis; fear of discrimination and prejudice; lack of autonomy of the child; emotional overload of the caregiver; concern about sexuality; low paternal schooling; mothers who cannot work; and older children. Mothers had the highest levels of stress. A balanced family division in relation to childcare with DS, as well as family psychological counseling, are alternatives to reducing stress levels and guarantee physical and mental health to caregivers. It is concluded that parental stress outbreaks are diverse and cause emotional distress, difficulties of acceptance and family adaptation.

Alianza tríadica familiar y salud mental parental / Triadic family alliance and parental mental health

El Lausanne Trialogue Play (LTP), instrumento que permite la evaluación estandarizada de la alianza familiar, releva la importancia del padre en los estudios de procesos e interacciones familiares, así como la existencia de un efecto familiar tríadico desde etapas tempranas. El presente estudio pretende aportar al conocimiento de la alianza familiar en familias con hijos(as) en edad preescolar, analizando su relación con la salud mental de los padres. 50 parejas parentales y sus hijos(as) fueron evaluadas en sus hogares con una batería de instrumentos que incluían el LTP, BDI-I, PSI-SF y un Cuestionario Sociodemográfico. Los resultados muestran que la mayoría de las familias evaluadas presentan alianzas familiares disfuncionales, sin evidenciarse una relación estadísticamente significativa con las variables de salud mental estudiadas. Sin embargo, se observa una tendencia a que familias con alianzas conflictivas presenten mayores niveles de sintomatología depresiva y estrés parental, sobre todo en el rol paterno.

The Lausanne Trialogue Play (LTP) is an instrument that allows the standardized assessment of the family alliance, highlighting the importance of the father in studies of family process and interactions, as also the existence of a triadic family effect since early stages. The present study pretends to contribute to extend the knowledge in family alliances in families with preschool aged children, analyzing it's relation with the parental mental health variables. 50 parental couples and their children were evaluated at their homes with the following instruments: LTP, BDI-I, PSI-SF and a sociodemographic questionnaire. Results show that most of the families have dysfunctional alliances, without proving a statistically significant relation with the parental studied variables. Nevertheless, families with conflictive alliances tend to show higher levels of depressive symptoms and parental stress, especially in fathers.

Entrenamiento Conductual y Atención Plena sobre el Estrés Parental y Relación Padre-Hijo / Behavioral Training and Mindfulness on Parental Stress and Parent-Child Relationship / Treinamento Comportamental e de Mindfulness sobre o Estresse Parental e a Relação entre Pais e Filhos

RESUMEN El objetivo principal de este estudio fue evaluar la efectividad de un procedimiento tradicional a padres combinado con uno de atención plena en la reducción del estrés parental e incremento en interacción positiva padre-hijo. Se utilizó un diseño pre test - pos test de un solo grupo. Durante el pre test y pos test se aplicaron el PSI, FFMQ y PCRI-M para evaluar el estrés parental, atención plena y relación padre-hijo, respectivamente. La intervención duró ocho semanas en que se implementó un procedimiento de entrenamiento de padres y uno de atención plena. Los resultados muestran que el entrenamiento combinado fue efectivo en la reducción del estrés parental, el incremento del uso de la atención plena y la mejora en la relación padre-hijo.

ABSTRACT The main objective of this study was to evaluate the effectiveness of a traditional parent training procedure combined with one of mindfulness in reducing parental stress and increasing positive parent-child interaction. A pretest-posttest design with one group was used. During the pretest and posttest phases the PSI, FFMQ and PCRI-M were applied to assess parental stress, mindfulness and parent-child relationship, respectively. The intervention lasted eight weeks in which a parent training procedure with mindfulness training was implemented. The results show that the combined training was effective in reducing parental stress, increasing mindfulness and improving parent-child relationship.

RESUMO O principal objetivo deste estudo foi avaliar a efetividade de um tradicional procedimento de treinamento de pais combinado a um treinamento de mindfulness na redução do estresse parental e no aumento de interações positivas entre país e filhos. Utilizou-se um delineamento com pré-teste e pós-teste e com um grupo. Durante as fases de pré-teste e pós-teste, aplicaram-se o PSI, o FFMO e o PCRI-M para avaliar estresse parental, mindfulness e relação entre país e filhos, respectivamente. A intervenção durou oito semanas, em que se implementaram o treinamento de pais e o de mindfulness. Os resultados demonstraram que o treinamento combinado foi efetivo na redução do estresse parental, no aumento de mindfulness e na melhora da relação etre país e filhos.

