Indian Journal of Psychiatric Nursing

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 18  |  Issue : 1  |  Page : 8--16

A Study to assess the challenges faced and measures taken by the mothers of children with attention-deficit hyperactivity disorder in a selected hospital, Kolkata, West Bengal


Soumi Mandal1, Bhanumati Dutta2,  
1 Lecturer, Department of Mental Health Nursing, BM Birla College of Nursing, Kolkata, India
2 Professor, BM Birla College of Nursing, Kolkata, India

Correspondence Address:
Ms. Soumi Mandal
Lecturer, Department of Psychiatric Nursing, B.M. Birla College of Nursing, Kolkata, West Benga
India

Abstract

Context: Children with attention-deficit hyperactivity disorder (ADHD) present a big challenge to mothers. They experience burden and lack of support and resources in child's care. Aims: This study aimed to assess the challenges faced and measures taken by mothers of children with ADHD. Settings: The present study was conducted at Outpatient Department of Manovikas Kendra, 482, Madudah. Plot 1-24, Sector - J, E. M. Bypass, Kolkata-700 107, West Bengal. Design: This was a descriptive survey approach. Subjects and Methods: Data were collected from 86 mothers included by nonprobability convenience sampling technique. Rating scale and semi-structured interview schedule were used to collect data. Statistical Analysis Used: Descriptive and inferential statistics was used for statistical analysis. Results: The findings revealed that only 2 (2.32%) mothers of children with ADHD faced mild (0–25), 81 (94.18%) mothers of children with ADHD faced moderate level (26–51), 3 (3.48%) mothers of children with ADHD faced severe (52–76) level of challenges, and all mothers (100%) used punishment/beating, provided the child toys for calming down, kept child under supervision, and praised their willingness to study rather than getting full marks. The computed Chi-square result showed significant association between level of challenges faced by the mothers with types of family, education qualification, and monthly family income (p < 0.05). Conclusions: Majority (94.18%) of the mothers of children with ADHD faced moderate level of challenges.



How to cite this article:
Mandal S, Dutta B. A Study to assess the challenges faced and measures taken by the mothers of children with attention-deficit hyperactivity disorder in a selected hospital, Kolkata, West Bengal.Indian J Psy Nsg 2021;18:8-16


How to cite this URL:
Mandal S, Dutta B. A Study to assess the challenges faced and measures taken by the mothers of children with attention-deficit hyperactivity disorder in a selected hospital, Kolkata, West Bengal. Indian J Psy Nsg [serial online] 2021 [cited 2022 Jan 23 ];18:8-16
Available from: https://www.ijpn.in/text.asp?2021/18/1/8/318671


Full Text



 Introduction



Attention-deficit hyperactivity disorder (ADHD) is a chronic and pervasive condition that begins in childhood and is characterized by inattention, impulsivity, and hyperactivity (American psychiatric association, 2013).[1] In 2018 prevalence of ADHD among primary school children was 5.7% in India.[2]. In West Bengal the prevalence in 2013 was 5.95%.[3] Often, the children with ADHD have impairment in sleep quality due to sleep-related behavior problems, so difficulties faced by parents related to activities of daily living.[4] Emotional and social ifficulties in children with ADHD due to lack of good attention, concentration, bad behavior, and language problem have an impact on school attendance.[5],[6] Mothers of children with ADHD suffer from increased level of anxiety due to their concerns and insufficient parenting skills.[7] Both children with ADHD and their siblings along with their mothers reported that they were substantially less happy with their family and with life overall due to the unmet health needs of ADHD children.[8] Stigmatizing experience of parents of children with a sudden diagnosis of ADHD and concern about how society would label their child, along with the associated social isolation and rejection.[9] Poor health in terms of ADHD reduces parental socioeconomic status by lowering their labor supply (and earnings) and reducing their relationship stability.[10] Further challenges are also reported in several studies.[11],[12],[13],[14] Primary caregivers of ADHD children experience burden, lack of support, and resources in their child's care.[15] Mothers of children with ADHD may face many challenges in different areas: activities of daily living, psychological well-being, social interaction, academic performance of the child, and socioeconomic loss. Various measures are adopted by family members of children with ADHD. Exposure to the natural environment has a positive impact on attention and concentration in children with ADHD.[16] A school-based group program for parents of children with ADHD along with teachers can deliver information about strategies used for managing the difficulties faced by children with ADHD.[17] Behavior management techniques are effective for children with ADHD.[18] Psychoeducation programs for parents of children with ADHD resulted in increased adherence to pharmacological treatment which resulted in improvement of clinical symptoms of children.[19] Inadequate parenting practices result in majority of the parents using physical punishment for treating their children.[20] In India, there is a lack of follow-up of patients with ADHD diagnoses. Therefore lack of awareness in community and family members in most cases results in a hindrance to the mother for rearing up her child with ADHD. Hence, the purpose of the study is to assess the challenges faced and measures taken by the mothers of children with ADHD. The objectives of the study were to assess the challenges faced by mothers of children with ADHD, to identify the measures taken by mothers of children with ADHD, and to find an association between the level of challenges and selected demographic variables.

