Caregiver's difficulty paying child's healthcare bills and bullying victimization of adolescents with physical disabilities

Res Nurs Health. 2021 Aug;44(4):653-663. doi: 10.1002/nur.22142. Epub 2021 May 16.


Guided by the ecological systems perspective, the objective of the study was to examine whether caregivers' difficulty paying their child's health-care bills is associated with bullying victimization directly and indirectly through the mediating mechanisms of caregivers' frustration, adolescents' internalizing problems, and social difficulty focusing on adolescents with physical disabilities. The 2019 National Survey of Children's Health dataset, which collected data on adolescents' and caregivers' demographic characteristics and health and well-being, was used. The study sample consisted of 368 caregivers of adolescents, 12-17 years of age with physical disabilities. No direct association between caregivers' difficulty paying their child's health-care bills and bullying victimization was found. However, caregivers' frustration and adolescents' internalizing problems were shown to have an indirect association with bullying victimization, which was mediated by difficulty making friends. In addition, adolescents' difficulty making friends was positively associated with bullying victimization. Practitioners working with adolescents with physical disabilities are encouraged to foster collaborative processes across various ecological systems of the adolescent and family to address caregivers' frustration and promote positive social and emotional development of the adolescent with physical disabilities, which can decrease their risk of bullying victimization.

Keywords: bullying; disabled persons; healthcare; parenting; socialization.

MeSH terms

  • Adolescent
  • Bullying / statistics & numerical data*
  • Caregivers / psychology*
  • Child
  • Crime Victims / statistics & numerical data*
  • Disabled Children / statistics & numerical data*
  • Female
  • Financing, Personal* / economics
  • Financing, Personal* / statistics & numerical data
  • Health Expenditures / statistics & numerical data
  • Humans
  • Male
  • Surveys and Questionnaires