Predictors of mental health among parents of children with cerebral palsy during the COVID-19 pandemic in Iran: A web-based cross-sectional study

Res Dev Disabil. 2021 May:112:103890. doi: 10.1016/j.ridd.2021.103890. Epub 2021 Feb 16.


Background: Caring for children with cerebral palsy (CP) for many aspects of their lives may affect caregiver's psychological health. Emergence of COVID-19 put added pressure on caregivers.

Aims: The aim of this study was to investigate the psychological health of Iranian caregivers of children with CP and associated risks during a lockdown period.

Methods: Using online snowball sampling, 160 caregivers of children with CP participated in this web-based cross-sectional study. The Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-4), Caregiver Difficulties Scale (CDS), and a demographic questionnaire were administered. Hierarchical multiple linear regression analysis was applied to identify risk factors related to caregiver psychological health.

Outcomes and results: Mental health problems were prevalent; (depression = 45.0% and anxiety = 40.6%). Significant correlations were found between CDS and HADS-Anxiety (r = 0.472, P < 0.001), HADS-depression (r = 0.513, P < 0.001), and perceived stress (PSS) related to COVID-19 (r = 0.425, P < 0.001). After controlling for demographic and clinical variables, burden (CDS) was found to significantly predict caregiver anxiety, depression and stress. Furthermore, several demographic characteristics (being married, low educational level and low income) were significantly related to high HADS Anxiety scores. For depression, only having a physical problem was significantly related to HADS among demographic variables. No significant correlations were found between PSS-4 and demographic variables.

Conclusions and implications: During COVID-19 outbreak, the mental health of caregivers of children with CP is affected by multiple factors such as burden of care and demographic characteristics. Due to the importance of well-being among caregivers of disabled children, a comprehensive plan including psychological consultation, remote education, or in-person handouts for the self-care or handling of the children and adequate distance support may enable better mental health for these caregivers.

Keywords: Anxiety; Burden of care; COVID-19; Caregiver; Depression; Neurodevelopmental disorders.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • COVID-19*
  • Caregiver Burden / epidemiology*
  • Caregiver Burden / psychology
  • Cerebral Palsy*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Depression / psychology
  • Educational Status
  • Female
  • Health Status
  • Humans
  • Income
  • Internet
  • Iran / epidemiology
  • Male
  • Marital Status
  • Mental Health
  • Parents / psychology*
  • Prevalence
  • Risk Factors
  • SARS-CoV-2
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires