This study will explore how caregivers adjust to having a child with Down syndrome.
Primary caregivers 18 years of age and older of a child with Down syndrome may be eligible
for this study. Participants complete a 20- to 30-minute survey that explores the subject s
thoughts and feelings about being a caregiver to a child with Down syndrome. Questions
explore the impact on the subject of being a caregiver for a child with Down syndrome, the
subject s uncertainties related to the child s condition and goals for the child related to
social skills, behavior, learning and education, physical and mental health, independence,
and other goals. It also asks questions about the caregiver, the family and the child with
The proposed study aims to explore the relationships between perceived uncertainty, hope and
adaptation in caregivers of children with Down Syndrome (DS). There are often uncertainties
surrounding the prognosis of DS which extend into various aspects of the child s life. In
addition to the possibility of chronic medical conditions associated with the syndrome, there
is also uncertainty related to the level of independence and cognitive, social and behavioral
functioning that the child will achieve. It is not fully understood how caregivers adapt to
having a child with DS in light of the uncertainty and the particular challenges associated
with this condition. While a high level of perceived uncertainty may be seen as a threat to
adaptation, there is also evidence that caregivers may find benefits in uncertainty.
Literature suggests that a person s level of hope influences how the perceived uncertainty is
appraised and that hope is also related to the process of adaptation. There is no research
that systematically explores the relationship between perceived uncertainty, hope, and
adaptation. This study s conceptual framework is based on Lazarus & Folkman s Transactional
Model of Stress and Coping and is also informed by Snyder s conceptualization of hope and
Mishel s theory of perceived uncertainty in illness. A cross-sectional research design will
quantitatively explore the relationships between perceived uncertainty, hope, and adaptation.
In addition, an open-ended section will be included to qualitatively describe the focus of
caregivers hope for their child and how the focus of hope relates to the degree of hope.
Participants will be recruited from DS support groups, website postings, listservs, and
clinic patient lists. They will have the option of completing either a paper or online
version of the survey, or completing the survey by phone. The main outcome variable is
psychological adaptation to being a care giver for a child with DS.
- INCLUSION CRITERIA:
Participants will be men and women ages 18 or older who are the primary caregivers of a
child with Down syndrome. The parent may be a biological or adoptive parent or other
primary caregiver and the child must reside with the primary caregiver.