الفهرس 
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Abstract
The importance assigned to cerebral palsy is attributed to its severity, the burden it places on affected children, their families and societies and its high frequency as a cause of severe activity limitation in childhood.The aim of the present study was to improve the quality of care of children with cerebral palsy with special emphasis on improving coping strategies of mothers of children with cerebral palsy.The study was conducted on 200 children of different forms of CP with an age ranged from 4 to 12 years. The children were selected attending the following setting:i.Physical medicine and rehabilitation outpatient clinic in Alexandria University Children’s Hospital.ii.Physiotherapy and rehabilitation clinic in Pediatric governmental hospital affiliated to Ministry of Health in Alexandria (AL- Anfoshy hospital .iii. Private child rehabilitation center in Alexandria (AL-Andalus centre.iv.Rehabilitation center for disabled children affiliated to some Non Governmental Organizations (NGOs) in Alexandria (Ali Ibn Abi-Talib center).
Demographic data showed male predominance (57% ) among studied children. Their age is ranged from 4 to 12 years with a mean of 6.39 ± 2.54 years. Regarding the birth order of the studied children with cerebral palsy, nearly two fifths (40.5%) were 1st order child and 29.5% were second child. Being 3rd order child or higher was found in 30.0% of the studied cases. School or nursery attendance was found in 75 (37.5%) of cases.Nearly of a half of children (46%) have bilateral spastic type. Only (15%) of studied children were free from any other disorder. However, nearly half of them (47.5%) have epilepsy. (22%) of studied children with CP suffered from communication disorders. Others co morbid condition that found in a minority of children were visual problems, cognitive disorders and hearing problems (6.5%, 4.5 % and 1.5% respectively.Based on GMFCS and BMFM levels, level III was the most commonly encountered. Physiotherapy was prescribed for the majority of studied children (88.5%) to minimize spasticity and improve motor function. More than one third (37%) of the studied children suffering from feeding problems like aspiration, recurrent chest infections, regurgitation and vomiting.Using PSI/SF it was found that 18% of studied mothers had a high stress level. The highest percentage of stress was found on difficult child subscale
No statistically significant association was found between occurrence of maternal stress and the etiology of CP,types of CP and severity of CP A significantly higher percentage of mothers with high stress level reported a monthly income of more than 2000 Egyptian pounds as compared to mothers with high stress level with a monthly income of less than 1000 L.E
Nearly two thirds (66.7%) of mothers with high stress were residing urban areas as compared to 41.5% of the rural one and this difference was statistically significant
Strategies belong to acquiring social support like sharing difficulties with relatives and Sharing concerns with close friends show agreement of a vast majority of studied mothers. The strategies less commonly utilized are attending religious services, and feeling that they are strong. Mothers with high stressors and high support had fewer outcome problems compared to mothers with low support and high stressors.Statistical significance was found between coping strategies and annual income.
SUMMARY
The importance assigned to cerebral palsy is attributed to its severity, the burden it places on affected children, their families and societies and its high frequency as a cause of severe activity limitation in childhood.
The aim of the present study was to improve the quality of care of children with cerebral palsy with special emphasis on improving coping strategies of mothers of children with cerebral palsy.
The study was conducted on 200 children of different forms of CP with an age ranged from 4 to 12 years. The children were selected attending the following setting:
i. Physical medicine and rehabilitation outpatient clinic in Alexandria University Children’s Hospital.
ii. Physiotherapy and rehabilitation clinic in Pediatric governmental hospital affiliated to Ministry of Health in Alexandria (AL- Anfoshy hospital ).
iii. Private child rehabilitation center in Alexandria (AL-Andalus centre).
iv. Rehabilitation center for disabled children affiliated to some Non Governmental Organizations (NGOs) in Alexandria (Ali Ibn Abi-Talib center).
Demographic data showed male predominance (57% ) among studied children. Their age is ranged from 4 to 12 years with a mean of 6.39 ± 2.54 years. Regarding the birth order of the studied children with cerebral palsy, nearly two fifths (40.5%) were 1st order child and 29.5% were second child. Being 3rd order child or higher was found in 30.0% of the studied cases. School or nursery attendance was found in 75 (37.5%) of cases.
Nearly of a half of children (46%) have bilateral spastic type. Only (15%) of studied children were free from any other disorder. However, nearly half of them (47.5%) have epilepsy. (22%) of studied children with CP suffered from communication disorders. Others co morbid condition that found in a minority of children were visual problems, cognitive disorders and hearing problems (6.5%, 4.5 % and 1.5% respectively).
Based on GMFCS and BMFM levels, level III was the most commonly encountered. Physiotherapy was prescribed for the majority of studied children (88.5%) to minimize spasticity and improve motor function. More than one third (37%) of the studied children suffering from feeding problems like aspiration, recurrent chest infections, regurgitation and vomiting.
Using PSI/SF it was found that 18% of studied mothers had a high stress level. The highest percentage of stress was found on difficult child subscale
No statistically significant association was found between occurrence of maternal stress and the etiology of CP,types of CP and severity of CP
A significantly higher percentage of mothers with high stress level reported a monthly income of more than 2000 Egyptian pounds as compared to mothers with high stress level with a monthly income of less than 1000 L.E
Nearly two thirds (66.7%) of mothers with high stress were residing urban areas as compared to 41.5% of the rural one and this difference was statistically significant
Strategies belong to acquiring social support like sharing difficulties with relatives and Sharing concerns with close friends show agreement of a vast majority of studied mothers. The strategies less commonly utilized are attending religious services, and feeling that they are strong. Mothers with high stressors and high support had fewer outcome problems compared to mothers with low support and high stressors.Statistical significance was found between coping strategies and annual income.