E-ISSN 1858-8360 | ISSN 0256-4408
 

Original Article

Online Publishing Date:
22 / 06 / 2023

 


SUDANESE JOURNAL OF PAEDIATRICS

2023; Vol 23, Issue No. 1

ORIGINAL ARTICLE

The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina

Alma Glinac (1,2), Selma Sinanovic (3), Lejla Glinac (4), Lejla Matovic (1)

(1) Department of Physical Medicine and Rehabilitation, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina

(2) Faculty of Education and Rehabilitation, University of Tuzla, Tuzla, Bosnia and Herzegovina

(3) University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina

(4) Health Care Center Dr “Mustafa Šehović,” Tuzla, Bosnia and Herzegovina

Correspondence to:

Alma Glinac

Department of Physical Medicine and Rehabilitation, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.

Email: glinacalma [at] gmail.com

Received: 21 September 2020 | Accepted: 28 March 2022

How to cite this article:

Glinac A, Sinanovic S, Glinac L, Matovic L. The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudan J Paediatr. 2023;23(1):60–67. https://doi.org/10.24911/SJP.106-1600718620

ABSTRACT

The aim of the study was to examine the impact of the quality of life of children with cerebral palsy (CP) on the quality of life of mothers. A total of 122 subjects participated in the study. The general quality of life assessment of paediatric subjects PedsQLTM 4.0 Generic Scale and the specific PedsQLTM 3.0 Module Cerebral Palsy Version 3.0 were used to assess the quality of life of children with CP, and the quality of life of mothers was assessed with the PedsQLTM 2.0 Family Impact Mode Questionnaire. In the present study, the quality of life of mothers is influenced by the physical and social functioning of the child, while the impact of emotional functioning has not been proven. The specific difficulties faced by children with CP, which have a statistically significant effect on the overall quality of life of the mother, are present in the domains: daily activities, mobility and balance and nutrition. The assessment of the quality of life of mothers and children with CP should be an integral part of the clinical assessment, as this will enable professionals to participate more successfully in providing professional assistance in the form of services, therapeutic approaches and prevention programs.


Keywords:

Quality of life of mothers; Cerebral palsy; Evaluation; Disability.


INTRODUCTION

Childcare is considered to be a common and normal parental obligation. The increased intensity of care for children with longtime limitations can become a burden for parents and affect their mental and physical health [14].

It is mothers who usually take over the care of diseased children [5,6]. They spend most of the time with the child from the earliest days, which is especially emphasised when it comes to a diseased child, so that they also bear the brunt of the burden in families with a child with disabilities. The mother must face the child’s diagnosis, provide her/him with special care, be actively involved in the treatment program, her lifestyle is adapted to the child’s condition [79], stays with the child in hospitals during frequent and long hospitalizations, and is under the greatest emotional strain due to their child’s condition [10]. Cerebral palsy (CP) is a non-progressive, permanent developmental disorder [11,12]. It is defined as a chronic condition characterised by a number of functional limitations resulting from damage to the developing central nervous system [13,14]. Damage that occurs in the foetal brain or early in life can lead to sensory, cognitive and motor disorders with certain functional limitations. Children may have difficulties in self-care (feeding, dressing and personal hygiene) and mobility [15]. The worldwide prevalence of this disorder is estimated at 2–2.5 cases per 1,000 live births in developed and around 7 per 1,000 newborns in underdeveloped countries [16,17]. The quality of life is defined as the individual experience of satisfaction with all aspects of life, that is, the perception of one’s own well-being and satisfaction with life, including physical, social, economic and psychological well-being, as well as a sense of positive social inclusion and the ability to realise one’s own potential [1820].

Measuring the quality of life of persons caring for children with chronic illnesses provides insight into the difficulties they face in the ongoing process of nurturing and caring for a child [21,22]. In this study, we were interested in whether the quality of life of a child with CP influences the quality of life of their mothers.


