تأثیر پتأثیر پریشانی روان‌شناختی و خودکارآمدی والدگری بر کیفیت زندگی در مادران کودکان مبتلا به اختلال نقص توجه/بیش‌فعالی با نقش میانجی ادراک حمایت همسر

Highlights:

• Psychological distress and parenting self-efficacy have both direct and indirect effects (through perceived spousal support) on the quality of life of mothers of children with ADHD.

• Perceived spousal support serves as a full mediating factor in the relationship between psychological distress and parenting self-efficacy with the quality of life of mothers of children with ADHD.

• The findings emphasize the importance of stress management training, parenting skills education, spousal support, and counseling in improving mothers' quality of life, with continuous follow-up of these programs strengthening family support.



Introduction: Child development is a dynamic process in which some children face difficulties due to genetic or environmental factors, with attention-deficit/hyperactivity disorder being one of the most common childhood disorders (Njardvik et al., 2025; Sabahi et al., 2025). This disorder causes behavioral, emotional, and cognitive self-regulation problems in children and increases psychological pressure on parents, especially mothers, reducing their quality of life (Peng, 2024; Amro, 2024; Moghaddar & Mohaddes, 2025). Psychological distress is a state of emotional suffering and psychological pressure accompanied by mood, anxiety, and somatic symptoms, having a direct negative impact on quality of life (Chen et al., 2024; Jalala et al., 2024; López-de-León et al., 2025). Furthermore, parenting self-efficacy plays a key role in enhancing parents' quality of life, and parents who have greater belief in their abilities to manage parenting challenges experience higher quality of life and better ability to cope with social pressures (Akafian et al., 2024; Feng et al., 2022). Perceived spousal support, as a key source of support, increases mothers' quality of life, strengthens maternal functioning and parenting self-efficacy, and reduces parenting stress (Lee et al., 2020; Nwozichi & Maciejewski, 2025; Ahmadpour et al., 2023; Suzuki, 2010; Goldyne, 2013). Given the high prevalence of ADHD and its effects on mothers, the present study aimed to model the impact of psychological distress and parenting self-efficacy on the quality of life in mothers of children with ADHD, with the mediating role of perceived spousal support.

Methodology: The present study was applied research with a correlational design using structural equation modeling. The statistical population included mothers of children with ADHD in Sabzevar city in 2025. According to the minimum recommended sample size for structural equation analysis (Lomax & Schumacher, 2015), 230 individuals were considered as the initial sample, with 210 valid questionnaires remaining for statistical analysis. Sampling was conducted using convenience and voluntary methods, with participants selected from mothers who referred to counseling and psychological service centers and were willing to participate. Inclusion criteria included age 20-50 years, having a child with ADHD, at least basic literacy, and absence of psychological problems. Exclusion criteria included unwillingness to continue or incomplete completion of questionnaires. Data analysis was performed using SPSS version 27 for descriptive analyses and LISREL version 8.8 for structural equation modeling analyses.

Findings: This study involved 210 mothers of children with ADHD (mean age 35.90 years). Most mothers (56.7%) were in the 30-40 age range and had bachelor's degrees (33.3%). Of the children, 53.3% were boys, and the most common child ages were 8, 10, and 11 years (23.3% each).Descriptive findings showed that the mean total quality of life score for mothers was 51.66, psychological distress was 22.19, parenting self-efficacy was 39.46, and perceived spousal support was 59.69. All variables had normal distributions.Correlation results showed that quality of life had a significant negative relationship with psychological distress (r = -0.54) and significant positive relationships with parenting self-efficacy (r = 0.56) and perceived spousal support (r = 0.65). Model fit indices (χ²/df = 1.82, RMSEA = 0.063, CFI = 0.93) indicated good fit of the structural model.Structural equation modeling findings showed that psychological distress had a direct negative effect (β = -0.17) and parenting self-efficacy had a direct positive effect (β = 0.26) on quality of life. Additionally, perceived spousal support played a significant mediating role in the relationship between psychological distress (β = -0.245) and parenting self-efficacy (β = 0.120) with quality of life. These findings highlight the importance of spousal support in improving the quality of life in mothers of children with ADHD.

Conclusion:

This study aimed to investigate the role of psychological distress and parenting self-efficacy on the quality of life in mothers of children with ADHD, with the mediating role of perceived spousal support. The results showed that psychological distress had a significant negative relationship with quality of life, and chronic caregiving pressures can reduce mothers' mental health and life satisfaction (Lazarus & Folkman, 1984). Furthermore, parenting self-efficacy had a significant positive relationship with quality of life and played a protective role in reducing parenting stress and promoting psychological well-being (Bandura, 1997). Perceived spousal support directly improved mothers' quality of life and was considered an important source of psychosocial support (Cohen & Wills, 1985). Additionally, spousal support played a mediating role in the relationship between psychological distress and quality of life and could moderate the negative effects of stress (Bowen, 1978). Overall, the findings emphasize the importance of strengthening coping resources, parenting self-efficacy, and spousal support in enhancing mothers' quality of life. The present study faced limitations in generalizability and inference of causal relationships due to convenience sampling, cross-sectional design, and use of self-report instruments, and future randomized, longitudinal, and multi-informant studies are recommended. The results are only generalizable to mothers in Sabzevar and should be generalized to other populations with caution. From a practical perspective, designing programs to reduce psychological distress, increase parenting self-efficacy, and strengthen spousal support can help improve mothers' quality of life.