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Relationship Between Parental Stress and Self-efficacy in Parents of Children with a Disability

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Abstract
 
Research suggests that parents of children with disabilities are prone to higher stress and lower self-efficacy levels than parents of typical children.  The current study sought to investigate the relationship between parental stress and self-efficacy in parents of children with a disability in Ireland.  The independent variables (IV) in the study are the status of diagnosis of the child, confirmed disability or suspected disability and the dependent variables (DV) are parental stress levels and parental self-efficacy levels. Using the Parental Sense of Competence Scale (PSOC) (Johnson & Mash 1989) and the Parental Stress Scale (PSS) (Berry & Jones 1995), parental stress and self-efficacy levels were investigated to determine if there was an relationship between stress and self-efficacy in parents of children with a confirmed disability and parents of children with a suspected disability.  Participants were recruited from an online support group for parents of children with disabilities to complete a demographic questionnaire, the PSOC and PSS questionnaires.  The study received a total of 290 respondents of which 266 were parents to children with a confirmed disability and 24 were parents of children with a suspected disability.  Results reported that there was a significant negative correlation between parental stress and self-efficacy levels suggesting that parents who have high-stress levels have low self-efficacy in their parenting role.  The research went on to suggest that there was no significant difference in the stress and self-efficacy levels between parents of children who have a confirmed or suspected disability.
Acknowledgements

1           Literature Review

Research suggests that there is a strong correlation between stress and self-esteem (Galanakis, Palaiologou, Patsi, Velegraki & Darviri, 2016).

1.1    Introduction to parenting

Hassall, Rose and McDonald (2005) imply that there is a high level of stress associated with raising children, subsequently Coleman and Karraker (1998) suggest that most parents find the job of parenting to be an enjoyable experience whilst terrifying at times it is one of the most demanding roles in early adulthood that puts immense intellectual, emotional, and physical pressure on an individual.
It is thought that there are some fundamentals to parenting such as endurance, tolerance, reliability, compassion, stability, and attention.  He goes on to suggest that these traits cannot always be attained as parents have many roles, duties and tasks that they must carry out on a daily basis.  With an ever-increasing number of parents working outside the home, dealing with household tasks and family obligations, as well as trying to find time to spend with their children, means there is little or no time for these fundamental parenting tasks (Small, 2010).
The relationship between parenthood and well-being is thought to be an extremely complicated one. Parenthood can be an unhappy time for some and as research suggests, the level of this unhappiness can be brought on by high levels of negativity and increased financial difficulties. In contrast with the complications of parenthood, it is suggested that parents who experience greater meaning in life, satisfaction of their basic needs, greater positive emotions, and enhanced social roles, they are met with happiness and joy (Nelson & Kushlev, 2014).

1.2    Disabilities

The World Health Organisation (WHO) declares that the term of disabilities is an umbrella type term which covers “impairments, activity limitations, and participation restrictions”. They go on to suggest that a “disability is not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives” (WHO, 2017).
A disability can be the result of a neuro developmental disability such as Autism, Dyspraxia or Downs Syndrome, it could be due to a physical disability such as Multiple Sclerosis, Muscular Dystrophy or Epilepsy, a behavioural disability such as ADD, ADHA, or a sensory impairment such as being visually impaired, deaf or blind (Boyle et al., 2011; Schalock, Luckasson & Shogren, 2007).  Recent figures published by The Central Statistics Office (CSO) report that there are now over seventy thousand children under the age of 19 with disabilities in Ireland today (CSO, 2016).

1.3    Stress

Selye (1974) implies that “stress is the nonspecific response of the body to any demand”, he goes on to add that we cannot just avoid stress and although there is just one type of stress, the effects of a “stressor” can be different depending on an individual.  Furthermore, he implies that the effect of a stressor on an individual is see when that individual produces a non-specific stress response.  Lazarus (1990) goes on to suggest that stress is a normal part of human life and it can be defined as the exhaustion of one’s human resources by the external demands placed upon them.
 
Boyce, Behl, Mortensen and Akers (2017) report that parents of a child with disabilities have more stress than their counterparts.  Furthermore, they also suggest that past investigations of parent stress have been limited by considering too few sources of stress.
Research by Weiss (2002) went on to evaluate stress levels in mothers of a typical child in contrast with a child with a disability. Notwithstanding, the results indicated that mothers of children with disabilities experienced higher levels of depressive symptoms, anxiety and somatic conditions than mothers of typical children, hence, Weiss also implies that parents who reported high levels of personal satisfaction in their parenting ability reported low levels of depression.

