Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Location, Study Design and Sampling
2.2. Study Participants and Recruitment
2.3. Instrument: Quality of Life in Autism (QoLA) Questionnaire
2.4. Operational Definition
2.5. Sample Size
2.6. Statistical Analysis
2.7. Ethical Consideration
3. Results
3.1. Sociodemographic and Clinical Characteristics of the Main Caregivers
3.2. Clinical Characteristics of ASD Children
3.3. The Response of the Quality of Life in Autism (QoLA) Part A and Part B
3.4. Univariate Linear Regression and Multiple Linear Regression Analysis for Factors Associated with Perceived Quality of Life (QoLA Part A) among the Main Caregivers
3.5. Univariate Linear Regression and Multiple Linear Regression Analysis for the Perceived Problem of the Child’s ASD Difficulties QoLA (Part B) among the Main Caregivers
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Frequency, n (%) | Mean ± SD |
---|---|---|
Age, years | - | 35.77 ± 3.10 |
Gender | ||
Male | 23 (19.8) | - |
Female | 93 (80.2) | |
Race | ||
Malay | 110 (94.8) | - |
Non-Malay | 6 (5.2) | |
Religion | ||
Muslim | 110 (94.8) | - |
Non-Muslim | 6 (5.2) | |
Spouse | ||
Having a spouse | 107 (92.2) | - |
Not having a spouse | 9 (7.8) | |
Educational status | ||
Secondary school | 18 (15.5) | - |
Certificate/diploma | 30 (25.9) | |
Degree | 51 (44.4) | |
Postgraduate | 17 (14.7) | |
Occupation | ||
Not working/housewife | 33 (28.4) | - |
Own business | 14 (12.1) | |
Private sector | 27 (23.3) | |
Government sector employee | 42 (35.2) | |
Household income | ||
MYR 1000–MYR 1999 | 11 (9.5) | - |
MYR 2000–MYR 2999 | 17 (14.7) | |
MYR 3000–MYR 4999 | 33 (28.4) | |
MYR 5000–MYR 6999 | 23 (19.8) | |
MYR 7000–MYR 9999 | 23 (19.8) | |
More than MYR 10,000 | 9 (7.8) | |
Type of house | ||
Single-storey | 33 (28.4) | - |
Double-storey | 38 (32.8) | |
Apartment/flat | 39 (33.6) | |
Condominium | 6 (5.2) | |
Total number of children | ||
1 | 32 (27.6) | - |
2 | 39 (33.6) | |
3 | 32 (27.6) | |
More than 4 | 13 (11.2) | |
Number of special need child | ||
1 child | 111 (95.7) | - |
2 children | 5 (4.3) | |
Attending parent training workshop | ||
Yes | 92 (79.3) | - |
No | 24 (20.7) | |
Frequency attending training | ||
1 | 42 (45.7) | - |
2 | 33 (35.9) | |
3 and above | 17 (18.3) | |
Involved in a parent support group | ||
Yes | 101 (87.1) | - |
No | 15 (12.9) | |
Source of support group | ||
96 (82.8) | - | |
60 (51.7) | ||
Others | 1 (0.9) | |
Support to help look after the child | ||
Yes | 55 (47.4) | - |
No | 61 (52.6) | |
Support to help look after the child | ||
Child’s grandparent | 27 (23.3) | - |
Child’s sibling | 26 (22.4) | |
Child’s auntie | 25 (21.6) | |
Babysitter | 9 (7.8) | |
Maid | 8 (6.9) | |
The child received any allowance | ||
Yes | 63 (54.3) | - |
