The Effectiveness of WHO Stress Management in Reducing Distress Among Parents as Caregivers of Children With Neurodevelopmental Disorders

Authors

  • Alifiani Nurrohmah Department of Psychiatry, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  • Gusti Ayu Maharatih Department of Psychiatry, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  • Vitri Widyaningsih Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

DOI:

https://doi.org/10.26911/thejmch.2025.10.03.01

Abstract

Background: Caring for a child with neurodevelopmental disorders presents a significant challenge for caregivers, often resulting in stress, emotional pressure, and disruption in family and work life. To support the mental health and well-being of caregivers, effective interventions are needed to manage stress. This study was conducted to evaluate the effectiveness of stress management recommended by WHO in reducing stress levels among caregivers of children with neurodevelopmental disorders.

Subjects and Method: The research was conducted using an experimental research design, pre-test and post-test design without a control group. The study was conducted at the Disability Service and Inclusive Education Center of Surakarta City in April-May 2024. A total of 103 participants completed the questionnaire, with 74 meeting the inclusion criteria (PSS score > 14). The dependent variable was distress measured using the PSS questionnaire. The independent variable was WHO Stress Management. Data were analyzed using the Wilcoxon test and multivariate linear regression.

Results: The majority of caregivers were female (91.9%) with a mean age of 37.89 years (SD=6.2). The results showed that the mean PSS score decreased significantly from 19.14(SD=3.06) at pre-test to 17.51 (SD=3.23) at post-test (p <0.001). The level of moderate stress decreased from 97.3% to 90.5%, and the level of severe stress decreased to 0% (p=0.003). Family income (p=0.000), caregiving support (p=0.001), and compliance in listening to audio (p <0.001) variables significantly influenced the reduction in PSS scores.

Conclusion: The WHO stress management intervention is effective in reducing distress among parents caring for children with neurodevelopmental disorders.

Keywords:

neurodevelopmental disorders, caregiver, WHO stress management, perceived stress scale

References

Adib NA, Ibrahim MI, Ab Rahman A, Bakar RS, Yahaya NA, Hussin S, Wan Mansor WNA (2019). Perceived stress among caregivers of children with autism spectrum disorder: a state-wide study. Int J Environ Res Public Health. 16(8):1468. doi: 10.3390/ijerph16081468.

Behbahani M. Zargar FM. Assarian F. Akbari H. Zargar F (2018). Effects of mindful parenting training on clinical symptoms in children with attention deficit hyperactivity disorder and parenting stress: randomized controlled trial. In Iran J Med Sci. 43(6).

Bourke-Taylor HM, Lee DA, Tirlea L, Joyce K, Morgan P, Haines TP (2021). Interventions to improve the mental health of mothers of children with a disability: systematic review, meta-analysis and description of interventions. J Autism Dev Disord. 51(10):3690-3706. doi: 10.1007/s10803020048264.

Bray M, Root M, Gelbar N, Bruder MB, Menzies V (2017). Relaxation and guided imagery for parents of off-spring with developmental disabilities. J. Abnorm. Psychol 06(01). https://doi.org/10.4172/24719900.1000155

Catalano D, Holloway L, Mpofu E (2018). Mental health interventions for parent carers of children with autistic spectrum disorder: practice guidelines from a critical interpretive synthesis (CIS) systematic review. Int J Environ Res Public Health. 15(2):341. doi: 10.3390/ijerph15020341.

Chua SY, Abd Rahman FN, Ratnasingam S (2023). Problem behaviours and caregiver burden among children with Autism Spectrum Disorder in Kuching, Sarawak. Front Psychiatry. 14:1244164. doi: 10.3389/fpsyt.2023.1244164.

Craig F, Operto FF, De Giacomo A, Margari L, Frolli A, Conson M, Ivagnes S, Monaco M, Margari F (2016). Parenting stress among parents of children with Neurodevelopmental Disorders. Psychiatry Res. 242:121-129. doi: 10.1016/j.psychres.2016.05.016.

Damen H, Scholte RHJ, Vermulst AA, Steensel P, Veerman JW (2021). Parental empowerment as a buffer between parental stress and child behavioral problems after family treatment. Children and Youth Services Review. 124. https://doi.org/10.1016/j.childyouth.2021.105982

Forbes L, Gutierrez D, Johnson SK (2018). Investigating adherence to an online introductory mindfulness program. mindfulness. 9(1). 271–282. https://doi.org/10.1007/s1267101707724

Francés L, Quintero J, Fernández A, Ruiz A, Caules J, Fillon G, Hervás A, Soler CV (2022). Current state of knowledge on the prevalence of neurodevelopmental disorders in childhood according to the DSM-5: a systematic review in accordance with the PRISMA criteria. Child Adolesc Psychiatry Ment Health. 16(1):27. doi: 10.1186/s13034022004621.