MATERIALS AND METHODS

Sample

A total of 122 subjects (61 children and 61 mothers) participated in the study. The sample was consecutive and consisted of children with CP and their mothers who bring them for examination or outpatient treatment at the Clinic for Physical Medicine and Rehabilitation of the University Clinical Center Tuzla or at the Center for Children with Multiple Disorders ‘Koraci nade’ in Tuzla. The criteria for participation in the study were for children: age 5–18 years, diagnosed with spastic form of CP, signed informed consent of parents to participate in the study, with permanent residence in the Tuzla Canton. Excluding criteria are respondents under 5 and over 18 years, respondents who, due to their level of mental development and education, are unable to complete the quality of life questionnaires independently, refusing to participate and sign informed consent. Including criteria for mothers: to have a child with CP (spastic form) aged 5 to 18 years, not to have children diagnosed additionally with a chronic illness and not to have any other diseased children in the family, mothers not diagnosed with a mental and/or chronic illness before the birth of a child, with permanent residence in the Tuzla Canton.

Measuring instrument and procedure

The General PedsQL™ 4.0 Questionnaire consists of 23 questions divided into 4 areas: physical health and activities: (8 questions), emotional health (5 questions), social activities (5 questions) and school/kindergarten activities (5 questions) [23]. The Specific Questionnaire PedsQL™ Modul Cerebral Palsy Version 3.0 contains a total of 35 ranging from 7 areas: daily activities (9 questions), school activities (4 questions), mobility and balance (5 questions), pain (4 questions), fatigue (4 questions), nutrition (5 questions), speech and communication (4 questions). The Questionnaire PedsQL™ 2.0 Family Impact Mode contains eight subscales with a total of 36 questions as follows: physical functioning (6 questions), emotional functioning (5 questions), social functioning (4 questions), cognitive functioning (5 questions), communication (3 questions), worries (5 questions), daily activities (3 questions) and family relations (5 questions) [24]. Questions are given in each section of the questionnaire referring to problems that a child and a mother have in performing certain activities as a result of the child’s health, during the last month and one answer is selected. A three-step Likert’s scale was used for the age 5–7 (0=it never presents a problem, 2=it sometimes presents a problem, 4=it almost always presents a problem) and a five-step scale was used for children aged 8–18 years and for reports received from mothers (0=it never presents a problem, 1=it almost never presents a problem, 2=it sometimes presents a problem, 3=it often presents a problem and 4=it almost always presents a problem). During the data processing responses are graded in reverse and a linear transformation in the 0–100 scale (0=100, 1=75, 2=50, 3=25 and 4=0) is conducted so that the higher the sum of points, the better the quality of life. The total score is calculated as the arithmetic mean of the values of the questions answered. If more than 50% of the answers to questions in a particular area are missing, the results of that area do not count. If less than 50% of the answers to questions in a particular area are missing, it is necessary to calculate the average of the area based on the answered questions. Since more than 50% of children who participated in this research did not attend school/kindergarten, the domains of school/kindergarten activities, psycho-social functioning and overall score were not examined by general questionnaire [25].

Statistical analysis

The data were analysed using the Statistical Package for Social Sciences version 23 computer program (SPSS Inc., Chicago, IL). Descriptive methods were applied to represent the basic demographic characteristics of the sample. In order to check the normality of the data, the Kolmogorov–Smirnov test was applied, accepting significance at the p < 0.05 level. Since the data collected through the questionnaires did not follow the normal distribution, non-parametric statistical tests were used. The relationship between subjectively perceived quality of life of mothers (as measured by PedsQLTM 2.0) and subjectively experienced quality of life of children with CP (as measured by PedsQLTM 4.0 and PedsQLTM 3.0) was investigated using Spearman’s (rho) rank correlation.


