EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
Kamel et al
THE IMPACT OF MENTAL DISABILITIES AMONG CHILDREN ON
PSYCHOLOGICAL WELLBEING OF MOTHERS IN EL MINIA CITY
By
Emad G. Kamel*, Awatef A. Mohamed**, Eman M. Mahfouz*,
Hala I Awadalla*** and Amr M El-Sherbini ****
Departments of *Public Health El-Minia Faculty of Medicine, ** Community Health, ElMinia Faculty of Nursing, *** Institute of Environmental Studies & Research, Ain Shams
University, and ****Psychiatry and Neurology El-Minia Faculty of Medicine
ABSTRACT:
Background: Promoting the health of children with disabilities requires caring
mothers and supporting community. Mothers face many challenges and stressors that
may lead to maternal distress if not well adjusted and adapted. Adaptation is an
adjustment to environmental condition, mother and child adaptation is mutually
interrelated. In Egypt, during 2002, the estimated number of population with
disabilities ranged from 2,6 to 7 millions.
Aim of the study: This study aimed at assessing maternal adaptation and describing
the relationship between maternal sociodemographic factors and their adaptation as
well as examining the presence of maternal distress.
Subjects and methods: This study was carried out in a governmental school for
mentally disabled children in El-Minia city, all mothers (100) with children aged from
6 to 18 years old and attending "El-Fekrya" school were recruited in the study. Three
tools were used: Demographic data sheet; Adaptation Scale to assess the nature of
mothers’ interaction and patterns of psycho-social adaptation; and The Structured
Clinical Interview for DSM-III-R (SCID) to detect the presence of psychiatric
disorders among studied mothers.
Results: Almost two thirds (65%) of mothers adapted negatively to their children's
condition and around one third (35%) of them only adapted positively, 62.9% of
positively adapted mothers had female children (p<0.001). Negatively adapted
mothers were slightly older than positively adapted mothers and had higher number of
children in their families. Maternal education and occupation had significant effects
on psycho-social adaptation (p<0.05). Knowledge of mothers about their children's
condition significantly affected the maternal adaptation as well as dependency of
children in eating, drinking and sleeping (p<0.05). Two thirds (66%) of mothers had
high levels of psychiatric disorders.
Conclusion: Two thirds of mothers with mentally disabled children were adapting
negatively with their children's condition and they suffer from several psychiatric
disorders.
KEY WORDS:
Mental disability
Sociodemographic
Adaptation
Psychiatric disorders
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Kamel et al
impairment but also influenced by
psychological and social factors and
thirdly; handicap refers to social role
and status (Stein & Susser , 1992).
INTRODUCTION:
Reliable statistics on the actual
numbers of people with disabilities in
Eastern
Mediterranean
Region
(EMRO) countries is lacking, however,
WHO estimated that about 10 percent
of the world’s population, of which
200 million are children, experience
some form of disability. Applying this
proportion to the population of EMRO
countries would result in an average of
40 million persons with disabilities. In
Egypt, during 2002, the estimated
number of population with disabilities
ranged from 2,6 to 7 millions (WHO,
2006).
Mothers of children with
mental disability may not only face
greater challenges from their child’s
condition, they may also be less
equipped to deal with those challenges.
The strongest and most consistent
predictor of maternal outcomes was the
extent and severity of the behavioral
symptoms of the child (Witt et al.,.,
2003).
Depressive symptoms may
interfere with a mother's ability to
appropriately read her child's cues
(expressions and behaviors) that
indicate his/her need. When a mother
or primary caregiver experiences
depression or other stress-related mood
problems, and does not manage her
stress appropriately, when she is with
her child, the child is more likely to be
directly affected (Reyes RL, 2002).
Mothers who are the primary
providers of care for children with
mental
disabilities
face
many
challenges and stressors that may lead
to maternal distress if not well adjusted
and adapted. For most children with
disabilities, their disability is not a
fixed condition, but is changeable over
time and with circumstances and
offered care. A single disability
condition could be complicated by
multiple disabilities if negligence is
dominating, care, love and support are
lacking. (Shaw et al., 2001).
