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Burnout in parents of chronically ill children
Örebro University, School of Health Sciences.
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Parents of children with a chronic disease are usually highly involved in their child’s treatment and may be affected by the heavy demands and constant stress. This can increase the risk of developing burnout, which is an individual reaction to long-term stress consisting of symptoms associated with emotional exhaustion, as well as physical and cognitive fatigue. The overall aim was to estimate the prevalence of burnout in parents of children with Type 1 Diabetes Mellitus (T1DM) and inflammatory bowel disease (IBD) (paper I), identify the risk factors associated with parenting a child with T1DM (paper II), explore how mothers suffering from burnout describe their mothering of a child with diabetes, with special focus on their need for control and Performance-based self-esteem (PBSE) (paper IV), and to evaluate the effect of a group intervention aimed at reducing stress-related symptoms (paper III). A total of 251 parents of children with T1DM, 38 parents of children with IBD and 124 parents of healthy children participated in a population-based study (I, II). The validated Shirom-Melamed Burnout Questionnaire (SMBQ) was used to assess burnout. 16 parents (SMBQ ≥3.75) participated in a group intervention and were evaluated for changes in SMBQ and PBSE (III). A total of 21 mothers of children with T1DM who scored for clinical burnout (SMBQ) participated in a qualitative study. Semi-structured interviews were conducted and Inductive content analysis was used (IV). In the study group 36.0% parents of children with a chronic disease scored for clinical burnout (SMBQ ≥3.75) compared to 20.2% of the reference parents (p=0.001) with a preponderance of mothers compared to fathers, 42% vs. 20.5% (p=0.001), respectively (I). Less support from the social network, sleep disturbances and lack of personal leisure time and recovery seem to be important risk factors for clinical burnout in parents of children with T1DM, especially mothers (II). Mothers’ experiences of mothering a child with T1DM were interpreted as one theme; Mission impossible, illustrating the extremely difficult circumstances under which they bring up the child with diabetes to adulthood (IV). Parents’ subjective evaluation of the intervention group was mainly positive and SMBQ (p=0.01) and PBSE scale (p= 0.04) measurements were significantly reduced 6 months after completion of the intervention (III). It is important to pay attention to how parents and especially mothers experience their daily life in order to support those who are at risk of developing burnout.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2016. , 101 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 131
Keyword [en]
Burnout, long-term stress, parents, children, chronic illness, T1DM, IBD, intervention group
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
URN: urn:nbn:se:oru:diva-47391ISBN: 978-91-7529-116-1 (print)OAI: oai:DiVA.org:oru-47391DiVA: diva2:893756
Public defence
2016-02-19, Universitetssjukhuset, Wilandersalen, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-01-13 Created: 2016-01-13 Last updated: 2017-10-17Bibliographically approved
List of papers
1. Increased prevalence of burnout symptoms in parents of chronically ill children
Open this publication in new window or tab >>Increased prevalence of burnout symptoms in parents of chronically ill children
2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 3, 427-432 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To examine the prevalence of burnout symptoms in the context of parenting a chronically ill child. Methods: A total of 252 parents of children with Type 1 Diabetes Mellitus and 38 parents of children with Inflammatory Bowel Diseases participated in a population-based study. A control group consisted of 124 randomly selected parents of healthy children. We used self-report questionnaires to assess symptoms of burnout. Results: The main finding was that significantly more parents of children with chronic diseases (36%) scored for clinical burnout, compared with parents of healthy children (20%). Burnout symptoms were most prominent among mothers of children with diabetes, although fathers of children with diabetes and mothers and fathers of children with inflammatory bowel diseases also reported higher levels of various burnout symptoms. Conclusion: Burnout may be a useful model for understanding long-term parental responses and should be acknowledged among the different types of psychological consequences of the multi-faceted experience of parenting a child with chronic illness. Gender seems to influence the risk of burnout symptoms. Continued research about other background factors, and how the parents' situation changes over time are warranted. In the clinic, we need to draw attention to the group of parents who may suffer from burnout.

