Mothers With MS May Be Unique in Their Management of Fatigue
Source: East Carolina University, College of Human Ecology
Mothers with multiple sclerosis (MS) may be managing fatigue in strikingly different ways than well mothers or those with rheumatoid arthritis (RA), say researchers at East Carolina University. In spite of the debilitating fatigue that many people with MS regularly experience, the fatigue that mothers with MS experience was not associated with their parenting.
For women with autoimmune illness, especially MS, fatigue can be a debilitating symptom that impacts many aspects of life. Yet, there is little research on maternal fatigue and its impact on the mothering experience for either well women or women with chronic illness.
In a study published in the December 2009 issue of Families, Systems, & Health, Carmel White, assistant professor; Mark White, associate professor; and Melissa Fox, doctoral student in child development and family relations compared the impact of fatigue on mothers with MS, mothers with RA, and well mothers in regard to three components: dealing with the typical daily hassles of parenting (e.g., children ignoring parental requests, struggles surrounding bedtime, or lack of privacy for parents), discipline styles (i.e., being lax or over-reactive in discipline), and monitoring the whereabouts of children.
Two hundred sixty-two mothers participated in the study: 103 mothers with MS, 68 mothers with RA, and 91 well mothers. In this study, the mothers rated their levels of fatigue, depression, quality and quantity of sleep, parenting daily hassles, discipline styles, and monitoring.
After sleep, depression, and number of children were controlled for in the analysis, fatigue was found to have a significant effect on monitoring child whereabouts for all three groups of mothers. Fatigue also factored significantly into the frequency and intensity of parenting daily hassles for well mothers and mothers with RA. To the surprise of the researchers, however, fatigue was not a big factor in parenting daily hassles for mothers with MS. For those mothers, the number of children in the family and poor sleep contributed much more to the escalation of parenting daily hassles.
“Since mothers with MS reported significantly more fatigue than well mothers and those with RA, we expected that fatigue would play a big role in the frequency and intensity of parenting daily hassles for mothers with MS, but we actually found that fatigue plays a small role for those we surveyed,” said Carmel White. “The study gave us some good information but it has also challenges us to speculate on how mothers with MS might be managing fatigue differently from other mothers.”
The researchers surmise from this study and other studies that the lived experience of fatigue may be quite different among the three groups of mothers. It is likely, they believe, that mothers with MS have learned to function in their role as a mother while experiencing regular fatigue by adjusting their expectations about parenting and/or their own parenting. For example, as reported in another research study by Carmel White and others published in the journal Chronic Illness, mothers with MS reported using more social support (e.g., their partners or their parents), more self-preservation parenting (e.g., letting a child play by herself while the mother rests in the same room), and higher expectations of mature behavior from their children (e.g., explaining to their children that they are too tired to do an activity) to cope with fatigue while parenting.
Carmel White said, “Other studies with older children and mothers with chronic fatigue tell us that because fatigue is so prevalent in women with MS, many children can easily spot the symptom in their mother and, thus, may adjust their behavior to create less hassles for her. It might also be with these women that they have worked out an arrangement of sorts with their children centering on their level of fatigue.” It also appears that adequate sleep plays a critical role in managing parenting stress for mothers with MS.
“By their nature families work at keeping things the same and when something out of the ordinary arises, they adjust accordingly,” said Jennifer Hodgson, associate professor of child development and family relations and adjunct associate professor of internal medicine, family medicine, and psychiatry at East Carolina University Brody School of Medicine. “If members of the family’s support system are educated about the fatigue factor of MS and are more actively involved in the co-parenting, they may rise to the need, liberating the mother with MS to rest and refresh.”
“This study helps us understand how fatigue impacts mothering in well mothers and mothers with chronic illnesses,” said Carmel White, “In fact, for mothers with MS, it was sleep, not fatigue, that was more influential on their parenting behaviors.“
Funding for this study was obtained through faculty start-up funds provided to Carmel White from East Carolina University’s Division of Research and Graduate Studies.