RESULTS

Of the 61 children with CP, 33 (54%) were males and 28 (46%) were females. The median age of the mothers was 36 years (children 8.7 years). Nine (14.8%) children had spastic hemiplegia, 37 (60.7%) spastic diplegia and 15 (24.6%) spastic quadriplegia. There were 34 immobile examinees with CP (55.74%), movable with aids 14 (22.95%) and 13 (21.31%) who can move independently.

The conducted correlation analysis showed that the overall quality of life of mothers of children with CP depends on the physical and social functioning of the child, while the emotional functioning of the child does not significantly affect the quality of life of the mother (Table 1).

The coefficients of Spriman’s rank correlation show that of the specific difficulties encountered by children with CP, the domains of daily activity, mobility and balance and nutrition have the greatest influence on the overall subjectively perceived quality of life of mothers. The domains of pain, fatigue and speech and communication did not affect mothers’ overall quality of life (Table 2).

Table 1. Effect of physical, emotional and social functioning of children with CP measured with general questionnaire on specific domains of quality of life of mother.

Mothers PedsQLTM 2.0 PF EF SF CF C W DA FR OS
children PedsQLTM 4.0
PF1 Spearman 0.393** 0.396** 0.328** 0.410** 0.278* 0.160 0.472** 0.123 0.435**
p 0.002 0.002 0.010 0.001 0.030 0.218 0.000 0.345 0.000
N 61 61 61 61 61 61 61 61 61
EF1 Spearman 0.042 0.065 0.083 0.136 0.059 0.033 0.124 0.026 0.078
p 0.747 0.618 0.523 0.297 0.650 0.802 0.339 0.844 0.551
N 61 61 61 61 61 61 61 61 61
SF1 Spearman 0.312* 0.225 0.387** 0.342** 0.155 0.300* 0.265* 0.251 0.365**
p 0.015 0.081 0.002 0.007 0.232 0.019 0.039 0.051 0.004
N 61 61 61 61 61 61 61 61 61

C, Communication; CF, Cognitive functioning; DA, Daily activities; EF, Emotional functioning; FR, Family relations; PF, Physical functioning; OS, Overall score; SF, Social functioning; W, worries.

**Correlation significant at the level of 0.01; *Correlation significant at the level of 0.05.

Table 2. The effect of specific domains of quality of life of children with CP measured with specific questionnaire on the quality of life of mother.

Mothers PedsQLTM 2.0 FF EF DF KF K B DA PO OS
children PedsQLTM 3.0
DA1 Spearman 0.258* 0.327* 0.413** 0.318* 0.196 0.288* 0.384** 0.152 0.394**
p 0.045 0.010 0.001 0.013 0.131 0.024 0.002 0.242 0.002
N 61 61 61 61 61 61 61 61 61
W1 Spearman 0.315* 0.353** 0.368** 0.437** 0.225 0.179 0.555** 0.157 0.438**
p 0.013 0.005 0.004 0.000 0.081 0.166 0.000 0.228 0.000
N 61 61 61 61 61 61 61 61 61
F Spearman 0.008 −0.014 −0.037 0.202 −0.200 −0.123 0.048 −0.312* −0.024
p 0.950 0.916 0.778 0.119 0.878 0.346 0.715 0.014 0.852
N 61 61 61 61 61 61 61 61 61
NUT Spearman 0.258* 0.260* 0.235 0.214 0.241 0.294* 0.256* 0.239 0.338**
p 0.044 0.043 0.068 0.098 0.061 0.021 0.046 0.063 0.008
N 61 61 61 61 61 61 61 61 61
SC Spearman 0.118 0.295* 0.142 0.297* 0.307* 0.061 0.384** −0.094 0.235
p 0.367 0.021 0.276 0.020 0.016 0.640 0.002 0.472 0.068
N 61 61 61 61 61 61 61 61 61

C, Communication; CF, Cognitive functioning; DA, Daily activities; EF, Emotional functioning; F, Fatigue; FR, Family relations; MB, Mobility and balance; NUT, Nutrition; P, Pain; PF, Physical functioning; OS, Overall score; SC, Speech and communication; SF, Social functioning; W, worries.