1.4    Self-efficacy

According to Bandura (1977), self-efficacy can be defined as an individual’s perceived ability to achieve a task or meet a certain goal.  Furthermore, Bandura suggests that the held perception an individual has, directly influences their performance in succeeding in any given task.  In his Social Cognitive theoretical framework of self-efficacy, Bandura implies that there are psychological factors present such as environmental, personal, and behavioural factors which alter the level and strength of one’s self-efficacy.  He goes on to suggest that our expectations of self-efficacy are taken from four sources, performance, persuasion, social observation, and emotions.  The main concept that lies behind the social cognitive psychology is that processes such as self-reflection, are not unconscious and individuals act based on their thoughts and beliefs.
Further research by Johnston and Mash (1989) suggests that not only parental perceptions but also the behaviour of the child brings about a negative relationship between self-efficacy and parental satisfaction in the role of being a parent.
High parenting self-efficacy is argued to be strongly correlated with the parent’s ability to provide a, motivating, loving and stimulating home life.  In contrast, low levels of parenting self-efficacy have been correlated with parental depression (Coleman & Karraker, 2000).

1.5    Stress and parenting of a child with disabilities

Barnett, Clements, Kaplan-Estrin and Fialka (2003) imply that parents of children with developmental disabilities are at risk for high levels of distress, furthermore, they argue that the parents of a child with a development disability can have feelings of segregation and stress that lead to depression.
There are a lot of impacts on the family structure when raising children with disabilities.  The family and child can become marginalised from society in many ways (Edelson, 2008).  Social exclusion, prejudice and discrimination can be isolating, not just to the child but also the family unit (Hinshaw, 2005). Furthermore, there is extensive research to suggest that being a caregiver for a child with a disability can impact on the mental health of an individual (Ferro &, Speechley 2009; Glenn, Cunningham, Poole, Reeves & Weindling, 2009; Singer 2006), hence, Panditaratne and Donnelly (2017) go on to suggest that parents of children with a disability report lower parental  self-efficacy than parents of typical children.  Subsequently, this lends support to the fact that primary caregivers of children with disabilities are at considerable risk of stress, depression, and low personal quality of life (Cummins, 2001).  He goes on to add that due to the intense level of care needed, the task of looking after a child with a disability can be more stressful than caring for a normal child and he argues that parents of children with disabilities suffer less well-being than parents of typical children.  In his review “The subjective well-being of people caring for a family member…”, Cummins evaluated the impact of care on a patient and the impact it has on the stress levels of the family.  He evaluated qualitative and quantitative data that highlights how the quality life felt by families is low.  He also suggests that the degree of and the type of disability that is being cared for is a major contributing factor to the stress felt by the families.  Subsequently, however, he adds a cautionary note to his review by arguing that there is a shortcoming in the data he studies, noting that the literature on family wellbeing is too vast for any review to be inclusive.
It is not easy to be a parent to a child with a disability.  Whilst it is acknowledged there are happy times, a parent can face a lot of challenges which may have negative effects on their wellbeing.  Furthermore, she goes on to argue that the job of a parent quite often for an individual means that they are worrying themselves sick, fighting for necessary services for the child, sacrificing their personal career, succumbing to high levels of debt to pay for services, and finally, the anger at the injustice of it all.  In addition, she points out that before the child had a diagnosis, the stress felt by parents was associated with their perceptions of their child’s development and stress was mostly related to social support (Anderson, 2010).
The experiences of parenting a child with a disability can be different depending on the specific need of the child, however, there are commonalities between the stressors experienced by parents of children with different challenges.  This seems to indicate that parental stress levels in children with disabilities is determined by the overall nature of the disability (Gupta, 2007).  Furthermore, Hayes and Watson, (2012) go on to add that there is a higher level of parental stress felt by parents of children with autism spectrum disorder than parents of typically children or those diagnosed with other disabilities such as Down syndrome cerebral palsy or an intellectual disability.

1.6    Self-efficacy and parenting of a child with disabilities

The experiences of parenting a child with a disability can be different depending on the specific need of the child, however, there are commonalities between the stressors experienced by parents of children with different challenges.  This seems to indicate that parental stress levels in children with disabilities is determined by the overall nature of the disability (Gupta, 2007).  Furthermore, Hayes and Watson, (2012) go on to add that there is a higher level of parental stress felt by parents of children with autism spectrum disorder than parents of typically children or those diagnosed with other disabilities such as Down Syndrome, Cerebral Palsy or a learning and intellectual disability.

1.7    Self-efficacy and parenting of a child with disabilities

Bandura (1993) suggests that one’s parental self-efficacy (PSE) beliefs represent the measure of which parents comprehend themselves as capable of performing the tasks associated with this challenging role.  Hence, he goes on to suggest that PSE is a vital element and is often linked with a parent’s competence in performing their parenting tasks.  This supports further research which suggests that heightened levels of parental self-efficacy are correlated with a higher quality of parent to child interaction and enhanced warmth in the relationship (Coleman & Karraker 1998).
Panditaratne and Donnelly (2017) imply in a recent research report that accessing services can be challenging for parents and consequently this causes low self-efficacy in parents which may explain the increased risk for depression.  They go on to argue that these low levels of self-efficacy are positively correlated with greater mood disorders. Things that become stressors in the life of a parent of a child with a disability may not become a stressor to a parent of a typical child.
In contrast, Jones and Prinz (2005) imply that high self-efficacy in parents has a positive outcome on the child relationship which can lead to the child taking on these positive outlooks as social norms and apply them to their own existence.