No | 53 (45.7) | |
Source of allowance (n = 63) | ||
Social welfare | 61 (96.8) | - |
State government | 2 (3.2) | |
The main caregiver has medical illness | ||
Yes | 30 (25.9) | - |
No | 86 (74.1) | |
Main caregivers with co-morbidities | ||
Depression | 20 (17.2) | - |
Anxiety | 17 (14.7) | |
Hypertension | 11 (9.5) | |
Asthma | 9 (7.8) | |
Others medical illness | 4 (3.4) | |
Diabetes mellitus | 3 (2.6) | |
Cholesterol | 3 (2.6) | |
Heart problem | 1 (0.9) |
Variables | Frequency, n (%) |
---|---|
Child of autism has co-morbidities | |
Yes | 62 (53.4) |
No | 54 (46.6) |
Child of autism with co-morbidities | |
ADHD | 30 (48.4) |
Epilepsy | 17 (27.4) |
Slow learner | 27 (43.5) |
Eating disorder | 62 (100.0) |
Sleep problem | 10 (16.1) |
Digestive problem | 12 (19.4) |
ADHD | 30 (48.4) |
Psychiatric problem | 0 (0.0) |
Child of autism attending follow-up | |
Yes | 86 (74.1) |
No | 30 (25.9) |
Distribution attending follow-up | |
Speech therapy | 72 (83.7) |
Occupational therapy | 70 (81.4) |
Paediatric clinic | 54 (62.8) |
Child psychiatric clinic | 45 (52.3) |
Dental clinic | 17 (19.8) |
ENT clinic | 12 (14.0) |
Physiotherapy | 4 (4.7) |
Handling urine her / himself | |
No | 17 (14.7) |
With help | 20 (17.2) |
Yes | 79 (68.1) |
Handling bowel motion her/himself | |
No | 30 (25.9) |
With help | 27 (23.3) |
Yes | 59 (50.9) |
The measure used to communicate | |
Talk in word or sentences | 71 (61.2) |
Using gesture | 71 (60.3) |
Picture exchange communication (PECS) | 31 (26.7) |
Use sign language | 8 (6.9) |
QoLA Part A Items | Scale (Very Much of a Problem for Me) (Not Much of a Problem for Me) | ||||
1 | 2 | 3 | 4 | 5 | |
n (%) | n (%) | n (%) | n (%) | n (%) | |
A1 Satisfied with life | 2 (1.7) | 16 (13.8) | 35 (30.2) | 45 (38.8) | 18 (15.5) |
A2 Feel stressed * | 9 (7.8) | 15 (12.9) | 47 (40.5) | 34 (29.3) | 11 (9.5) |
A3 Feel happy and content | 6 (5.2) | 12 (10.3) | 41 (35.3) | 41 (35.3) | 16 (13.8) |
A4 Feel depressed or anxious * | 17 (14.7) | 19 (16.4) | 45 (38.8) | 23 (19.8) | 12 (10.3) |
A5 Feel good about self or person | 17 (14.7) | 10 (8.6) | 34 (29.3) | 38 (32.8) | 17 (14.7) |
A6 Satisfied with close relationship | 6 (5.2) | 9 (7.8) | 35 (30.2) | 42 (36.2) | 24 (20.7) |
A7 People are there for me when I need | 4 (3.4) | 16 (13.8) | 30 (25.9) | 35 (30.2) | 31 (26.7) |
A8 Satisfied with social life | 7 (6.0) | 17 (14.7) | 33 (28.4) | 42 (36.2) | 17 (14.7) |
A9 Satisfied with family | 4 (3.4) | 9 (7.8) | 28 (24.1) | 48 (41.4) | 27 (23.3) |
A10 Satisfied with financial situation | 18 (15.5) | 19 (16.4) | 45 (38.8) | 25 (21.6) | 9 (7.8) |
A11 Satisfied with where live | 3 (2.6) | 22 (19.0) | 26 (22.4) | 45 (38.8) | 20 (17.2) |
A12 Enough money to meet needs | 21 (18.1) | 28 (24.1) | 35 (30.2) | 25 (21.6) | 7 (6.0) |
