Health-Promoting Behaviors Between Parenting Stress and Health-Related Quality of Life

Background: Studies show that parents of children with cerebral palsy (CP) exhibit high parenting stress and low health-related quality of life (HRQOL). Health-promoting behaviors (HPB) may reduce the effect of parenting stress on HRQOL. However, no studies have examined the role of HPB in the parenting stress-HRQOL relationship among mothers of children with CP. Objective: To explore overall and specific indirect effects of HPB on the parenting stress-HRQOL relationship in mothers of children with CP. Theoretical framework: This study is based on transactional model of stress and coping to evaluate the joint and individual influences of health-promoting behaviors in the relationship between parenting stress and HRQOL among mothers of children with CP. Methods: A convenience sample of 180 mothers of children with CP aged 10 months to 12 years was recruited in Korea. HPB were measured using Health-Promoting Lifestyle Profile II, consisting of health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management subscales. Multiple mediation analyses were conducted to separately explore mediating roles of individual HPB. Results: HPB had a significant indirect effect on the relationship between parenting stress and mental HRQOL but not physical HRQOL. The total indirect effect was not significant, but health responsibility had a significant indirect effect on the parenting stress-physical HRQOL association. Regarding the parenting stress-mental HRQOL association, the total indirect effect of HPB was significant, as were the indirect effects of spiritual growth and stress management. Conclusion: HPB should be promoted among mothers of children with CP to attenuate the effect of parenting stress on mental HRQOL. Multiple mediation analyses provide evidence for determining which specific HPB could be effective in improving HRQOL for family caregivers of children with disabilities, thus supporting development of interventions tailored for this population.