The Impact of Perinatal Stroke on Parents and Families

Abstract

In this dissertation, I examined the parental and familial impact of raising a child with perinatal stroke. This was accomplished through three carefully planned studies that used a population-based perinatal stroke research cohort and survey methodology. In the first study, the APSP Parental Outcome Measure (POM) was developed to assess the psychosocial impact of raising a child with perinatal stroke, including quantifiable measures of guilt and blame. The results provided strong evidence for the POM’s psychometric properties among a sample of parents of children with perinatal stroke. More specifically, evidence was gathered for the POM’s internal consistency, test-retest reliability, concurrent validity, convergent validity, incremental validity, and factor structure. In the second study, the psychosocial impact of raising a child with perinatal stroke was examined. Mothers of children with perinatal stroke were compared with mothers of children with typical development and fathers of children with perinatal stroke on measures of well-being. The results illustrated that the majority of mothers of children with perinatal stroke were indistinguishable from controls. However, mothers of children with moderate and severe conditions had worse outcomes on measures of depression, quality of life, marital satisfaction, and family functioning. Furthermore, mothers of children with perinatal stroke had similar or slightly worse outcomes than fathers with the most pronounced differences in their anxiety symptoms and feelings of guilt. In the third study, predictors of parent and family outcomes were examined, along with mediators and moderators, in order to better understand the process of adaptation to raising a child with perinatal stroke. The results showed that child and psychosocial variables predicted parent and family outcomes. Mores specifically, condition severity, social support, anxiety symptoms, and blame independently predicted caregiver depression, while condition severity, stress levels, and marital quality independently predicted family functioning. An evaluation of mediators and moderators yielded evidence that parental blame mediates the relationship between condition severity and caregiver depression. Collectively, these findings demonstrate that raising a child with perinatal stroke increases parents’ risk for psychosocial morbidity. However, a large portion of parents demonstrate resiliency, and a complex interplay of factors contribute to the condition’s parental and familial impact.