A13 Satisfied with achievements | 6 (5.2) | 19 (16.4) | 47 (40.5) | 33 (28.4) | 11 (9.5) |
A14 Satisfied with general health | 3 (2.6) | 14 (12.1) | 45 (38.8) | 41 (35.3) | 13 (11.2) |
A15 Have a healthy lifestyle | 9 (7.8) | 13 (11.2) | 52 (44.8) | 30 (25.9) | 12 (10.3) |
A16 Satisfied with leisure activities | 13 (11.2) | 21 (18.1) | 46 (39.7) | 28 (24.1) | 8 (6.9) |
A17 Health problem stops them do things that they want to * | 5 (4.3) | 14 (12.1) | 31 (26.7) | 26 (22.4) | 40 (34.5) |
A18 Feel in control of life | 10 (8.6) | 18 (15.5) | 44 (37.9) | 31 (26.7) | 13 (11.2) |
A19 Set and achieve goals in life | 10 (8.6) | 22 (19.0) | 41 (35.3) | 34 (29.3) | 9 (7.8) |
A20 Make a plan of action and follow it | 4 (3.4) | 16 (13.8) | 48 (41.4) | 37 (31.9) | 11 (9.5) |
A21 Make own decision | 6 (5.2) | 13 (11.2) | 46 (39.7) | 39 (33.6) | 12 (10.3) |
A22 Feel guilty * | 8 (6.9) | 12 (10.3) | 36 (31.0) | 32 (27.6) | 28 (24.1) |
A23 Part of a community | 7 (6.0) | 18 (15.5) | 43 (37.1) | 34 (29.3) | 14 (12.1) |
A24 Can get the support they need from the community | 4 (3.4) | 23 (19.8) | 53 (45.7) | 25 (21.6) | 11 (9.5) |
A25 Able to get to where they need to | 13 (11.2) | 24 (20.7) | 41 (35.3) | 22 (19.0) | 16 (13.8) |
A26 Feel safe in everyday life | 7 (6.0) | 15 (12.9) | 35 (30.2) | 46 (39.7) | 13 (11.2) |
A27 Feel respected in everyday life | 0 (0.0) | 16 (13.8) | 49 (42.2) | 34 (29.3) | 17 (14.7) |
A28 Satisfied with the availability of health services | 12 (10.3) | 14 (12.1) | 43 (37.1) | 32 (27.6) | 15 (12.9) |
QoLA Part B Items | Scale (Very Much of a Problem for Me) (Not Much of a Problem for me) | ||||
1 | 2 | 3 | 4 | 5 | |
n (%) | n (%) | n (%) | n (%) | n (%) | |
B1 Child socialising with people | 19 (16.4) | 37 (31.9) | 36 (31.0) | 19 (16.4) | 5 (4.3) |
B2 Child having friends | 23 (19.8) | 29 (25.0) | 40 (34.5) | 21 (18.1) | 3 (2.6) |
B3 Child understand other’s feelings | 24 (20.7) | 28 (24.1) | 35 (30.2) | 25 (21.6) | 4 (3.4) |
B4 Child holding a conversation | 28 (24.1) | 32 (27.6) | 29 (25.0) | 20 (17.2) | 7 (6.0) |
B5 Child communicating needs | 12 (10.3) | 23 (19.8) | 36 (31.0) | 30 (25.9) | 15 (12.9) |
B6 Child taking a literal meaning of comments | 30 (25.9) | 34 (29.3) | 29 (25.0) | 15 (12.9) | 8 (6.9) |
B7 Child saying things that are socially embarrassing | 13 (11.2) | 19 (16.4) | 26 (22.4) | 24 (20.7) | 34 (29.3) |
B8 Child needs to stick to a routine | 17 (14.7) | 20 (17.2) | 39 (33.6) | 28 (24.1) | 12 (10.3) |
B9 Child being overly interested in a particular topic | 16 (13.8) | 19 (16.4) | 36 (31.0) | 37 (31.9) | 8 (6.9) |
B10 Child getting anxious in a specific situation or during changes | 18 (15.5) | 20 (17.2) | 48 (41.4) | 25 (21.6) | 5 (4.3) |
B11 Child is sensitive to certain sensations | 16 (13.8) | 27 (23.3) | 40 (34.5) | 23 (19.8) | 10 (8.6) |