1.8    The Present Study: research aims

The aim of the current study therefore was to address the following research questions:

  1. Is there a significant relationship between parental stress and self-efficacy in parents of children with a disability?
  2. Is there a significant difference in scores on a measure of parental stress between parents of children with a confirmed disability, and parents of children with a suspected disability?
  3. Is there a significant difference in scores on a measure of self-efficacy between parents of children with a confirmed disability and parents of children with a suspected disability?

2           Methodology

2.1    Design

A between groups cross-sectional correlational design was used to examine levels of parental stress and self-efficacy in parents of children with a confirmed disability and parents of children with a suspected disability.  The independent variables (IV) in the study are the status of diagnosis of the child, confirmed disability or suspected disability and the dependent variables (DV) are parental stress and parental self-efficacy.

2.2    Participants

For inclusion in the study, participants must be parents of children who are 1) children with a confirmed disability and or 2) children with a suspected disability who are waiting on an assessment of need (AON) for diagnosis.  Two hundred and ninety-five participants responded. Four were excluded for not having a child with a disability and one was excluded for non-responses, leaving a total of 290 participants.  This was made up of 285 (98.28%) females and 5 males (1.72%).  As is illustrated in Table 2‑1 below, 266 (91%) participants had a child with a confirmed disability, this was made up of  262 females (90%) and 4 males (1%). 24 (8%) had a child with a suspected disability made up of 23 females (7.7%) and 1 male (0.3%).
Table 2‑1 Gender and age of parents of children with a confirmed and suspected disability.

  
Variable
Child with a
confirmed disability 
N (%)
Child with a
suspected disability 
N (%)
Total 
 
 
N (%)
266 (91.7%) 24 (8.3%) 290 (100%)
Gender Male 
Female
4 (1.4%) 
262 (90%)
1 (0.3%) 
23 (8%)
5 (1.7%) 
285 (98.3%)
Age 20 – 30 
31 – 40
41 – 50
51 – 60
20  (7%) 
111  (39%)
121  (42%)
14  (5%)
0 (0%) 
17  (6%)
6  (2%)
1  (.34%)
20 (6.9%) 
128 (44.1%)
127 (43.8%)
15 (5.2%)
Child’s gender Male 
Female
185 (64%) 
81 (28%)
17 (6%) 
7 (2%)
202 (69.6%) 
88 (30.3%)

2.3    Research Instruments

Participants were presented with three self-report measures; (1) a demographic questionnaire (see Appendix A) which was used to record the participants’ gender, age group, child’s gender, age and disability, assessment of need waiting time, diagnosis waiting time and area resided in; (2) the Parenting Sense of Competence questionnaire (PSOC) (see Appendix B) and (3) the Parental stress Scale (PSS) questionnaire (see Appendix C).

2.3.1        Parenting Sense of Competence Scale (Johnston & Mash, 1989)

The Parenting Sense of Competence Scale (PSOC) aims to measure the competence levels of parents of children from 5 to 12 years. There are 17 questions in the questionnaire.  The questionnaire is presented as a 6-point Likert scale questionnaire where 6 indicates strongly agree and 1 indicates strongly disagree. The PSOC contains two subscales; satisfaction and efficacy.  The first subscale Satisfaction, contains 10 items relating to satisfaction in the parenting role (anxiety, motivation, and frustration).  The second subscale, efficacy, is a 7-item domain-general measure and examines parent’s competence, capability, and problem-solving abilities in the parenting role.  To compute the parental stress score, the positive Items 2, 3, 4, 5, 8, 9, 12, 14 and 16 are reverse scored, and then, all items are summed.  The total score ranges from a low of 17 to a high of 102 and the scores are categorised to one of three ranges, low, moderate or high.  Scores between 17 and 50 represent low parental confidence, scores between 51 and 69 represent moderate parental confidence and scores between 70 and 102 represent high parental confidence.

2.3.2        Parental stress Scale (Berry & Jones 1995)

The Parental Stress Scale (PSS) measures the general levels of stress felt by parents.  It is an 18 item, self-report questionnaire that measures themes of parenthood from both positive and negative aspects. For each statement, respondents rate their level of agreement on a 6-point Likert type scale (1 being strongly disagree, to 6 strongly agree). To compute the parental stress score, the positive Items 1, 2, 5, 6, 7, 8, 17, and 18 are reverse scored, and then, all items are summed. Higher scores reflect more parental stress. The possible range of the PSS is 18 (low stress) to 90 (high stress). There are no sub-scales in this measure (Louie, Cromer & Berry, 2017).