Mothers were characterized as
having any distress or depression if
they endorsed any of these items: (1)
having a depressive episode lasting at
least 2 weeks in the past year, (2)
having a manic or manic-depressive
episode lasting at least 2 weeks in the
past year, or (3) being frequently
depressed or anxious in the past 2
weeks. Absence of all 3 was coded as
no distress or depression. The measure
of maternal distress incorporates both
symptoms and self-reported diagnoses
(Witt et al., 2003).
Communicable diseases, high
rates of consanguinity, weak prenatal
and child health services, traffic
accidents and political violence, are
important determinants contributing to
current levels of disability in EMRO
countries. Attention to health and its
social determinants are essential to
promote and protect the health of
people with disabilities and for greater
fulfillment of human rights (WHO,
2006).
Research findings on maternal
depression indicated that depressed
mothers were more likely to withdraw
from their children, responded with
little or no emotion or energy, were
less positive with their children, felt
less competent during feedings, perceived their children as more difficult,
Mental retardation can be
described
in
terms
of
three
components: firstly, impairment refers
to an underlying biological disorder,
secondly; disability refers to a deficit
in function, usually consequent of
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Kamel et al
and became intrusive and hostile
toward their infants. (Reyes RL, 2002).
mother in child’s daily care (Wallander
and Varni, 1998).
Mothers were characterized as
having any distress or depression if
they endorsed any of these items: (1)
having a depressive episode lasting at
least 2 weeks in the past year, (2)
having a manic or manic-depressive
episode lasting at least 2 weeks in the
past year, or (3) being frequently depressed or anxious in the past 2 weeks.
Absence of all 3 was coded as no distress or depression (Witt et al., 2003).
Adaptation is an adjustment to
environmental condition. Adaptation
theory acknowledge that human being
struggle continuously to survive, adapt
and change their environment as well
as to deal with challenges that can be
present in these environments (Mohr et
al., 2000). Mother and child adaptation
is mutually interrelated. Children tend
to adapt most successfully to living
with a chronic illness when their
mothers and family functioning remain
strong (Wallander and Varni, 1998 &
Allen and Vessy, 2004). Maternal
anxiety is the main factor causing poor
adaptation in a child with mental
retardation which makes the child
liable to negative outcomes (El-Nimr,
2001).
Rehabilitation is a goaloriented and time-limited process
aimed at enabling an impaired child to
reach an optimum mental, physical
and/or social functional level, thus
providing her or him with the tools to
change her or his own life. It can
involve
measures
intended
to
compensate for a loss of function and
other measures intended to facilitate
social adjustment or readjustment (Witt
et al., 2003).
Other challenges that can be
stressful to mothers including time
spent in managing illness and in daily
care giving activities, financial
difficulties caused by unexpected
expenses and increased use of health
services to treat and help manage the
condition, decreased in family
socialization activities which alter
family life dramatically (Zin El-Dean,
2000 & Yantzi et al., 2001).
In
Egypt,
medical
and
rehabilitation care services are
available and are provided by
governmental and non governmental
organizations. However, they do not
cover actual needs, particularly in rural
areas and urban areas outside big
cities. Teachers in some institutions
for
children
with
intellectual
impairments were trained as part of a
project to upgrade public special
education institutions (WHO, 2006).
Justification and implications of the
study:
- Identification of the stressors that
lead to maladjustment of those mothers
having children with mental disabilities
and cause maternal distress will pave
the way towards its elimination or
appropriate intervention by special
support groups and programs to help
mothers in caring their children and
provide tertiary prevention properly.
- Focus on mothers because mothers
still tend to have primary responsibility
for child care and are most subject to
the challenges associated with their
child’s disability.
Mental retardation is a chronic
illness that is long term and almost
without cure. Children with mental
disability and their mothers are at
increased risks for psycho-social
problems compared to their peers.
Frequently, the father is left out and
may become less involved than the
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The following research questions
were used to guide the study:
1. What are the challenges and impact
for mothers of children with
disabilities and other special needs?
2. Are there relationships between
maternal
distress
and
sociodemographic factors of mothers?
3. Are there relationships between
maternal maladaptation and some
factors such as the presence of
psychiatric disorders & severity of the
disability condition of their children
and the degree of carrying out different
activities of daily living?
Kamel et al
Three tools were used for data
collection in this study:
Tool I: Demographic data sheet: a
structured questionnaire was designed
by the researchers and used to collect
information about mothers’ age,
education level, occupation, number of
children, social status and residence. It
also
included
questions
about
children’s age, gender, rank in the
family, degree of child independency
in daily activities as well as mothers’
knowledge about the illness.
