The Effects of Recreational Activities on Depressive Symptoms and Burnout Level of Mothers Having Children with Autism Spectrum Disorders

Year 2020, Volume: 3 Issue: 2, 74 - 82, 20.12.2020

Eren Şahin , Ahmet Onur Öz , Rabia Hürrem Özdurak Sıngın , Serkan Düz

https://doi.org/10.33438/ijdshs.754440

Abstract

Several studies revealed some mood disorders such as depression and burnout in nursing parents as a result of difficulties brought by Autism Spectrum Disorder (ASD) symptoms. On the other hand, recreative activities have a therapeutic effect on mental health. The aim of the study was to determine the effect of physical activity-based recreation on mothers' depression and burnout levels. 15 mothers having children with ASD were included in the single-group pre-test and post-test experimental design study. Beck Depression Inventory and Maslach Burnout Inventory were applied to mothers to determine depression and burnout levels before and after the one-week camp. According to the results of the paired sample t-test, the depression levels of the mothers decreased significantly after the camp, whereas burnout levels remained the same. While depression and burnout levels of the mothers were moderately correlated before the recreation camp, they did not correlate following the recreation camp. It can be concluded that burnout emotional state in parents of children with ASD may correlate with depression which might be reduced as a result of physical activity based recreative activities. Further longitudinal studies including quantitative and qualitative research methods are needed to determine the cause-effect relationship and create effective recreational programs for families having children with ASD.

Keywords

recreation, autism spectrum disorder, depression, burnout, mother

Thanks

We would like to express our thank and gratitude to the Kayseri Erciyes Camp and Education Center of the Ministry of Youth and Sports for the refreshments and housing they provide.