Diferenças por sexo, adaptação e validação da Escala de Estresse Parental / Differences by gender, adaptation and validation of the Parental Stress Scale / Diferencias por género, adaptación y validación de la Escala de Estrés Parental

Esta pesquisa objetivou adaptar e investigar evidências de validade da Escala de Estresse Parental (EEPa) (Parental Stress Scale ­ PSS) para o português brasileiro. Participaram 304 pais, distribuídos na mesma proporção por sexo (pais/mães). Inicialmente, foram realizadas as etapas de tradução e investigação de validade de conteúdo da escala; em seguida, foi conduzida a análise empírica com a EEPa traduzida. O resultado da análise fatorial exploratória indicou uma estrutura final para a EEPa, composta por 16 itens distribuídos em 2 subescalas, modelo unifatorial com consistência interna adequada. Atestaram-se ainda evidências de validade concorrente da EEPa com a PSS-14 e o IPP. De maneira geral, neste primeiro estudo psicométrico no Brasil, a EEPa apresentou características psicométricas promissoras, podendo ser um instrumento válido e confiável para medir o estresse parental de pais/mães de crianças em geral.(AU)

This study aimed to cross-culturally adapt and investigate the psychometric properties of the Parental Stress Scale (PSS) for BrazilianPortuguese. There were 304 participating parents, distributed in the same proportion by gender (mothers and fathers). Initially, we carried out stages of translation and investigation of the scale's content validity; then we conducted an empirical analysis with the translated PSS. The results of the exploratory factor analysis indicated a final structure for the PSS composed of 16 items divided into two subscales, a unifactorial model with internal consistency adequate for the total score. There was also evidence of concurrent validity of the PSS with the PSS-14 and the IPP. Finally, in this first psychometric study in Brazil, the PSS presented satisfactory psychometric properties, proving to be a valid and reliable instrument to measure parental stress in parents in general.(AU)

Este estudio objetivó adaptar e investigar evidencias de validez de la Escala de Estrés Parental (PSS) para el portugués brasileño. Participaron 304 padres, distribuidos en la misma proporción por género (madres y padres). Inicialmente, se llevó a cabo las etapas de traducción e investigación de la validez del contenido de la escala; después se realizó un análisis empírico con el PSS traducido. Los resultados del análisis factorial exploratorio indicaron una estructura final compuesta por 16 ítems divididos en dos subescalas, unifactorial y exhibiendo consistencia interna adecuada.. Hubo evidencia de validez concurrente de la PSS con el PSS-14, como también entre la PSS y el IPP. Por último, en este primer estudio psicométrico acerca de la PSS en Brasil, fueron obtenidas propiedades psicométricas satisfactorias, siendo un instrumento válido y fiable para medir el estrés parental de padres/madres de niños en general.(AU)

Augmentative Effects of Working Memory Training on Behavioral Problems and Parental Stress in Medicated Children and Adolescents with Attention-Deficit Hyperactivity Disorder

OBJECTIVES: Executive dysfunctions including working memory deficit have been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of working memory training on the behavioral problems, quality of life, and parental stress of medicated children with ADHD. METHODS: Twenty-five children with ADHD, aged 9 to 19 years, who were being treated with ADHD medication, were included. The participants were trained with a commercially available and computerized working memory program (Cogmed®) for 5 weeks without any alteration of their medication. The Child Behavior Checklist (CBCL), KIDSCREEN-52 quality of life measure, and Parenting Stress Index-Short Form (PSI-SF) were administered before training, and 4 weeks and 7 months after training, respectively. RESULTS: After completing the training, the anxiety/depression, social problems, thought problems, attention problems, aggressive behavior, and externalizing problems scores in the CBCL were significantly reduced. The score on the Parent-child dysfunctional interaction in the PSI-SF was also decreased. However, the scores related to the quality of life were not changed. These changes were still observed 7 months after the training. CONCLUSION: Cogmed working memory training can be a promising training option for the additional improvement of behavioral problems and parental stress in medicated children with ADHD.

Estrés parental y las actitudes de las madres solteras hacia la relacion con los hijos

El objetivo principal de la investigación fue conocer la relación entre el estrés parental y las actitudes de las madres solteras hacia la relación con sus hijos. El trabajo tuvo un enfoque cuantitativo, con alcance correlacional, diseño no experimental transversal y una muestra conformada por 104 madres solteras de la ciudad de Lima, Perú. La información fue recolectada con el cuestionario de estrés parental y con el inventario de relaciones padre-hijo, ambos instrumentos adaptados al contexto peruano. Los resultados indican que la correlación entre el estrés parental y la actitud hacia la relación con sus hijos es negativa (-.65), esto indicaría que a mayor estrés las madres solteras manifiestan menos apoyo a los hijos, baja satisfacción, compromiso, comunicación y autonomía, no establecen limites y presentan baja deseabilidad social. Se observó que las mujeres con educación superior, con más de 40 años y con apoyo externo en la crianza presentan menos estrés. Además, las madres con educación superior y apoyo externo presentan más actitudes positivas hacia la crianza.

