title: Time demands of caring for children with cerebral palsy: what are the implications for maternal mental health?
abstract: OBJECTIVE
  To examine the relationship between maternal mental health problems and the time required by mothers to care for children with cerebral palsy (CP).
  
  
  METHODS
  Cross-sectional study of 158 mothers of children with cerebral palsy (98 males, 60 females; mean age 11y 3mo, range 6-17y). Gross Motor Function Classification System levels of the children were 37% level I, 20% level II, 9% level III, 12% level IV, and 22% level V. Manual Ability Classification System levels were 19% level I, 27% level II, 22% level III, 13% level IV, and 19% level V. Maternal mental health problems were assessed using the General Health Questionnaire. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. A time-diary was used to measure caregiving time. Experience of time pressure was assessed using the Time Crunch Scale.
  
  
  RESULTS
  On average, mothers spent 6.0 hours per 24 hours on weekdays and 8.3 hours per 24 hours on weekends caring for children with CP. There was a significant positive relationship between maternal psychological problems and both caregiving time required per 24 hours (p = 0.03) and mothers' experience of time pressure (p < 0.001). There was also a significant positive association between maternal depressive symptoms and experience of time pressure (p = 0.003).
  
  
  CONCLUSIONS
  It is important to support mothers to find ways of reducing the real and perceived impact of caregiving. This might include identifying sources of 'respite' support for caregivers, training in stress and time management, and appropriate treatment of mental health problems.
authors.affiliation: Children, Youth and Women's Health Service, Adelaide, Australia. michael.sawyer@adelaide.edu.au
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sawyer
authors.forename: Michael
authors.initials: M
authors.lastname: Bittman
authors.forename: Annette M
authors.initials: AM
authors.lastname: LA Greca
authors.forename: Angela D
authors.initials: AD
authors.lastname: Crettenden
authors.forename: Nina
authors.initials: N
authors.lastname: Borojevic
authors.forename: Parimala
authors.initials: P
authors.lastname: Raghavendra
authors.forename: Ray
authors.initials: R
authors.lastname: Russo
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002547:Cerebral Palsy / Q000451:nursing*; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008429:Maternal Welfare / Q000523:psychology*; D008603:Mental Health; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors