Jurnal Keperawatan Komprehensif │

TUGAS LITERATUR REVIEW

DI SUSUN OLEH
FITRIA DILA SARI
2121312035

DOSEN:
Hema Malini, SKp., MN., PhD

PROGRAM STUDI MAGISTER KEPERAWATAN

UNIVERSITAS ANDALAS PADANG
FAKULTAS KEPERAWATAN
2021

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Original Article
The Effect Of Social Support On The Coping Of Parents Of Children With
Disabilities In Experienced Stress: Literature Review
Fitria Dila Sari1 │ Hema Malini2
1
Student Master of
Nursing program,
Andalas Padang
University's Faculty,
West Sumatera Island-
Indonesia
2
Lecturer
Department of
Nursing's Master,
Andalas Padang
University's, Faculty
of Nursing's, West
Sumatera Island-
Indonesia
*contact
sfitriadila@yahoo.co.id
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Abstract
Aims : Having children with special needs requires parents to be more creative in
their care, and it is not uncommon for parents to feel stressed. Many studies
demonstrate that good social support is essential for the development of coping
skills in parents. The purpose of this study is to look at the impact of social
support on the stress coping of parents who have children with impairments.
Methdos : This study is a literature review. For relevant studies, articles are
gathered from databases such as PubMed and Science Direct. The study's
inclusion criteria were full-text papers that were free and in English; research
was conducted on parents of children with disabilities or disabilities; the content
of the article was relevant to the topic; and it was an original article published in
the last 7 years (2015-2021). There were five articles discovered that fulfilled the
eligibility requirements.
Results : There were five articles discovered that fulfilled the eligibility
requirements. The findings of this study show that social support has a major
impact on the development of parental coping strategies for dealing with
challenges or stress experienced by parents of disabled children.
Conclusions : The conclusion is that offering adequate social support
interventions to parents can shape parental coping to be adaptive, allowing
parents to overcome stress. This will also influence how parents relate, behave,
and care for their children, resulting in a favorable impact on his child's
development.
KEYWORDS : coping styles, parental stress, Social support, children
with disabilities.
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INTRODUCTION
According to various reports, parents of disabled children, particularly moms,
experience higher levels of stress than parents of normally developing or normal
children (Mirnawati, 2020). If the stress experienced by parents is allowed to continue,
the child will become a trigger for violence towards children because the parents are
exhausted and unable to deal with their children. According to the Ministry of Women
and Children Empowerment's Online Information System for the Protection of Women
and Children (SIMFONI) and the Indonesian Child Protection Commission (KPAI), case
reports are constantly increasing. According to the "Global Report 2017: Ending
Violence in Childhood," 73.7 percent of Indonesian children aged 1 to 14 years face
physical and psychological abuse at home (Perlindungan, 2017). This demonstrates the
importance of social support for parents in order to improve their coping abilities.
Social support, such as friendship and emotional support, can be gained from others in
their environment, helping parents to support the growth and development of children
with special needs (Nikmah, 2017).

Children with Disabilities are children who have long-term physical, mental, intellectual,
or sensory disabilities, and who may face challenges in engaging with the community's
environment and attitudes that prevent them from participating completely and
effectively on the basis of equal rights (Suharlina, 2010). According to the Riskesdas
report from 2018, 3.3 percent of Indonesian children aged 5 to 17 have a disability. The
majority of disabilities affect teenagers aged 15 to 17, accounting for 4.2 percent of all
children with disabilities in 2019 There were 134,045 children with disabilities
(Kemendikbud, 2019).

Children with disabilities frequently endure a variety of psychological issues as a result

of congenital defects or environmental responses to the child's impairment. It becomes
a major difficulty that children must face, especially if the child does not receive social
support from his or her family or environment. Support from the social environment
has a significant impact on the development of children with special needs (Efendi,
2008). Children's health and ability to adjust in life are aided by social support from
their families. As long as children with disabilities receive strong social support in the
form of emotional social assistance from their families, they will be able to develop
appropriate emotional social skills. Children require a coping mechanism in order to

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develop good emotional social skills; if children possess good emotional social skills,
their coping will be adaptive.

