الفهرس 
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Abstract
Summary
onduct disorders are not uncommon in general population,
they are highly disruptive to others in child environment,
and they are chronic and predictive of problems. The way the
family functions therefore has profound effects on the
development of behavioral problems, where there is quarrelling
or stained relationship, neglect or lack of affection. In addition
to CD children usually experiences peer rejection,
distinhibition, low frustration to tolerance, negative selfconcept, anxious. Parents, teachers and friends know that the
child is ’’misbehaving’’ or ’’different’’ but they may not be able to
tell exactly what is wrong, children with CD somewhere not
able to adapt or compensate on their own areas of weakness and
didn’t receive any help from parents, teachers or professionals.
Those children should receive all the help necessary for coping
with their areas of weakness and available to spare them the
frustration and anguish often associated these conditions.
Aim of the study:
These aim of this study to enhance the coping strategies
(intervention protocol) of parents having children with conduct
disorders.
C
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114
This aim was achieved through:
Assessing coping patterns of parents caring for children
with conduct disorders.
Implementing coping strategies’ intervention protocol to
enhance parents coping patterns.
Evaluating the effect of this protocol on parents’ coping
patterns of care provided to their children.
Hypothesis:
Coping strategies interventions protocol for parents has a
positive effect on children with conduct disorders.
Research setting:
The study was conducted at the Outpatient Clinic of the
Institute of Psychiatry, Ain Shams University at designated
days of child psychiatric outpatient clinic (Saturdays &
Thursdays).
Subjects:
Sample type
A purposive sample was obtained from all available
parents having children with conduct disorders who met the
inclusion criteria during their follow-up visits to the previously
mentioned setting.
Sample size
The current study was conducted on 40 of parents
accompanying their children with conduct disorders who were
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115
receiving follow up care at the Child Psychiatry Outpatient
Clinic, Institute of Psychiatry, Ain Shams University Hospitals
for six successive months.
Inclusion criteria
These inclusion criteria for children with conduct
disorders and parents caring for them:
School age 6 -12 years.
Sex: both sexes (boys & girls)
Free from other neurological disorders or chronic
physical diseases or handicapped (through checking the
patient chart).
Parents accompanying their children
Consent for participation.
Parents who give direct care to the child.
Tools of data collection:
A- Interview questionnaire pre-post test protocol
Intervention (Appendix I).
It was designed by the researcher based on the literature
review and supervisors’ guidance, to assess the parents’
knowledge regarding conduct disorder and practices toward their
child with conduct disorders pre- post protocol intervention.
Implementation of the questionnaire consisting of 62
questions that include all of the following:
1- Biosocial data related to parents of conduct disordered
children (age, education, and marital status, occupation, type
of family, income & residence)
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116
2- Biosocial data related to conduct disordered children (age,
sex, educational level, number of siblings & rank in family).
3- Knowledge of parent about conduct disorders including
definition, causes, manifestations, associated features, and
treatment.
4- Parent practices towards their children with conduct disorders
(action taking by parent when dealing with their CD in living
activities related to aggression, lying, stealing, impulsivity
through the following possible parental responses:
B- Parent’s Locus of Coping Scale to assess the coping
responses of the respondents to different sources of
stress (pre-post protocol) (Appendix II).
Originally developed by Shek and Cheung (1990), it
aims to assess the coping responses of the respondents to
different sources of stress. It consists of 19 items; each
item was rated on a 4 - point scale:
1=never, 2=rarely, 3=often, and 4= always.
C- Parental Shame Scale to measure the shame that a parent
experiences about his/her own child’s externalizing
behaviors:(pre-post protocol) (Appendix III).
Originally developed by Lau (2004), it aims to assess shame
that a parent experience about his or her own conduct towards
child’s externalizing behaviors and academic performance. It
consists of 17 items; each item was rated on a 5- point scale.
1= strongly disagree, 2= disagree, 3 =not sure, 4= agree,
and 5= strongly agree.
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117
D- Parenting Sense of Competence Scale to measure
parenting self-efficacy: (pre-post protocol) (Appendix IV):
Originally developed by Lyman and Dunn (1986), it aims
to assess parenting self-efficacy and satisfaction. It consists
of 7 item was rated on a 5- point scale:
1= strongly disagree, 2= disagree, 3= not sure, 4 agree,
and 5 = strongly agree.
