Abstract
Caregivers caring for a child with a genetic condition may experience psychosocial distress, which may be compounded by the context in which the caring takes place. Few studies have examined psychosocial distress and support among caregivers caring for a child with a genetic disorder in low-middle-income countries such as Ghana. The purpose of the current study was to investigate the psychosocial impacts of caring for a child with a genetic disorder in an urban setting in Ghana’s capital, Accra. We conducted individual interviews among 17 caregivers who were taking care of children with various genetic disorders including, albinism, Edward’s syndrome, osteogenesis imperfecta, sickle cell disease, and spondyloepiphyseal dysplasia congenita. Thematic analysis of the data revealed three main themes on the psychosocial impacts, including: (1) self-blame, guilt, and shame; (2) sleep and mood disturbances; and (3) discrimination and stigmatization. We observed three themes about support: (1) psychological support; (2) family and community support; and (3) institutional support. Participants reported limited support from professionals such as psychologists. Discussion focuses on the supportive care needs of caregivers and implications for genetic counselling awareness, advocacy, and training.
Similar content being viewed by others
Data availability
Data is available on request.
References
Adegoke SA, Kuteyi EA (2012) Psychosocial burden of sickle cell disease on the family, Nigeria. Afr J Prim Health Care Fam Med 4(1):380. https://doi.org/10.4102/phcfm.v4i1.380
Alwan A, Modell B (2003) Recommendations for introducing genetics services in developing countries. Nat Rev Genet 4(1):61–68. https://doi.org/10.1038/nrg978
Appiah S, Osei EA (2023) “People keep staring at you in public for no reason”: experiences and coping strategies of parents WITH autistic children in Accra, Ghana. Int J Africa Nurs Sci 18. https://doi.org/10.1016/j.ijans.2023.100536
Asare EV, Wilson I, Benneh-Akwasi Kuma AA, Dei-Adomakoh Y, Sey F, Olayemi E (2018) Burden of sickle cell disease in Ghana: the Korle-Bu experience. Adv Hematol 6161270. https://doi.org/10.1155/2018/6161270
Barlow JH, Ellard DR (2006) The psychosocial well-being of children with chronic disease, their parents and siblings: an overview of the research evidence base. Child Care Hlth Dev 32(1):19–31. https://doi.org/10.1111/j.1365-2214.2006.00591.x
Baumbusch J, Wu S, Lauck SB, Banner D, O’Shea T, Achtem L (2018) Exploring the synergies between focused ethnography and integrated knowledge translation. Health Res Policy Syst 16(103). https://doi.org/10.1186/s12961-018-0376-z
Bioku AA, Ohaeri JU, Oluwaniyi SO, Chaimowitz GA, Olagunju AT (2021) Emotional distress among parent caregivers of adolescents with sickle cell disease: association with patients and caregivers variables. J Health Psychol. 26(14):2851–2860. https://doi.org/10.1177/1359105320935986
Blue S, Shove E, Carmona C, Kelly MP (2016) Theories of practice and public health: understanding (UN) healthy practices. Crit Public Health 26(1):36–50. https://doi.org/10.1080/09581596.2014.980396
Beighton C, Wills J (2019) How parents describe the positive aspects of parenting their child who has intellectual disabilities: A systematic review and narrative synthesis. J Appl Res Intellect Disabil 32(5):1255–1279
Boettcher J, Denecke J, Barkmann C, Wiegand-Grefe S (2021) Quality of life and mental health in mothers and fathers caring for children and adolescents with rare diseases requiring long-term mechanical ventilation. Int J Environ Res Public Health 17(1). https://doi.org/10.3390/ijerph17238975
Bogart LM, Mutchler MG, McDavitt B, Klein DJ, Cunningham WE, Goggin KJ, Ghosh-Dastidar B, Rachal N, Nogg KA, Wagner GJ (2017) A randomized controlled trial of rise, a community-based culturally congruent adherence intervention for Black Americans living with HIV. Ann Behav Med 51(6):868–878. https://doi.org/10.1007/s12160-017-9910-4
Braun V, Clarke V (2006) Using thematic analysis in psychology. Eward Arnold (Publishers) Ltd, England. https://doi.org/10.1191/1478088706qp063oa
Čagalj D, Buljevac M, Leutar Z (2018) Being a mother of a child with prader-willi syndrome: experience of accessing and using formal support in Croatia. Scand J Disabil Res 20(1):228–237. https://doi.org/10.16993/sjdr.13
Cardinali P, Migliorini L, Rania N (2019) The caregiving experience of fathers and mothers of children with rare diseases in Italy: challenges and social support perceptions. Front Psychol. https://doi.org/10.3389/fpsyg.2019.01780
Casey K, Fink R, Krugman M, Propst J (2004) The graduate nurse experience. J Nurs Adm 34(6):303–311. https://doi.org/10.1097/00005110-200406000-00010
Christianson A, Modell B (2004) Medical genetics in developing countries. Annu Rev Genom Hum G 5:219–265. https://doi.org/10.1146/annurev.genom.5.061903.175935
Cuijpers P, van Straten A, Warmerdam L, Andersons G (2009) Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Depress Anxiety 26(3):279–288. https://doi.org/10.1002/da.20519
District Analytical Report (2010). La Nkwantanang- Madina Municipality. PDF. Retrieved on 30/10/2020 from www.statsghana.gov.gh.
