Prior quantitative research has indicated that parents of children with disabilities experience elevated levels of stress (Baker-Ericzen, Brookman-Frazee, & Stahmner, 2005; Lessenberry & Rehfeldt, 2004; Tomanik, Harris, & Hawkins, 2004). Prior qualitative research has indicated that parents experience positive outcomes related to having a child with a disability (Hastings, Allen, McDermott, & Still, 2002; Klein & Schive, 2001). Quantitative and qualitative research methods are built upon philosophical differences, yet there is an epistemological argument for using both to fully understand a phenomenon (Foss & Ellefsen, 2002). This paper uses a mixed methods approach to understand what parent themes about having a child with a disability are associated with parent stress. Findings are interpreted using McCubbin and McCubbin's (1993) model of family stress, coping, and adaptation.
Twenty-five parents participated in a two-step process data collection process. First, parents participated in focus groups. Krueger and Casey's (2000) guidelines for moderating focus groups were used to train facilitators and develop an interview guide. In addition to topics covered in the interview guide, parents also raised new topics of importance to them. Parent-initiated topics led to the recognition that focus group members were experiencing varying levels of stress. There was a unique opportunity to triangulate the data by following-up with a quantitative survey that included the Parenting Stress Index Short Form (PSI-SF).
After data collection, analysis proceeded in a three-step process. First, audio taped focus group discussions were transcribed and imported into NVivo7 (QSR International Pty Ltd, 2006). Second, quantitative survey data were analyzed in SPSS 17.0. Percentile scores were computed for the PSI-SF. Parents were classified by PSI-SF score into a clinically significantly stressed group or a not stressed group. After parents were classified, one investigator extracted all qualitative comments for the parents in each profile. Finally, two investigators blinded to the results of the quantitative analysis identified themes in the qualitative data.
Themes in the stressed parent profile included: 1) social isolation from peers, neighbors, and extended family; 2) lack of support from extended family and community members; and 3) failure of the child to meet developmental milestones. Themes in the not stressed parent profile included: 1) benefits of the child's interactions with others including siblings; 2) educating others; 3) strengths of the child with the disability; and 4) the future of the child with the disability. Consistent with McCubbin and McCubbin's (1993) model, family resources (e.g. support from family) and appraisals (e.g. perceptions of strengths) were associated with variation in parent stress.
Implications and Conclusions
Results were consistent with the McCubbin and McCubbin's (1993) model. Positive appraisals appeared to be a protective factor against stress and lack of support appeared to be a risk factor. Findings have implications for intervening with parents. Intervention approaches that assist families in creating positive appraisals, envisioning a positive future for their family members, and mobilizing support resources may be beneficial in preventing later parental stress.