References

• American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC.
• Aydın, İ. (2018). Rekreasyon terapisi kamplarının sosyal etkilerinin değerlendirilmesi [Assessment of social effects of recreation therapy camps]. Anatolia: Journal of Tourism Research, 29(1). 106-112. doi: 10.17123/atad.441192
• Baker-Ericzén, M. J., Brookman-Frazee, L., & Stahmer, A. (2005). Stress levels and adaptability in parents of toddlers with and without autism spectrum disorders. Research and Practice for Persons with Severe Disabilities, 30(4), 194–204. doi: 10.2511/rpsd.30.4.194
• Bazarfeshan, B., Kargar-Dolatabadi, A., Mohammadi, M., Sarmadi, P., Lakzaei, J., Hosseininejad, S.,… Jouybari, L. (2018). Quality of life of the mothers of children with autism. Journal of Gorgan University of Medical Sciences, 20(4). 77-82. Available from http://goums.ac.ir/journal/article-1-3541-fa.pdf
• Beck, A. T. (1967). Depression: Clinical, experimental and theoretical aspects. Hoeber: New York.
• Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1). 77-100. doi: 10.1016/0272-7358(88)90050-5
• Benjak, T., Vuletić, G., & Kolarić, B. (2011). Subjective quality of life for parents of children with autism spectrum disorders in Croatia. Applied Research in Quality of Life, 6, 91-102.
• Bottini, S., Wiseman, K., & Gillis, J. (2020). Burnout in providers serving individuals with ASD: The impact of the workplace. Research in Developmental Disabilities, 100, 103616. doi: 10.1016/j.ridd.2020.103616
• Boyd, B. A. (2002). Examining the relationship between stress and lack of social support in mothers of children with autism. Focus on Autism and Other Developmental Disabilities, 17(4), 208-215. doi: 10.1177/10883576020170040301
• Carruthers C.P., & Hood, C. D. (2007). Building a life of meaning through therapeutic recreation: The leisure and well-being model part I, Therapeutic Recreation Journal, 41(4), 276-297.
• Chiri, G., & Warfield, M.E. Unmet Need and Problems Accessing Core Health Care Services for Children with Autism Spectrum Disorder. Matern Child Health J., 16, 1081–1091 (2012). https://doi.org/10.1007/s10995-011-0833-6
• Columna, L., Pyfer, J., & Senne, T. A. (2011). Physical recreation among immigrant Hispanic families with children with disabilities. Therapeutic Recreation Journal, 45(3), 214-233. Available from: https://search.proquest.com/openview/402cc4b3eb7461200be58762f5c50d9e/1?cbl=5997&pq-origsite=gscholar
• Creswell, J. W., & Creswell, D. J. (2018). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. London: SAGE Publications.
• Çam, O. (1989). Hemşirelerde tükenmişlik ve çeşitli değişkenlere göre incelenmesi [Burnout in nurses and examining according to several variables]. (Unpublished PhD thesis). Ege University, İzmir.
• Daley, M. R. (1979). Burnout: smoldering problem in protective services, Social Work, 24(5), 375-379. doi: 10.1093/sw/24.5.375
• Darıca N., Gümüşçü-Tuş Ş. & Abdioğlu-Pişkin Ü. (2000). Otizm ve Otistik Çocuklar [Autism and Autistic Children]. Özgür Publications: İstanbul.
• Demirci, N., Yıldırım, İ., Toptaş-Demirci, P., & Ersöz, Y. (2018). Why should we do physical activity? More active people for a healthier world. International Journal of Disabilities Sports and Health Sciences, 1(2), 1-14. doi: 10.33438/Ijdshs.488292
• Demirtaş, Ö., Şahin, E., & Atlı, F. (2019). Otizm spektrum bozukluğu olan bireylerin bakım verenlerinin yaşam kaliteleri ve boş zaman aktivitelerine katılımını engelleyen faktörlerin incelenmesi [Investigation of Factors Affecting Quality of Life and Participation In Recreation Activities Of Caregivers With Autism Spectrum Disorder Individuals]. Oral Presentation at 17. International Sport Sciences Congress, Antalya-Turkey. s. 2352-2352 http://burkonturizm.com/duyuru/burkon/82/SBK2019.pdf
• Diken, İ., Ardıç, A., Diken, Ö., & Gilliam, J. (2012). Gilliam otistik bozukluk derecelendirme ölçeği-2 Türkçe versiyonu’nun geçerlik ve güvenirliğinin araştırılması: Türkiye standardizasyon çalışması [Exploring the validity and reliability of Turkish version of Gilliam Autism Rating Scale-2: Turkish standardization study]. Education and Science, 37(166), 318-320. Retrieved from http://egitimvebilim.ted.org.tr/index.php/EB/article/view/1924/460
• Dinas, P. C., Koutedakis, Y., & Flouris, A. D. (2011). Effects of exercise and physical activity on depression. Irish Journal of Medical Science, 180(2). 319-325. doi: 10.1007/s11845-010-0633-9
• Dabrowska, A., & Pisula, E. (2010). Parenting stress and coping styles in mothers and fathers of pre-school children with autism and Down syndrome. Journal of Intellectual Disability Research, 54, 266-280. doi: 10.1111/j.1365-2788.2010.01258.x