A coping mechanism is any action in which a person interacts with their surroundings
with the intention of solving a problem (Chaplin, 2019). Because their children with
disabilities have a shortage or hurdle in their ability to execute something and in their
self-acceptance, parents of children with disabilities frequently require coping skills.
When people have non-positive coping or adaptive deficits, many rights will be violated,
including parents' refusal to accept a disability condition in their child, which will have
an impact on their own mental, social, and emotional health, as well as their children's.
In contrast, if parents of children with special needs have good or positive coping, they
will exhibit good and positive support for their children, allowing parents to strengthen
their care and love for their children, as well as positive things that children can feel.
Children have no less remarkable achievements in the field of form education when
their parents have adaptive coping mechanisms. As a result, it is critical that we pay
attention to the social emotional talents of parents of disabled children in order to
ensure that they have a pleasant existence that will aid their child's growth and
development.

Fauzia and Mangunsong's research, "The Effect of Social Support on the Social-
Emotional Ability of Children with Special Needs Mediated by Parental Acceptance of
Children," was published in 2020. explains how emotional social support for parents
might increase parental coping and affect social emotions in disabled children (p =
0.000).

METHODS

This is a literature review based on a PubMed/NCBI and Science Direct electronic

database search. The findings were published using the PRISMA (Preferred Reporting
Items for Systematic Reviews and Meta-Analysis) protocol, which was chosen based on
the inclusion criteria. The search for articles was performed in November and
December 2021. I searched for relevant papers on coping styles, parental stress, social
support, and children with disabilities using a variety of keywords. all articles that
matched the research requirements for inclusion, namely: (1) Free full-text English
papers from the last seven years (2015-2021) (2) Research on parents of children with
special needs or disabilities, (3) content of relevant articles, and (4) original papers will

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all be considered for inclusion in the study. The following items were excluded from this
study: (1) research on children; (2) systematic review research; (3) research that did
not fit the research theme; and (4) research process. The PRISMA figure in Figure 1 will
provide a detailed explanation.

Figure 1. the PRISMA flow diagram.

Keywords coping style, and parental

stress, and social support, and children
with special needs.
Identification

PudMed Science Direct

N : 56 N : 695

Publication of Articles from

the last 7 years
Publication of Articles from N : 656
the last 7 years
N: 95
Eligilibilitas

Doesn't fit the criteria

for inclusion
N : 20

Article not full text

N : 14

Article with the same title

N:9
Included

Analyzed articles
N:5 Excluded articles (N = 75)
1. Literature review = 3
2. Systematic review = 7
3. Inappropriate population = 20
4. Not in accordance with research = 35
5. Research protocol = 10

RESULTS

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Data extraction was carried out after reviewing the study's quality on five publications
that were deemed as good. Data was extracted by evaluating the author's name, title,
purpose, study technique, number of samples, and research findings. Table 1 shows the
outcomes of the data extraction. After going through the screening and selection of
papers based on inclusion, exclusion, and article eligibility criteria specified by the
author based on the Preferred Reporting Items for Systematic Reviews and Meta-
analyses (PRISMA) guideline format, there are five articles in this review.

The average age criteria for the sample of parents in the five publications discovered
using were 22-60 years old, with a hospital environment, and the average parent having
children with autism, epilepsy, and Down syndrome. In the study, ordinary parents
were asked to test their coping skills in dealing with the stress that comes with having a
kid with a disability, as evidenced through the social support supplied by others.

The findings of research conducted by Jakobsen & Elklit, ( 2021) show that good self-
control and coping responses will be able to overcome the stress experienced by
parents, as long as the social support needs of parents are met. If social support is not
met, it will have no effect on self-control and parental coping, so social support is no
longer a contributing factor. Therefore, the need for social support for parents must be
reviewed so that it c This is also confirmed by studies by Obeid & Daou, (2015) who
claim that if parents of autistic children utilize coping methods and receive the
appropriate social support, their health will increase and their stress levels will drop.

Research conducted by Bujnowska et al., (2021) shows that every parent who has a
child with a disability experiences a high level of stress, so that a good coping style and
social support is needed in order to cope with the perceived stress. Problem coping
strategies, rather than avoidance coping strategies, are preferred by most parents of
disabled children because they lessen parental stress. Furthermore, the most common
type of social support offered to parents is emotional social support, as this type of
assistance is better suited to assisting parents in adapting their coping strategies. This is
also in accordance with Fauzia & Mangunsong's (2020) research, which found that
providing social assistance in the form of emotional support to parents not only
improves parental coping but also improves kid coping. It will improve the child's
growth and development process when dealing with adaptive children.