**Correlation significant at the level of 0.01; *Correlation significant at the level of 0.05.


DISCUSSION

Analysing the results of this study, which examined the impact of results on specific domains of quality of life of children with CP on certain domains of quality of life of mothers, we found that the physical functioning of the child was related to physical (Spearman’s rho=0.393; p=0.002), emotional (Spearman’s rho=0.396; p=0.002), social (Spearman’s rho=0.328; p=0.010) and cognitive (Spearman’s rho=0.278; p=0.030) maternal functioning, with daily activities (Spearman’s rho=0.472; p=0.000) and overall quality of life (Spearman’s rho=0.435; p=0.000) of the mother, whereas no relatedness has been demonstrated with care and family relationships. Social functioning of the child is associated with social functioning (Spearman’s rho=0.387; p=0.002), cognitive functioning (Spearman’s rho=0.342; p=0.007) and overall quality of life of the mother (Spearman’s rho=0.365; p=0.004), while it is less closely related to physical functioning (Spearman’s rho=0.312; p=0.015), care (Spearman’s rho=0.300; p=0.019), and mother’s daily activities (Spearman’s rho=0.265; p=0.051). There is no correlation between the child’s social functioning and the mother’s quality of life in the areas of emotional functioning, communication and family relationships. Furthermore, the results showed that the child’s emotional functioning did not significantly affect the examined domains of the mother’s quality of life.

Glasscock [26] and Koman et al. [27]. indicate that CP has not only a medical but also social, psychological and economic impact on the overall quality of life of a person with CP and her/his environment, which is consistent with the results of our research. Numerous studies have shown that the psychological and physical health of a parent is greatly influenced by the child’s developmental status, her/his behaviour and the demands placed before her/him [28,29]. A study involving 818 respondents from 7 countries showed that the severity of motor and intellectual impairment in children with CP was strongly associated with a poorer parental report on quality of life in the domains of physical well-being, autonomy and social support [30]. Our results are in concordance with the results of studies confirming that the constant care of a child with CP adversely affects the physical domain of caregiver’s quality of life [2 22,31,32]. In our study, no association was found between the physical, social and emotional functioning of a child and the quality of family relationships, but according to some studies parents of children with the most severe disabilities or health needs were at the highest risk for problems with family functioning [33].

The results of our study indicate that among specific difficulties encountered by children with CP, the overall quality of life of mothers is moderately influenced by the results achieved in the domains of daily activities (Spearman’s rho=0.394; p=0.002), mobility and balance (Spearman’s rho=0.438; p=0.000) and nutrition (Spearman’s rho=0.338; p=0.008). The overall quality of life of the mother was not affected by the domains of pain, fatigue and speech and communication of a child.

Long-term care of a child with CP can affect the physical, social and emotional health of the caregiver, as well as their well-being, marital status, employment and financial status [34,35] and social relationships [36]. All the above mentioned can later lead to a deterioration in the health and quality of life related to the caregiver’s health [11,15,3743]. For the organization of family life with a child with CP, the functional abilities of the child which mainly depend on the degree of disability, are paramount. The independence of the child in daily life does not require family members to increase the amount of time, effort and care needed, nor does it require special organization in the child’s environment. The restriction on the independence of the child presents a greater burden for parents [44,45]. Often, family members face difficulties while completing all the demands of daily life, and they also struggle to maintain interpersonal relationships [46]. Mothers invest a lot of time in childcare and do not have enough time to meet their own social needs, which has an impact on physical and mental health, well-being, marital status, employment, financial situation and sometimes mental well-being [34], and it can lead to the redefinition of family roles, which can result in a decrease of income and a decrease in maternal independence [47]. The most common difficulties that parents of children with CP report in studies are: altered relationships with friends, major changes in family activities, health problems, medical costs, the need for specialised childcare, time-consuming responsibilities, as well as intra-family tension [48]. It is therefore essential that professionals include not only children but the whole family in the CP-induced treatment [49], and understanding how child’s condition can affect the caregivers can improve the treatment of the whole family [50].


