Parental Stress in Parents of Hearing Impaired Children: An Exploratory Study Using ICF Classification

Abstract

Parents of children with hearing impairment (HI) often face a lot of psychosocial issues apart from the economical and day-to-day adjustments concerning their disabled child. Therefore, addressing the stress in caregivers/parents of HI children from a biopsychological perspective may be more pertinent than from solely a biomedical model. The main aim of the study was to understand the problems and life effects in parents of HI children using the International Classification of Functioning, Disability and Health (ICF) framework and to correlate it with the responses from a close-ended questionnaire (item Caregiver Strain Questionnaire, CGSQ). Using a prospective survey design, 100 parents of HI children participated in the study. Two ICF open-ended questions and a 21-item CGSQ were administered. The first question of ICF probed into problems or challenges that are faced by parents of HI children (problem question: PQ) and the second to their life effects (life effect question: LEQ). Responses were coded by three trained professionals and were linked to codes in ICF categories: body functions, activity limitation, environmental factors and personality factors. A total of 862 codes were obtained. Bland-Altman analysis revealed high inter-coder reliability. 437 responses were related to problems faced and 425 responses were related life effects. Thirteen responses did not fit into any of the ICF categories. The descriptive (mean and median) analyses of the frequency count for overall responses revealed that participants had experienced more difficulties in PQ than LEQ, although they were not reaching statistical significance Most of the responses were related to activity limitations, and participation restrictions (358/862), followed by body function (321/862), highlighting the stress induced limitations in their day-to-day activities from a psychosocial perspective. In CGSQ, the item rated “Very much a problem” by most of the parents (56/100) was the sadness felt as a result of their child’s hearing problem. The second most reported stress parents faced were related to the future of their child. The least reported item was for the child getting into trouble with the neighbours, the school, the community, or law enforcement. There was no significant correlation between ICF domains and CGSQ responses. The responses coded to ICF show that parents of HI children encounter challenges in many domains, which are otherwise not assessed using questionnaires and hence are largely ignored in the conventional rehabilitation process.