The main purpose of the research was to know the relation between parental stress and the attitudes of single mothers towards relationship with children. The research was quantitative, correlational, non-experimental, cross-sectional and with a sample of 104 single mothers from Lima, Peru. The information was collected with the Parenting Stress Index and with the Parent-child relationship inventory, both questionnaires adapted to the Peruvian context. The results indicate that the correlation between parental stress and the attitudes of single mothers towards relationship with children is negative (-.65), this would indicate that the greater the stress of single mothers, they show less support for their children, low satisfaction, commitment, communication and autonomy, they don't set limits and have low social desirability. It was observed that women with higher education, with more than 40 years and with external support in raising have less stress. Furthermore, mothers with higher education and external support have more positive attitudes towards parenting.

A finalidade da investigação foi a de conhecer a relação entre o estresse parental e as atitudes de mães solteiras em relação a dos filhos. A investigação foi quantitativa, correlacional, não experimental, transversal e com uma amostra de 104 mães solteiras de Lima, Peru. As informações foram coletadas com o questionário de estresse parental e com o inventário das relações pai-filho, ambos instrumentos adaptados ao contexto peruano. Os resultados indicam que a correlação entre o estresse parental e as atitudes de mães solteiras em relação a dos filhos é negativa (-.65), isso indicaria que quanto maior o estresse das mães solteiras, elas mostram menos apoio aos filhos, baixa satisfação, comprometimento, comunicação e autonomia, não estabelecem limites e têm baixa desejabilidade social. Observou-se que mulheres com ensino superior, com mais de 40 anos e com apoio externo na criação têm menos estresse. Além disso, mães com ensino superior e apoio externo têm atitudes mais positivas em relação a criação.

Flexibilidad relacional y estrés parental / Relational Flexibility and Parental Stress

El objetivo de este estudio fue evaluar la relación entre niveles altos y moderados de estrés parental y relaciones derivadas, en una muestra de padres y estudiantes de pregrado. Para este estudio se utilizó un diseño de comparación entre grupos con una medida pretest. La muestra total se dividió en tres grupos, trece padres con niveles altos en el Índice de Estrés Parental (IEP) fueron asignados a un grupo, otros trece padres con puntajes moderados en el IEP se asignaron a un segundo grupo y trece estudiantes de pregrado fueron asignados a un grupo control. Inicialmente, todos los participantes fueron expuestos a un video de un niño presentando conductas disruptivas. Seguido de esto, todos los participantes fueron expuestos a un procedimiento de entrenamiento en discriminaciones condicionales A-B y A-C; el grupo de estímulos A correspondía a figuras sin sentido, el grupo B a conductas disruptivas de los niños y el grupo C de estímulos a conductas positivas de los padres. Luego se entrenaron relaciones mixtas (A-B y A-C), y finalmente se evaluaron relaciones de transitividad y equivalencia. Los resultados muestran que los participantes con estrés alto presentaron menor precisión de respuesta y mayores latencias de respuesta en las relaciones derivadas, comparado con el grupo de estrés moderado y control. Lo anterior indica que los padres que presentan altos niveles de estrés parental tienen mayor dificultad para establecer nuevas relaciones de estímulos, especialmente aquellos con valencia emocional. Estos resultados tienen implicaciones a nivel clínico, específicamente en la flexibilidad relacional.

The aim of this study was to evaluate the relationship between higher and moderate parental stress scores and derived relations in parents and undergraduate students. A group comparison design with a pretest measure was used in this study. The sample size was divided in three different groups, thirteen parents with high scores on the Parental Stress Index (PSI) were assigned to one group, other thirteen parents with moderate scores on the PSI were assigned to a second group, and thirteen undergraduate students were assigned to a control group. Initially all participants were exposed to a video of a child exhibiting disruptive behaviors. Following this all participants were exposed to a conditional discrimination training A-B and A-C, one stimulus set A corresponded to nonsense figures, a second stimulus set B corresponded to children's disruptive behaviors, and the set C to positive parenting behaviors. Then mixed relations (A-B and A-C) were trained followed by transitivity and equivalence tests. The results show that participants with high scores on the PSI exhibited low response accuracy and longer response latencies during derived relations compared to the control group and moderate stress. These results suggest that parents with high PSI scores, have greater difficulty in establishing new relations between stimuli, especially stimuli loaded with emotional value. These findings have implications at clinical level, specifically in relational flexibility.