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According to the findings of a study conducted by Çalışkan et al., (2021), the most
common problems faced by parents were caring for their children with disabilities,
feeling ununderstood by those around them, and 61.1 percent expressing "sadness,
disappointment, and anxiety" for their disabled children. Parents' emotional tiredness
(stress) will be reduced as their quality of life improves. When parents' quality of life
improves, it is influenced by the coping style they develop as a result of the social
support they receive, resulting in a tighter bond between parents and their children.

Table 1. Data Extraction Results

N Title/Author/Year Purpose Method and Results
o sample
1. Self-control and The goal of this The study is As long as
coping responses study was to assess descriptive and sufficient social
are mediating the need for cross-sectional in support is
factors between parental support in design. provided, self-
child terms of control and
behavior difficulties psychological 162 parents of coping methods
and parental stress characteristics children with can help parents
and family impact in (self-control and severe epilepsy overcome their
caregivers coping strategies) who were stress p = 0.001.
of children with that have trouble hospitalized were The family is still
severe epilepsy dealing with given a sad, unhappy,
children's questionnaire and facing
Anne Vagner behavior, parental about the impact financial
Jakobsen, Ask Elklit stress, and the of family, coping difficulties as a
impact of severe responses from result of the
2021 childhood epilepsy social support, damage.
on the family. parental sense of
control, and stress
levels.
2. Coping with stress The goal of this This is study used The results of
in parents of study is to A cohort design. this study
children with compare the stress suggest that
developmental management 167 parents of there are
disabilities approaches and children with substantial
strategies of developmental differences
Anna M. Bujnowska, parents of children impairments and between parents
Nigel V. Marsh, with 103 parents of of children with
Celestino Rodríguez, developmental children with developmental
Trinidad disabilities to typical impairments and
García,Debora parents of children developmental parents of
Areces without disabilities freely children without
developmental participated in the developmental
2021 disabilities. study. At random, disabilities. They

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parents were employed coping

chosen. The methods (p
parents were =.001) and
given a coping styles (p
questionnaire in =.011),
which they were according to the
asked to rank data. The
their coping styles average parent
for stress with
situations. Coping developmental
strategies were impairments
categorized into employs
three categories: problem-
task-oriented, solving-oriented
emotion-oriented, coping to deal
and avoidance- with stress,
oriented. which
necessitates
emotional social
assistance to
improve their
coping.
3. Determination of The purpose of this Design and The findings
burnout, life study is to assess Methods: revealed that
satisfaction, and the issues, Descriptive and when parents'
stress coping weariness, life cross-sectional life happiness
styles of parents satisfaction, family study, in which improved, so did
with disabled stress, and coping 191 parents of their emotional
children techniques of children with weariness and
families with disabilities their sense of
Zehra Çalışkan PhD, disabled children, volunteered. personal
Derya Evgin PhD, as well as their accomplishment
Nuray Caner PhD, relationship. (p = 0.05). As a
Bahriye Kaplan PhD, result, parents of
Gonca Ö zyurt MD children with
impairments in
2021 dealing with
perceived stress
require adaptive
coping
techniques
derived through
social support to
minimize fatigue
and promote life
satisfaction.
4. The Effect of Social The purpose of this This research The study's
Support on the study was to see method is an findings
Social-Emotional how social support analytical survey demonstrated

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Ability of Children for parents of where the that social

with Special Needs children with participants support in the
Mediated by special needs include 291 form of
Parental Acceptance affected their parents, mothers emotional
of Children children's social or fathers, support and
emotional elementary school mentoring had
Jimny Hilda Fauzia, capacities through children with an indirect
Frieda Maryam the impact of special needs, impact on
Mangunsong parental both children with
acceptance. developmental special needs'
2020 and physical emotional social
needs, in abilities.
Indonesia. (p=0.000)
Researchers find
participants by
contacting
communities that
may consist of
samples with
predetermined
characteristics
such as inclusive
elementary
schools, special
elementary
schools, and
communities.
5. The effects of coping The purpose of this This is a cross- The findings of
style, social support, study is to see how sectional research this study show
and behavioral coping techniques, method. that if a mother
problems on the social support, and employs a
well-being of children's A total of 163 Release coping
mothers of children behavioral moms with ASD style or
with symptoms affect children were addresses
Autism Spectrum the well-being of recruited for this challenges with
Disorders in 65 women in study, and adequate social
Lebanon Lebanon who have questionnaires support, her
children with were delivered to perceived well-
Rita Obeid, Nidal Autism Spectrum them. being can
Daou Disorders (ASD). improve. (p =
0.001) p = 0.001
2015 p = 0.001

DISCUSSION
Parental stress can arise as a result of the significant role played by parents, particularly
mothers, in the process of caring for children with disabilities. Parents of children with
disabilities have greater psychological stress than parents of children without
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disabilities, because children with disabilities require more parental assistance than
children without disabilities (Perlindungan D. B., 2019). If allowed to continue, the
stress experienced by parents would be extremely harmful, since children will become a
trigger for violence against children. Furthermore, when children do not receive the
care and attention they require, it can negatively impact their quality of life, thus many
parents must consider their coping techniques.

