Ruth S. Farber, PhD, OTR/L Salus University, Philadelphia, USA

Margaret L. Kern, PhD Centre for Positive Psychology The University of Melbourne

! A salient role for most women with or without a disability/chronic illness "  I feel that I might appreciate my time with my

daughter more, appreciate my mobility/ability to play more than other mothers who do not have an illness

! Requires orchestrating physical, psychological, social, and cognitive activities with and

for their children. . . need positive engagement/participation

! MS often diagnosed during peak childrearing years

! New treatments help with functioning

! But raising children remains complicated

! Many women find creative ways to participate/be engaged in salient roles**

! Two types: period (relapse/remit MS) and continuing (progressive MS)

!  As clinicians we need to know how to help woman thrive despite challenges of the disease

Social interaction: (Environment Mastery)

Experience community or family as

Normalizing Son is “my royal footman”

or Marginalizing

Participation: Individually valued, culturally common maternal practices

“Doing what mothers Do”

Experience of Self (Self-Acceptance):

Subjective experience of being a mother & having a disability

“just a little disability” or not

Changes Over time

Initial Qualitative Finding: Mothers with Chronic Illnesses/Disabilities: Farber, 2000, 2004

! Encouraging participation(functioning and engagement), as well as satisfaction with this participation is important for the lives of mothers who experienced a chronic condition. "  “As I am writing this it is snowing. Going out and

playing in the snow is hard in a wheelchair, but I have managed to hit my kids with a pretty good snowball.”

! To do this mothers with MS may even need to have a more robust sense of self/well-being (and or social support) to continue this participation.

Environmental Factors

Social support

Positive Personal Factors

(Wellbeing scale)

Greater Role Participation

Physical/Emotional

Parental Satisfaction

! 111 community-dwelling mothers with MS "  Primarily solicited through NMSS newsletter "  At least one child 12 or under

! Type of MS: "  Relapse remit=101 "  Progressive=10 "  Unknown=7

1.POSITIVE PERSONAL FACTORS: "  Psychological Well-being Scale (Ryff & Singer, 2006) !  Environmental mastery !  Self-acceptance !  Purpose in Life !  Positive relations !  Autonomy !  Personal growth

2. ENVIRONMENTAL FACTORS (Support & Relationships): !  Social Support: MOS, Social Support Scale (Sherbourne & Stewart,1991)

3. ROLE PARTICIPATION "  Health-related quality of life scale (SF-36) "  Role-emotional, Role-physical scale.

4. SATISFACTION WITH PARENTING #  Parental Participation Scale(PPS) (Farber, 2008)

! Hierarchical regression analyses tested unique effects of social support and positive (psychological) personal factors (self-acceptance, environmental mastery & purpose in life) on role participation and satisfaction with parenting.

!  Additional analyses: Tested synergistic combination of social support and positive personal factors.

! Social support explained 35-44% of variance in each outcome

! Positive personal factors(self-acceptance and environmental mastery) explained an additional 9-17%.

! Synergistic effect: the combination of social support and positive factors (environmental mastery, self-acceptance, & purpose in life) predicted greater role function and satisfaction with parenting than either alone.

! Mastery, social support and physical role function

! Purpose, social support and emotion role function

! Self-acceptance, social support parental satisfaction

! Both social support & positive personal (psychological) factors uniquely predicted greater physical & emotional role function and parental satisfaction

! Combination of social support with high self-acceptance, purpose, and environmental mastery are best.

! “I rely on the ‘village. ’When I can’t do all that needs to be done… my son really does have a village of people looking out for him. This support is critical in facilitating how positive I feel about mothering.”

! “I have a cooling vest to wear when I take the children out for walks so that my MS is not so affected by hot weather”

! I truly believe my children are growing up more self-sufficient and independent because I can not do as much for them. By gently and politely asking for their help, when needed and trying not to over-ask, my children almost always respond without a fuss.. .

! They’ve grown accustom to certain ways of walking with me, a shoulder to gentle support from the younger ones, an arm from the older one.

!  

! Now instinctively my children are much more aware of the many small ways they can help some one-holding a door, running an errand, offering a hand. And they see how helpful others are, always with a smile on their faces and feeling of warmth. . .

! One fun thing is taking advantage of the handicapped cut lines at the amusement park. Mom can get the family onto rides much quicker and some for two rides in a row.

! Developing framework to help women with MS cultivate fuller & more satisfying lives

! Demonstrating the value of incorporating a positive psychological focus into clinical/rehabilitation practices.

! Practitioners might focus on building, social support, environmental mastery and developing high quality social support

! rfarber@salus.edu