E- Child Behavior Checklist (CBCL) Competence a scale of
a specific behavior: (Appendix IIV):
Originally developed by Achenbach (1991), it aims to elicit
parent’s reports of the amount and quality of their child’s
participation in sports, hobbies, games, activities, jobs and
chores, and friendships; how well the child gets along with
others and plays and works alone; and how the child
functions in school. It consists of 89 items each is rated on a
3- point scale:
0, 1, and 2.
F- Intervention Protocol
The protocol was designed by researcher as a nursing
intervention for the purpose to enhance the coping strategies
(intervention protocol) of parents having children with conduct
disorders.
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118
The present nursing intervention protocol was conducted in
three phases:
First: Preparatory and designing phases:
This phase aims at planning for intervention protocol
through setting its objectives, preparing the activities, and
designing the methodology and media such as handouts, real
situations and conducting a pilot study.
Second: implementing phase:
This phase began by data collection, then implementation
the intervention protocol for enhancement of coping strategies
among parents having children with conduct disorders who met
criteria. Subjects involving in the study were interviewed and
assessed two times, before protocol to obtain baseline data, and
after implementing protocol to evaluate the effectiveness of
implementing the protocol on the parents having children with
conduct disorders.
Third: Evaluation phase
Upon the completion of intervention protocol, the post test
was done for parents having children with conduct disorders to
estimate the effect of the intervention protocol on enhancement of
coping strategies among parents having children with conduct
disorders using the same pre- protocol tools.
The main results revealed that:
- The highest frequency of age among conduct disordered.
Children were between 10-12 years and the majority of them
were boys (70%).
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- For the majority there is positive family history (80%).
- As for child order the highest percent (52.50%) of CD
children ranked the second among siblings.
- The majority of mothers (85%) were housewives and more
than half of them had secondary education.
- Most of parents (95%) at the sample were from urban areas
and three quarters of them were nuclear families.
- Three quarters (75%) of the sample were parents co-living.
- There was a statistically significant difference in parents’
total knowledge scores about CD of their children after
intervention.
- There was a statistically significant difference in parents’
total practices score toward their CD of their children after
intervention.
- There was a statistically significant difference in parents’
total sense of competence score about CD children after
intervention.
- There was a statistically significant difference in parents’
total coping score about CD children after intervention.
- There were statistically significant relations between parents’
knowledge scores and characteristics pre-post program
regarding to child’s sex, mother’s education, and family type
(X2
=6.349,5.674,& 3.905 at p<0.012,0.018, &0.046).
- There were statistically significant relations between parents’
practices and characteristics pre- post program regarding to
child’s birth, order, father’s age and family income
(X2
=5.165, 6.359,& 5.345 at p< 0.047, 0.025, & 0.041).
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120
- There were statistically significant relations between parents’
sense of competence and characteristics pre-post program
regarding to child’s birth order, mother’s age, father’s age
and family income (X2
= 14.410, 12.103, 6.305,&10.125 at
p<0.002,0.007, 0.042&0.018).
- There were statistically significant relations between parents’
feeling shame and characteristics pre-post program
regarding to child’s birth order, mother’s age, mother’s
education, father’s age (X2
=13.157, 21.043, 18.873,& 8.271
at p<0.004, 0.001, 0.038, & 0.041).
- There were statistically significant relations between parents’
coping and characteristics pre-post program regarding to
child’s birth order, mother’s age, and family income
(X2
=6.349, 7.715, &12.063 at p<0.030, 0.050, &0.007).
Conclusion:
There was general improvement of the level of parents’
knowledge, practices, competence and coping patterns towards
their conduct disordered after children implementation of the
intervention protocol compared to before with statistically
significant differences.
Recommendations:
Providing regular seminars between parents, and school
teachers and other members of the Institute of Psychiatry to
discuss the common problems affecting the child and the best
ways to deal with them.
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Regular parent’s communications with schools in order to
follow up and evoke positive changes on their children with
CD.
The social workers must teach the parents how to define the
problem early and not to put the blame on someone else or to
refuse to recognize the problem.
Orientation programs should be carried at in order to
increasing public health awareness ab