Interrelationship Between Musculoskeletal Pain, Anxiety, and Depression Among Mothers of Children with Cerebral Palsy Attending Two Tertiary Hospitals in Ibadan, Nigeria: A Cross-Sectional Study.
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Abstract
Background: Cerebral palsy (CP) remains the most prevalent motor disability among children, often necessitating long-term, intensive caregiving. Mothers, who constitute the majority of primary caregivers, are particularly susceptible to both physical and psychological health challenges. Musculoskeletal pain (MSP), anxiety, and depression are frequent yet understudied coexisting conditions in this population, especially within low-resource settings such as Nigeria. Understanding their interrelationship is crucial to developing holistic caregiver support interventions. To determine the prevalence and interrelationship of musculoskeletal pain, anxiety, and depression among mothers of children with cerebral palsy in southwestern Nigeria.
Methods: A descriptive cross-sectional design was employed. A total of 114 mothers of children diagnosed with CP were purposively recruited from the Physiotherapy Outpatient Clinics of the University College Hospital and Oni Memorial Children’s Hospital, Ibadan. Data were collected using a socio-demographic questionnaire, the Nordic Musculoskeletal Questionnaire (NMQ), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics summarized demographic and clinical characteristics. Associations between variables were explored using Chi-square tests, while interrelationships were examined via Spearman’s rank correlation at a significance level of p < 0.05.
Results: Among participants, 50.9% reported no-to-mild MSP, 19.3% moderate pain, and 29.8% severe pain. Anxiety symptoms were identified in 44.7% of mothers, Most mothers demonstrated mild depressive symptoms, consistent with the overall mean PHQ-9 score of 5.20 (SD = 4.86), although a smaller proportion reported moderate to moderately severe depressive symptoms Musculoskeletal pain showed a significant positive correlation with anxiety (χ² = 17.938, p = 0.001; r = 0.348, p < 0.001), indicating that mothers experiencing severe MSP were more likely to exhibit higher anxiety levels. Furthermore, anxiety was significantly associated with depression (χ² = 23.815, p < 0.001; r = 0.316, p = 0.001). No significant associations were observed between MSP and depression or between caregiving duration and any of the studied outcomes.
Conclusion: Mothers of children with cerebral palsy in Nigeria experience substantial musculoskeletal and psychological burdens. The significant linkage between MSP and anxiety, and between anxiety and depression, underscores the bidirectional relationship between physical strain and emotional distress in caregiving. These findings advocate for the integration of physiotherapeutic, ergonomic, and psychosocial interventions into paediatric neurorehabilitation programs. Addressing caregiver well-being holistically may improve both maternal health outcomes and the quality of care provided to children with CP.
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