All ETDs from UAB

Advisory Committee Chair

Beverly A Mulvihill

Advisory Committee Members

Russell Kirby

Joshua C Klapow

Mary A Pass

David T Redden

Document Type

Dissertation

Date of Award

2008

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

A cross-sectional study was conducted to investigate the relationship of child, family, and medical home status to quality of life for mothers of children with and without special health care needs. Mothers of children with (n=100) and without (n=80) special health care needs, completed a questionnaire at a children’s hospital in the southeastern United States focusing on the child, family, and medical home and maternal quality of life. Standardized instruments were used to measure quality of life (SF-36) and social support (Social Support Questionnaire). Non-standardized instruments used in other research were incorporated into the maternal questionnaire. Logistic and linear regression models were built to test the relationship between child, family, and medical home characteristics and maternal quality of life scores. Factors influencing mothers’ quality of life were the number of children with special health care needs (p=0.01), severity of the child’s condition (p<0.0001), presence of a behavior problem (p=0.0001), type of insurance coverage (p=0.045), maternal education level (p=0.005), maternal employment (p=0.0002), household income (p=0.0026), social support (p<0.0001), and satisfaction with social support (p<0.001)). Insurance coverage was not iii associated with the mental subscale of the quality of life measure. The number of children in the home was associated with the physical subscale of the quality of life measure (p=0.0348). It was determined that there was no association between having a medical home and maternal quality of life (p=0.5984). The multiple regression model including social support satisfaction and network, condition severity, the presence of a behavior problem, and income explained 35% of the variability in the maternal quality of life scores. Although having a medical home was not associated with maternal quality of life, this study validated previous research which indicated lower quality of life for mothers of CSHCN compared to mothers of children without SHCN. Additional studies focusing on accurately measuring medical home and quality of life are recommended. Additionally, other possible predictors of quality of life should be investigated to determine and implement interventions which could enrich maternal quality of life.

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