CONCLUSION

The quality of life of mothers’ of children with CP depends on the quality of life of their children. The quality of life of mothers is influenced by the physical and social functioning of a child, whereas it is not influenced by emotional functioning. Specific difficulties that children with CP face and that have statistically significant impact on the overall quality of life of the mother are present in the following domains: daily activities, mobility and balance and nutrition. The assessment of the quality of life of mothers and children with CP should be an integral part of the clinical assessment, as this will enable professionals to identify determinants of the quality of life of these populations and to participate more successfully in providing professional assistance in the form of services, therapeutical approaches and prevention programs.


REFERENCES

  1. Benjak T, Vuletić Mavrinac G, Pavić Simetin I. Comparative study on self-perceived health of parents of children with autism spectrum disorders and parents of non-disabled children in Croatia. Croat Med J. 2009;50(4):403–9. https://doi.org/10.3325/cmj.2009.50.403
  2. Brehaut JC, Kohen DE, Raina P, Walter SD, Russell DJ, Swinton M, et al. The health of primary caregivers of children with cerebral palsy: how does it compare with that of other Canadian caregivers? Pediatrics. 2004;114(2):e182–91. https://doi.org/10.1542/peds.114.2.e182
  3. DeMarle J, Pieter le Roux D. The life cycle and disability: experiences of discontinuity in child and family development. J Loss Trauma. 2001;6(1):29–43. https://doi.org/10.1080/108114401753197459
  4. Plant KM, Sanders MR. Reducing problem behavior during care-giving in families of preschool-aged children with developmental disabilities. Res Dev Disabil. 2007;28(4):362–85. https://doi.org/10.1016/j.ridd.2006.02.009
  5. Leggatt M. The role of family organizations in mental health care. Fam Mental Disord Burden Empower. 2005:192–216. https://doi.org/10.1002/0470024712.ch9
  6. Kuipers E, Bebbington P, Barrowclough B. Research on burden and coping strategies in families of people with mental disorders: problems and perspectives. Fam Mental Disord Burden Empower. 2005:217–34. https://doi.org/10.1002/0470024712.ch10
  7. Button S, Pianta RC, Marvin RS. Partner support and maternal stress in families raising young children with cerebral palsy. J Dev Phys Disabil. 2001;13(1):61–81. https://doi.org/10.1023/A:1026509400487
  8. Ketelaar M, Volman MJ, Gorter JW, Vermeer A. Stress in parents of children with cerebral palsy: what sources of stress are we talking about? Child Care Health Dev. 2008;34(6):825–9. https://doi.org/10.1111/j.1365-2214.2008.00876.x
  9. Sen E, Yurtsever S. Difficulties experienced by families with disabled children. J Spec Pediatr Nurs. 2007;12(4):238–52. https://doi.org/10.1111/j.1744-6155.2007.00119.x
  10. Goldbeck L. Parental coping with the diagnosis of childhood cancer: gender effects, dissimilarity within couples, and quality of life. Psychooncology. 2001;10(4):325–35. https://doi.org/10.1002/pon.530
  11. Ones K, Yilmaz E, Cetinkaya B, Caglar N. Assessment of the quality of life of mothers of children with cerebral palsy (primary caregivers). Neurorehabil Neural Repair. 2005;19(3):232–7. https://doi.org/10.1177/1545968305278857
  12. Neves EB. Trends in neuropediatric physical therapy. Front Public Health. 2013;1:5. https://doi.org/10.3389/fpubh.2013.00005
  13. Rethlefsen SA, Ryan DD, Kay RM. Classification systems in cerebral palsy. Orthop Clin North Am. 2010;41(4):457–67. https://doi.org/10.1016/j.ocl.2010.06.005
  14. Snider L, Majnemer A, Darsaklis V. Virtual reality as a therapeutic modality for children with cerebral palsy. Dev Neurorehabil. 2010;13(2):120–8. https://doi.org/10.3109/17518420903357753
