Factors Affecting Occupational Balance Among Iranian Caregivers of Children With Cerebral Palsy: A Cross‐Sectional Study
Mahnaz Hejazi-Shirmard, Hosna Mohammadi, Marzieh PashmdarfardIntroduction
Children with cerebral palsy (CP) face lifelong motor, functional, and participation challenges, requiring continuous support for daily activities. Although caregiving can enhance family bonds, it often negatively affects caregivers′ physical and social well‐being, family dynamics, independence, and financial stability. The aim of the present study was to investigate the associations between occupational balance, caregiver burden, and related factors among parents of Iranian children with CP.
Methods
This cross‐sectional study recruited 112 informal caregivers of children aged 2–18 years with CP from March to October 2023. Children′s functional status was assessed using classification systems for gross motor function (GMFCS), manual ability (MACS), communication function (CFCS), and cognitive status (SPARCLE). Caregivers′ burden, quality of life, and occupational balance were evaluated with the Caregiver Difficulties Scale (CDS), WHOQOL‐BREF, and OBQ‐11, respectively. Moreover, caregivers′ psychological well‐being was measured through the Perceived Stress Scale (PSS‐14) and Hospital Anxiety and Depression Scale (HADS). Data were analyzed using correlation analyses, independent t ‐tests, one‐way ANOVAs, and hierarchical multiple linear regression model.
Results
Caregivers′ occupational balance was significantly associated with key demographic and child‐related factors, including employment status, type of CP, and GMFCS level V. Psychological variables—anxiety/depression, perceived stress, caregiver burden, and quality of life—were also significant independent predictors. The final model explained 36.5% of the variance in occupational balance.
Conclusion
Caregivers′ occupational balance is influenced by caregiver characteristics, psychological well‐being, and the severity of the child′s functional limitations. Therefore, comprehensive and multidisciplinary interventions targeting both parents and children—including rehabilitation, psychological support, and social services—are essential and urgently needed.