Dogba MJ, Bedos C, Durigova M, Montpetit K, Wong T, Glorieux FH, Rauch F (2013) The impact of severe osteogenesis imperfecta on the lives of young patients and their parents - a qualitative analysis. BMC Pediatrics 30(3). https://doi.org/10.1186/1471-2431-13-153
Drapeau A, Marchand A, Beaulieu-Prévost D (2012) Epidemiology of psychological distress. In: Mental illnesses - understanding, prediction and control. IntechOpen. https://doi.org/10.5772/30872
Duvdevany I, Abboud S (2003) Stress, social support and well-being of Arab mothers of children with intellectual disability who are served by welfare services in northern Israel. J Intellect Disabil Res 47(4-5):264–272. https://doi.org/10.1046/j.1365-2788.2003.00488.x
Dzokoto V, Anum A, Affram AA, Agbavitoh JKM, Dadzie HA, Mintah RK, Norman QA, Owusu-Prempeh C, Tawam LN, Turkson SM, Osei-Tutu A (2022) “A lot of Ghanaians really don’t understand the work we do”—cultural adaptations and barriers in Ghanaian psychotherapy practice. Int Perspect Psychol 11. https://doi.org/10.1027/2157-3891/a000015
Dzokoto V, Barnett C, Osei-Tutu A, Briggs A (2018) Mental health reportage in Ghanaian newspapers between 2000 and 2015: a qualitative analysis. Int J Ment Health 47(3):192–214. https://doi.org/10.1080/00207411.2018.1488557
Haw T, Henriques S (2021) Exploring how mothers of a child with a genetic disorder experience their couple relationship in a low socio-economic setting. J Genet Couns 30(3):885–899. https://doi.org/10.1002/jgc4.1391
Hofmann SG, Pollack MH, Otto MW (2006) Augmentation treatment of psychotherapy for anxiety disorders with D-cycloserine. CNS Drug Rev 12(3-4):208–217. https://doi.org/10.1111/j.1527-3458.2006.00208.x
James C, Hadley D, Holtzman N et al (2006) How does the mode of inheritance of a genetic condition influence families? A study of guilt, blame, stigma, and understanding of inheritance and reproductive risks in families with X-linked and autosomal recessive diseases. Genet Med 8:234–242. https://doi.org/10.1097/01.gim.0000215177.28010.6e
Joling KJ, ten Have M, de Graaf R et al (2019) Risk factors for suicidal thoughts in informal caregivers: results from the population-based Netherlands mental health survey and incidence Study-2 (NEMESIS-2). BMC Psychiatry 19:320. https://doi.org/10.1186/s12888-019-2317-y
Karch D, Nunn KC (2011) Characteristics of elderly and other vulnerable adult victims of homicide by a caregiver: National Violent Death Reporting System—17 US States, 2003-2007. J Interpers Violence 26(1):137–157
Kuerten BG, Brotkin S, Bonner MJ, Ayuku DO, Njuguna F, Taylor SM, Puffer ES (2020) Psychosocial burden of childhood sickle cell disease on caregivers in Kenya. J Pediatr Psychol 45(5):561–572. https://doi.org/10.1093/jpepsy/jsaa021
Mbamba CR, Ndemole IK (2021) “I paused my life”: experiences of single mothers caring for their autistic children in Ghana. J Soc Serv Res 47(5). https://doi.org/10.1080/01488376.2021.1875966
Mumuni ND, Osman W, Alhassan BA, Alhassan A (2023) Burden experienced by informal caregivers of children with sickle cell disease (SCD): a qualitative exploratory study at Tamale Teaching Hospital, Ghana. BMJ Open 13(4):e066311
National Alliance for Caregiving, AARP (2009) Caregiving in the U.S. https://www.aarp.org/livable-communities/learn/health-wellness/info-12-2012/Caregiving-in-the-us-2009.html
National Human Genome Research Institute [NHGRI] (2018) Insight into genetics, human biology and disease gleaned from family based genomic studies. Open Arch. https://doi.org/10.1038/s41436-018-0408-7
O'Dwyer ST, Janssens A, Sansom A, Biddle L, Mars B, Slater T et al (2021) Suicidality in family caregivers of people with long-term illnesses and disabilities: a scoping review. Compr Psychiatry 110:152261. https://doi.org/10.1016/j.comppsych.2021.152261
Oti-Boadi M (2017) Exploring the lived experiences of mothers of children with intellectual disability in Ghana. Sage Open 71(3):1–7. https://doi.org/10.4102/hts.v7li32762
Oti-Boadi M, Dankyi E, Kwakye-Nuako CO (2020) Stigma and forgiveness in Ghanaian mothers of children with autism spectrum disorders (ASD). J Autism Dev Disord 50:1391–1400. https://doi.org/10.1007/s10803-020-04366-x
Oti-Boadi M, Osei-Tutu A, Mate-Kole CC (2022) Challenges and support needs of parents of children with developmental disabilities (DD) in Accra, Ghana. Res Dev Disabil 128:104274. https://doi.org/10.1016/j.ridd.2022.104274
Pelentsov LJ, Fielder AL, Laws TA, Esterman AJ (2016) The supportive care needs of parents with a child with a rare disease: results of an online survey. BMC Family Pract 17(88). https://doi.org/10.1186/s12875-016-0488-x
Queremel Milani DA, Tadi P (2023) Genetics, chromosome abnormalities. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing Available from: https://www.ncbi.nlm.nih.gov/books/NBK557691/
Stoller JK (2018) The challenge of rare diseases. Chest 153:1309–1314. https://doi.org/10.1016/j.chest.2017.12.018
Tsai SM, Wang HH (2009) The relationship between caregiver’s strain and social support among mothers with intellectually disabled children. J Clin Nur 18(4):539–548
Udoh EE, Omorere DE, Sunday O, Osasu OS, Amoo BA (2021) Psychological distress and burden of care among family caregivers of patients with mental illness in a neuropsychiatric outpatient clinic in Nigeria. PLoS One 16(5):e0250309
van Scheppingen C, Lettinga AT, Duipmans JC, Maathuis KG, Jonkman MF (2008) The main problems of parents of a child with epidermolysis bullosa. Qual Health Res 18(4):545–556. https://doi.org/10.1177/1049732308315110
Vitaliano P, Borson S, Scanlan JM, Sadak T, Lessig M (2014) Dementia services mini-screen: a simple method to identify patients and caregivers in need of enhanced dementia care services. Am J Geriat Psychiat 22(8):746–755. https://doi.org/10.1016/j.jagp.2013.11.001
Weng HJ, Niu DM, Turale S, Tsao LI, Shih FJ, Yamamoto-Mitani N et al (2012) Family caregiver distress with children having rare genetic disorders: a qualitative study involving Russell–Silver Syndrome in Taiwan. J Clin Nurs 21(1-2):160–169. https://doi.org/10.1111/j.1365-2702.2010.03583.x
West African Genetic Medicine Centre (2020) The WAGMC Report, 2020. University of Ghana
Wonkam A, Ponde C, Nicholson N, Fieggen K, Ramesar R, Davidson A (2012) The burden of sickle cell disease in Cape Town. S Afri Med J 102(9):752–754
World Health Organization (2006) The world health report, 2006: working together for health. WHO. Retrieved on 30/10/2020 from https://apps.who.int/iris/handle/10665/43432
Zurynski Y, Deverell M, Dalkeith T, Johnson S, Christodoulou J, Leonard H et al (2017) Australian children living with rare diseases: experiences of diagnosis and perceived consequences of diagnostic delays. Orphanet J Rare Dis 12(1):68. https://doi.org/10.1186/s13023-017-0622-4
Funding
This study was funded by the West African Genetic Medicine Centre of the University of Ghana.
Author information
Authors and Affiliations
Contributions
Conceptualization: Paul Opoku, Annabella Osei-Tutu, Mabel Oti-Boadi; methodology: Paul Opoku, Annabella Osei-Tutu, and Mabel Oti-Boadi; formal analysis and investigation: Paul Opoku, Annabella Osei-Tutu, and Mabel Oti-Boadi; writing—original draft preparation: Annabella Osei-Tutu, Mabel Oti-Boadi, and Paul Opoku; writing—review and editing: Annabella Osei-Tutu, Mabel Oti-Boadi, and Paul Opoku; funding acquisition: Paul Opoku; supervision: Annabella Osei-Tutu and Mabel Oti-Boadi.
Corresponding author
Ethics declarations
Ethics approval and consent to participate
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Opoku, P., Osei-Tutu, A. & Oti-Boadi, M. Psychosocial impacts of caring for a child with a genetic disorder in Accra, Ghana. J Community Genet 14, 565–574 (2023). https://doi.org/10.1007/s12687-023-00662-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12687-023-00662-y