Tool II: Adaptation Scale: that was
developed and applied to the Egyptian
culture by Hewalla (1991). It was used
to assess the nature of mothers’
interaction, patterns of psycho-social
adaptation toward their mentally ill
children. Measuring the scores of
mothers patterns of adaptation was
done by determining whether the item
was positive or negative, then the
following scores were used for positive
items; 4 points for agree, 3 points for
hesitate and 2 points for disagree. For
negative items; 2 points for agree, 3
points for hesitate and 4 points for
disagree. Summation for items scores
were done and total score more than or
equal to 65 indicated positive attitude,
while score less than 65 indicated
negative attitude toward adaptation
(Khalil et al., 2006).
Aim of the study:
This study aimed at assessing
maternal adaptation towards their
children with mental disabilities, and
describing the relationship between
maternal sociodemographic factors and
their adaptation as well as examining
the presence of maternal psychiatric
disorders.
Research hypothesis:
Mothers with children with
mental disability are not adapted with
their life and usually suffer from
psychiatric disorders.
Subject and methods
El-Minia city is the capital of
El Minia governorate which is one of
Upper Egypt governorates located at
240 kilometers south of Cairo. ElMinia city has only one governmental
school for mentally disabled children
called “El-Fekrya School”. All mothers
with children aged from 6 to 18 years
old and attending the mentioned school
were recruited in the study. Their total
number was 111 mothers, eleven
mothers refused to participate in the
study, the number of the included
mothers was one hundred.
Tool III: The Structured Clinical
Interview for DSM-III-R (SCID) was
used to detect the presence of
psychiatric disorders in mothers of
mentally disabled children in the past
year (Spitzer et al., 1990). Mothers
were screened for the presence of
depressive disorders, panic disorder,
social phobia, specific phobia,
obsessive compulsive disorder and
generalized anxiety disorder. They
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were also screened to detect
subsyndromal presentations of these
disorders.
Kamel et al
of the children. Inquiring about the
birth order of the disabled children
revealed that 70.1% of the negatively
adapted mothers reported that the
disabled child was the second child or
higher birth order, while negatively
adapted mothers with the first child
were 24.5%. On the other hand, nearly
half (51.4%) of positively adapted
mothers reported that the disabled
child was the second child or higher
birth order. The relation between birth
order and maternal adaptation was not
statistically significant.
A pilot study was conducted on
10% of the number of the studied
subjects. Necessary modifications were
done on the basis of the pilot study. A
Verbal consent was taken from every
mother participating in the study. Each
mother was individually interviewed.
The actual field work was carried out
during the period from September
2007 to November 2007.
The data were examined for
significant associations by using SPSS
Advanced Statistical Software version
13 (SPSS Inc., Chicago, USA).
Quantitative data were presented as
mean ± standard deviation while
qualitative data were presented as
frequencies and percentages. Chisquare and Student t-test were used for
comparison of categorical variables
and continuous variables respectively,
P value less than 0.05 was considered
to indicate a significant difference.
This study showed that
maternal education and occupation had
significant effects on psycho-social
adaptation. Table (2) shows that
84.6% of negatively adapted mothers
were illiterate compared to 42.9% of
the positively adapted mothers. The
Majority of negatively adapted mothers
were housewives (81.5%) compared to
57.1% of the positively adapted
mothers (p<0.05). Negatively adapted
mothers were slightly older than
positively adapted mothers, moreover
negatively adapted mothers had higher
number of children in the family than
positively adapted mothers. However,
differences between the two groups
were not statistically significant.
Similarly, there was no significant
difference between the marital status
and psycho-social adaptation. It was
found that 60% of mothers lived in
urban areas and 40% lived in rural
areas. However, mothers from both
areas had the same adaptation pattern
(p>0.05).
RESULTS:
This study included 100
mothers with mentally retarded
children, their age ranged from 6 to 18
years. All mothers were assessed for
psycho-social adaptation toward their
ill children. Almost two thirds of
mothers adapted negatively to their
children's and around one third of them
only adapted positively as found in
65% and 35% of them respectively.
The mean age of mothers was 39.9±5.3
years.
