abstract: 'Objective. This study examines 1) the way that children with chronic

  conditions are cared for at home and assisted by technology affects

  maternal employment and child care; 2) the social and clinical factors

  associated with the decision of a mother to quit employment to care for

  a child at home; and 3) the way in which care at home and the decision

  of a mother to quit a job affects maternal mental health.

  Design. The 6-month postdischarge status of 70 mothers of children

  assisted by technology (study group) was compared with the 6-month

  postdischarge status of 58 mothers of children (matched for age and

  gender) hospitalized for acute illnesses (comparison group). Between

  January and December 1993, we gathered information on sociodemographic

  status, employment status and changes in employment, severity of the

  child''s condition, child care and nursing services at home, family

  support, and maternal mental health.

  Results. One third of mothers in the study group reported that they quit

  employment to take fare of a child at home with only 37.1\% remaining

  employed outside the home, compared with 69.0\% of comparison group

  mothers. Single caretakers were 15 times more likely to quit employment

  compared with mothers in two-parent families. Availability of child care

  had an independent effect on a mother''s decision to quit a job, whereas

  the severity of the child''s condition did not. Child care hours were

  significantly lower in study group families and were provided mostly by

  relatives compared with daycare facilities and regular babysitters in

  comparison families. Family support was highest among employed mothers

  in both the study and the comparison groups and lowest in study group

  mothers who were neither employed currently nor before the child''s

  illness or who had quit employment to care for the child. Family income

  was significantly lower in families with a child assisted by technology.

  Families in the study group had 20-fold higher uncompensated health care

  costs than did the comparison group. Mothers caring for a child assisted

  by technology reported less good mental health than did comparison group

  mothers, and employment seems to mediate this relationship.

  Conclusions. Caring for a child assisted by technology seems to create

  barriers to maternal employment diminishing family resources at a time

  when financial needs actually may increase. Lack of family support and

  child care services increase the likelihood that mothers of children

  assisted by technology will stay out of the labor force. Remaining

  employed buffers the negative effects of care at home on maternal mental

  health. Health policies for children with chronic health problems should

  address issues of financial burdens and the labor force participation of

  their caretakers.'
affiliation: 'Thyen, U (Corresponding Author), Univ Lubeck, Klin Padiat, Kahlhorststr
  31-35, D-23538 Lubeck, Germany.

  Univ Lubeck, Klin Padiat, D-23538 Lubeck, Germany.

  Massachusetts Gen Hosp, Div Gen Pediat, Boston, MA 02114 USA.

  Harvard Univ, Sch Med, Dept Pediat, Boston, MA 02115 USA.'
author: Thyen, U and Kuhlthau, K and Perrin, JM
author-email: uthyen@compuserve.com
author_list:
- family: Thyen
  given: U
- family: Kuhlthau
  given: K
- family: Perrin
  given: JM
da: '2023-09-28'
doi: 10.1542/peds.103.6.1235
eissn: 1098-4275
files: []
issn: 0031-4005
journal: PEDIATRICS
keywords: 'chronic illness; home care; technology assisted; family support;

  employment; quality of life; child care'
keywords-plus: 'PSYCHOLOGICAL ADJUSTMENT; FAMILY; STRESS; WOMEN; WORK; DISABILITIES;

  FATHERS; IMPACT; PARENT'
language: English
month: JUN
number: 6, 1
number-of-cited-references: '49'
orcid-numbers: Perrin, James/0000-0002-1810-3708
pages: 1235-1242
papis_id: feb18513860c6daa075e0e95cfb36004
ref: Thyen1999employmentchild
times-cited: '135'
title: Employment, child care, and mental health of mothers caring for children assisted
  by technology
type: Article
unique-id: WOS:000080613400030
usage-count-last-180-days: '1'
usage-count-since-2013: '13'
volume: '103'
web-of-science-categories: Pediatrics
year: '1999'