Maternal belief system regarding independence of children with cerebral palsy among Saudi mothers

Background: Cerebral palsy is a non-progressive condition that causes neurological disorders, and is one of the main causes of child disability in Saudi Arabia. Different treatment methods are proposed as part of the rehabilitation plans for children with cerebral palsy. These are usually designed to improve the child’s functional skills, so as to develop their independence, as a major goal. Parents have a major role in their children’s rehabilitation programmes, therefore their understanding of their child’s expected abilities and outcomes is essential. In order to understand the parent’s analysis of their child’s development it may be helpful to explore their beliefs. An overview of the existing literature showed that a number of studies investigated parental beliefs regarding the causes and meanings of their children’s disabilities, the unique skills of the professionals, the impact of religion and also their behaviour toward independence. Whilst some studies addressed some parental behaviour towards some aspects of independence, the current study is the first to explore parental beliefs focusing on different aspects of the independence of children with cerebral palsy. Purpose of the study: the current study aimed to explore maternal belief systems regarding the independence of children with mild and moderate cerebral palsy among Saudi mothers. Methods: the study adopted an interpretive descriptive strategy, using two rounds of qualitative semi-structured interviews. The interviews took place in two rehabilitation centres in the eastern province of Saudi Arabia. Saudi mothers of children with mild and moderate cerebral palsy aged from 6.5 to 14 were recruited. Iterative interpretive thematic analysis was used to analyse the obtained data. Findings: Nineteen Saudi mothers of children with mild or moderate cerebral palsy were recruited. The study reveals maternal religious and cultural beliefs related to their children’s development to achieve independent. It also provides knowledge about the mothers’ beliefs regarding their children’s potential to be independent, showing the maternal understanding of independence and their expectation of their children’s abilities to be independent. It also revealed the maternal beliefs regarding the motivations, precautions and techniques of child training to be independent, highlighting at the same time those beliefs regarding the family members’ role in the training process. The current findings also proposed factors that might contribute to constructing the mothers’ beliefs, factors related to the mothers, the children, and external factors. Conclusion: the study found that the mothers’ understanding of independence is not unique and that they provided different understandings and prioritizations of independence. It was also found that maternal beliefs regarding independence can be identified through an understanding of their beliefs regarding the potential and training to be independent. It was also found that maternal beliefs were informed by religious and cultural beliefs, and influenced by multiple factors. Therefore, capturing the relation of different maternal beliefs provided more understanding of maternal belief systems regarding the independence of children with cerebral palsy