2.4    Procedure

Participants were invited to participate in the survey by clicking on a published link on a support group Facebook page for parents of children with disabilities.  When the participants clicked on the link, it brought them to the Google Forms page where they were presented with an overview of the survey, what it aimed to achieve and the estimated time to complete (See Appendix D).  The introductory section assured the participants that their contribution would be anonymous and confidential.  The contact details of the researcher and research supervisor were provided should the participants need further information on the research study.  Participants were then asked to complete a section where they indicated their consent prior to proceeding with the questionnaire, participants then completed the online survey which should have taken them approximately 10 minutes.
Following completion of the questionnaires, the participants were again thanked for participation, given a recap on the aim of the research and re-assured of confidentiality and the expiration procedure of the data.  Participants were once again provided with the researcher’s contact details if more information was sought and in the unlikely event that the research study had given rise to any potential issues with the participants, they were also supplied with the details for the support groups, Aware and the Samaritans.
On expiration of the survey, the respondent’s data was downloaded from google forms by the researcher.  The data was then imported into an Excel Spreadsheet where it was screened, and data cleansed.  The data was then imported into IBM SPSS v24 where it was coded, labelled and saved to a secure and encrypted OneDrive account as a. sav output file for analysis.

2.5    Ethical Considerations

An approval form to commence research was completed and submitted to the Dublin City University (DCU) Ethics Committee. Research Approval was granted (see Appendix F).  Throughout the research study the ethical guidelines of the Psychology Society of Ireland (PSI) were strictly adhered to.

3           Results

3.1    Reliability

Internal reliability for the PSS and the PSOC was assessed using the Cronbach alpha coefficient as it is one of the most frequently used indicators of internal reliability.  For a scale to be considered to have an acceptable level of internal reliability the Cronbach’s alpha coefficient should be 0.70 or above (Pallant, 2013).  As shown in Table 3.1, the PSS has a Cronbach’s alpha score of 0.76 and the Cronbach alpha coefficient was 0.77 which suggests acceptable consistency and reliability for the scale.  The PSOC has a Cronbach Alpha score of 0.79 and the coefficient was 0.78 which suggested acceptable internal consistency and reliability for the scale with this sample.
Table 3.2 Cronbach’s α Factor Reduced Scale

Variable Cronbach’s α Cronbach’s alpha
coefficient
PSS .76 .77
PSOC .79 .78

3.2    Data Screening

The data was screened and cleaned and found suitable for further analysis.  A pairwise deletion method was used in the anaylsis, meaning that any missing data variables that participants failed to provide answers towere not excluded from the study, however, their unanswered questions were not taken into consideration for analyses of the specified missing variable.

4           Tests of Normality

4.1    Parental Sense of Competence Scale

Normality of the data distribution for the PSOC Scale variable was assessed by examining the skewness and kurtosis values, as well as the mean, median, and range.  The PSOC had a mean score of 61.45 and a median score of 61.50.  This initially suggested a normal distribution as the values were close.  Closer investigation showed there was a positive skew, meaning there was a cluster of scores to the left at low values (Pallant, 2013).  The Kurtosis value was negative and indicated a curve that was slightly platykurtic.  However, as shown in Table 4‑1 Kurtosis and Skewness values for the PSOC scale were between the ranges -1 and +1 (Pallant, 2013).
Table 4‑1 Skewness and Kurtosis Values for the PSOC

  
Scale
  
N
  
Kurtosis
  
Skewness
PSOC 284 -.426 .057

As represented in the histogram (Figure 4‑1 Histogram for the ) the data appeared to be distributed in a normal bell curve distribution.  All the tests of normality for PSOC scores demonstrated that the data were normally distributed (see Figure 4.1 for a histogram of PSOC scale).  These results suggested that the data from the PSOC were suitable for parametric statistical testing.

Figure 4‑1 Histogram for the PSOC
 
Normality of the data distribution for the PSOC subscales of satisfaction and efficacy was assessed by examining the skewness and kurtosis values, as well as the mean, median, and range.
The satisfaction subscale had a mean score of 31.59 and a median score of 31.50. This initially suggested normal distribution as the values were close.  Closer investigation showed there was a negative skew, meaning there was a cluster of scores to the right at high values (Pallant, 2013). The Kurtosis value was negative, indicating a curve that was platykurtic.
However, as shown inTable 4‑2, the kurtosis and skewness values for the PSOC satisfaction subscale were within normal ranges -1 and +1 (Pallant, 2013).  This indicated that the data was normally distributed, as illustrated in the histogram that showed a normal bell curve distribution.  All the tests of normality for PSOC scores demonstrated that the data was normally distributed (see Figure 4‑2 Histogram of PSOC sub-scale).  These results suggested that the PSOC satisfaction subscale was suitable for use in parametric testing.
The efficacy subscale had a mean of 29.82 and a median of 30.00.  This initially suggested normal distribution as the values were close.  Closer investigation showed there was a negative skew, meaning there was a cluster of scores to the right at high values (Pallant, 2013).  The Kurtosis value was negative, indicating a curve that was slightly platykurtic.
However, as shown in Table 4‑2, the kurtosis and skewness values for the PSOC efficacy subscale were within normal ranges -1 and +1 (Pallant, 2013).  This indicated that the data was normally distributed as illustrated in the histogram that showed a normal bell curve distribution.  All the tests of normality for PSOC efficacy subscale scores demonstrated that the data was normally distributed (see Figure 4‑3 Histogram of PSOC efficacy sub-scale).  These results suggested that the PSOC efficacy subscale was suitable for use in parametric testing.
Table 4‑2 Skewness and Kurtosis Values for the PSOC sub-scales

  
PSOC
SubScales
  
N
  
Kurtosis
  
Skewness
Satisfaction 284 -.084 -.176
Efficacy 290 -.109 -.098


Figure 4‑2 Histogram of PSOC sub-scale satisfaction.
 
