Otizm Spektrum Bozukluğu Tanılı Çocukların Ebeveynlerinde Yaşam Kalitesi, Kaygı, Depresyon Düzeyleri ve İlişkili Faktörler

Yıl 2022, , 217 - 224, 15.09.2022

Barış Güller , Ferhat Yaylacı

https://doi.org/10.32708/uutfd.1124107

Öz

Bu çalışmada otizm spektrum bozukluğu (OSB) tanılı çocukların ebeveynlerinde yaşam kalitesi, kaygı, depresyon riski ve ilişkili faktörler araştırıldı. Çalışmaya OSB tanılı 182 çocuk ve ebeveyni dahil edildi. Ebeveynler tarafından Otizmde Yaşam Kalitesi Ölçeği-Ebeveyn Formu (OYKA-E) ve Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) dolduruldu. Çalışmacı tarafından Çocukluk Otizmi Derecelendirme Ölçeği (ÇODÖ) uygulandı. Çocukların %85,2’si erkek (n=155), tüm çocukların ortanca yaş değeri 8 (2-13) bulundu. Çalışmaya katılan ebeveynlerin % 79,1’i (n=144) annelerdi. OYKA-E Bölüm A ortanca değeri 84,00 (39-140), Bölüm B ortanca değeri 55,00 (20-95) bulundu. HAD-A ölçeğinde kesme puanı üzerinde yanıt oranı %59,3, HAD-D ölçeğinde %68,1 idi. ÇODÖ’nün OYKA-E Bölüm A (r=-0,201; p=0,006) ve Bölüm B (r=-0,486; p<0,001) ile arasında negatif korelasyon bulundu. OYKA-E Bölüm A ile HAD-A (r=-0,628; p<0,001) ve HAD-D (r=-0,659; p<0,001) arasında negatif korelasyon bulundu. Yine OYKA-E Bölüm B ile HAD-A (r=-0,438; p<0,001) ve HAD-D (r=-0,372; p<0,001) arasında negatif korelasyon bulundu. OYKA-E Bölüm A ile baba eğitim düzeyi (r=0,191; p=0,010) ve aylık gelir düzeyi (r=0,269; p<0,001) arasında pozitif korelasyon bulundu. OYKA-E Bölüm B ile çocuğun yaşı arasında (r=-0,149; p=0,045) negatif, aylık gelir düzeyi (r=0,187; p=0,011) ile arasında pozitif korelasyon bulundu. Çalışmamız OSB şiddeti, çocukta ilaç kullanımı, çocuğun yaşı, ailenin gelir düzeyi ve babanın eğitim düzeyi gibi faktörlerin ebeveyn yaşam kalitesini ve ruh sağlığını etkileyen faktörler olabileceğini düşündürmektedir. Çocuklara yönelik müdahaleler yanında, ebeveynlerin baş etme becerilerini geliştirecek programların planlanması, ebeveyn yaşam kalitesinde artış ve ruh sağlığında iyileşme sağlayabilir.

Anahtar Kelimeler

Otizm spektrum bozukluğu, ebeveylik, yaşam kalitesi, anksiyete, depresyon

Quality of life, anxiety, depression levels and related factors in parents of children with Autism Spectrum Disorder

Öz

disorder (ASD). One hundred and eighty-two children with ASD and their parents were included in the study. The Quality of Life in Autism Scale-Parent Version (QOLA-P) and the Hospital Anxiety and Depression Scale (HADS) were filled in by the parents. The Childhood Autism Rating Scale (CARS) was applied by the researcher. It was determined that 85,2% of the children were male (n=155), and the median age of all children was 8 years (2-13). Mothers constituted 79.1% (n=144) of the parents participating in the study. The median value of QOLA-P Part A was 84.00 (39-140), and the median value of of Part B was 55.00 (20-95). The response rate above the cut-off point on the HAD-A scale was 59.3% and 68.1% on the HAD-D scale. There was a negative correlation between the CARS and the QOLA-P Part A (r=-0.201;p=0.006) and Part B (r=-0.486; p<0.001). A negative correlation was found between QOLA-P Part A and HAD-A (r=-0.628; p<0.001) and HAD-D (r=-0.659; p<0.001). Again, a negative correlation was found between QOLA-P Part B and HAD-A (r=-0.438; p<0.001) and HAD-D (r=-0.372; p<0.001). A positive correlation was found between the QOLA-P Part A and the father's education level (r=0.191; p=0.010) and monthly income level (r=0.269; p<0.001). There was a negative correlation between the QOLA-P Part B and the age of the child (r=-0.149; p=0.045), and a positive correlation with monthly income level (r=0.187; p=0.011). Our study determined that factors such as ASD severity, drug use, child's age, income level, and father's education level are among the factors affecting the parental quality of life and mental health. In addition to interventions for children, planning programs that will improve parents' coping skills can increase the parental quality of life and improve mental health.

