Mental health and parenting stress in mothers of children with diabetes treated in a patient-centred medical home

2018 ◽  
Vol 36 (4) ◽  
pp. 486-492
Author(s):  
L Adelyn Cohen ◽  
Christine A Limbers

Abstract Background Mothers of children with diabetes are at-risk for experiencing parenting stress and diminished mental/emotional health. To the best of our knowledge, no studies to date have examined whether there are differences in these outcomes between mothers whose diabetic child is managed in a patient-centred medical home or not. Objective The objective of the present study was to assess whether there were differences in mental health and parenting stress among mothers whose diabetic child was managed in a patient-centred medical home or not. Methods Two hundred fifty-three mothers of children with diabetes (mean age = 12.50 years; SD = 3.90) from the 2011–2012 National Survey of Children’s Health were included in this study. Hierarchical multiple regression was conducted to determine the amount of variance that having a patient-centred medical home contributed to maternal emotional/mental health and parenting stress. Results After controlling for child sex, age, race/ethnicity and family poverty level, patient-centred medical home status was associated with better mental health for mothers and less parenting stress. Effective care coordination was the only subcomponent of the patient-centred medical home that significantly contributed to the variance in mother’s mental/emotional health and parenting stress. Conclusions Receiving care in a patient-centred medical home, particularly the care coordination component, may mitigate some of the negative maternal effects of managing a child’s diabetes.

2020 ◽  
Vol 11 ◽  
pp. 215013272093606
Author(s):  
Christine A. Limbers ◽  
Abbi Gutierrez ◽  
L. Adelyn Cohen

Objective: This study examined the correlations between receiving care in patient-centered medical home and maternal reports of their mental health and parenting stress in a national sample of mothers of children with autism spectrum disorder (ASD). Method: Participants were 1108 mothers of children with ASD (average age = 10.6 years; 81% male) from the 2011-2012 National Survey of Children’s Health. Multiple linear regression analysis and polynomial logistic regression analysis were used to evaluate if having a child with ASD cared for in a patient-centered medical home was significantly associated with maternal reports of their parenting stress and mental health. We also assessed whether 5 indicators of the American Academy of Pediatrics medical home definition were differentially associated with maternal outcomes. Results: Receiving care in a patient-centered medical home was associated with maternal reports of less parenting stress (standardized β = −0.201; P < .001) and better mental health (odds ratios range from 0.204 to 0.360; P < .001) after controlling for sociodemographic variables. Of the 5 indicators of the medical home definition, only effective care coordination was significantly associated with maternal perceptions of their parenting stress and mental health. Conclusion: Future longitudinal studies are needed to assess the temporal associations between patient-centered medical home status and maternal perceptions of their mental health and parenting stress in mothers of children with ASD.


2009 ◽  
Vol 38 (9) ◽  
pp. 491-497 ◽  
Author(s):  
Jeanne W. McAllister ◽  
Elizabeth Presler ◽  
Renee Turchi ◽  
Richard C. Antonelli

2011 ◽  
Vol 29 ◽  
pp. 127 ◽  
Author(s):  
Ruby Dhand

Ethno-racial psychiatric consumer/survivors face complex forms of discrimination as a result of the culture specific stigmatization of mental health disabilities, institutional racism and culturally inappropriate care. In an effort to achieve better access to justice for ethno-racial communities, we must strive to understand their complex needs, perspectives and conceptions of mental health. Thus, I identify and critique the legal barriers, which are perceived to differentially affect ethno-racial psychiatric consumer/survivors in Ontario, through an analysis of the Consent and Capacity Board [CCB]. I propose the hypothesis that factors such as race, ethnicity, culture, poverty and social exclusion are not fully addressed by the CCB. I use data collected from interviews with stakeholders to reveal the procedural, structural/systemic and discretionary barriers faced by ethno-racial psychiatric consumer/survivors within the CCB’s pre-hearing, hearing and post-hearing processes, along with recommendations to address these barriers.Les consommateurs/survivants de la psychiatrie ethnoraciale doivent surmonter des formes complexes de discrimination en raison de la stigmatisation culturelle des troubles mentaux, du racisme institutionnel et des soins culturellement inappropriés. Pour améliorer l’accès à la justice des collectivités ethnoraciales, nous devons nous efforcer de comprendre leurs besoins complexes, leurs perspectives et leurs conceptions de la santé mentale. Dans le présent travail, je relève et critique les obstacles juridiques, qui sont perçus comme touchant différemment les consommateurs/survivants de la psychiatrie ethnoraciale en Ontario, en effectuant une analyse des travaux de la Commission du consentement et de la capacité (la « CCC »). J’émets l’hypothèse que la CCC ne prend pas pleinement en compte des facteurs comme la race, l’ethnicité, la culture, la pauvreté et l’exclusion sociale. J’utilise des données provenant d’entrevues avec des parties prenantes pour illustrer les obstacles procéduraux, structurels/systémiques et discrétionnaires auxquels font face les consommateurs/survivants de la psychiatrie ethnoraciale lors des audiences préparatoires et des audiences de la CCC et dans le cadre des processus suivis par la CCC après les audiences, et je formule des recommandations visant à surmonter ces obstacles.


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