Parental stress and social support of caregivers of children with cerebral palsy / Estresse parental e suporte social de cuidadores de crianças com paralisia cerebral / Estrés paternal y soporte social de cuidadores de niños con parálisis cerebral

Stress and social support are relevant variables for understanding the impact of disability on the care relationship. Thus, this study investigates the association between the parental stress index, social support indicators, and the sociodemographic variables of caregivers of children with cerebral palsy in a capital city of the Eastern Amazon. The following instruments were applied to 100 caregivers: the Sociodemographic Inventory, the Gross Motor Function Classification System, the Parenting Stress Index, and the Medical Outcomes Study Social Support Survey. For data analysis, descriptive statistics were used, in addition to techniques of multivariate analysis. It was found that most participants had high parental stress and a high perception of social support. Specific aspects of the perception of social support and sociodemographic indicators were associated with stress. This knowledge favors the design of more assertive interventions because it outlines the aspects of these variables that appear to have a more effective impact on parental stress.

O estresse e o suporte social são variáveis relevantes para se compreender o impacto da deficiência na relação de cuidado. Neste sentido, este estudo investigou a existência de associação entre o índice de estresse parental e indicadores de suporte social e variáveis sociodemográficas de cuidadores de crianças com paralisia cerebral em uma capital da Amazônia Oriental. Cem cuidadores responderam aos instrumentos: Inventário sociodemográfico, Sistema de Classificação da Função Motora Grossa, Índice de Estresse Parental e Medical Outcomes Study Social Support Survey. Para a análise dos dados, utilizou-se a estatística descritiva com técnicas de análises multivariadas. Verificou-se que a maioria dos participantes apresentou um alto estresse parental e a percepção de elevado suporte social. Aspectos específicos da percepção de suporte social e de indicadores sociodemográficos estiveram associados ao estresse. Este conhecimento favorece o planejamento de intervenções mais assertivas, pois delineia que aspectos parecem impactar mais efetivamente no estresse parental.

El estrés y el soporte social son relevantes para comprenderse el impacto de la deficiencia en la relación del cuidado. En ese sentido, investígase la asociación del índice de estrés paternal e indicadores de soporte social y variables sociodemográficas de cuidadores de niños con parálisis cerebral en una capital de Amazonia Oriental. Cien cuidadores contestaron los instrumentos: Inventario sociodemográfico, Sistema de Clasificación de Función Motora Gruesa, Índice de Estrés Paternal y Medical Outcomes Study Social Support Survey. Para el análisis de los datos, se utilizó la estadística descriptiva con técnicas de análisis multivariadas. Verificase que la mayoría de los participantes presentaron alto nível de estrés paternal y alta percepción de soporte social. Aspectos específicos de la percepción de soporte social y de indicadores sociodemográficos estaban asociados al estrés. Este conocimiento favorece la planificación de intervenciones más asertivas, una vez que delinea qué aspectos de estas variables parecen impactar más efectivamente el estrés paternal.

A Comparative Study of Parenting Styles, Parental Stress and Resilience among Parents of Children Having Autism Spectrum Disorder, Parents of Children Having Specific Learning Disorder and Parents of Children Not Diagnosed With Any Psychiatric Disorder.

Background: Raising a child is a big responsibility for the parents. This responsibility increases if the child has a disability like autism spectrum disorder (ASD) or specific learning disorder (SpLD). Objectives: To study and compare the parental stress, parenting style and resilience in parents of children having ASD, SpLD and children who do not have a psychiatric disorder. Methods: A cross-sectional study was done where we assessed the participants using the Parental stress scale, Parenting styles questionnaire and The Connor-Davidson Resilience Scale. Results: The study sample consisted of parents of 98 children, which included 53 mothers and 45 fathers. Mean stress scale score was significantly higher in parents having a child diagnosed with ASD than in parents having a child with specific learning disorder than in parents having a child with neither of these (p<0.001). Mean parental stress score was also significantly higher in parents with a male child than in parents with a female child (p=0.039) Stress score also was higher in female parents than in male parents (p=0.033). Housewives and unemployed parents had significantly higher mean stress scores than employed population (p=0.006). The mean resilience score was significantly higher (p =0.003) in authoritative parenting followed by permissive with authoritarian parents having the least score. Conclusion: Perceived level of stress in a parent is affected by the type of disability, time spent with the child and gender of the parent and child whereas parental resilience is affected by parenting styles.