Effects of stress and self-efficacy on quality of life of mothers with autistic children: Covariance-Based Structural Equation Modeling (CB-SEM) approach
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Keywords

autism spectrum disorder
parenting stress
quality of life
self-efficacy
child
CB-SEM

How to Cite

Bee Wah, Y., Mohd Nasir, N. N., Hadrawi, M. F., Kamaruddin, A. A., Jannoo, Z., & Afthanorhan, A. (2024). Effects of stress and self-efficacy on quality of life of mothers with autistic children: Covariance-Based Structural Equation Modeling (CB-SEM) approach. Belitung Nursing Journal, 10(2), 201–208. https://doi.org/10.33546/bnj.3096
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Accepted for publication: 2024-02-21
Peer reviewed: Yes

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Abstract

Background: Mothers who have children with autism encounter significant difficulties in caring for their autistic youngsters, leading to higher stress levels and a reduced overall quality of life. External or internal factors can cause and respond to stress, affecting an individual’s physical, psychological, and emotional health. Thus, it is crucial to examine the quality of life of mothers with autistic children.

Objectives: This study aimed to investigate the relationships between stress, self-efficacy, and quality of life (QoL) in mothers of children with autism.

Methods: A cross-sectional study design was used. Self-administered questionnaires were distributed from October to November 2019 to mothers with autistic children using cluster sampling techniques to capture their demographics and perceptions of stress, self-efficacy, and QoL. The data analysis was performed using covariance-based structural equation modeling (CB-SEM).

Results: Of the 290 questionnaires distributed, 238 (response rate of 82%) sets were returned, but only 181 questionnaires were usable for further analysis. The findings demonstrated a notable impact of stress and self-efficacy on quality of life and an adverse effect of stress on self-efficacy. Self-efficacy serves as an intermediary in the relationship between stress and quality of life.

Conclusion: In general, mothers of autistic children typically face moderate stress levels, but they have low levels of self-efficacy and quality of life. Mothers of children with autism need assistance and support from healthcare professionals, such as doctors, nurses, and psychiatrists, so that they can bear the challenges of raising children with special needs and enjoy a higher standard of living with less emotional and physical strain.

https://doi.org/10.33546/bnj.3096
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Supporting Agencies

The authors thank UNITAR International University for the funding of the publication of this paper

Copyright

Copyright (c) 2024 Yap Bee Wah, Noor Nadia Mohd Nasir, Mohd Fikri Hadrawi, Ainur Amira Kamaruddin, Zeinab Jannoo, Asyraf Afthanorhan

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

The authors declare no conflict of interest.

Acknowledgment

The authors would like to thank Mrs. Rusmawati Bt Abdullah and all NASOM officers for their assistance and support of this study. We hope that the findings will be beneficial to NASOM and related agencies. The authors would like to express their gratitude to all participants in this study and the hospital for their help in completing this research.

Authors’ Contributions

Conceptualization and design (YBW), Investigation and data collection (NNMN), Methodology ZJ, AA), Data analysis and interpretation (MFH), and Manuscript writing (AAK, YBW). All authors were accountable for and approved this study according to ICMJE authorship criteria.

Data Availability

The datasets generated during and analyzed during the current study are not publicly available due to respondents’ confidentiality but are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

The authors have declared that no generative AI and AI-assisted technologies are used in writing.


References

Abidin, R. R. (1995). The parenting stress index (3rd ed.). Odessa, FL: Psychological Assessment Resources.

Afthanorhan, A., Awang, Z., & Aimran, N. (2020). An extensive comparison of CB-SEM and PLS-SEM for reliability and validity. International Journal of Data and Network Science, 4(4), 357-364. http://dx.doi.org/10.5267/j.ijdns.2020.9.003

Aimran, A. N., Ahmad, S., Afthanorhan, A., & Awang, Z. (2017). The assessment of the performance of covariance-based structural equation modeling and partial least square path modeling. AIP Conference Proceedings, 1842(1), 030001. https://doi.org/10.1063/1.4982839

Al-Farsi, O. A., Al-Farsi, Y. M., Al-Sharbati, M. M., & Al-Adawi, S. (2016). Stress, anxiety, and depression among parents of children with autism spectrum disorder in Oman: A case–control study. Neuropsychiatric Disease and Treatment, 12, 1943-1951. https://doi.org/10.2147/NDT.S107103

Alhuzimi, T. (2021). Stress and emotional wellbeing of parents due to change in routine for children with Autism Spectrum Disorder (ASD) at home during COVID-19 pandemic in Saudi Arabia. Research in Developmental Disabilities, 108, 103822. https://doi.org/10.1016/j.ridd.2020.103822

Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182. https://doi.org/10.1037/0022-3514.51.6.1173

Burnham, B. R. (2011). Perceived self-efficacy and well-being in fathers of children with autism [Masters Thesis, California State University]. Chico. http://hdl.handle.net/10211.3/10211.4_260

Daundasekara, S. S., Arlinghaus, K. R., & Johnston, C. A. (2020). Quality of life: The primary goal of lifestyle intervention. American Journal of Lifestyle Medicine, 14(3), 267-270. https://doi.org/10.1177/1559827620907309

Efron, B. (1992). Bootstrap methods: another look at the jackknife. The Annals of Statistics, 7(1), 1-26. https://doi.org/10.1214/aos/1176344552

Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65(6), 591-598. https://doi.org/10.1203/PDR.0b013e31819e7203

Gibaud-Wallston, J., & Wandersmann, L. P. (1978). Development and utility of the Parenting Sense of Competence Scale. John F. Kennedy center for research on education and human development. https://www.bristol.ac.uk/media-library/sites/sps/documents/c-change/parenting-sense-of-competence-scale.pdf

Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis (7th ed.). New York: Pearson Education.

Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408-420. https://doi.org/10.1080/03637750903310360

Hulland, J., Chow, Y. H., & Lam, S. (1996). Use of causal models in marketing research: A review. International Journal of Research in Marketing, 13(2), 181-197. https://doi.org/10.1016/0167-8116(96)00002-X

Li, C., & Ning, G. (2022). More income, less depression? Revisiting the nonlinear and heterogeneous relationship between income and mental health. Frontiers in Psychology, 13, 1016286. https://doi.org/10.3389/fpsyg.2022.1016286

Li, F., Tang, Y., Li, F., Fang, S., Liu, X., Tao, M., Wu, D., & Jiang, L. (2022). Psychological distress in parents of children with autism spectrum disorder: A cross-sectional study based on 683 mother-father dyads. Journal of Pediatric Nursing, 65, e49-e55. https://doi.org/10.1016/j.pedn.2022.02.006

Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474. https://doi.org/10.1016/j.jaac.2017.03.013

Maenner, M. J. (2021). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2018. MMWR. Surveillance Summaries, 70(SS-11), 1-16. http://dx.doi.org/10.15585/mmwr.ss7011a1

Miniarikova, E., Vernhet, C., Peries, M., Loubersac, J., Picot, M.-C., Munir, K., & Baghdadli, A. (2022). Anxiety and depression in parents of children with autism spectrum disorder during the first COVID-19 lockdown: Report from the ELENA cohort. Journal of Psychiatric Research, 149, 344-351. https://doi.org/10.1016/j.jpsychires.2021.11.022

National Institute of Mental Health. (2024). What is ASD? https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

Ohan, J. L., Leung, D. W., & Johnston, C. (2000). The Parenting Sense of Competence scale: Evidence of a stable factor structure and validity. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 32(4), 251-261. https://doi.org/10.1037/h0087122

Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717-731. https://doi.org/10.3758/BF03206553

Rahlin, N. A., Awang, Z., Afthanorhan, A., & Aimran, N. (2019). Antecedents and consequences of employee safety climate in the small manufacturing enterprises: Translation, validation and application of the generic safety climate questionnaire. International Journal of Innovation, Creativity and Change, 7(10), 307-328.

Reitman, D., Currier, R. O., & Stickle, T. R. (2002). A critical evaluation of the Parenting Stress Index-Short Form (PSI-SF) in a head start population. Journal of Clinical Child and Adolescent Psychology, 31(3), 384-392. https://doi.org/10.1207/S15374424JCCP3103_10

Resnick, B., & Parker, R. (2001). Simplified scoring and psychometrics of the revised 12-item Short-Form Health Survey. Outcomes Management for Nursing Practice, 5(4), 161-166.

Rosenblum-Fishman, S. D. (2013). Maternal self-efficacy and perceived stigma among mothers of children with ASD, ADHD, and typically developing children [Doctoral Dissertatiom, University of Massachusetts Boston]. https://www.proquest.com/openview/88d13163976147ff92b0664a782ed939/1?pq-origsite=gscholar&cbl=18750

Santurri, L. E. (2012). An analysis of the relationship between stress, self-efficacy, social support, and health-related quality of life among women living with interstitial cystitis in the United States (Publication Number 3529852) [Doctoral DIssertation, Kent State University]. https://www.proquest.com/openview/4025b3f45d2d918af71a6f438de649d8/1?pq-origsite=gscholar&cbl=18750

Sarris, M. (2017). Stress and the autism parent. https://iancommunity.org/ssc/stress-and-autism-parent

Testa, M. A., & Simonson, D. C. (1996). Assessment of quality-of-life outcomes. New England Journal of Medicine, 334(13), 835-840. https://doi.org/10.1056/NEJM199603283341306

Turnage, D., & Conner, N. (2022). Quality of life of parents of children with Autism Spectrum Disorder: An integrative literature review. Journal for Specialists in Pediatric Nursing, 27(4), e12391. https://doi.org/10.1111/jspn.12391

Vasilopoulou, E., & Nisbet, J. (2016). The quality of life of parents of children with autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 23, 36-49. https://doi.org/10.1016/j.rasd.2015.11.008

Vernhet, C., Michelon, C., Dellapiazza, F., Rattaz, C., Geoffray, M.-M., Roeyers, H., Picot, M.-C., & Baghdadli, A. (2022). Perceptions of parents of the impact of autism spectrum disorder on their quality of life and correlates: Comparison between mothers and fathers. Quality of Life Research, 31, 1499–1508. https://doi.org/10.1007/s11136-021-03045-3

Wang, Z., Wang, L., Chang, S., & Wang, H. (2022). The mediating effect of parenting stress on the relationship between social support and quality of life in parents of children with autistic spectrum disorder: A meta-analytic structural equation modeling. Frontiers in Psychiatry, 13, 713620. https://doi.org/10.3389/fpsyt.2022.713620

Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220-233.

Warner, L. M., & Schwarzer, R. (2020). Self-efficacy and health. In K. Sweeny, M. L. Robbins, & L. M. Cohen (Eds.), The Wiley Encyclopedia of Health Psychology (pp. 605-613). https://doi.org/10.1002/9781119057840.ch111

Zhao, X., Lynch Jr, J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research, 37(2), 197-206. https://doi.org/10.1086/651257


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