B12 Child understands the rules of social interaction | 26 (22.4) | 36 (31.0) | 35 (30.2) | 14 (12.1) | 5 (4.3) |
B13 Child is able to manage emotional response | 20 (17.2) | 30 (25.9) | 42 (36.2) | 20 (17.2) | 4 (3.4) |
B14 Child needs to do things a certain way | 13 (11.2) | 19 (16.4) | 54 (46.6) | 23 (19.8) | 7 (6.0) |
B15 Child has destructive behaviour including anger and aggression | 13 (11.2) | 22 (19.0) | 41 (35.3) | 28 (24.1) | 12 (10.3) |
B16 Child showing inappropriate emotional reactions | 16 (13.8) | 23 (19.8) | 51 (44.0) | 18 (15.5) | 8 (6.9) |
B17 Child has unusual repetitive behaviours or body movement | 16 (13.8) | 20 (17.2) | 44 (37.9) | 25 (21.6) | 11 (9.5) |
B18 Child engaging in reckless or tactless behaviour | 19 (16.4) | 17 (14.7) | 42 (36.2) | 28 (24.1) | 10 (8.6) |
B19 Child doing daily living tasks independently | 15 (12.9) | 22 (19.0) | 22 (19.0) | 22 (19.0) | 13 (11.2) |
B20 Child responding when approached socially | 14 (12.1) | 29 (25.0) | 44 (37.9) | 21 (18.1) | 8 (6.9) |
Variables | Simple Linear Regression a | Multiple Linear Regression b | ||||
---|---|---|---|---|---|---|
B c (95% CI) | t | p-Value | Adj. B d (95% CI) | t | p-Value | |
Race | ||||||
Malay | ref | 1 | - | - | - | |
Non-Malay | −18.69 (−32.65, −4.72) | −2.650 | 0.009 * | |||
Religion | ||||||
Muslim | Ref | 1 | - | - | - | |
Non-Muslim | −18.69 (−32.65, −4.72) | −2.650 | 0.009 * | |||
Educational status | ||||||
Secondary school | ref | 1 | - | - | - | |
Certificate/ diploma | 4.87 (−5.21, 14.93) | 0.955 | 0.341 | |||
Degree | 7.34 (−1.92, 16.60) | 1.571 | 0.119 | |||
Postgraduate | 13.36 (1.94, 24.78) | 2.317 | 0.022 * | |||
Type of house | ||||||
Single storey | ref | 1 | ref | 1 | ||
Double storey | −1.11 (−8.94, 6.71) | −0.282 | 0.778 | 2.61 (−11.30, 6.08) | −0.598 | 0.552 |
Apartment/flat | −9.82 (−17.60, −2.04) | −2.502 | 0.014 * | −11.37 (−19.52, −1.17) | −2.812 | 0.008 * |
Condominium | 10.67 (−3.93, 25.26) | 1.448 | 0.150 | 5.77 (−10.31, 21.85) | 0.714 | 0.477 |
Frequency attending training | ||||||
1 | ref | 1 | ref | 1 | ||
2 | 8.37 (0.84, 15.89) | 2.208 | 0.030 * | 10.35 (1.17, 19.52) | 2.281 | 0.028 * |
3 and above | 12.47 (3.16, 21.77) | 2.663 | 0.009 * | 13.36 (2.01, 24.70) | 2.382 | 0.022 * |
Support Group Facebook | ||||||
Yes | Ref | 1 | - | - | - | |
No | −8.88 (−17.16, −0.61) | −2.127 | 0.036 * | |||
Support Group WhatsApp | ||||||
Yes | ref | 1 | - | - | - | |
No | −8.70 (−14.86, −2.53) | −2.791 | 0.006 * | |||
Child’s siblings help to look after the child | ||||||
Yes | ref | 1 | - | - | - | |
No | 10.59 (3.20, 17.98) | 2.841 | 0.005 * | |||
Main caregivers with anxiety | ||||||
Yes | ref | 1 | - | - | - | |
No | −9.12 (−17.97 0.27) | −2.042 | 0.043 * | |||
Slow learner | ||||||
Yes | ref | 1 | - | - | - | |