 
 

Figure 4‑3 Histogram of PSOC efficacy sub-scale efficacy.

4.2         Parental Stress Scale

Normality of the data distribution for the PSS Scale variable was assessed by examining the skewness and kurtosis values, as well as the mean, median, and range.  The PSS had a mean score of 55.86 and a median score of 56.00.  This initially suggested a normal distribution as the values were close.  (see Figure 4‑4 Histogram of PSS).  Closer investigation showed there was a positive skew, meaning there was a cluster of scores to the left at low values (Pallant, 2013).  The kurtosis value was negative and indicated a curve that was slightly platykurtic.  However, as shown on Table 4‑3, kurtosis and skewness values for the PSS scale were within normal ranges -1 and +1 (Pallant, 2013).
Table 4‑3 Skewness and Kurtosis Values for the PSS

  
Scale
  
N
  
Kurtosis
  
Skewness
PSS 290 -.304 -.026


Figure 4‑4 Histogram of PSS
 

5           Descriptive Statistics

5.1    Descriptive Statistics Parental Sense of Competence Scale

Descriptive statistics on the parenting sense of competence scale for the total group (n=290) indicated a mean score of 56.72 with a standard deviation score of 10.71 (M=56.7, SD=10.71) (Table 5‑1 Mean and standard deviation for PSOC).
Descriptive statistics on the parenting sense of competence satisfaction subscale for the total group (n=284) indicated a mean score of 31.59 with a standard deviation score of 7.28 (M=31.59, SD=7.28) (see Table 5‑2 Mean and Standard Deviation for PSOC satisfaction sub-scale).
Descriptive statistics on the parenting sense of competence efficacy subscale for the total group (n=290) indicated a mean score of 29.82 with a standard deviation score of 6.36 (M=29.82 SD=6.36).  (see  Table 5‑3  Mean and Standard Deviation for PSOC efficacy sub-scale).

5.2    Descriptive Statistics Parental Stress Scale

Descriptive statistics on the parental Stress Scale for the total group (n=290) indicated a mean score of 58.23 with a standard deviation score of 8.24 (M=58.23, SD=8.24).  (see Table 5‑4 PSS Mean and Standard Deviation scores of parents of children with a confirmed and suspected disability).

5.3    Mean and Standard Deviations Parental Sense of Competence Scale

The mean and standard deviation scores of parents of children with a confirmed disability and parents of children with a suspected disability on the parenting sense of competence scale.  Parents of children with a confirmed disability parents reported mean scores of 57.02 and a standard deviation of 10.83 (M=57.02, SD=10.83, parents of children with a suspected disability reported mean scores of 53.50 and a standard deviation of 8.92 (M=53.50, SD=8.92) (see Table 5‑1 Mean and standard deviation for PSOC).
Table 5‑1 Mean and standard deviation for PSOC

  
Scale
  
Variable
  
N
  
Mean
 
  
SD
PSOC
Parents of children with a confirmed disability 260 57.02 10.83
Parents of children with a suspected disability. 24 53.50 8.92
Total PSOC 
Scores
284 61.45 11.17

The PSOC scale scores range between 17 and 102.  There is a scoring algorithm leading to one of three acuity ranges, low, moderate or high.  Parents of children with a confirmed disability had slightly higher levels of PSOC (M=57.02, SD=10.83) than parents of children with a suspected disability (M=53.50SD=8.92).  Both individual groups had mean scores in the moderate acuity range.  The mean scores of the total group (M=61.45) suggest that participants in this study had moderate levels of self-efficacy in the parenting role.
The mean and standard deviation scores of parents of children with a confirmed and suspected disability on the parenting sense of competence satisfaction subscale.  Parents of children with a confirmed disability reported mean scores of 31.70 and a standard deviation of 7.18 (M=31.70 SD=7.18), parents of children with a suspected disability reported mean scores of 30.38 and a standard deviation of 8.40 (M=30.38 SD=8.40).   (see Table 5‑2 Mean and Standard Deviation for PSOC satisfaction sub-scale).
Table 5‑2 Mean and Standard Deviation for PSOC satisfaction sub-scale

  
PSOC Scale
  
Variable
  
N
  
Mean
 
  
SD
Satisfaction 
Subscale
Parents of children with a confirmed disability 260 31.70 7.18
Parents of children with a suspected disability. 24 30.38 8.40
Total Parental PSOC Score on satisfaction 
subscale
284 31.59 7.28