 Subjects and Methods



The sample was drawn from the mothers of children (5–12 years) with ADHD who attended the OPD of Manovikas Kendra (West Bengal). In this study, nonprobability convenience sampling technique was adopted to select the mothers of children with ADHD who attended the OPD of Manovikas Kendra. Inclusion criteria were (1) mothers having children of 5–12 years of age with ADHD and (2) mothers available at the time of data collection. Mothers of children diagnosed with comorbid mental disorders were excluded from the study.

Demographic was developed to gather personal information of mothers of children with ADHD. It consisted of 10 items which include age of mothers, age of the children, number of children, place of living, type of family, marital status, level of education, occupation of mothers, family income, and adherence to treatment. Bengali and Hindi version rating scale was used to assess the challenges faced by the mothers of children with ADHD. Bengali and Hindi version semi-structured interview schedule was used to assess measures taken by mothers of children with ADHD. These tools were found reliable and valid for study.

The study was approved by the Ethical Committee of Manovikas Kendra, Kolkata, West Bengal. Written informed consent was also collected from subjects before proceeding to data collection after explaining the study objectives, their involvement, confidentiality of information, and possible use of findings.

 Results



Majority (50%) of mothers of children with ADHD belongs to the age group of 36-45 years of age [Figure 1]. Majority (67.44%) of mothers had children of 5-8 years of age with ADHD [Figure 2]. Majority (81.40%) of mothers had one child [Figure 3]. Majority (59.30%) of mothers lived in town [Figure 4]. Majority (81.39%) of mothers belonged to nuclear family [Figure 5]. Majority of mothers (96.51%) were staying with their husband [Figure 6]. Majority (61.63%) of mothers were having higher secondary and above level of educational standard [Figure 7]. Majority (84.88%) of mothers were housewife [Figure 8]. Majority (86.05%) of mothers had family income in the range of 10000rs and above per month [Figure 9]. Majority (61.63%) of mothers' children were adherent with treatment [Figure 10].{Figure 1}{Figure 2}{Figure 3}{Figure 4}{Figure 5}{Figure 6}{Figure 7}{Figure 8}{Figure 9}{Figure 10}

Data presented in [Table 1]A show that 45 (52.33%) mothers always face difficulty for engaging their child in hobbies or playing the game quietly for a long time and 52 (60.47%) mothers sometimes found it difficult in resulting their child from taking junk food.{Table 1}

Data presented in [Table 1]B show that 75 (87.21%) mothers were always worried about imagining what will happen to her child in her absence as her child will have nobody for support and sometimes difficult to control the child when he/she loses temper and misbehave with others for majority 52 (60.47%) of mothers.

Data presented in [Table 1]C show that 40 (56.98%) mothers always found it awkward when her child actively denies or refuses to respond to others call and majority 52 (60.07%) of mothers sometimes found it difficult to go relatives home as they do not tolerate her child's behaviors, especially jumping and running, unnecessarily.

