انجام راهبردهای مقابله ای واسطه ای متوسط و یا رابطه بین استرس والدگری و کیفیت زندگی برای پدران دارای کودکان مبتلا به اوتیسم؟

In response to the dramatic change in the perception of fatherhood and the significant expansion in fatherhood research, this study came to fill the gap in literature and examine the possible mediation and moderation effects of coping in the relationship between fathers’ of children with autism parenting stress and quality of life (QoL). Mediation and moderation effects were examined using multiple programs and software which included hierarchical regression, structural equation modeling and special Macros added to the analysis programs to confirm the findings. None of the investigated coping strategies could mediate or moderate the stress–QoL relationship among the 101 participating fathers. This study provides interesting information on how the stress-coping-QoL relationship among fathers of children with autism can be affected by the nature of their stress provoking situation, their individual characteristics, the environment and its demands and resources, and the way fathers perceive and apply their coping responses.

The birth of a new child is considered a pleasant time for most fathers. Unfortunately, nearly one out of 68 fathers receives upsetting news that his child will demonstrate delays across all areas of development due to a pervasive chronic disability. Autism is currently considered the number one occurring developmental disability that can impose significant impacts on fathers’ ordinary roles and render them despaired, powerless, and at risk for many psychosocial problems (Lyons, Leon, & Roecker Phelps, 2010). The literature addressing fathers of children with autism suggested that once the child is introduced into the family, the whole fatherhood experience changes (Donaldson, Elder, Self, & Christie, 2011). Fathers’ chronic caregiving responsibilities may threaten their emotional, physical, and social well-being. For instance, fathers of children with autism usually experience higher levels of psychological distress and poorer quality of life (QoL) than fathers of typical children do (Ericzon, Frazee, & Stahmer, 2005; Mungo, Ruta, Arrigo, & Mazzona, 2007). Further, fathers may feel emotionally charged because of their inability to protect their children from pain or harm (Pelchat, Levert, & Bourgeois-Guérin, 2009). Dealing with health services may also be physically strenuous for most fathers. Moreover, some studies report that many fathers feel strain in building up their social networks either because of their demanding roles as care providers or because of the lack of public understanding of their unique experiences (Lewis, Skirton, & Jones, 2010). One of the most commonly searched psychological outcomes for parenting a child with autism is parenting stress. Studies have long revealed significant high levels of stress among fathers of children with autism (Dardas and Ahmad, 2014a, Dardas and Ahmad, 2014b and Ericzon et al., 2005; Seltzer, Abbeduto, Krauss, Greenberg, & Swe, 2004). Fathers report high stress usually because of their children daily management, the need to search for and deal with available services and educational programs, and the potential financial strains (Parish, Seltzer, Greenberg, & Floyd, 2004). Furthermore, fathers’ lack of knowledge about their children's disability (Kucuker, 2006), and the lack of active planning for fathers’ engagement in all areas of service delivery (Premberg, Hellstrom, & Berg, 2008) can lead to high patenting stress. The prolonged nature of parenting stress highlights the significant short and long term risks to fathers’ mental and physical health. The entire QoL of fathers of children with autism is believed to be threatened with the presence of a child with autism (Dardas and Ahmad, 2014c and Dardas and Ahmad, 2014d). Poor QoL reported by those fathers reflects a multidimensional outcome that incorporates their physical health, psychological state, social relationships, and relationships with salient features of the environment. Overall, fathers raising children with autism face several challenges that make their coping and adjustment to the child's disability an on-going complex task. Based on the prior findings, it becomes clear that fathers of children with autism are fair much better if they can have means to cope with their inevitable stressors. In fact, relevant studies reported that the ways fathers of children with autism cope with stress is more influential to their health and QoL than the stressors themselves (Dabrowska and Pisula, 2010 and Hastings et al., 2005). Several links between the types of coping strategies used by fathers of children with autism and their levels of stress and QoL have been revealed (Dabrowska and Pisula, 2010, Gray, 2006 and Hastings et al., 2005). For instance, the use of less emotion-focused coping and more problem-focused coping was associated with better QoL (Lyons et al., 2010). More specifically, King et al. (2006) found that adopting positive meanings to the lived experiences is a popular coping strategy among