Knowledge of mothers about
their children's condition significantly
affected the maternal adaptation. Few
mothers reported that they had
complete information or read about
their children disease. In general,
negatively adapted mothers who
reported that they did not know any
thing about the definition, etiology,
Table (1) shows that there was
a significant relationship between
maternal adaptation and sex as 62.9%
of positively adapted mothers had
female children while 37.1% of them
had male children. On the other hand,
there was no significant relationship
between maternal adaptation and age
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manifestation,
management
and
complications of the illness were more
than positively adapted mothers (table
3). About 77% and 53.9% of
negatively adapted mothers did not
know the nature of the condition of
their children or its causes compared to
34.3% and 42.9% of positively adapted
mothers
respectively
(p<0.001).
Similarly, 64.6% and 84.7% of
negatively adapted mothers had no
idea
about
manifestations
and
management of the condition of their
children compared to 34.3% and
62.8% of positively adapted mothers
respectively (p<0.05). The relations
between maternal adaptation and
knowledge of mothers regarding their
children's condition were statistically
significant.
Kamel et al
daily living are shown in table (4).
Analyzing the different disabilities of
daily activities, it was found that:
Dependency in eating, drinking and
sleeping had significant statistical
relations to maternal adaptation.
Mothers of mentally disabled
children
had
high
levels
of
psychopathology, 66% of them had
either: a syndromal disorder (27%), a
subsyndromal disorder (28%), or both
(11%). The remaining one third of
mothers had no disorder Figure (1).
Table (5) shows different
psychiatric disorders and subsyndromes present in mothers. More than
one diagnosis were allowed for each
individual. Generalized anxiety (32%)
and dysthymic disorder (24%) were the
most common disorders followed by
major depressive disorder (18%) and
depression subsyndrome (18%).
The relations between maternal
adaptation
and
their
children's
dependency in selected activities of
Table (1): Relation between maternal adaptation and their children's characteristics in
El-Minia city in 2007
Adaptation
Children's characteristics
Gender
Males
Females
Total
Negative adaptation
Positive adaptation
42 (64.6%)
23 (35.4%)
65 (100%)
p= 0.001
18 (27.7%)
47 (72.3%)
65 (100%)
p= 0.18
3 (4.4%)
16 (24.5%)
46 (70.1%)
65 (100%)
p= 0.15
13 (37.1%)
22 (62.9%)
35 (100%)
χ2 = 6.9
Age/y
6-12
≥ 12-18
Total
χ2 = 1.73
Birth order
Single
First
Second+
Total
χ2 = 3.83
113
15 (42.6%)
20 (57.4%)
35 (100%)
2 (5.8%)
15 (42.8%)
18 (51.4%)
35 (100%)
EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
Kamel et al
Table (2): Relation between maternal adaptation and their sociodemographic
characteristics in El-Minia city in 2007
Adaptation
Positive
Negative adaptation
Sociodemographic characteristics
adaptation
55 (84.6%)
15 (42.9%)
Mothers' education:
Illiterate
10 (15.4%)
20 (57.1%)
Educated
65 (100%)
35 (100%)
Total
2
χ = 16.9
p= 0.001
53 (81.5%)
20 (57.1%)
Mothers' occupation: Housewife
12 (18.5%)
15 (42.9%)
Employed
65 (100%)
35 (100%)
Total
χ2 = 5.69
p= 0.02
39.4±4.4
38.9±4.2
Age of mothers
t = 0.11
p=0.89
3.2±1.9
2.7±1.3
Number of children in the family
t = 1.55
p=0.14
60 (92.3%)
31 (88.6%)
Marital status
Married
3 (4.6%)
2 (5.7%)
Divorced
2 (3.1%)
2 (5.7%)
Widow
65 (100%)
35 (100%)
Total
χ2 = 0.49
p= 0.78
40 (61.5%)
20 (57.1%)
Residence
Urban
25 (38.5%)
15 (42.9%)
Rural
65 (100%)
35 (100%)
Total
2
χ = 0.18
p= 0.67
Table (3): Relation between maternal adaptation and knowledge of mothers
regarding their children's condition in El-Minia city in 2007
Adaptation
Negative adaptation
Positive adaptation
Knowledge
(n=65)
(n=35)
3 (4.6%)
5 (14.3%)
Definition: Complete
12 (18.5%)
18 (51.4%)
Incomplete
50 (76.9%)
12 (34.3%)
Don't know
2
χ = 17.6
p= 0.001
1 (1.5%)
9 (25.7%)