• Duygun, T., & Sezgin, N. (2003). Zihinsel engelli ve sağlıklı çocuk annelerinde stres belirtileri, stresle başa çıkma tarzları ve algılanan sosyal desteğin tükenmişik düzeyine olan etkisi [The effects of stress symptoms, coping styles and perceived social support on burnout level of mentally handicapped and healthy children's mothers]. Turkish Journal of Psychology, 18(52), 37-52.
• Elçi, Ö. (2004). Predictive values of social support, coping styles and stress level in posttraumatic growth and burnout levels among the parents of children with autism. Unpublished master thesis, Middle East Technical University, Social Sciences Institute, Ankara.
• Erol, E. & Yazıcıoğlu, İ. (2019). Tükenmişlik Düzeyinin İş Performansına Etkisinde Rekreatif Aktivitelerin Aracılık Rolü: Yiyecek İçecek İşletmelerinde Bir Araştırma [Mediating role of recreational activities in the effect of burnout level on business performance: A research in food and beverage businesses]. Tourism Academic Journal, 6 (2), 139-152. Retrieved from https://dergipark.org.tr/tr/download/article-file/868907
• Estes, A., Munson, D., Dawson, G., Koehler, E., Zhou, X., & Abbot, R. (2009). Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism, 13(4). 375–387. doi:10.1177/1362361309105658.
• Falk, N., Norris, K., & Quinn, M. G. (2014). The factors predicting stres, anxiety and depression in the parents of children with autism. Journal of Autism and Developmental Disorders, 44(12), 3185-3203. doi: 10.1007/s10803-014-2189-4
• Freudenberger, H. J. (1974). Staff Burn-Out. Journal of Social Issues, 30(1), 159–165. doi:10.1111/j.15404560.1974.tb00706.x
• Gay, L. R. (1996). Educational research, competencies for analysis and application (5th Edition). OHIO: Merrill an imprint of Prentice Hall.
• Gay, L. R., & Airasian, P. (2000). Educational research competencies for analysis and application (6th Edition). Ohio: Merrill an imprint of Prentice Hall.
• Gürbüz-Özer, B., Aksu, H., & Eser, E. (2017). Otizmde yaşam kalitesi anketi anne-baba sürümünün Türkçe geçerliliği ve güvenilirliği [Turkish validity and reliability of quality of life in autism questionnaire-parent version]. Anatolian Journal of Psychiatry, 18(4). 344-352. doi: 10.5455/apd.249390
• Hastings, R. P. (2003). Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. Journal of Intellectual Disability Research, 47(4‐5), 231-237. doi: 10.1046/j.1365-2788.2003.00485.x
• Hastings, R. P., Kovshoff, H., Brown, T., Ward, N. J., Espinosa, F. D., & Remington, B. (2005). Coping strategies in mothers and fathers of preschool and school-age children with autism. Autism: The International Journal of Research and Practice, 9(4) 377-391. doi: 10.1177/1362361305056078
• Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(3), 629-642. doi: 10.1007/s10803-012-1604-y
• Hisli, N. (1988). Beck Depresyon Envanterinin Üniversite Öğrencileri Için Geçerliği, Güvenirliği [Validity and reliability of Beck Depression Inventory for university students]. Turkish Psychological Journal, 6(23). 3-13. Available from: http://www.turkpsikolojiyazilari.com/PDF/TPD/23/08.pdf
• Kaçmaz, N. (2005). Tükenmişlik (burnout) sendromu [Burnout syndrome]. Journal of Istanbul Faculty of Medicine, 68 (1), 29-32. Retrieved from https://dergipark.org.tr/tr/pub/iuitfd/issue/9260/116046
• Khanna, R., Madhavan, S. S., Smith, M. J., Patrick, J. H., Tworek, C., & Becker-Cottrill, B. (2011). Assessment of health-related quality of life among primary caregivers of children with autism spectrum disorders. Journal of autism and developmental disorders, 41(9), 1214–1227. doi: 10.1007/s10803-010-1140-6
• Kim, I., Ekas, N. V. & Hock, R. (2016). Associations between child behavior problems, family management, and depressive symptoms for mothers of children with autism spectrum disorder. Research in Autism Spectrum Disorders, 26, 80-90. doi: 10.1016/j.rasd.2016.03.009
• Krausz, M. & Meszaros, J. (2005). The retrospective experiences of a mother of a child with autism. The International Journal of Special Education, 20(2), 36-46. Retrieved from https://files.eric.ed.gov/fulltext/EJ846933.pdf
• Lai, W. W., & Oei, T. P. S. (2014). Coping in parents and caregivers of children with autism spectrum disorders (ASD): A review. Review Journal of Autism and Developmental Disorders, 1(3). 207-224. doi: 10.1007/s40489-014-0021-x
• Leiter, M. P., & Maslach, C. (1988). The impact of interpersonal environment on burnout and organizational commitment. Journal of Organizational Behavior, 9(4). 297–308. doi: 10.1002/job.4030090402
• Leiter, M. P., & Maslach, C. (2004). Areas of work-life: A structured approach to organizational predictors of job burnout. In P. L. Perrewe, D. C. Ganster (Ed.), Research in Occupational Stress and Well Being 3, (p. 91-134). doi: 10.1016/S1479-3555(03)03003-8
• Maenner MJ, Shaw KA, Baio J, Washington, A., Patrick, M., DiRienzo, M.,… Christensen, D. L. (2020). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years-Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Surveillance Summaries, 69(No. SS-4). 1–12. doi: 10.15585/mmwr.ss6904a1
• Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2, 99-113. doi: 10.1002/job.4030020205 Patten, S. B., Williams, J. V. A., Lavorato, D. H., & Eliasziw, M. (2009). A longitudinal community study of major depression and physical activity. General Hospital Psychiatry, 31(6), 571–575. doi: 10.1016/j.genhosppsych.2009.08.001
• Russell, R. V. (1987). The Importance of Recreation Satisfaction and Activity Participation to the Life Satisfaction of Age-segregated Retirees. Journal of Leisure Research, 19(4). 273–283. doi: 10.1080/00222216.1987.11969698.
• Russell, R. V. (1990). Recreation and Quality of Life in Old Age: A Causal Analysis. Journal of Applied Gerontology, 9(1). 77–90. doi: 10.1177/073346489000900107
• Singh, J., Goolsby, J. R., & Rhoads, G. K. (1994). Behavioral and Psychological Consequences of Boundary Spanning Burnout for Customer Service Representatives. Journal of Marketing Research, 31(4), 558–569. doi: 10.1177/002224379403100409
• Sikora, D., Moran, E., Orlich, F., Hall, T. A., Kovacs, E. A., Delahaye, J.,…Kuhlthau, K. (2013). The relationship between family functioning and behavior problems in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(2), 307-315. doi: 10.1016/j.rasd.2012.09.006
• Sylvester C. (2014) Therapeutic recreation and disability studies: Seeking an alliance. Therapeutic Recreation Journal, 48(1). 46-60.
• Şahin, C. (2010). Examination of correlation between depression and hopelessness levels in mothers of children who attend rehabilitation centers. Procedia-Social and Behavioral Sciences, 2(2), 5100-5103. doi: 10.1016/j.sbspro.2010.03.828
• Şireli, Ö., & Soykan, A., A. (2016). Depresyonu olan ergenlerin anne-babayı kabul-ret algıları ve aile işlevleri açısından incelenmesi [Examination of relation between parental acceptance-rejection and family functioning in adolescents with depression]. Journal of Psychiatry, 17(5), 403-410. doi: 10.5455/apd.179441
• Weiss, J. M. (2002). Hardiness and social support as predictors of stress in mothers of typical children with autism, and children with mental retardation. SAGE Publications and The National Autistic Society, 6(1). 115-130. doi: 10.1177/1362361302006001009
• Tel, H., & Ertekin-Pınar, Ş. (2013). Kronik ruhsal sorunlu hastaların primer bakım vericilerinde tükenmişlik ve depresyon arasındaki ilişkinin incelenmesi [Investigation of relationship in between burnout and depression in primary caregivers of chronic mental problem patients]. Journal of Psychiatric Nursing, 4(3): 145-152 doi: 10.5505/phd.2013.58088
• Toker, S., & Biron, M. (2012). Job burnout and depression: Unraveling their temporal relationship and considering the role of physical activity. Journal of Applied Psychology, 97(3), 699–710. doi:10.1037/a0026914
• Tunçel, A. (2017). Çocuklarında otizm spektrum bozukluğu olan annelerin depresyon, tükenmişlik ve umutsuzluk düzeylerinin çocuktaki otizmin ağırlık derecesine göre karşılaştırılması [Comparison of the levels of depression, burnout, and hopelessness of the mothers of children with autism spectrum disorders according to the severity of autism in the child.] (Unpublished Master Thesis). Hasan Kalyoncu University, Gaziantep.
• Tunçel, A., Tarı-Cömert, I., & Semerci, B. (2018). Maslach Tükenmişlik Ölçeğinin otizm spektrum bozukluğu olan çocukların anne-babalarında kullanılabilirliğinin belirlenmesi [Determining Maslach Burnout Inventory usability of parents of autistic spectrum disorder children]. Anatolian Journal of Psychiatry, 19(2), 64-71. doi: 10.5455/apd.295975
• Turnbull, A., Turnbull, R., Erwin, E. & Soodak, L. (2007). Families, proffessionals, and exceptionality positive outcomes through partnerships and trust (5.ed.). New Jersey: Pearson.
• Tütüncü, Ö. (2012). The Role of Recreation and Recreation Therapy in Quality of Life [Turkish]. Anatolia: Journal of Tourism Research, 32(2), 248-252. https://dergipark.org.tr/en/download/article-file/154442
• Tütüncü Ö., & Aydın İ. (2016). Engelsiz turizm kapsamında rekreasyon terapi kamplarının değerlendirilmesi. Anatolia: Journal of Tourism Research, 27(2). 290-297. https://www.anatoliajournal.com/atad/depo/dergiler/Cilt27_Sayi2_Yil2016_1484086518.pdf
• Vella E.J., Milligan B., & Bennett J. L. (2013). Participation in Outdoor Recreation Program Predicts Improved Psychosocial Well-Being Among Veterans with Post-Traumatic Stress Disorder: A Pilot Study, Military Medicine, 178(3),254-260. doi: 10.7205/MILMED-D-12-00308
• Williams K. E., & Bond, M. J. (2002). The roles of self-efficacy, outcome expectancies and social support in the self-care behaviors of diabetes. Psychology, Health & Medicine, 7(2). 127-141. doi: 10.1080/13548500120116076