The PSOC sub-scale satisfation scores range between 17 and 102.  There is a scoring algorithm leading to one of three acuity ranges, low, moderate or high.  Parents of children with a confirmed disability had slightly higher levels of PSOC (M=31.70, SD=7.18) than parents of children with a suspected disability (M=30.38SD=8.40).  Both individual groups had mean scores in the low acuity range.  The total score for both groups combined (M=31.59, SD=7.28) had an acuity range of low. The mean scores of the total group (M=31.59) suggest that participants in this study had low levels of self-efficacy in the parenting role in the satisfaction scale.
The mean and standard deviation scores of parents of children with a confirmed disability and parents of children with a suspected disability on the parenting sense of competence efficacy subscale.  Parents of children with a disability reported mean scores of 30 and a standard deviation of 6.28 (M=30, SD=6.28), parents of children with a suspected disability reported mean scores of 27.83 and a standard deviation of 6.98 (M=27.83 SD=6.98).  (see Table 5‑3  Mean and Standard Deviation for PSOC efficacy sub-scale).
Table 5‑3  Mean and Standard Deviation for PSOC efficacy sub-scale

  
PSOC Scale
  
Parents
  
N
  
Mean
 
  
SD
Efficacy 
subscale
Parents of children with a confirmed disability 266 30 6.28
Parents of children with a suspected disability. 24 27.83 6.98
Total Parental PSOC Score on efficacy subscale 290 29.82 6.36

The PSOC sub-scale efficacy scores range between 17 and 102.  There is a scoring algorithm leading to one of three acuity ranges, low, moderate or high.  Parents of children with a confirmed disability had slightly higher levels of PSOC (M=30, SD=6.28) than parents of children with a suspected disability (M=27.83SD=6.98).  Both individual groups had mean scores in the low acuity range.  The total score for both groups combined (M=29.82 SD=6.36) had an acuity range of low.  The mean scores of the total group (M=29.82) suggest that participants in this study had low levels of self-efficacy in the parenting role in the efficacy scale.

5.4    Mean and Standard Deviations Parental Stress Scale

The mean scores on the parental stress scale reflect the strength of ones levels of parental  stress .  The minimum score range is 18, and maximum score range is 90.  A higher score represents higher parental stress levels.  Participants within this study had a range of scores between 34 and 77.  The mean scores of the total group (M=58.23) suggest that participants in this study had moderate levels of stress .
 
The mean and standard deviation scores of parents of children with a confirmed disability and parents of children with a suspected disability on the parental stress scale.  Parents of children with a confirmed disability reported mean scores of 58.24 and a standard deviation of 8.39 (M=58.24, SD=8.39).  Parents of children with a suspected disability reported mean scores of 58.17 and a standard deviation of 6.55 (M=58.17, SD=6.55).  (see Table 5‑4 PSS Mean and Standard Deviation scores of parents of children with a confirmed and suspected disability).
Both groups reported scores above 50, which is considered to be within the moderate score range.  On average parents of children with a confirmed disability (M=58.24, SD=8.39) did not have significantly higher scores of parental stresses than parents of children with a suspected disability (M=58.17, SD=6.55).  (see Table 5‑4 PSS Mean and Standard Deviation scores of parents of children with a confirmed and suspected disability).
Table 5‑4 PSS Mean and Standard Deviation scores of parents of children with a confirmed and suspected disability.

  
Scale
  
Variable
  
N
  
Mean
 
  
SD
Parental stress Scale
Parents of children with a confirmed disability 266 58.24 8.39
Parents of children with a suspected disability. 24 58.17 6.55
Total PSS 
score.
290 58.23 8.24

 

6           Inferential Statistics

6.1    Hypothesis 1

H0 (Null Hypothesis): There will be no significant relationship between parental stress levels and parental self-efficacy Levels.
H(Alternate Hypothesis): There will be a significant relationship between parental stress levels and parental self-efficacy levels.
 
The relationship between parental stress (as measured by the PSS) and self-efficacy (as measured by the PSOC) was investigated using Pearson product-moment correlation coefficient. Preliminary analyses were performed to ensure no violation of the assumptions of normality, linearity and homoscedasticity. There was a strong, significant negative correlation between the two variables, (r = –.69, n = 284, p < .05), meaning that higher scores of parental self-efficacy was significantly negatively related to lower scores on stress the participants reported. A scatterplot summarises the results (Figure 6‑1 Scatterplot PSS levels and PSOC levels.)
Therefore, the null hypothesis is rejected, and the alternative hypothesis is retained.

Figure 6‑1 Scatterplot PSS levels and PSOC levels.

6.2    Hypothesis 2

H0 (Null Hypothesis): There will be no significant difference in the parental stress levels between parents of children who have received a confirmed disability and parents of children with a suspected disability waiting on assessment of need.
H(Alternate Hypothesis): There will be a significant difference in the parental stress levels between parents of children who have received a confirmed disability and parents of children with a suspected disability waiting on assessment of need.
An independent samples t-test was used to investigate significant differences in parental stress between parents of children with a confirmed disability and parents of children with a suspected disability.  There was no significant difference in the scores for parents of children with a confirmed diagnosis (M = 55.88, SD = 10.14) and parents of children with a suspected disability (M = 55.67, SD = 7.52; t (288) = .10, p>.05, two-tailed).
Therefore, the null hypothesis was retained.
(see Figure 6‑2 PSS scores of parents of children who have a confirmed disability and parents of children with a suspected disability.)
 

