Current Status And Influencing Factors Of Posttraumatic Growth In Primary Caregivers Of Children With Developmental Disabilities Under 6 Years Old

Objective:This study intends to explore the current status and influencing factors of posttraumatic growth in the primary caregivers of children with developmental disabilities under 6 years old,so as to provide scientific basis for improving the posttraumatic growth and mental health of the primary caregivers of children and formulating corresponding psychological intervention programs.Method:The first stage: A total of 200 primary caregivers of children with developmental disabilities were selected as cross-sectional subjects by random sampling in the Department of Children’s Rehabilitation of a Class Ⅲ Grade A hospital in Chongqing and a children’s rehabilitation institution in Chongqing,among which 198 were valid,for a valid rate of 99%.The General Demographic data Questionnaire,the Chinese version of Posttraumatic Growth Inventory(PTGI-C),the Connor-Davidson Resilience Scale-10(CD-RISC-10),the Simplified Coping Style Questionnaire(SCSQ)and the General Self-Efficacy Scale(GSES)were used as measurement tools to investigate the statistical relationships among variables of the posttraumatic growth of the primary caregivers of children with developmental disabilities under 6 years old.Epidata3.3 was used for data entry,and SPSS25.0 was used for descriptive analysis of relevant variables after verification.Independent sample t-test and One-Way ANOVA analysis of variance were used for difference test among variables.Pearson bivariate correlation analysis was used to analyze the correlation between posttraumatic growth,resilience,positive coping style and self-efficacy,and the PROCESS macro program was used to test the mediation model.The second stage: The study adopted descriptive phenomenological research method of qualitative research method.According to the results of the first stage of the study and the review of relevant literature,on the basis of consulting experts and professors in psychology,nursing and child rehabilitation,the primary caregivers(12 grandparents and 14 parents)of children with developmental disabilities under 6 years old who had posttraumatic growth experience were chosen.With semi-structured interviews,Goo Seeker software and Colaizzi7-step analysis method were used to analyze the data to code themes,which aimed to clarify the similarities and differences in the reasons for posttraumatic growth between the grandparents and parents.Results:1.General status of post-traumatic growth of primary caregivers of children with developmental disabilities under 6 years old.The average score of posttraumatic growth of primary caregivers was 61.99±12.05,showing a moderate level of posttraumatic growth.Among them,27 primary caregivers(13.64%)experienced high-level of posttraumatic growth;132 primary caregivers(66.67%)experienced moderate posttraumatic growth;39 primary caregivers(19.69%)experienced low-level posttraumatic growth.There were five dimensions of posttraumatic growth: The scores of relating to others,new possibility,personal strength,appreciation of life and spiritual–existential change were 19.92±4.82,14.28±3.75,13.41±3.16,9.60±2.37 and4.78±2.02 respectively.2.General demographic characteristics of posttraumatic growth of primary caregivers of children with developmental disabilities under 6 years of ageThere were significant differences in the effects of different demographic variables,namely education level,monthly income,residence and relationship with children,on the posttraumatic growth of primary caregivers(P < 0.05).In addition,the gender of the primary caregivers of children with developmental disabilities and the diagnosis of their child had no statistical significance for the posttraumatic growth of the caregivers(P >0.05).3.Relationship between posttraumatic growth,resilience,coping style and self-efficacy and of primary caregivers of children with developmental disabilities under 6 years oldThe total score of posttraumatic growth of primary caregivers were positively correlated with resilience,positive coping style and self-efficacy(r=0.445,P<0.001;r=0.595,P<0.001;r=0.482,P < 0.001).Negative coping styles were positively correlated with the new possibilities in posttraumatic growth(r=0.184,P < 0.01).Positive coping style and self-efficacy play a mediating role between resilience and posttraumatic growth.4.The causes of posttraumatic growth in primary caregivers of children with developmental disabilities under 6 years oldGrandparents of children with developmental disabilities interviews presented the following themes: 1)The derivations of positive psychological: perceived progress of children,looking forward to a better future,positive coping styles;2)New life perception: accepting reality calmly,shifting focus of life,valuing health more;3)The enhancement of personal strength: the enhancement of resilience,the enhancement of self-efficacy,optimism and prospect;4)The enhancement of support system: the enhancement of emotional support,the enhancement of social support;5)Interpersonal harmony: altruistic behavior,improvements in relationships with others.Parents of children with developmental disabilities interviews presented the following themes: 1)The derivations of positive psychological: perceived progress of children,looking forward to personal development,positive coping styles;2)New life perception: accepting reality calmly,shifting focus of life,valuing family more;3)The enhancement of personal strength: the enhancement of resilience,the enhancement of self-efficacy,optimism and prospect,personal growth;4)The enhancement of support system: the enhancement of emotional support,the enhancement of social support;5)Interpersonal harmony: altruistic behavior,improvements in relationships with others,appreciating parents.Qualitative studies of grandparents and parents of children with developmental disabilities showed that there were differences in themes and subthemes:(1)The derivations of positive psychological:Grandparents’ vision for the future is all about the child,while parents’ vision for the future personal development and achievement.(2)New life perception:Grandparents shift their focus of life to change their retirement plans and take full care of children,while parents shift their focus of life from work to children,and some parents even give up their original jobs.And grandparents value health more than parents value family integrity and happiness.(3)The enhancement of personal strength: Parents experience personal growth and change and actively seek treatment,while grandparents do not.(4)The enhancement of support system: Parental emotional support included peer support but grandparents did not mention it.(5)Interpersonal harmony: Grandparents become close and harmonious with the people around them,while parents are more aware of the closer and harmonious relationship between their husband or wife.Conclusions:1.The primary caregivers of children with developmental disabilities under 6 years old had a moderate level of posttraumatic growth during the care of children.However,there are few primary caregivers with high level of posttraumatic growth,which still needs to be further improved.2.General demographic variables: Education level,monthly income,residence and relationship with children had significant effects on posttraumatic growth of primary caregivers.3.Resilience,positive coping style and self-efficacy were positively correlated with posttraumatic growth and all dimensions.Negative coping style was positively correlated with new possibility in posttraumatic growth.Positive coping style and self-efficacy play a mediating role between resilience and posttraumatic growth.4.The causes of the posttraumatic growth of the primary caregivers of were the derivations of positive psychological,new life perception,the enhancement of personal strength,the enhancement of support system,interpersonal harmony.The influential factors of grandparents’ posttraumatic growth are different from those of parents.