title: Family adaptation to cerebral palsy in adolescents: A European multicenter study.
abstract: OBJECTIVE
  Factors promoting family adaptation to child's disability are poorly studied together. The aim of the study was to describe the family adaptation to disability and to identify determinants associated with using a global theoretical model.
  
  
  METHODS
  286 families of teenagers [13-17 years] with cerebral palsy (CP) from 4 European disability registers were included and visited at home. Face to face interviews were performed in order to measure parental distress, perceived impact in various dimensions of family life, family resources and stressors. Relationships were modelled with structural equations.
  
  
  RESULTS
  31.8% of parents living with an adolescent with CP showed clinically significant high stress requiring professional assistance. The main stressors were the level of motor impairment and behavioural disorders in adolescent. A good family functioning was the best protective factor. Respite in care and a parents' positive attitude were significantly related to less parental distress. Material support, socioeconomical level, marital status or parental qualifications did not appear to be significant protector factors.
  
  
  CONCLUSIONS
  Particular attention must be paid not only on physical condition but also on adolescent psychological problems to improve family adaptation. Families at risk of experiencing severe distress should be targeted early and proactive caregiver interventions on the whole family should be performed.
  
  
  CONCLUSIONS
  Family is a dynamic system: facing disability, it tries to recover its balance with available resources and its perception of the situation. Literature highlights potential stressors and protecting factors that could affect the disabled child's family adaptation but few papers study a global model including most of these factors. This study validated a global theoretical model of family adaptation to disability at adolescence. It identified behaviour disorders and motor impairment level as main stressors, family functioning as the largest protecting factors, and equipment and financial support as non significant protective factors.
authors.affiliation: UGA/CNRS/CHU de Grenoble, TIMC-IMAG UMR 5525, Themas, Grenoble F-38041, France. Electronic address: AGuyard1@chu-grenoble.fr.
authors.forename: Audrey
authors.initials: A
authors.lastname: Guyard
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Oster Farimagsgade 5, 1399 Copenhagen, Denmark. Electronic address: sim@niph.dk.
authors.forename: Susan I
authors.initials: SI
authors.lastname: Michelsen
authors.affiliation: INSERM, UMR 1027, Paul Sabatier University, 31000 Toulouse, France. Electronic address: Catherine.Arnaud@univ-tlse3.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.affiliation: UGA/CNRS/CHU de Grenoble, TIMC-IMAG UMR 5525, Themas, Grenoble F-38041, France. Electronic address: Jerome.Fauconnier@imag.fr.
authors.forename: Jerome
authors.initials: J
authors.lastname: Fauconnier
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D002547:Cerebral Palsy / Q000523:psychology*; D005060:Europe; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D000066553:Problem Behavior / Q000523:psychology*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*
keywords: Adolescent; Behavioural disorders; Cerebral palsy; Family adaptation; Parental distress; Structural equation modelling