Figure 6‑2 PSS scores of parents of children who have a confirmed disability and parents of children with a suspected disability.

6.3    Hypothesis 3

H0 (Null Hypothesis): There will be no significant difference in the Self-efficacy levels between parents of children who have received a confirmed disability and parents of children with a suspected disability waiting on assessment of need.
H(Alternate Hypothesis): There will be a significant difference in the Self-efficacy levels between parents of children who have received a confirmed disability and parents of children with a suspected disability waiting on assessment of need.
An independent samples t-test was used to investigate Significant differences in parental self-efficacy scores between parents of children with a confirmed diagnosis and parents of children with a suspected disability.  There was no significant difference in the scores for parents of children with a confirmed diagnosis (M = 61.75, SD = 11.31) and parents of children with a suspected disability (M = 58.21, SD = 9.20; t (282) = 1.49, p>.05, two-tailed).
Therefore, the Null Hypothesis was retained.
(see Figure 6‑3 PSE scores of parents of children with a confirmed diagnosis and parents of children with a suspected diagnosis on the PSOC).
An independent samples t-test was used to investigate significant differences in parental self-efficacy scores on the efficacy subscale between parents of children with a confirmed diagnosis and parents of children with a suspected disability.  There was no significant difference in the scores for parents of children with a confirmed diagnosis (M =30.00, SD = 6.29) and parents of children with a suspected disability (M = 27.83, SD = 6.90; t (288) = 1.60, p>.05, two-tailed).
Therefore, the Null Hypothesis was retained.
(see Figure 6‑3 PSE scores of parents of children with a confirmed diagnosis and parents of children with a suspected diagnosis on the PSOC).
An independent samples t-test was used to investigate significant differences in parental self-efficacy on the satisfaction subscale between parents of children with a confirmed diagnosis and parents of children with a suspected disability.  There was no significant difference in the scores for parents of children with a confirmed diagnosis (M = 31.70, SD = 7.18) and parents of children with a suspected disability (M = 30.38, SD = 8.40; t (282) = .85, p>.05, two-tailed).
Therefore, the Null Hypothesis was retained.
(see Figure 6‑3 PSE scores of parents of children with a confirmed diagnosis and parents of children with a suspected diagnosis on the PSOC).

Figure 6‑3 PSE scores of parents of children with a confirmed diagnosis and parents of children with a suspected diagnosis on the PSOC, efficacy and satisfaction sub-scale.

7           Discussion

7.1    Aims and Results and Interpretations of Findings

The aim of the current research study was to investigate parental stress and parental self-efficacy levels as reported by parents of children with disabilities in Ireland.

7.1.1        Hypothesis 1

The first hypothesis investigated to determine if there was a significant relationship between parental stress levels and parental self-efficacy levels in parents of children with disabilities.  A significant negative relationship was found when analysing the data indicating that a high level of parental stress correlates with a low level of self-efficacy and a high level of parental self-efficacy, correlates with a low level of stress. This result was not a surprise as it supports previous research by Galanakis, et. al, (2016) which found that there was a strong correlation between stress and self-esteem.
Further research which examined stress levels in mothers of children indicated that mothers of children with disabilities experienced high levels of depressive symptoms and anxiety, hence, it also suggested that parents who reported high levels of personal satisfaction in parenting reported low levels of depression (Weiss, 2002).  The results lend support to a literature review done of parental stress in families of children with disabilities by Dervishaliaj (2013), reporting that parents of children with disabilities do not just experience higher stress levels but their mental health can also be affected.  She goes on to add that parents can suffer from depression anxiety, higher levels of guilt and failure, higher levels of hopelessness and also less marital satisfaction.

7.1.2        Hypothesis 2

The second research question aimed to investigate if there was a significant difference in the stress levels between parents of children who have received a confirmed disability diagnosis and parents of children with a suspected disability who are waiting on assessment of need.  A significant difference was not found.  This finding contrasts with previous research which suggests that some parents have a sense of relief following the diagnosis as it puts an end to the worrying and doubts they experience and provides answers which the researchers suggest results in reduced stress (Martin & Colbert, 1997).  However, the fact that a significant difference was not found may be due to the fact that prior to diagnosis, a parents wellbeing is affected by denial and disbelief which results in emotional stress and after diagnosis the stress is related to advocating for services and support for the child.  Although there is no difference in the stress felt by the parent, the stressor is different prior to and after diagnosis.  Martin and Colbert (1997) suggest that before the child had a diagnosis, the stress felt by parents was associated with their perceptions of their child’s development and post diagnosis stress was mostly related to social support.
Subsequently, the results correlate with research by Anderson (2010) which suggests that it is not easy to be a parent to a child with a disability.  She goes on to suggest that the job of a parent of a child with a disability quite often means worrying themselves sick, fighting for necessary services, sacrificing their career, high levels of debt, and anger at the injustice of it all.  This is in line with research which suggests that there are a lot of impacts on the family structure when raising children with disabilities (Edelson, 2008; Hinshaw, 2005).  The experiences parenting a child with a disability can be different depending on the specific need of the child, however, there are commonalities between the stressors experienced by parents of children with different challenges and as the research suggests, stress is present prior to and following diagnosis, even if the predicted stressors are different.

