Resources and mental health in mothers of chronically ill children
Silver, Ellen Johnson
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Although mothers of chronically ill children may be at risk for mental health problems, many do well and research is needed to identify factors that might predict psychological distress. Evidence suggests that the level of impaired functioning exhibited by the child might influence the mother's mental health. In addition, intrapersonal resources such as self-esteem (sense of self-worth) and efficacy (feelings of control over life situations) may be important contributors to one's emotional response to environmental events, but their relationships to mental health status in mothers of chronically ill children have not been investigated. This study examined: (1) whether self-esteem, efficacy, and child's functioning related to mothers' psychiatric symptoms, and (2) if psychological resources modified the impact of children's functional limitations on mother's mental health.;Subjects were 365 mothers whose children were 5-8 years old, had a chronic health condition, and received health care at two large urban medical centers. They were mostly minority (45% Hispanic, 37% Black) and of low-middle socioeconomic status (48% on welfare). Mothers responded to a face-to-face interview that included the Psychiatric Symptom Index (Ilfeld, 1976), Rosenberg Self-Esteem scale (1979) and Ilfeld Efficacy scale (1978). The short version of the Functional Status II(R) (Stein & Jessop, 1990) assessed the degree to which the child's illness interfered with roles and tasks of daily living.;Better self-esteem, efficacy, and functional status scores each were independently associated with fewer psychiatric symptoms. Mothers who scored low (worse) on both the self-esteem and efficacy scales had the most symptoms of distress. Higher self-esteem exerted a protective effect on mother's mental health regardless of her child's functional status. However, there was an interaction effect of efficacy by functional status indicating that mothers were more likely to exhibit psychological distress when the child was classified as having functional limitations due to illness and her efficacy was low. Enhancing a mother's perceived control may reduce the likelihood that she will experience negative emotional consequences particularly when caring for a child who has functional limitations due to an ongoing physical health condition.