The purpose of this study was to identify the predictors of health-related quality of life (HRQOL) among caregivers of children with autism spectrum disorders (ASD) in China. Two hundred and seventy-three caregivers were surveyed using questionnaires on HRQOL, family functioning, coping style, social support, and caregiver burden. Besides socio-demographic characteristics of children with ASD and their caregivers, results demonstrate that family functioning, coping style, social support, caregiver burden are predictors of HRQOL in caregivers of children with ASD, and these predictors correlated with each other.These results indicate that comprehensive intervention, which focuses on improving caregivers' coping strategies, social support (especially from family members and friends) and family functioning, and on releasing caregiver burden, should be provided to caregivers of children with ASD.Keywords: autism spectrum disorder, caregivers, quality of life Studies show that caring for a child with an ASD can be challenging and substantially affects caregivers' health-related quality of life (HRQOL) (Khanna et al., 2011; Kheir et al, 2012; Yamada et al., 2012). HRQOL refers to the physical and mental aspects of health (Testa & Simonson, 1996), which directly correlates with the caregiver's health, and also impacts on the quality of care they provide to children with ASD and their resultant rehabilitation (Beach et al., 2005). Therefore, it is important to identify the predictors of HRQOL and provide effective interventions to caregivers of children with ASD.
A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPTPredictorsIn terms of predictors of HRQOL, studies conducted in the USA indicate that coping skills (Zablotsky, Bradshaw & Stuart., 2013), social support (Zablotsky, Bradshaw & Stuart.,2013 ), (Yang & Kleinman, 2008). These cultural concerns can have an adverse effect on the informal support caregivers need. In China, autism rehabilitation centres are mostly privately operated. Previous studies have found that teachers in these autism rehabilitation centres have limited knowledge and several misconceptions regarding autism spectrum disorders (Yang, Guo & Qian, 2012; Zhang, Li, Mao, Wang & Geng, 2012). These may cause lack of formal support among caregivers, because teachers in these autism rehabilitation centres are caregivers' main source of formal support. Several studies reported that parents of children with ASD exhibited lower mental health (Liu et al., 2006) and poorer quality of life (Xie, Liu & Zhang, 2012; Zhou et al., 2010), and were more likely to develop depression and anxiety compared with parents of children with typical development (Guo, Li & Zou, 2006). Researchers have found that caregivers of children with ASD and general population only have limitedknowledge about autism spectrum disorders in China (Wang et al., 2013; Wang, Huang, Xiao, Xie, and Chen, 2009
Methods
Study Design and Data CollectionThis is a cross-sectional study, conducted in 15 autism centres in Hunan Provi...