Article in Press
Back to the articles list |
Back to browse issues page
Department of Nursing, Faculty of Nursing, Birjand University of Medical Sciences, Birjand, Iran
Abstract: (13 Views)
Introduction: Cerebral palsy (CP) is a lifelong neurodevelopmental condition that poses significant physical, psychological, and social challenges for both the affected child and the family. Caring for a child with CP often exposes parents to chronic stress, emotional exhaustion, and a persistent sense of burden that may lead to parental burnout. Despite growing attention to caregiver stress, the underlying processes and contextual factors contributing to parental burnout, particularly within the context of trauma and prolonged psychological pressure, remain poorly understood. This study aimed to explain the process of burnout among parents of children with cerebral palsy in the context of trauma and psychological stressors.
Methods: This qualitative study used grounded theory. Participants were the primary caregiver parents (mothers and fathers) from two-parent households whose children had a confirmed CP diagnosis for at least one year. Sampling was conducted using purposive and theoretical approaches. Data were collected via in-depth semi-structured interviews with parents and, when theoretically necessary, with members of the healthcare team. Data collection and analysis were conducted concurrently, following Strauss and Corbin's (2015) approach, until theoretical saturation was achieved. Ethical approval was obtained from the Ethics Committee of Birjand University of Medical Sciences, Birjand, Iran.
Results: This study's findings led to the development of a locally and culturally grounded theoretical model explaining the process, stages, and contextual conditions influencing parental burnout among parents of children with CP in Iran. The model clarified the dynamic interactions between trauma, psychological stressors, and long-term caregiving demands, offering a comprehensive understanding of how burnout emerges and changes over time.
Conclusions: These results guide future empirical research and provide a foundation for developing tailored interventions and supportive policies in this context, ultimately enhancing family well-being and strengthening evidence-based care for children with CP.
Methods: This qualitative study used grounded theory. Participants were the primary caregiver parents (mothers and fathers) from two-parent households whose children had a confirmed CP diagnosis for at least one year. Sampling was conducted using purposive and theoretical approaches. Data were collected via in-depth semi-structured interviews with parents and, when theoretically necessary, with members of the healthcare team. Data collection and analysis were conducted concurrently, following Strauss and Corbin's (2015) approach, until theoretical saturation was achieved. Ethical approval was obtained from the Ethics Committee of Birjand University of Medical Sciences, Birjand, Iran.
Results: This study's findings led to the development of a locally and culturally grounded theoretical model explaining the process, stages, and contextual conditions influencing parental burnout among parents of children with CP in Iran. The model clarified the dynamic interactions between trauma, psychological stressors, and long-term caregiving demands, offering a comprehensive understanding of how burnout emerges and changes over time.
Conclusions: These results guide future empirical research and provide a foundation for developing tailored interventions and supportive policies in this context, ultimately enhancing family well-being and strengthening evidence-based care for children with CP.
Type of Study: Study protocol |
Subject:
Nursing
Received: 2025/11/3 | Accepted: 2025/12/14 | ePublished ahead of print: 2025/12/20
Received: 2025/11/3 | Accepted: 2025/12/14 | ePublished ahead of print: 2025/12/20
References
1. Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr. 2020;9(1):125-35. [DOI:10.21037/tp.2020.01.01]
2. Mohammadnia M, Hosseinkhanzadeh AA. Identifying and prioritizing the needs of parents of children with cerebral palsy. J Child Ment Health. 2020;7(1):181-92. [DOI:10.29252/jcmh.7.1.16]
3. Alaee N, Shahboulaghi FM, Khankeh H, Mohammad Khan Kermanshahi S. Psychosocial challenges for parents of children with cerebral palsy: A qualitative study. J Child Fam Stud. 2015;24(7):2147-54. [DOI:10.1007/s10826-014-0016-3]
4. Chiluba BC, Moyo G. Caring for a cerebral palsy child: a caregivers perspective at the University Teaching Hospital, Zambia. BMC Res Notes. 2017;10(1):724. [DOI:10.1186/s13104-017-3011-0]
5. Jenaabadi H. The study and comparison of stress levels and coping strategies in parents of exceptional (mentally retarded, blind and deaf) and normal children in Zahedan. Procedia Soc Behav Sci. 2014;114:197-202. [DOI:10.1016/j.sbspro.2013.12.684]
6. Malekshahi F, Rezaian J, Almasian M. Intellectually Disabled Children and Their Parents' Problems: Preliminary Evaluation and the Suggestion of Effective Strategies. Crescent J Med Biol Sci. 2020;7(3):336-41.
