Does self-competence of caregivers of ADHD and non-ADHD children predict being liked and disliked by themselves in a statistically significant way?
Does self-competence of caregivers of ADHD and non-ADHD children predict their QOL in a statistically significant way?
Does self-liking of caregivers of ADHD and non-ADHD children predict their QOL in a statistically significant way?
Does self-competence of caregivers of ADHD and non-ADHD children predict their self-liking in a statistically significant way?
A comparative research design was utilized in this study and was conducted between 20th of June and 21th of July 2020.
This study was conducted in the early intervention center for children with special needs and learning disorders in Elsinbellawin City at Dakahlia Governorate in Egypt. This center helps the children with special needs to make adaptation to their condition and helps them to learn academically and socially in contact with others in the community. The center contains 5 floors which consist of 15 rooms for children with autism, ADHD, mental retardation, and children with learning disorders; 1 room for the director; 1 room for the staff; 1 room for workers; 1 room for activity; and 1 room for play. According to the following inclusion criteria, both genders, between the ages of less than 30 and more than 40 years and free from any chronic disease, are included.
The samples were collected from 216 caregivers and were divided into two groups; caregivers of 108 children diagnosed to have ADHD according to DSM IV-T international criteria and with a minimum IQ ≥ 70 (investigator-estimated) were eligible for the study. General information and questionnaires were filled in by patents. The exclusion criteria comprised abnormal laboratory findings, acute or unstable medical conditions, cardiovascular disorder, history of seizures, psychosis, bipolar disorder, suicidal ideation, any medical condition that might increase sympathetic nervous system activity, or the need for psychotropic medication other than study drug. The second sample was composed of 108 normal children with the following inclusion criteria: normal children’s development not having any previous use of drugs for chronic diseases and not being treated for any psychiatric disorders. The groups were both genders. In the control group, according to caregivers, included the following criteria: agreed to contribute in the study, each of the two genders (male and female) were represented in the sample, and the mean age of the caregivers was 20–60 years.
Mean ± SD of QOL among ADAH group was 64.97 ± 31.92 and 76.78 ± 29.89 of control group (pilot study), and confidence level is at 95% with power of study 80%. Sample size was calculated using Open Epi and 108 caregiver for each group.
Data collection procedure
After obtaining the required permission to conduct the study, the researchers inter-viewed the caregivers in their center in order to attain their verbal consent to participate in the study after being informed about its aim. The selected caregivers were divided into groups (5 to 10 caregivers for each group). The researchers interviewed caregivers, explained each statement to them, and then asked them to complete the questionnaire. Each group required about 30–45 min to be completed. As a result of pandemic COVID-19, the necessity of taking safety precautions such as physical distancing, wearing a mask, keeping rooms well ventilated, avoiding crowds, cleaning hands, and data collection was completed in about 1 month.
Data collection tool
Tool I: socio-demographic data and personnel characteristics
Questionnaire was established by researchers including questions about population age, gender, the level of education, marital status, job, and medical history of diseases.
Tool II: the WHO Quality of Life Scale-Brief (WHOQOL-Brief)
The shortened version of the original instrument WHOQOL-100, comprises of 26 questions. Two are related to an individual’s overall perception about QOL. The remaining 24 represent four domains of the original instrument; I—physical, II—psychological; III—social; and IV—environment domain . The WHOQOL-Brief produces a profile with four domain scores and two individually scored items about an individual’s overall perception of quality of life and health. The four domain scores are scaled in a positive direction with higher scores indicating a higher quality of life. The study pro forma prepared in English was translated into the Arabic language (local language) and translated to Arabic to check the validity of translation by translation experts. Scoring system of QOL; low for < 50%, fair for 50–< 75%, and good for ≥ 75%.
Tool III: self-liking/self-competence scale
The scale was designed by  and consists of 16 items on 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree), of two dimensions; self-liking and self-competence. Scoring system self-competence/self-liking; low for < 50% (0–19), fair 50–< 75% (20–29), and good for ≥ 75% (30–40).
Content validity and reliability
Validity of tools II and III were tested for their content by a jury of five experts in the field of psychiatric and mental health nursing to ascertain relevance and completeness of the tools and the needed modifications were done. Tools II and III reliability were assessed by Cronbach’s alpha through measuring their internal consistency. They show good level of reliability as follows: QOL score (α = 0.737), self-competence score (α = 0.742), and self-liking score (α = 0.741).
The researchers conducted a pilot study on 10% of the study sample (20 cases, 10 from each group) to test the applicability of the data collection tool and the feasibility of the study. It was done to assess the study questionnaire clearness, easiness, and feasibility, as well as to estimate the required time to complete the questionnaire. Based on the pilot study results, some changes made to the questionnaire were mostly rephrasing and using simpler semantic for the statements, and adding some modifications was made to the instruments. Self-liking/self-competence scale (consisting of 16 items). The experts in the field of psychiatric and mental health nursing recommended classifying into two dimensions of self-esteem (8-point self-liking and 8-point self-competence). Also, define the three items need to be reversed before scoring regarding WHOQOL-Brief scale. Sample who took part in the pilot study were not included in the main study.
Statistical data analysis
All data were collected, tabulated and statistically analyzed using SPSS 20.0 for windows (SPSS Inc., Chicago, IL, USA 2011). Quantitative data were expressed as the mean ± SD and (range), and qualitative data were expressed as absolute frequencies (number) and relative frequencies (percentage). Percent of categorical variables were compared using chi-square test. Spearman correlation coefficient was calculated to assess relationship between various study variables, (+) sign indicate direct correlation and (−) sign indicate inverse correlation, also values near to 1 indicate strong correlation and values near 0 indicate weak correlation. All tests were two sided. P value < 0.05 was considered statistically significant (S), and p value ≥ 0.05 was considered statistically insignificant (NS).