174156 Disability beyond borders: New approaches to understanding children's special health care needs and maternal mental health

Wednesday, October 29, 2008: 8:45 AM

Betty G. Brown, PhD, MPH, RN , Department of Health Sciences, Northern Arizona University, Flagstaff, AZ
The impact of children's special health care needs on maternal mental health has been the subject of considerable research, but to examine this relationship, many have focused on specific childhood diagnoses. Extending public health understandings beyond the borders of diagnostic categories requires an alternative view. Using the National Survey of Children's Health, 2003, this study assessed the broader implications of mothers' caregiving for children with special needs.

Screening questions from the Maternal and Child Health Bureau of the U.S. Department of Health and Human Services, piloted for the first time in this national sample, formed the basis of special needs criteria. The relationships among special needs and mothers' mental health and anxiousness about their child's outcomes were assessed within the framework of the stress process using multiple regression and simple slopes analyses.

Results of this study not only indicate that children's special needs – beyond diagnoses – are significantly associated with mothers' mental health but also suggest that a broader view of maternal stressors contributes to our understanding of at-risk families with disabled children. In this sample, mothers' perceived coping, a child's regular source of care, and neighborhood support either mediated or buffered the effects of maternal caregiver stress. The significant effects of structural environments and contexts of social stress on maternal well-being underscore the importance of viewing a disability within the context of environmental limitations rather than that of individual capabilities. This important shift in perspective can form the basis for stronger and more effective family public health interventions.

Learning Objectives:
1. Identify ways in which children’s special health care needs can be explored beyond diagnostic categories 2. Discuss the impact of perceived coping and social support on maternal caregiver stress 3. Evaluate the roles of children’s special needs and structural environments on maternal mental health

Keywords: Special Needs, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my dissertation research and data analyses on this topic using the NCHS dataset.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.