Abstracts

Mothers of children who have seizure disorders are at risk for a poor adaptation related to the challenges of managing a condition that can be unpredicable, difficult to control, and often associated with a stigma. The purpose of this study was to investigate the influence of child characteristics, maternal characteristics, and maternal perceptions of the impact of the child[apos]s seizure disorder on maternal adaptation to the child[apos]s epilepsy. Maternal adaptation was conceptualized as low level of negative affect, high confidence in seizure condition management, and maintenance of family leisure activities. Perceptions of impact were proposed to mediate the effects of child and maternal characteristics on maternal adaptation.
Research participants were recruited from a large Midwestern university medical center, private practices, and school nurses. The children were required to have a diagnosis of a seizure disorder for at least six months prior to enrollment. The sample for this study consisted of 156 mother-child dyads. Data were collected by trained research assistants in structured interviews. Mulitiple regression was used to test the relationships among the variables. Three preliminary sets of regressions were carried out as a prerequisite to testing for mediation. First, indicators of maternal adaptation were regressed on child and maternal characteristics variables. The proposed mediators (maternal perceptions of the seizure condition[apos]s impact) were regressed on child and maternal characteristics variables in the second step. Thirdly, indicators of maternal adaptation were regressed on the proposed mediators. Eight potential mediated relationships were identified by this method. To test each of the eight relationships, both the independent variable (child or maternal characteristic) and the proposed mediator (maternal perception) were entered into the same regression simultaneously. Mediation was supported if the influence of the independent variable decreased to a nonsignificant level.
None of the eight relationships identified as potentially mediated were supported statistically. The effects of child characteristics, maternal characteristics, and maternal perceptions of impact of the seizure condition were direct rather than mediated. Maternal learned helplessness was associated with all outcome variables. Child internalizing behavior problems were associated with maternal depressive mood and maternal family satisfaction was associated with confidence in seizure condition management. Seizure severity and maternal family satisfaction were associated with maintenance of family leisure activities.
The results of this study suggest that maternal adaptation to a child[apos]s chronic seizure condition is complex and includes multiple factors in addition to the characteristics of the child[apos]s seizure condition. Mothers who perceive themselves as helpless, are dissatisfied with their nuclear famlies, and have children with more behavior problems are at risk for a poor adaptation.
[Supported by: NR04536]