  15. Rodrigues dos Santos MT, Bianccardi M, Celiberti P, de Oliveira Guaré R. Dental caries in cerebral palsied individuals and their caregivers’ quality of life. Child Care Health Dev. 2009;35(4):475–81. https://doi.org/10.1111/j.1365-2214.2009.00976.x
  16. Blair E. Epidemiology of the cerebral palsies. Orthop Clin North Am. 2010;41(4):441–55. https://doi.org/10.1016/j.ocl.2010.06.004
  17. Rocha AP, Afonso DR, de Souza Morais RL. Relação entre desempenho funcional de crianças com paralisia cerebral e qualidade de vida relacionada à saúde de seus cuidadores. Fisioter Pesqui. 2008;15(3):292–7. https://doi.org/10.1590/S1809-29502008000300013
  18. De Melo EL, Corbella MB, Baz MB, Alonso MÁ, Martínez BA, Gómez-Vela M, et al. Calidad de vida en niños y adolescentes con parálisis cerebral. Rev Bras Promoç Saúde. 2013;25(4):426–34. https://doi.org/10.5020/18061230.2012.p426
  19. Majnemer A, Shevell M, Rosenbaum P, Law M, Poulin C. Determinants of life quality in school-age children with cerebral palsy. J Pediatr. 2007;151(5):470–5. https://doi.org/10.1016/j.jpeds.2007.04.014
  20. Waters E, Maher E, Salmon L, Reddihough D, Boyd R. Development of a condition-specific measure of quality of life for children with cerebral palsy: empirical thematic data reported by parents and children. Child Care Health Dev. 2005;31(2):127–35. https://doi.org/10.1111/j.1365-2214.2004.00476.x
  21. Driscoll KA, Montag-Leifling K, Acton JD, Modi AC. Relations between depressive and anxious symptoms and quality of life in caregivers of children with cystic fibrosis. Pediatr Pulmonol. 2009;44(8):784–92. https://doi.org/10.1002/ppul.21057
  22. Eker L, Tüzün EH. An evaluation of quality of life of mothers of children with cerebral palsy. Disabil Rehabil. 2004;26(23):1354–9. https://doi.org/10.1080/09638280400000187
  23. Varni JW, Seid M, Kurtin PS. PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care. 2001;39(8):800–12. https://doi.org/10.1097/00005650-200108000-00006
  24. Varni JW, Burwinkle TM, Berrin SJ, Sherman SA, Artavia K, Malcarne VL, et al. The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the generic core scales and cerebral palsy module. Dev Med Child Neurol. 2006;48(6):442–9. https://doi.org/10.1017/S001216220600096X
  25. Varni JW, Sherman SA, Burwinkle TM, Dickinson PE, Dixon P. The PedsQL family impact module: preliminary reliability and validity. Health Qual Life Outcomes. 2004;2(1):55. https://doi.org/10.1186/1477-7525-2-55
  26. Glasscock R. A phenomenological study of the experience of being a mother of a child with cerebral palsy. Pediatr Nurs. 2000;26(4):407–10.
  27. Koman LA, Smith BP, Shilt JS. Cerebral palsy. Lancet. 2004;363(9421):1619–31. https://doi.org/10.1016/S0140-6736(04)16207-7
  28. 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):e626–36. https://doi.org/10.1542/peds.2004-1689
  29. Vermaes IP, Janssens JM, Mullaart RA, Vinck A, Gerris JR. Parents’ personality and parenting stress in families of children with spina bifida. Child Care Health Dev. 2008;34(5):665–74. https://doi.org/10.1111/j.1365-2214.2008.00868.x
  30. Arnaud C, White-Koning M, Michelsen SI, Parkes J, Parkinson K, Thyen U, et al. Parent-reported quality of life of children with cerebral palsy in Europe. Pediatrics. 2008;121(1):54–64. https://doi.org/10.1542/peds.2007-0854
  31. Jelsma J, Mhundwa K, De Weerdt W, De Cock P, Chimera J, Chivaura V. The reliability of the Shona version of the EQ-5D. Cent Afr J Med. 2001;47(1):8–13. https://doi.org/10.4314/cajm.v47i1.8584
  32. Navaie-Waliser M, Feldman PH, Gould DA, Levine C, Kuerbis AN, Donelan K. When the caregiver needs care: the plight of vulnerable caregivers. Am J Public Health. 2002;92(3):409–13. https://doi.org/10.2105/AJPH.92.3.409