Etiology: Complete
29 (44.6%)
11 (31.4%)
Incomplete
35 (53.9%)
15 (42.9%)
Don't know
χ2 = 14.8
p= 0.001
2 (3.1%)
8 (22.8%)
Manifestations: Complete
21
(32.3%)
15
(42.9%)
Incomplete
42 (64.6%)
12 (34.3%)
Don't know
2
χ = 13.5
p= 0.001
1 (1.5%)
3 (8.6%)
Management: Complete
9 (13.8%)
10 (28.6%)
Incomplete
55 (84.7%)
22 (62.8%)
Don't know
2
χ = 6.8
p= 0.03
2
(3.1%)
10 (28.6%)
Complications: Complete
6 (9.2%)
3 (28.6%)
Incomplete
57 (87.7%)
22 (62.8%)
Don't know
χ2 = 14.1
p= 0.001
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Kamel et al
Table (4): Multiple regression analysis of disabilities related to maternal adaptation in
El-Minia city in 2007
Unstandardized
Standardized
Coefficients
Coefficients
B
Std. Error
Beta
0.959
0.199
(Constant)
-0.529
0.091
-0.881
Eating
0.400
0.114
0.625
Drinking
0.224
0.060
0.325
Sleeping
0.187
0.132
0.303
Defecation
0.213
0.012
0.025
Self cleaning after toilet
0.007
0.079
0.114
Bathing
0.005
0.093
0.086
Clothes care
0.005
0.123
0.085
Urination
0.003
0.063
0.053
Treatment
0.003
0.079
0.044
Going to school
N.B. The dependent factor is maternal adaptation score
Both Syndrome
& Subsyndrome
11%
t
p
4.82
5.80
3.49
3.761
1.41
0.841
1.01
0.584
0.457
0.525
-0.455
0.001
0.001
0.001
0.001
0.161
0.651
0.317
0.560
0.649
0.601
0.650
No disorder
34%
Subsyndromal
disorder
28%
Syndromal
disorder
27%
Figure (1): Frequency distribution of maternal psychiatric disorders in mothers
with mentally retarded children in El-Minia city in 2007
Table (5): Frequency distribution of psychiatric disorders* in mothers with mentally
retarded children in El-Minia city in 2007
Frequency
Number
Percent
Psychiatric disorders
32
Generalized anxiety subsyndrome
32%
24
Dysthymia
24%
18
Depression Subsyndrome
18%
18
Major depression
18 %
14
14%
Generalized anxiety disorder
12
12 %
Panic disorder
8
8%
Social phobia Subsyndrome
2
2%
Obsessive compulsive
Subsyndrome
2
2%
Social phobia
2
2%
Specific phobia
0
0
Obsessive compulsive disorder
* More than one diagnoses were allowed for each individual.
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Kamel et al
gender could increase the risk of maladaptation and psychological burden
for mothers, and that some mothers
may perceive that the disease is more
serious in boys than in girls.
DISCUSSION:
There are several factors that
prevent persons with disabilities from
benefiting from good quality, affordable, acceptable and accessible
medical services. These include inadequate financial resources, limitations of
existing health facilities and infrastructures (including physical inaccessibility), lack of legislation, low level of
awareness among decision makers,
shortage of information, negative attitudes towards persons with disabilities,
high cost of medical services, and
discrimination (WHO, 2006).
It was clear from the results of
the present study that there was a
statistically significant difference between maternal adaptation and their
work and education, where positive
adaptation was more common among
working as well as educated mothers.
Educated mothers can be more helpful
in the adaptation process, this was in
accordance with Jeprrett (2004) who
revealed that the highly educated
parents learn to manage their child's
illness and move from the early
struggle with adaptation to more
competent care. Working mothers had
more experience due to their presence
in the community and viewing a lot of
events which made them know how to
deal with the problem. These findings
agreed with Fuller & Schaller (1999)
and Refatt (2002) who reported a
significant
relationship
between
maternal adaptation and occupation.
The working and/or educated mothers
know that they are not alone having
such a problem and there are many
mothers have similar or more advanced
conditions, and this may be helpful in
the adaptation process. These results
were also supported by Zin El-Dean
(2000), he mentioned that educated and
working mothers had higher levels of
adaptation than illiterate and nonworking mothers.