No | −8.90 (−16.81, 0.99) | −2.251 | 0.028 * | |||
Paediatric clinic | ||||||
Yes | ref | 1 | - | - | - | |
No | 7.18 (0.93, 13.43) | 2.276 | 0.025 * | |||
Child talks in a sentence | ||||||
Yes | ref | 1 | - | - | - | |
No | 7.47 (1.08, 13.86) | 2.316 | 0.022 * |
Variables | Simple Linear Regression a | Multiple Linear Regression b | ||||
---|---|---|---|---|---|---|
B c (95%CI) | t | p-Value | Adj. B d (95%CI) | t | p-Value | |
Race | ||||||
Malay | ref | 1 | - | - | - | |
Non-Malay | −11.15 (−21.24, −1.05) | −2.187 | 0.031 * | |||
Religion | ||||||
Muslim | Ref | 1 | - | - | - | |
Non-Muslim | −18.69 (−32.65, −4.72) | −2.187 | 0.031 * | |||
Type of house | ||||||
Single storey | ref | 1 | ||||
Double storey | −2.02 (−7.81, 3.77) | −0.690 | 0.491 | |||
Apartment/flat | −5.87 (−11.63, −0.12) | −2.021 | 0.046 * | |||
Condominium | −2.50 (−13.30, 8.30) | −0.459 | 0.647 | |||
Frequency attending training | ||||||
1 | ref | 1 | ||||
2 | 3.50 (−2.24, 9.24) | 1.211 | 0.229 | |||
3 and above | 7.11 (0.02, 14.20) | 1.992 | 0.049 * | |||
Support Group Facebook | ||||||
Yes | Ref | 1 | - | - | - | |
No | 6.91 (1.01. 12.82) | 2.319 | 0.022 * | |||
Maid helps to look after the child: | ||||||
Yes | ref | 1 | ref | 1 | ||
No | −9.86 (−18.68, −1.04) | 2.215 | 0.029 * | −13.54 (−24.17, −12.91) | −2.534 | 0.013 * |
Child’s grandparent helps to look after the child: | ||||||
Yes | ref | 1 | ref | 1 | ||
No | −7.56 (−12.78, −2.34) | 2.872 | 0.005 * | −8.65 (−14.33, −2.96) | −3.025 | 0.003 * |
Main caregivers with anxiety | ||||||
Yes | ref | 1 | - | - | - | |
No | −7.28 (−13.59, −0.97) | −2.286 | 0.024 * | |||
Main caregivers with asthma | ||||||
Yes | ref | 1 | ref | 1 | ||
No | 8.81 (0.44, 17.18) | −2.084 | 0.039 * | 8.44 (0.02, 16.86) | 1.993 | 0.049 * |
Paediatric clinic | ||||||
Yes | ref | 1 | - | - | - | |
No | 5.45 (0.99, 9.91) | 2.419 | 0.017 * | |||
Child talks in a sentence | ||||||
Yes | ref | 1 | - | - | - | |
No | 5.18 (0.59, 9.76) | 2.237 | 0.027 * |
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Asahar, S.F.; Malek, K.A.; Isa, M.R. Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2021, 18, 9861. https://doi.org/10.3390/ijerph18189861
Asahar SF, Malek KA, Isa MR. Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2021; 18(18):9861. https://doi.org/10.3390/ijerph18189861
Chicago/Turabian StyleAsahar, Siti Fairus, Khasnur Abd Malek, and Mohamad Rodi Isa. 2021. "Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 18, no. 18: 9861. https://doi.org/10.3390/ijerph18189861
APA StyleAsahar, S. F., Malek, K. A., & Isa, M. R. (2021). Quality of Life and Child’s Autism-Specific Difficulties among Malaysian Main Caregivers: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 18(18), 9861. https://doi.org/10.3390/ijerph18189861