  33. Mulvihill BA, Wingate MS, Altarac M, Mulvihill FX, Redden DT, Telfair J, et al. The association of child condition severity with family functioning and relationship with health care providers among children and youth with special health care needs in Alabama. Matern Child Health J. 2005;9(2 Suppl):S87–97. https://doi.org/10.1007/s10995-005-3860-3
  34. Davis E, Shelly A, Waters E, Boyd R, Cook K, Davern M. The impact of caring for a child with cerebral palsy: quality of life for mothers and fathers. Child Care Health Dev. 2010;36(1):63–73. https://doi.org/10.1111/j.1365-2214.2009.00989.x
  35. Yilmaz H, Erkin G, İzki AA. Quality of life in mothers of children with cerebral palsy. ISRN Rehabil. 2013;2013:1–5. https://doi.org/10.1155/2013/914738
  36. Sawyer MG, Bittman M, La Greca AM, Crettenden AD, Borojevic N, Raghavendra P, et al. Time demands of caring for children with cerebral palsy: what are the implications for maternal mental health? Dev Med Child Neurol. 2011;53(4):338–43. https://doi.org/10.1111/j.1469-8749.2010.03848.x
  37. Berker AN, Yalçin MS. Cerebral palsy: orthopedic aspects and rehabilitation. Pediatr Clin North Am. 2008;55(5):1209–25. https://doi.org/10.1016/j.pcl.2008.07.011
  38. Shanbhag DN, Krishanmurthy A. Mental health and quality of life of caregivers of individuals with cerebral palsy in a community based rehabilitation programme in rural Karnataka. Disabil CBR Incl Dev. 2012;22(3):29–38. https://doi.org/10.5463/dcid.v22i3.56
  39. Jones MW, Morgan E, Shelton JE, Thorogood C. Cerebral palsy: introduction and diagnosis (part I). J Pediatr Health Care. 2007;21(3):146–52. https://doi.org/10.1016/j.pedhc.2006.06.007
  40. Oh H, Lee EK. Caregiver burden and social support among mothers raising children with developmental disabilities in South Korea. Int J Disabil Dev Educ. 2009;56(2):149–67. https://doi.org/10.1080/10349120902868624
  41. O’Shea TM. Diagnosis, treatment, and prevention of cerebral palsy. Clin Obstet Gynecol. 2008;51(4):816–28. https://doi.org/10.1097/GRF.0b013e3181870ba7
  42. Liptak GS, Accardo PJ. Health and social outcomes of children with cerebral palsy. J Pediatr. 2004;145(2 Suppl):S36–41. https://doi.org/10.1016/j.jpeds.2004.05.021
  43. Erdoğanoğlu Y, Günel MK. Serebral paralizili çocukların ailelerinin sağlıkla ilgili yaşam kalitelerinin araştırılması. Toplum Hekimliği Bülteni. 2007;26(2):35–9.
  44. Chodkowska M. Mieć dziecko z porażeniem mózgowym. Pamiętniki matek. Lublin, Poland: Pracownia Wydawnicza Fundacji Masz Szansę; 1995. Available from: https://www.ambulans.com.pl/niepenosprawnosc-intelektualna-i-fizyczna/25003-mie%C4%87-dziecko-z-pora%C5%BCeniem-m%C3%B3zgowym-pami%C4%99tniki-matek.html
  45. Parchomiuk M. Rodzice dzieci z mózgowym porażeniem dziecięcym wobec sytuacji trudnych. Lublin, Poland: Wydawnictwo Uniwersytetu Marii Curie-Skłodowskiej. 2007.
  46. Elllis JB, Hirsch JK. Reasons for living in parents of developmentally delayed children. Res Dev Disabil. 2000;21(4):323–7. https://doi.org/10.1016/S0891-4222(00)00045-7
  47. Langridge P. Reduction of chronic sorrow: a health promotion role for children’s community nurses? J Child Health Care. 2002;6(3):157–70. https://doi.org/10.1177/136749350200600302
  48. Pritzlaff A. Examing the coping strategies of parents who have children with disabilities. (Unpublished research paper). Menomonie, WI: University of Wisconsin- Stout; 2001.
  49. Miller F. Knee, leg, and foot. In: Cerebral palsy. New York, NY: Springer; 2005, pp 667–802. Available from: https://link.springer.com/chapter/10.1007/0-387-27124-4_11; https://doi.org/10.1007/0-387-27124-4_11
  50. Shaligram D, Girimaji SC, Chaturvedi SK. Quality of life issues in caregivers of youngsters with thalassemia. Indian J Pediatr. 2007;74(3):275–8. https://doi.org/10.1007/s12098-007-0043-9