7. van der Kemp J, Ketelaar M, Rentinck I, Sommers-Spijkerman M, Benders M, Gorter J. Exploring parents' experiences and needs during disclosure of a cerebral palsy diagnosis of their young child: A scoping review. Child Care Health Dev. 2024;50(6):e13327. [DOI:10.1111/cch.13327]
8. Lima MB, Ramos EM, Pontes FA, Silva SS. Cerebral palsy: parental stress of caregivers. Psico-USF. 2021;26(2):357-68. [DOI:10.1590/1413-82712021260213]
9. Raina P, O'Donnell M, Rosenbaum P, Brehaut J, Walter SD, Russell D, et al. The health and well-being of caregivers of children with cerebral palsy. Pediatrics. 2005;115(6):626-36. [DOI:10.1542/peds.2004-1689]
10. Basaran A, Karadavut KI, Uneri SO, Balbaloglu O, Atasoy N. The effect of having a children with cerebral palsy on quality of life, burn-out, depression and anxiety scores: a comparative study. Eur J Phys Rehabil Med. 2013;49(6):815-22.
11. Vadivelan K, Sekar P, Sruthi SS, Gopichandran V. Burden of caregivers of children with cerebral palsy: an intersectional analysis of gender, poverty, stigma, and public policy. BMC Public Health. 2020;20(1):645. [DOI:10.1186/s12889-020-08808-0]
12. Dzielińska M, Lasota M, Piotrowski K. Parental Burnout Among Parents of Children with Disabilities and Chronic Illnesses. Psychologia Rozwojowa. 2023;28(2):135-52. [DOI:10.4467/20843879PR.23.021.19914]
13. Paula AJ, Condeles PC, Moreno AL, Ferreira MB, Fonseca LM, Ruiz MT. Parental burnout: a scoping review. Rev Bras Enferm. 2021;75(3):e20210203. [DOI:10.1590/0034-7167-2021-0203]
14. Mrosková S, Reľovská M, Schlosserová A. Burnout in parents of sick children and its risk factors: a literature review. Cent Eur J Nurs Midw 2020;11(4):196-206. [DOI:10.15452/cejnm.2020.11.0015]
15. Mikolajczak M, Brianda ME, Avalosse H, Roskam I. Consequences of parental burnout: its specific effect on child neglect and violence. Child Abuse Negl. 2018;80:134-45. [DOI:10.1016/j.chiabu.2018.03.025]
16. Mikolajczak M, Roskam I. A theoretical and clinical framework for parental burnout: The balance between risks and resources (BR2). Front Psychol. 2018;9:886. [DOI:10.3389/fpsyg.2018.00886]
17. Davenport S, Zolnikov TR. Understanding mental health outcomes related to compassion fatigue in parents of children diagnosed with intellectual disability. J Intellect Disabil. 2022;26(3):624-36. [DOI:10.1177/17446295211013600]
18. Sonune SP, Gaur AK, Shenoy AJJofm, care p. Prevalence of depression and quality of life in primary caregiver of children with cerebral palsy. J Family Med Prim Care. 2021;10(11):4205-11. [DOI:10.4103/jfmpc.jfmpc_70_21]
19. Vicentic S, Sapic R, Damjanovic A, Vekic B, Loncar Z, Dimitrijevic I, et al. Burnout of formal caregivers of children with cerebral palsy. 2016;53(2):10-5.
20. Obembe OB, Adeyemo S, Ogun OC, Ijarogbe GT. The relationship between coping styles and depression among caregivers of children with cerebral palsy in Nigeria, West Africa. Arch Clin Psychiatry. 2019;46(6):145-50. [DOI:10.1590/0101-60830000000215]
21. Ren X, Cai Y, Wang J, Chen O. A systematic review of parental burnout and related factors among parents. BMC public health. 2024;24(1):376. [DOI:10.1186/s12889-024-17829-y]
22. Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. 4th ed. Thousand Oaks, CA: SAGE; 2015.
23. Mohajan, D, & Mohajan, HK. Development of Grounded Theory in Social Sciences: A Qualitative Approach. Studies in Social Science & Humanities. 2022;1(5), 13-24. [DOI:10.56397/SSSH.2022.12.02]
24. Ruslin R, Mashuri S, Rasak MS, Alhabsyi F, Syam H. Semi-structured Interview: A methodological reflection on the development of a qualitative research instrument in educational studies. Journal of Research & Method in Education. 2022;12(1):22-9.
25. Thomson SB. Sample size and grounded theory. J Admin and Governance. 2010;5(1):45-52.
26. Birks M, Mills J, Francis K, Chapman Y. A thousand words paint a picture: the use of storyline in grounded theory research. J Res Nurs. 2009; 14(5): 405-17. [DOI:10.1177/1744987109104675]
27. Hernández Merino A. Helsinki declaration: ethical principles of medical research with human beings. 2024 review. Rev Pediatr Aten Primaria. 2024;26(104):439-43. [DOI:10.60147/fab6cdec]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Attribution-NoneCommercial CC BY-NC