Data presented in [Table 1]D show that for 35 (40.70%) mothers, it was always difficult to make their children able to take down all class notes and 58 (67.44%) mothers sometimes found it difficult in finding appropriate ways to let their child study as they avoid, dislike, or did not want to give study as they avoid, dislike, or did not want to give ongoing mental effort to complete their home task.

Data presented in [Table 1]E show that 24 (27.91%) mothers had always and 43 (50%) mothers had sometimes difficulties for frequent travel to school for parents meeting.

The data presented in [Table 2] show that 2 (2.32%) mothers of children with ADHD had a mild level of challenges. The data presented in [Table 3] shows that majority 81 (94.18%) mothers of children with ADHD had a moderate level of challenges during rearing up their child, and 3 (3.48%) mothers of children with ADHD had a severe level of challenges.{Table 2}{Table 3}

The data presented in [Table 4] show that the range of scores of challenges faced by the mothers of children with ADHD was 22–60. The mean score was 38.98 and data were highly dispersed (3.81%).{Table 4}

Data presented in [Table 5]A show that all (100%) mothers praised their child's effort, use punishment/beating, and consult with other family members about their child's discipline plan.{Table 5}

Data presented in [Table 5]B show that all (100%) mothers communicate with other parents to know about their discipline strategies and provide their child with an opportunity to calm by giving access to toys.

Data presented in [Table 5]C show that all (100%) mothers keep their child away from triggers such as hunger and loud noise because they make them hyperactive at social gatherings and kept their child under supervision outside of home.

Data presented in [Table 5]D show that all (100%) mothers helped their child in completing their homework, encouraged in new learning skill, praised their willingness to study rather than getting full marks, and provided them with books with colorful pages.

Data presented in [Table 5]E show that 56 (65.11%) mothers do not talk or do not allow to have access to toys when he/she damage things.

The data presented in [Table 6] show that challenges faced by mothers of children with ADHD were significantly associated with the type of family, education qualification of mother, and monthly income at 0.05 level of significance.{Table 6}

 Discussion



This study was formulated to assess the challenges faced and measures taken by mothers of children with ADHD. The result of the present study showed that the maximum (94.18%) of mothers faced a moderate level of challenges.

The present study findings were discussed with the findings of similar studies based on the objectives and hypotheses of the study.

The first objective was to assess the challenges faced by mothers of children with ADHD. As there was no such study conducted in the same field, so research supported the study with the findings of some studies those revealed psychological and emotional, social, and economic challenges of caregivers endure while living with children with ADHD.[11] The previous study also reported findings on five themes: burden of care, emotional effects, social effects, and impact of educational challenges.[21]

The second objective was to assess the measures taken by mothers of children with ADHD. The present study findings were supported by some previous studies which the previous researcher said that generally, mothers took various types of interventions such as medical interventions, environmental modifications, academic skill building, and social skill development.[22] Similar findings were also reported in studies where they explained how the parents deal with their challenging situation with the help of subcategories such as good mothering, advocating, and seeking necessary support from family and friends.

The third objective was to find an association between the level of challenges faced and selected demographic variables. In the present study, type of family, education qualification of mothers, and monthly family income were found to be significantly associated with challenges faced by mothers. Similar findings also reported in studies which reported type of family, marital status, family income, and treatment facilities were significantly associated with challenges of mothers.[23]

 Conclusions



In summary, the findings of the present study suggest that majority of mothers of children with ADHD faced a moderate level of challenges in the following five areas: Area I: activities of daily living, Area II: psychological well-being, Area III: social interaction, Area IV: academic performance of the child, and Area V: economical loss. The study suggested that all mothers consulted with other family members about discipline plans, communicated with other parents, kept their child under supervision, encourage in learning new skills, and provide them books with colorful pages. The study also suggested that challenges of mothers were associated with the type of family, education qualification of mother, and monthly income.

The findings of the present study could not generalized because of small sample size, conducted in a single setting, and nonprobability convenience sampling technique was used.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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