Presence of mentally disabled
child in a family is a big problem for
all the family members specially the
mother. This study showed that almost
two thirds of mothers with mentally
disabled children were negatively
adapted with the condition of their
children. These findings were in
accordance with Johanson (2005) who
mentioned that mothers were usually
the primary caregivers of chronically
ill children. They might experience
greater demands upon their personal
resources and consequently felt more
distressed and maladaptive. Gosch
(2001) reported that more than half of
the mothers of mentally disabled
children showed negative adaptation to
their ill children and found difficulty to
accept them, this figure was less than
that resulted from the current study.
There was a statistically significant relationship between maternal
adaptation and sex of the mentally
disabled children. This result was
similar to what was found by Azar and
Solomon (2001), they revealed that the
child's sex had a different effect on
mother's feeling of self-confidence and
adaptation in managing the case and
that mother had more confidence when
the child was a girl. Similarly, Mott et
al., (1999) mentioned that the child's
Concerning the association
between adaptation and knowledge of
mothers about the nature of the illness,
manifestations,
management
and
complications, it was found that there
were significant effects of maternal
knowledge on their adaptation. A
research carried out by Doornbos
(1997) supported this point, as he
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found that caregivers of mentally
retarded children identified the beneficial effect of increasing their
knowledge in the adaptation process
and found that 88% of mothers felt
better about themselves by learning to
manage their child's condition.
Kamel et al
individuals and in the population as a
whole (Nies, 2007).
Various emotions and challenges experienced by mothers caring for
mentally disabled children. Feelings
of shock, despondency and sadness
dominated the early stages when the
retarded children are still young.
During later years, as the children were
growing up, the mothers felt shame,
fear, frustration, anger, disappointment
and worry, however, acceptance
followed, as the children grew older
(Ntswane & van Rhyn, 2007).
Melnyk et al., (2000) reported
that the commonly cited source of
stress and mal-adaptation for mothers
was the difficult day to day health care,
which was time consuming and
described as the chronic burden of
care. He added that mothers of the
mentally ill children often experience
more strain related to time of caring of
the disabled child as well as higher
levels of psychological distress than
mothers of healthy children. According
to the association between maternal
adaptation and the degree of
dependency on mothers in selected
activities of daily living, the results of
the current study showed statistically
significant
relationships
between
maternal adaptation and children
dependency in some activities such as
eating, drinking and sleeping. Abd ElMegeed (1999) found a statistical
significant
difference
between
adaptation of mothers having children
with
mental
disabilities
and
dependency of these children on their
mothers in defecation, urination and
clothes care.
Findings of the current study
showed that depressive disorders were
highly distributed among the reported
psychiatric disorders, this results was
in agreement with Singer (2006), who
revealed that there was an increased
psychiatric morbidity particularly
depressive disorders in the mothers of
mentally handicapped children.
CONCLUSION:
Mothers of children having
mental disabilities were adapting
negatively with their children's
condition. Factors affecting the adaptation of mothers were maternal sociodemographic characteristics especially
education and occupation, gender of
children, their knowledge about
children's condition and dependency of
children in some activities of daily
living. They had high levels of
psychopathology, two thirds of them
had either: a syndromal diagnosis, a
subsyndromal disorder, or both.
Community health nurse play a
significant role in the control of mental
health problems with individuals and
with population group. Effective
control includes assessment of risks
and factors influencing mental health
problems, as well as the planning,
implementation, and evaluation of
health care programs directed toward
mental health. Community health
nurses are actively involved in
assessing of these risks as well as for
the presence of mental illness in
Recommendations:
1. Based on the present study
findings and conclusion, the
following recommendations are
suggested:
2. Early detection of the mental
disabilities through screening
programs during different stages
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
3.
4.
5.
6.
of growth and development, may
help mothers in detecting the
problem early, control it and
avoid future complications.
Mothers of children with mental
disabilities seem to display a high
burden, this finding must be
taken into account in policy
making to provide better and
more specific supports and
interventions for this group of
mothers, this will help in
avoiding
development
of
maternal psychiatric disorders.
Counseling
services
should
involve training programs for the
mentally disabled children and
health education services for their
mothers to teach and help
mothers on how to manage day to
day problems related to the
condition.
