title: Risks and Protective Factors for Stress Self-Management in Parents of Children With Autism Spectrum Disorder: An Integrated Review of the Literature.
abstract: OBJECTIVE
  Stress in parents of children with autism spectrum disorder (ASD) has been reported to be very high. However, little is known about what risk and protective factors influence parental stress self-management in this population. Accordingly, this manuscript is a synthesis of the risk and protective factors that impact self-management of stress in these parents. The concepts in the individual and family self-management theory context domain were used as a framework to guide data collection and analysis.
  
  
  METHODS
  Searches were conducted using CINAHL, MedLine and PsychInfo. Studies were included if they addressed context factors in parents of children with ASD and were written in English.
  
  
  METHODS
  Ninety-eight studies met review criteria.
  
  
  RESULTS
  This review highlighted risk factors to parental stress self-management within the context of condition-specific factors, physical and social environment, and individual and family. The most concerning of these findings is that parents struggle accessing a diagnosis and services for their child and are frustrated with health care providers' knowledge of ASD and lack of communication.
  
  
  CONCLUSIONS
  The risks parents experience as they care for their child with ASD far outweigh the protective factors for self-management of parental stress.
  
  
  CONCLUSIONS
  Nurses who are aware of these issues can make important changes to their practice and have a significant impact on parental stress self-management and the care of children with ASD.
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI. Electronic address: bonis@uwm.edu.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Bonis
authors.affiliation: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI; Department of Nursing Research, Children's Hospital of Wisconsin, Box 1997, Milwaukee, WI.
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Sawin
mesh_terms: D000328:Adult; D000067877:Autism Spectrum Disorder / Q000523:psychology* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D055500:Resilience, Psychological; D020377:Self Efficacy; D060685:Sense of Coherence; D013315:Stress, Psychological / Q000517:prevention & control*
keywords: Access; Autism; Diagnosis; Parents; Self-management; Stress