Anahtar Kelimeler

Autism spectrum disorder, parenting, quality of life, anxiety, depression

Kaynakça

• 1. American Psychiatric Association DS, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5). Washington, DC: American psychiatric association; 2013.
• 2. Maenner MJ, Shaw KA, Bakian AV, Bilder DA, Durkin MS, Esler A et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ 2021;70:1–16.
• 3. What quality of life? The WHOQOL Group. "World health organization quality of life assessment." World Health Forum 1996;17:4.
• 4. Mugno D, Ruta L, D'Arrigo VG, Mazzone L. Impairment of quality of life in parents of children and adolescents with pervasive developmental disorder. Health Qual Life Outcomes 2007;5:22.
• 5. Allik H, Larsson JO, Smedje H. Health-related quality of life in parents of school-age children with Asperger syndrome or high-functioning autism. Health and quality of life outcomes.2006;4:1-8.
• 6. Yazıcı KU. Otizm Spektrum Bozukluğu Tanılı Olguların Tipik Gelişim Gösteren Kardeşlerinde Depresif Özellikler ve Yaşam Kalitesinin Değerlendirilmesi: Tedavinin Kardeşlerdeki Bulgular Üzerine Etkisi. Fırat Tıp Dergisi 2020;25:23-33.
• 7. Gümüş R, Aluçlu MU, Sarıbaş S. Diyarbakır'da 2010-2015 Yılları Arasında Sağlık Bakanlığı Hastaneleri Tarafından Evde Bakılan Çocuk ve Gençlerin Sağlık Durumları Üzerine Bir Araştırma. Dicle Tıp Dergisi 2016;43:549-55.
• 8. Altiere MJ, von Kluge S. Searching for acceptance: Challenges encountered while raising a child with autism. J Intellect Dev Disabil 2009;34:142–52.
• 9. Machado Junior SB, Celestino MIO, Serra JPC, Caron J, Pondé MP. Risk and protective factors for symptoms of anxiety and depression in parents of children with autism spectrum disorder. Dev Neurorehabil 2016;19:146–53.
• 10. Https://www.aile.gov.tr/asgari-ucret/asgari-ucret-2021/ 13.10.2021 tarihinde erişilmiştir.
• 11. Schopler E, Reichler R, Rochen Renner B. The Childhood Autism Rating Scale. Western Psychological Services. 1988.
• 12. İncekaş S, Baykara B, Avcil S, Demiral Y. Çocukluk otizmi derecelendirme ölçeği, Türkçe formunun geçerlik ve güvenirlik çalışması. Türk Psikiyatri Dergisi 2016;27(4):266-74).
• 13. Zigmond AS, Snaith RP. "The hospital anxiety and depression scale." Acta psychiatrica scandinavica 1983;67:361-70.
• 14. Aydemir Ö, Güvenir T, Kuey L, Kültür S. Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi 1997;8: 280-87.
• 15. Eapen V, Črnčec R, Walter A, Tay KP. Conceptualisation and development of a quality of life measure for parents of children with autism spectrum disorder. Autism Research and Treatent. 2014.
• 16. Özgür BG, Aksu H, Eser E. Otizmde Yaşam Kalitesi Anketi Anne-Baba sürümünün Türkçe geçerliliği ve güvenilirliği. Anatolian J Psychiatry 2017;18:344–52.
• 17. Asahar SFİ, Malek KA, Isa MR. Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Stud. Int J Environ Res Public Health. 2021;18: 9861.
• 18. 18 Öz B, Yüksel T, Nasıroğlu S. Otizm Spektrum Bozukluğu Tanısı Alan Çocukların Annelerinde Görülen Depresyon-Anksiyete Belirtileri ve Damgalanma Algısı. Arch Neuropsychiatry 2020;57:50-55.
• 19. Hayes SA, Watson SL. 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 2013;43: 629–42.
• 20. Falk NH, Norris K, Quinn MG. The factors predicting stress, anxiety and depression in the parents of children with autism. Journal of Autism and Developmental Disorders 2014; 44: 3185–203.
• 21. Phetrasuwan S, Shandor Miles M. Parenting stress in mothers of children with autism spectrum disorders. Journal for Specialists in Pediatric Nursing 2009;14:157–65.
• 22. Hsiao YJ. Pathways to mental health-related quality of life for parents of children with autism spectrum disorder: Roles of parental stress, children’s performance, medical support, and neighbor support. Research in Autism Spectrum Disorders 2016; 23:122–130.
• 23. Wheeler AC, Skinner DG, Bailey DB. Perceived quality of life in mothers of children with fragile X syndrome. American Journal on Mental Retardation 2008;113:159–77.
• 24. Cappe É, Poirier N, Sankey C, Belzil A, Dionne C. Quality of life of French Canadian parents raising a child with autism spectrum disorder and effects of psychosocial factors. Qual Life Res 2018;27:955–67.
• 25. Hartley SL, Schultz HM. Support needs of fathers and mothers of children and adolescents with autism spectrum disorder. J Autism Dev Disord 2015;45:1636–48.
• 26. Singer GHS. Meta-analysis of comparative studies of depression in mothers of children with and without developmental disabilities. AJMR 2006;111:155–69.
• 27. Estes A, Munson J, Dawson G, Koehler E, Zhou XH, Abbott R. Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay. Autism. 2009;13:375–87.
• 28. Chen SJ, Wu CC. The mediation of coping behaviors in the relationships between parenting stress and depression, hopelessness, and quality of life among mothers of preschool children with autism spectrum disorders. Journal of Education & Psychology 2017;40:63–90.
• 29. Benson PR. The impact of child symptom severity on depressed mood among parents of children with autism spectrum disorder: The mediating role of stress proliferation. Journal of Autism and Developmental Disorders 2006;36:685–95.
• 30. Zablotsky B, Anderson C, Law P. The Association Between Child Autism Symptomatology, Maternal Quality of Life, and Risk for Depression. Journal of Autism and Developmental Disorders 2013;43:1946–55.
• 31. Guralnick MJ. Why early intervention works: A systems perspective. Infants and Young Children 2011;24:6–28.