Parental Stress and Coping
The demands of parenting can cause considerable stress for families. This may be particularly the case for parents of CSHCN, who have to deal with more child health issues than other parents. In the NSCH, parents were asked how often during the past month they had felt that their child was much harder to care for than others of his or her age; how often the child did things that really bothered them a lot; and how often they had felt angry with the child. Parents were considered to often feel stressed if they answered “usually” or “always” to at least one of these measures. CSHCN were twice as likely to have parents who report feeling stress as non-CSHCN: the parents of 20.0 percent of CSHCN usually or always feel stress, compared to 7.9 percent of non-CSHCN.
Among CSHCN with complex needs, the parents of 26.8 percent report usually or always feeling stress. The percentage of all CSHCN whose parents usually or always feel stress has increased since 2003, from 17.4 percent of CSHCN and 5.9 percent of non-CSHCN. Across states, the percentage of all CSHCN whose parents usually or always feel stress ranges from 10.5 percent to 26.6 percent.
Similarly, parents of CSHCN are less likely than other parents to report that they are coping very well with the demands of parenting. 51.9 percent of CSHCN's parents said they were coping very well, compared to 62.3 percent of non-CSHCN's parents. Rates of parental coping were particularly poor for parents of CSHCN with more complex problems: Among CSHCN with more complex service needs, the parents of less than half (48.8 percent) reported that they were coping very well.
Parents of older children are also less likely to report that they are coping very well: of CSHCN aged 12-17 years, the parents of 47.0 percent reported that they were coping very well, compared to 61.9 percent of the parents of CSHCN age 0-5. This pattern is evident among children without special health care needs as well.
Parental stress and coping was particularly poor for parents of children with emotional, behavioral, or developmental (EBD) conditions: Parents of only 42.8 percent of CSHCN aged 2-17 with EBD conditions reported that they were coping very well with parenting, compared to the parents of 57.2 percent of CSHCN without EBD conditions (data not shown). Likewise, parents of nearly one-third (32.8 percent) of CSHCN with EBD conditions reported usually or always feeling stress, compared to the parents of 10.8 percent of CSHCN aged 2-17 without these conditions.
The parents of approximately 87 percent of children report that they have emotional support in parenthood, whether or not the children have special health care needs. However, the parents of only about 77 percent of children in low-income households report that they have this support (data not shown).