How to Cite this Article
Pubmed Style

Glinac A, Sinanovic S, Glinac L, Matovic L. The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudan J Paed. 2023; 23(1): 60-67. doi:10.24911/SJP.106-1600718620


Web Style

Glinac A, Sinanovic S, Glinac L, Matovic L. The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. https://sudanjp.com//?mno=136867 [Access: July 25, 2024]. doi:10.24911/SJP.106-1600718620


AMA (American Medical Association) Style

Glinac A, Sinanovic S, Glinac L, Matovic L. The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudan J Paed. 2023; 23(1): 60-67. doi:10.24911/SJP.106-1600718620



Vancouver/ICMJE Style

Glinac A, Sinanovic S, Glinac L, Matovic L. The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudan J Paed. (2023), [cited July 25, 2024]; 23(1): 60-67. doi:10.24911/SJP.106-1600718620



Harvard Style

Glinac, A., Sinanovic, . S., Glinac, . L. & Matovic, . L. (2023) The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudan J Paed, 23 (1), 60-67. doi:10.24911/SJP.106-1600718620



Turabian Style

Glinac, Alma, Selma Sinanovic, Lejla Glinac, and Lejla Matovic. 2023. The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudanese Journal of Paediatrics, 23 (1), 60-67. doi:10.24911/SJP.106-1600718620



Chicago Style

Glinac, Alma, Selma Sinanovic, Lejla Glinac, and Lejla Matovic. "The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina." Sudanese Journal of Paediatrics 23 (2023), 60-67. doi:10.24911/SJP.106-1600718620



MLA (The Modern Language Association) Style

Glinac, Alma, Selma Sinanovic, Lejla Glinac, and Lejla Matovic. "The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina." Sudanese Journal of Paediatrics 23.1 (2023), 60-67. Print. doi:10.24911/SJP.106-1600718620



APA (American Psychological Association) Style

Glinac, A., Sinanovic, . S., Glinac, . L. & Matovic, . L. (2023) The impact of life of a child with cerebral palsy on the quality of life of mothers: Tuzla Canton/Bosnia and Herzegovina. Sudanese Journal of Paediatrics, 23 (1), 60-67. doi:10.24911/SJP.106-1600718620





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