Keyword
Burnout, Childhood, Inflammatory bowel disease, Parents, Stress, Type 1 Diabetes
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:oru:diva-13026 (URN)10.1111/j.1651-2227.2009.01586.x (DOI)000274147200023 ()19912139 (PubMedID)2-s2.0-77249139238 (Scopus ID)
Available from: 2011-01-03 Created: 2011-01-03 Last updated: 2017-12-11Bibliographically approved
2. Parental burnout in relation to sociodemographic, psychosocial and personality factors as well as disease duration and glycaemic control in children with Type 1 diabetes mellitus
Open this publication in new window or tab >>Parental burnout in relation to sociodemographic, psychosocial and personality factors as well as disease duration and glycaemic control in children with Type 1 diabetes mellitus
2011 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 7, 1011-1017 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To examine associations between burnout and sociodemographic, psychosocial, personality and medical factors in parents of children with Type 1 Diabetes Mellitus (T1DM). Methods: A total of 252 parents of children with T1DM participated in a population-based study. We used self-report questionnaires to assess symptoms of burnout and background factors. Results: Psychosocial background factors were significantly associated with burnout in parents, whereas there were no associations between sociodemographic or medical factors and burnout. For both genders, parental burnout was associated with low social support, lack of leisure time, financial concerns and a perception that the child's disease affects everyday life. Low self-esteem and high need for control were risk factors for maternal burnout. Conclusion: In the screening of risk factors for long-term stress in parents of children with T1DM, we should recognize parents' attitudes as well as situational psychosocial issues. In clinics, we need to pay attention to the day-to-day life circumstances in the support of these parents. Certain factors were associated with the risk for burnout only for mothers, which warrant further investigation of gender aspects. Continued research about the causal relationship between the parental responsibility, psychosocial factors and burnout is warranted.

National Category
Pediatrics Family Medicine
Research subject
Pediatrics; Family Medicine
Identifiers
urn:nbn:se:oru:diva-18695 (URN)10.1111/j.1651-2227.2011.02155.x (DOI)000291224200029 ()21414025 (PubMedID)2-s2.0-79958058968 (Scopus ID)
Available from: 2011-09-29 Created: 2011-09-29 Last updated: 2017-12-08Bibliographically approved
3. Group intervention for burnout in parents of chronically ill children: a small-scale study
Open this publication in new window or tab >>Group intervention for burnout in parents of chronically ill children: a small-scale study
2016 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 4, 678-686 p.Article in journal (Refereed) Published
Abstract [en]

Background: Long-term stress leading to burnout symptoms is prevalent in parents of chronically ill children. The aim of the study was to evaluate the effect of a group intervention by measuring changes in self-rated clinical burnout and performance-based self-esteem. In addition, the parental perceptions of the acceptability of the intervention were explored.

Methods: Previously, we have explored the prevalence of clinical burnout in parents of patients 1–18 years with type 1 diabetes mellitus (T1DM) and inflammatory bowel disease (IBD) in the county of Örebro. All parents who exhibited clinical burnout symptoms in accordance with the Shirom–Melamed Burnout Questionnaire (SMBQ) were then invited to participate in a group intervention, which was evaluated in the present small-scale study. The group intervention consisted of eight sessions over a 12-week period, including education about behaviour, cognition and symptoms associated with burnout, intending to help the parents to develop adequate strategies for coping with and reducing stress. We evaluated the effect of the intervention in terms of self-rated clinical burnout and performance-based self-esteem (PBSE). In addition, the acceptability of the intervention was evaluated by analyses of recruitment and retention and self-reports from parents.

Results: Sixteen parents (13 of children with TIDM and three of children with IBD) out of 104 reporting clinical burnout participated in the intervention. All participants completed the intervention, and the mean attendance rate at all sessions was 90%. Parents’ subjective evaluations were mainly positive, and SMBQ (p = 0.01) and PBSE scale (p = 0.04) measurements were significantly reduced, which effects remained 6 months after completion of the intervention.

Conclusions: Despite the small-scale study, we consider that this intervention for parents with clinical burnout was appreciated and well accepted. The significant reduction in clinical burnout symptoms requires further evaluation in randomised controlled studies based on larger groups of parents.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keyword
burnout, chronic illness, diabetes, inflammatory bowel disease, intervention, parenting stress
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-47759 (URN)10.1111/scs.12287 (DOI)000389453000005 ()26395446 (PubMedID)2-s2.0-84945262059 (Scopus ID)
Note

Funding Agencies:

Research Committe of Örebro County Council OLL-180151

Örebro University

Available from: 2016-01-25 Created: 2016-01-25 Last updated: 2017-11-30Bibliographically approved
4. “Mission impossible”: The mothering of a child with diabetes type 1 - from the perspective of mothers suffering from burnout
Open this publication in new window or tab >>“Mission impossible”: The mothering of a child with diabetes type 1 - from the perspective of mothers suffering from burnout
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:oru:diva-47870 (URN)
Available from: 2016-02-01 Created: 2016-02-01 Last updated: 2017-10-17Bibliographically approved

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