Frantz R, Hansen SG, Machalicek W (2018). Interventions to Promote Well-Being in Parents of Children with Autism: a Systematic Review. Rev J Autism Dev Disord 5, 58–77 (2018). https://doi.org/10.1007/s4048901701233

George A (2022). Caregiver burden and coping strategies among parents of special children. https://www.researchgate.net/publication/377269859

Godoy LD, Rossignoli MT, Delfino-Pereira P, Garcia-Cairasco N, de Lima Umeoka EH (2018). A comprehensive overview on stress neurobiology: basic concepts and clinical implications. Front Behav Neurosci. 12:127. doi: 10.3389/fnbeh.2018.00127.

Hallberg U, Klingberg G (2023). Children with special needs: An overview of knowledge on disability. Springer-Briefs in Social Work, 1st Edition. Springer.

Hartley M, Dorstyn D, Due C (2019). Mindfulness for children and adults with autism spectrum disorder and their caregivers: a meta-analysis. J Autism Dev Disord. 49(10):4306-4319. doi: 10.1007/s10803019041453.

Herrero R, Díaz A, Zueco J (2024). The burden and psychological distress of family caregivers of individuals with autism spectrum disorder: a gender approach. J Clin Med. 13(10): 2861. https://doi.org/10.3390/jcm13102861.

Jaiswal S, Muggleton NG, Juan CH, Liang WK (2019). Indices of association between anxiety and mindfulness: a guide for future mindfulness studies. Personal Neurosci. 2:e9. doi: 10.1017/pen.2019.12.

Koly KN, Martin-Herz SP, Islam MS, Sharmin N, Blencowe H, Naheed A (2021). Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review. PLoS One. 16(3):e0247432. doi: 10.1371/journal.pone.0247432.

Lindsey RA, Barry TD (2018). Protective factors against distress for caregivers of a child with autism spectrum disorder. J Autism Dev Disord. 48(4):1092-1107. doi: 10.1007/s1080301733721.

Maridal HK, Bjørgaas HM, Hagen K, Jonsbu E, Mahat P, Malakar S, Dørheim S (2021). Psychological distress among caregivers of children with neurodevelopmental disorders in Nepal. Int J Environ Res Public Health. 18(5):2460. doi: 10.3390/ijerph18052460.

McEwen BS, Akil H (2020). Revisiting the stress concept: implications for affective disorders. J Neurosci. 40(1):12-21. doi: 10.1523/JNEUROSCI.073319.2019.

Octaviani ID. Maharatih GA. Herdaetha A (2023). Effectiveness of WHO stress management for improving insomnia severity index score in telegram’s self-isolated online group population. Majalah Kedokteran Bandung. 55(2). https://doi.org/10.15395/mkb.v55n2.2753

Prata J, Lawson W, Coelho R (2019). Stress factors in parents of children on the autism spectrum: an integrative model approach. Int. J. Clin. Neurosci. Ment. Health. 4(2). https://doi.org/10.21035/ijcnmh.2019.6.2

Salari N, Ghasemi H, Abdoli N, Rahmani A, Shiri MH, Hashemian AH, Akbari H, Mohammadi M (2023). The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis. Ital J Pediatr. 49(1):48. doi: 10.1186/s13052023014561.

Siebelink NM, Bögels SM, Speckens AEM, Dammers JT, Wolfers T, Buitelaar JK, Greven CU (2022). A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents. J Child Psychol Psychiatry. 63(2):165-177. doi: 10.1111/jcpp.13430.

Silva ACS. Miranda AS. Rocha NP. Teixeira AL (2019). Neuropsychiatric disorders in chronic kidney disease. In Frontiers in Pharmacology .10(7). Frontiers Media S.A. https://doi.org/10.3389/fphar.2019.00932

Willekens B, Perrotta G, Cras P, Cools N (2018). Into the moment: does mindfulness affect biological pathways in multiple sclerosis? Front Behav Neurosci. 12:103. doi: 10.3389/fnbeh.2018.00103.

Yu Y, McGrew JH, Boloor J (2019). Effects of caregiver-focused programs on psychosocial outcomes in caregivers of individuals with ASD: A Meta-analysis. J Autism Dev Disord. 49(12):4761-4779. doi: 10.1007/s1080301904181z.

Zygopoulou M, Gkiolnta E, Papaefstathiou E, Sarri K, Syriopoulou-Delli CK (2021). Interventions to support parents of pre-school children with Autism Spectrum Disorders: a systematic review. Research. Society and Development. 10(14). e102101421932. https://doi.org/10.33448/rsdv10i14.21932

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Published

2025-05-16

How to Cite

Alifiani Nurrohmah, Gusti Ayu Maharatih, & Vitri Widyaningsih. (2025). The Effectiveness of WHO Stress Management in Reducing Distress Among Parents as Caregivers of Children With Neurodevelopmental Disorders . Journal of Maternal and Child Health, 10(3), 124–139. https://doi.org/10.26911/thejmch.2025.10.03.01

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