Hope Of And Construction Of Hope Intervention Program For Parents Of Children With Autism Spectrum Disorder

Objective:1.To investigate the level of hope among parents of children with autism spectrum disorder and compare that with parents of children with typical development.2.To explore the effects of hope on coping style,parenting stress,quality of life and analyze influencing factors of hope among parents of children with autism spectrum disorder.3.To describe the hope experience in mothers of children with autism spectrum disorder.4.To construct an intervention program to enhance the level and perception of hope among parents of children with autism spectrum disorder.Methods:1.A cross-sectional study was conducted among 147 parents with autistic children and 147 parents with typical developmental children who were matched by autistic children’s gender and age.Two groups of parents were investigated by a self-designed Demographic Questionnaire,and the Adult Dispositional Hope Scale in Children’s specialty hospital from January 1,2020 to March 1,2020.Using IBM SPSS 22.0 to analyze data,descriptive analysi s and t test were used.2.A cross-sectional study was conducted among 270 parents with autistic children.Parents were investigated by a self-designed Demographic Questionnaire,the Adult Dispositional Hope Scale,the Parenting Stress Index-Short Form,the World Health Organization Quality of Life Instrument-Brief and the Simplified Coping Style Questionnaire and the Childhood Autism Rating Scale in three specialty hospital from March 2,2020,to August 1,2020.Pearson correlation analysis was used to explore the relationships among hope,coping style,parenting stress,and quality of life;Process macro version 3.3 was used to constructed path model.Descriptive analysis,t test,ANOVA and multiple linear regression were used to investigate influencing factors of hope among parents of children with autism spectrum disorder.3.A descriptive qualitative study was conducted among 15 mothers with autistic children who were recruited by purposive sampling method.Semi-structured interviews and inductive content analysis were used to describe the hope experience in these mothers.4.Based on the results from quantitative and qualitative research,combined with theory and literature analysis,an intervention program to enhance the level and perception of hope among parents with autistic children was constructed;Group discussion and Delphi method were used to revise the intervention program.Result:1.The average score of hope,agency thinking and pathway thinking of 147 parents with autistic children were(22.56±3.61,(10.90±2.01),and(11.66±1.97),respectively and all significantly lower than that of parents with typical developmental children(all P<0.01).The hope level of 83.68% parents is moderate to low.2.The relationship between hope and positive coping style or hope and quality of life was significant and positive,while the relationship between hope and parenting stress,or hope and negative coping style was significant and negative.(r=-0.176～0.553,P<0.05).Hope could predict coping style,parenting stress,and quality of life of parents with autistic children.Hope could also indirectly affect quality of life through four paths: the independent mediating effect of positive coping style or parenting stress,and the chain mediating effect between positive coping style and parenting stress,or negative coping style and parenting stress,of which bootstrap 95% confidence intervals were [0.08,0.21],[0.01,0.09],[0.02,0.06],[0.01,0.04],respectively,and accounts for 43.38% of total effect.The results of multiple linear regression analysis show that parents and children relationship,husband and wife relationship,the score of social relationship sphere and environmental sphere of quality of life,parenting stress,coping style,child with self-harm,the intervals between age at diagnosis and age at current were the main influencing factors of hope level among parents with autistic children,which can explain32.9% variation(all P<0.05).3.Four themes were extracted including the understanding,source,role of hope and the hindering factors of hope perception.4.An intervention program to enhance the level and perception of hope among parents with autistic children was constructed after two rounds of Delphi consultation.The intervention program includes 5 intervention modules,15 intervention topics,and 63 intervention measures.The positive coefficient(recovery rates)of two rounds of Delphi consultation were both 100%;The coefficient of expert authority is 0.70 to 1.00;The coefficient of group authority is 0.91;The mean score of the importance or rationality of items is 4.30 to 5.00,and the coefficient of variation is 0.00 to 0.16.Conclusion:1.The hope level of parents with autistic children is moderate to low.Nurses should focus on the level and influencing factors of hope among parents with autistic children in nursing practice for providing reference to establish effective interventions.2.Hope can be used as a key point to be intervened to improve the parents’ psychophysical adjustment,which is of great significance to make parents use positive coping style to solve the difficulties and challenges and reduce parenting stress and improve parental quality of life.Nurses should focus on mothers’ hope level whose children with self-injury or long interval between age at diagnosis and age at current.Parents’ hope level can be promoted by improving husband and wife relationship,parental stress,parental quality of life and strengthening parental coping ability.3.Mothers regarded hope as a motivation to insist autistic training;Hope could strengthen their power to actively cope with dilemma and make them accept the fact that child was diagnosed with autism.Parental hope perception can be strengthened from these aspects including strengthening family support and inner belief,mentality build,positive information support,positive language encouragement,parenting training and education,and improving children’s autistic symptoms.4.The intervention program is scientific,important,feasible and has common and individual characteristics,which is significant for enhancing hope level,hope perception,parental coping ability and improving parenting stress,quality of life among parents with autistic children.