Estresse e resiliência em pais de crianças com paralisia cerebral

Abstract

This PhD thesis aimed to investigate the parental stress levels, their relationship to the degree of sons of motor impairment with cerebral palsy, a possible association between stress and resilience of parents of children with cerebral palsy and identify protective factors and risk in the words of parents little stressed. This research is organized in five studies, being constituted by theoretical sessions (Studies 1 and 2) and empirically (study 3, 4 and 5). The first theoretical study describes the importance of the family for the development of children with cerebral palsy according to bioecological theory of human development Bronfenbrenner. For this presents a discussion on family, typical and atypical development, families of children with disabilities and family implications arising from the birth of a child with cerebral palsy. The second theoretical study it is a systematic review consisting of 26 articles published between 2003 and 2015. The findings of this review showed the Parental Stress Index reduced version (PSI S / F) and the Classification System Function Gross Motor (GMFCS) as the main psychometric instruments used for the evaluation of parental stress and motor impairment in children with cerebral palsy, respectively. Moreover also it showed that the aspects relating to fathers and mothers and children with CP, among others, greatly influence the manifestation of stress in the studied parental population. With regard to studies of the empirical section, we emphasize that all were conducted with parents of children diagnosed with cerebral palsy (ICD- 10-G80) met in a federal reference public hospital in the state of Pará, and 92 participated in the first and according to studies that session (studies 3 and 4). The latest study (Study 5) was performed with 101 parents at first, followed by the final sample consisted of seven participants. Regarding the instruments used in these empirical studies, it is emphasized that in all were used Inventory demographic Partner (ISD), the GMFCS and PSI / SF, and Connor's Resilience Scale and Davidson (CD-RISC) only used in 4 study and focus group technique only in the study 5. Finally as regards the analysis of the data was performed using the statistical package SPSS version 20.0 with a significance level of p <0.005 for quantitative analysis and NVivo software to 10 qualitative analysis. The findings of empirical studies have shown that found approximate age range of children with cerebral palsy in both stressed parent groups and little stressed, but highlighted the presence of younger parents in the stressed parent group and prolonged union of parents when children with cerebral palsy was born in the little group of stressed parents (study 3). Moreover, it was observed in the study 4 that the following items ISD parents union time, age of child, age of parents, school adjustment, health problems, government benefit, child attends school and town you live interacted with RISC CD factors were: courage / determination, adaptability, social support and control, adversity, tolerance, self-efficacy, social support and trust and full resilience, explained the resilience in groups of stress obtained. Furthermore, this research showed that older fathers are more likely to have high resilience, the same occurring with parents of younger children. Finally, there was a higher frequency of protective accounts, mainly related to the person, and others on the context and time, which may explain the low level of stress found (study 5). Finally it is hoped that this research will encourage the development of public policies of assistance to families of children with chronic conditions, such as cerebral palsy, to ensure the creation and implementation of assistance programs aimed at detection and treatment when necessary, the symptoms of parental emotional stress.