Understanding stress among low-income parents in Hong Kong

Abstract

Abstract Objective: Economic hardship and associated family tension may contribute to parental stress, predisposing individuals and families to mental health problems. This cross-sectional study aims to explore the association between personal and familial factors, stress and depressive symptoms among low-income parents in Hong Kong. Methods: 217 low-income parents were recruited from 2 less affluent districts in Hong Kong between March2016-October2017 to complete face-to-face survey. Parental stress was evaluated by the Depression-Anxiety-Stress-Scale(DASS)-21-Stress-subscale, where score≥8 indicates stressful experience. The Patient-Health-Questionnaire-9(PHQ-9) was used to assess presence/severity of depressive symptoms. Probable factors contributing to parents stress were collected: poverty, parental education level, marital status, intimate partner abuse assessed by the Abuse-Assessment-Screen-5(AAS-5), family harmony assessed by Family-Harmony-Scale-5(FHS-5), children factors including child’s cognitive ability, history of Attention-Deficit-Hyperactivity-Disorder(ADHD) and behavioral problems using Strength-and-Difficulties-Questionnaire(SDQ). Independent t-test and chi-square were applied to examine differences between groups. Logistic regression was performed to examine factors associated with parental stress by adjusting all covariates. Results: Significantly more stressed parents(i.e DASS≥8,N=38) experienced depressive symptoms(PHQ-9-score≥10: 27.0%vs.4.8%, p<0.001) and suffered from mental illnesses(26.3%vs.5.6%,p<0.001). They were more likely to be single-parent (39.5%vs.19.0%,p=0.004), victim of intimate partner abuse (26.3%vs.8.4%,p=0.002), or have children with behavioral problems(mean SDQ-score(SD):15.47(6.54)vs.9.32(5.30),p<0.001). In addition, the families of the group were less harmonious (mean FHS-5-score(SD):17.22(4.91)vs.19.81(2.91),p<0.001) compared to families of non-stressed parents. After adjusting for covariates, family disharmony(Odds Ratio(OR)=0.811,p=0.006) and children behavioral problem(OR=1.141,p=0.001) significantly affected parental stress. Conclusion: Family harmony and behavioral problems of their children were highly correlated with parental stress and associated depression/mental illnesses. Whether the relationship is bi-directional needed to be further explored in longitudinal study.