title: Stress in parents of children with cerebral palsy: what sources of stress are we talking about?
abstract: BACKGROUND
  Parents of children with cerebral palsy (CP) often experience high levels of stress. Little is known however on the different sources of stress parents experience. The purpose of the present study was to explore the relation between aspects of parental distress in the parenting role and the child's limitations in functional skills and the child's behavioural difficulties, in parents of children with CP.
  
  
  METHODS
  A cross-sectional study among 42 parents of ambulatory children with CP (age 3-8 years; GMFCS levels I-III) was performed, using the Parenting Stress Index (PSI), the Paediatric Evaluation of Disability Inventory (PEDI) and the Vineland Adaptive Behaviour Scales (VABS).
  
  
  RESULTS
  Regression analysis revealed that the PEDI Functional Skills and VABS Maladaptive behaviour scores explained 27% of the total variance in the PSI Parent domain total stress score. Maladaptive behaviour did significantly contribute to parental stress scores for the Parent domain subscales Attachment, Relationship with spouse, Depression, and, in particular, Sense of competence.
  
  
  CONCLUSIONS
  Parents' functioning can be affected by behavioural aspects of the child with CP, and sense of competence could be an important variable in this relation. This emphasizes the importance of the development of specific interventions that support the family as a whole.
authors.affiliation: Rehabilitation Center De Hoogstraat, Center of Excellence for Rehabilitation Medicine, Utrecht, the Netherlands. m.ketelaar@dehoogstraat.nl
authors.forename: M
authors.initials: M
authors.lastname: Ketelaar
authors.forename: M J M
authors.initials: MJ
authors.lastname: Volman
authors.forename: J W
authors.initials: JW
authors.lastname: Gorter
authors.forename: A
authors.initials: A
authors.lastname: Vermeer
mesh_terms: D002547:Cerebral Palsy / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000523:psychology*; D002668:Child Rearing / Q000523:psychology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D019957:Motor Skills Disorders / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*