Coping mechanisms are behaviors or countermeasures for any acts in which people
engage with their surroundings in order to solve an issue (Chaplin, 2019). Parents
frequently require coping methods to deal with perceived challenges. Focused on the
issue Coping is a type of coping that is frequently employed by parents to solve
problems that are more problem-oriented, such as efforts to regulate or change the
external situations that are the source of worry or do something to change the source of
the anxiety. An external strategy is problem-focused coping. Finding and dealing with
the main problem through learning new tactics or abilities in order to lessen the
stressors people face or feel is the major focus of problem-focused coping. This is in line
with research conducted by Bujnowska et al., (2021) which shows that parents of
children with disabilities more often use coping strategies that focus on problems
rather than avoidance, because they are considered more able to resolve the stress felt
by parents. with the help of social support.

Social support is one of the main factors in positive coping, namely people get help and
support from family and friends in social interaction activities, including actual material
objective support, emotional subjective support, and the use of support, which have a
positive impact on the psychological stress felt by people (Smet, 2017). old. If social
support is high, it can help increase the level of self-efficacy, so that the adaptive coping
style is positive, thereby reducing psychological stress levels. Individuals with more
social support believe that they can get the support and assistance they need when
faced with adversity or setbacks, so their confidence in their problem-solving abilities
continues to increase (i.e., stronger self-efficacy). They are more likely to use a positive
coping style to deal with issues, reducing the likelihood of developing psychological
disorders. According to studies conducted by Jakobsen & Elklit, (2021) self-control and
coping methods can help parents manage stress if they have strong and suitable social
support from their parents. As a result, the parents' coping skills will become adaptive

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(p = 0.001). Parents who receive appropriate social support and professional assistance
report higher levels of life satisfaction and are better able to cope with stress.

Social resources and social support, such as friendship support and emotional support,
are very important for parents of children with special needs to obtain from the people
in their environment, so that parents can carry out their functions properly and
ultimately encourage the growth and development of children with special needs. The
emotional support that parents receive has a huge impact on the emotional social
abilities of children with special needs since most parents reject the reality that their
children have special needs. They may also engage in bargaining, express anger, and
endure depression until they eventually accept reality. As a result, in order to deal with
the acceptance of children with impairments, parents require what is known as
emotional social support from their environment (ADD). This is supported by Fauzia &
Mangunsong, (2020) research, which found that parents require social help in the form
of emotional support in order to cope with their stress, and that assistance has a direct
and indirect impact on the emotional social capacities of children with special needs (p
= 0.000).

The social environment's support for children with special needs has a significant
impact on their development (Efendi, 2008). Children with exceptional needs who
receive adequate social support from their environment can accomplish equally
impressive results in both formal education and skills, allowing them to be self-
sufficient in their lives (Walinono, 1999). Furthermore, if the youngster has a positive
coping style, it can improve the child's overall quality of life.

CONCLUSION
Overall, the five articles examined found that social support had a considerable impact
on dealing with parents in problem-solving situations. When parents practice adaptive
coping, their children's coping will become adaptable as well. More research should be
done in-depth to address what kind of social support are required by parents of
children with impairments, according to the suggestion given.

REFERENCES

Bujnowska, A. M., Rodríguez, C., García, T., Areces, D., & Marsh, N. V. (2021). Coping with
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stress in parents of children with developmental disabilities. International Journal

of Clinical and Health Psychology, 21(3).
https://doi.org/10.1016/j.ijchp.2021.100254

Çalışkan, Z., Evgin, D., Caner, N., Kaplan, B., & Ö zyurt, G. (2021). Determination of
burnout, life satisfaction, and stress coping styles of parents with disabled children.
Perspectives in Psychiatric Care, 57(3), 1505–1514.
https://doi.org/10.1111/ppc.12746

Fauzia, J. H., & Mangunsong, F. M. (2020). The Effect of Social Support on the Social-
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Pembinaan Yogyakarta.

Lampiran

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