fathers experiencing stress. Other adaptive strategies included participating in religious and individual activities and emphasizing strong moral and religious standards, planful problem solving, and self-control (Sivberg, 2002). On the other hand, the reliance on passive and avoidant coping strategies was found ineffective with chronic stressors such as raising a child with autism (Hastings et al., 2005 and King et al., 2006). The application of the stress-coping theories on parenting children with pervasive disabilities has yielded lots of interesting yet mixed results. In addition, there is a lag in coping research on fathers raising children with autism when compared to mothers, making it difficult to draw firm conclusions about their coping outcomes (Vacca, 2006). In their extensive review, Hastings et al. (2005) stated that it was difficult to locate published papers describing coping strategies adopted by fathers of children with autism. Further, Premberg et al. (2008) have stated that although available studies could clarify some issues for fathers, a small number of fathers were usually included and their voices were mixed with those of mothers. Therefore, it is of critical importance to understand the underlying structure of coping used specifically by fathers of children with autism. 1.1. Why this study? There are compelling practical and theoretical reasons for conducting this study. Research generally suggests that the way fathers cope with life stressors can significantly affect their children's, partners’, families’, and ultimately their own health and well-being (Gray, 2006, King et al., 2006 and Sivberg, 2002). Fathers, although labeled by some as the ‘peripheral parent’, can set the tone for the whole family's reaction to the child with a disability (Donaldson et al., 2011). When fathers’ coping strategies fall short, it becomes difficult for them to support other family members. To date, many gaps are left unresolved in the arena of coping behaviors adopted by fathers of children with chronic disabilities in general and autism in particular. It is not well understood how fathers’ empirically derived coping responses are linked to their psychological functioning and QoL. Available literature includes an investigation for the concepts of stress, coping and QoL through bivariate relationships. However, relationships among variables are often considered more complex than simple bivariate relationships with the presence of potential effects of other variables that may work as mediators or moderators in the existing relationships (Baron and Kenny, 1986 and Bennett, 2000). A mediator is a third variable that links a cause and an effect. A moderator is a third variable that modifies a causal effect (Wu & Zumbo, 2008). In other words, mediation explains the process of “why” and “how” a cause-and-effect happens, whereas moderation postulates “when” or “for whom” an independent variable most strongly (or weakly) causes a dependent variable (Frazier, Tix, & Baron, 2004). Investigating the role of such variables in psychology not only verifies researchers’ substantive theories around a phenomenon but also answers practical questions about whether an intervention or treatment program has the expected effect (Wu & Zumbo, 2008). Nevertheless, experts in this field claim that studying mediation and moderation causal nature effect is often overlooked or simply misunderstood leading to misapplication and misinterpretation in much of applied research (Frazier et al., 2004 and Rose et al., 2004). In this study, we aimed at investigating eight coping strategies as possible mediators or moderators in the relationship between fathers’ of children with autism parenting stress and QoL. 1.2. Theoretical framework and hypothetical model This study was guided by the Lazarus and Folkman's Transactional Model of Stress and Coping (1984). The model addresses the concepts of stress and coping. Stress is perceived as “a relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her well-being” (Lazarus & Folkman, 1984, p. 21). Coping is defined as the cognitive and behavioral efforts that are constantly changing to master, reduce, or tolerate a specific stressor appraised as exceeding one's available resources and abilities. Thus, stressful experiences are perceived in this model as dynamic and reciprocal person–environment transactions. A striking point in the model is that coping strategies are the intermediate process between stressors and health outcome. Lazarus and Folkman (1984) suggested that the process of coping can change the relationship between life stressors and health. Generally, ineffective coping strategies can generate negative emotions, harmful long-term effects, and calls for additional and/or different coping efforts. On the other hand, effective coping leads to positive emotions and beneficial long-term effects. We assumed that the style of coping fathers of children with autism use to address their stressors can significantly affect their parenting experience outcomes (QoL) by working as mediators or moderators in an existing stress–QoL relationship.