7.1.3        Hypothesis 3

The third research question aimed to investigate if there was a significant difference in the self-efficacy levels between parents of children who have received a confirmed diagnosis of a disability and parents of children with a suspected disability waiting on assessment of need.  A significant difference was not found.  The results suggest that following a diagnosis of a disability, there is no change in the self-efficacy levels felt by parents of children with a suspected disability.  However, with parents of children with a disability reporting lower parental self-efficacy than parents of typical children, research recently reported that accessing services can be challenging for parents and consequently this can cause low self-efficacy in parents.  Furthermore, it goes on to suggest that these low levels of self-efficacy are positively correlated with greater mood disorders (Panditaratne & Donnelly, 2017).  This seems to indicate that the things that become stressors in the life of a parent of a child with a disability may not become a stress or to a parent of a typical child.  Again, this this result conflicts with research by Martin and Colbert (1997) suggesting that some parents have a sense of relief following the diagnosis of their child.
These results also align with Bandura (1977) and his theory of Social Cognition.  Bandura suggests that self-efficacy is an individual’s perceived ability to achieve a task, hence, that perception has direct influences on that individual’s performance.  In the context of parenting a child with a disability or suspected disability, the theory of Social Cognition demonstrates how, if the parent perceives they don’t have the ability to do something, then the child being either undiagnosed or diagnosed with a disability does not affect their perception of their ability.

7.2    Strengths and Limitations of Present Research

A gender imbalance was noted as one of the main limitations of the present study.  The male population was underrepresented in the study with a total sample size made up of 285 females and 5 males (N=290) which could contribute to a gender imbalance.  Although parental participation was encouraged within the research study, just 1.72% of the responding sample were male.
There were some limitations to the PSOC, firstly, the PSOC scale had questions which are aimed at “mothers” rather than parents or guardians.  There were comments made by some male participants who felt that they weren’t eligible to participate in the study as they were obviously not mothers.  This may have been the cause of some fathers not participating in the study.  The second limitation of the PSOC is the fact that the questionnaire is recommended for children from the ages of 5 to 12.  In the current study, the ages of participants children ranged from a minimum of 3 to a maximum of 18.  As some of the participants are outside the recommended age scale of the instrument, it may have picked up data which was not sufficient to the current study.
Results of the research indicated that there was a non-significant result in the levels of stress and self-efficacy between parents of children with a confirmed disability and parents of children with a suspected disability.  This may be due to the fact that whilst both variable groups are experiencing stress, there is no change to the stress once diagnosis is made.  Alternatively, it may suggest that the research instrument was not sensitive enough to pick up on the changes of stress and self-efficacy of parents who were waiting for diagnosis and those who have an official diagnosis.
A strength of the study was the use of online questionaires which helped with the high response rate.  Some participants did not answer all the questions in the study.  This could be related to technology issues or could be related to a lack of understanding of the content of the questions by the study participants.  However, in contrast to this, there could have been less participants if this research was done as a standard pen and paper exercise as there would not have been access to such many recipients in such short period of time.
It is also noted that although a random sampling technique was utilised to
recruit participants, participants self subscribed to the study, therefore, the results of this study cannot be guaranteed to reflect the perceptions of the overall population of parents of children with a disability.

7.3    Recommendations for Future Research

With only 2% of the total sample being male, there is a gender imbalance present in the research study.  If the research was to be repeated, significantly more effort to recruit a male sample population to participate in the study should be undertaken as this would bring about a gender balance result to the research.  There are Facebook groups for “Fathers of children with disabilities” which could be targeted for the study.  Another way to encourage additional male participation is to ask each female participant to share with their spouse.
It is recommended that future research should involve rewording questions on the PSOC research instrument that relate to mothers to “parent or guardian” or to find an alternative questionnaire that could better fit the research.

7.4    Conclusion

It was the aim of the current study to investigate parental stress and parental self-efficacy in parents of children with disabilities in Ireland.  The current study also sought to examine if significant differences existed between the stress and self-efficacy levels of parents of children with a confirmed disability and parents of children with a suspected disability.
Whilst there was a significant negative relationship between self-efficacy and parental stress levels overall, there was no significant difference between the stress and self-efficacy levels felt by parents of children who were diagnosed when correlated with parents of children who had a suspected diagnosis.
The study has highlighted that there is in fact a significant negative relationship between parental stress and self efficacy in parents of children with a disability.  The fact that the child has or has not received an official diagnosis does not make any significant difference to the stress and self-efficacy levels felt by parents
Although this study contributes in a small manner to the limited research into the area stress and self-efficacy levels of parents of children with disabilities, it can be used to support further research.
References



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