Adverse health in parents of children with disabilities and chronic health conditions: A meta-analysis using the Parenting Stress Index's Health Sub-domain

Background: Compared with parents of same-aged children without disabilities, parents of children with disabilities and with chronic health conditions (CHC) show higher levels of stress and depression. Fewer studies, however, examine the physical health of these parents, and studies report mixed findings. Many studies, however, report mother's self-reported health using the Health Sub-domain of Abidin's Parenting Stress Index (PSI). We therefore conducted a meta-analysis comparing the physical health of parents of children with developmental disabilities (DD) and CHC vs. parents of children without DD/CHC in studies utilising this measure. Methods: Eligible studies used the long form of the PSI and reported results from the 5-item Health sub-domain. Group comparison effect sizes were synthesised in a meta-analysis, and we also examined the potential relations of child, parent, and study characteristics. Our search yielded 19 eligible studies. Results: Compared with parents of children without DD/CHC, parents of children with DD/CHC reported higher PSI health problem scores, with a weighted mean effect size of 0.39 (95% CI=0.23-0.55). Effect sizes ranged from -0.13 to 1.46 and there was evidence of heterogeneity in the effect sizes (τ²=0.07; Q₁₈=48.64, P<0.01; I²=63.0%). Studies with higher numbers of reporting quality indicators generally reported larger effects and more recent studies showed smaller effects. Although several child and parent characteristics were moderately associated with effect sizes, none reached statistical significance. Conclusions: Practitioners should be alerted to the need for health prevention and treatment in this at-risk parent group.