Raising community awareness
about disability, improving the
capacities of Non Governmental
Organizations to provide services
in areas that lack them, forming a
national rehabilitation authority
providing information about
available services.
Group therapy for children and
mothers who share common
feeling and cases may be
beneficial
and
help
in
transmission of expertise.
Kamel et al
4. Doornobs M (1997): The
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5. El-Nimr A (2001): Intelligence
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Medicine, Cairo University.
6. Fuller R and Schaller R (1999):
Health assessments – A Nursing
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503-10.
7. Gosch A (2001): Maternal
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8. Hewalla A (1994): Family
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9. Jeprrett M (2004): Parents of
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10. Johanson S (2005): Health
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11. Khalil AA, El-Gileel WE, ElSharkawy SG and Farrage JM (2006):
Maternal adaptation toward their
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12. Melnyk B (2000): Intervention
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13. Mohr K, Lafuze E and Brain D
(2000): Opening caregiver minds:
National alliance for mentally ill’s
provider education program. Archives
of Psychiatry Nursing; 5:238-251.
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‫‪EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008‬‬
‫أثر اإلعاقة الذهنية لألطفال على السالمة النفسية لألمهات فى مدينة المنيا‬
‫عماد جرجس كامل‪ -‬عواطف عبد الرازق محمود – إيمان محمد محفوظ ‪ -‬هالة ابراهيم‬
‫عوض هللا‪ -‬عمرو مكرم الشربينى‬
‫يتطلب االرتقاء بصحة األطفال ذوى االحتياجات الخاصة رعاية األمهات و مساندة‬
‫المجتم ع حيععت تتضععر األمهععات للضديععد مععض ال ععاوط و التحععديات الت ع يم ععض أض تععىدى إل ع‬
‫اال طرابات النفسية لديهض إذا لم تتم ض مض الت يف م هذا الو ‪ .‬و يضرف الت يف بأنه التأقلم‬
‫للضوامل البيئية ‪ .‬و يتراوح ععدد المضعاقيض فع مصعر ععام ‪ 2002‬بعيض اننعيض و نصعف الع سعبضة‬
‫مالييض مضاق‪ .‬و تهدف هذه الدراسة ال تقييم ت يف األمهات إلصابة األطفال باإلعاقة الذهنية و‬
‫دراسة الضالقة بيض الضوامل الس انية وت يف األمهات و ذلك التضرف علي اال عطرابات النفسعية‬
‫لدى األمهعات ‪.‬وقعد أجريعت هعذه الدراسعة فعي احعدم المعدارك الح وميعة للتربيعة الف ريعة بمدينعة‬
‫المنيا عام ‪ 2007‬وقد اشتملت هذه الدراسة علي أمهعات األطفعال بعيض ‪ 18-6‬سعنة وقعد بلعج حجعم‬
‫عينة الدراسة مائة مض األمهات وقد تم استخدام نالت أدوات فعي هعذه الدراسعةس اسعتبياض للبيانعات‬
‫الس انية لألم والطفل ومقيعاك لتقيعيم ت يعف األمهعات إلعاقعة األبنعاء و مقيعاك اال تئعاب للتضعرف‬
‫علععي وجععود اال ععطربات النفسععية لععدى األمهععات ‪.‬وقععد أرهععرت نتععائا الدراسععة اض نلنععي الضينععة‬
‫يت يفععوض سععلبيا إلعاقععة األبنععاء بينمععا يت يععف النلععت البععاقي ايجابيععا و انععت ‪ %62.9‬مععض األمهععات‬
‫ايجابية الت يف لديهض أطفاال إنانا و انت األمهات سلبية الت يف ا بعر فعي الضمعر وأ نعر فعي ععدد‬
‫األبناء‪ .‬و وجعدت عالقعة بعيض تضلعيم األمهعات ومهنعتهض وبعيض ت عيفهض وقعد عاض لمضرفعة األمهعات‬
‫مضلومات عض حالة األطفال أنر علي ت عيفهض و أو عحت الدراسعة اض نلنعي األمهعات يضعانيض معض‬
‫بض اال طرابات النفسية‪ .‬و مما سعب فقعد استخلصعت الدراسعة العي اض نلنعي األمهعات يت عيفض‬
‫سلبيا إلعاقة األبناء واض نسبة ممانلة مض األمهات لديهض بض اال طرابات النفسية‪.‬‬
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