This study examines family quality of life (FQOL) in Saudi Arabian families with children who have disabilities, emphasizing the dual roles of giving and receiving social support, alongside economic factors. Prior literature highlights individual influences, including sociodemographic variables and types of disabilities, and identifies social support and resilience as significant contributors to FQOL. A cross-sectional survey was conducted with 200 family members of children with intellectual disability (n = 142) or other disabilities (n = 58). Five domains of FQOL were measured: family interaction, parenting, emotional well-being, physical/material well-being, and disability-related support. Multiple regression analyses revealed that both giving and receiving emotional and instrumental support were significant predictors of family interactions, with giving support showing strong associations. Additionally, maternal education level was linked to emotional well-being and disability-related support, while higher monthly income correlated with improved physical/material well-being. The findings suggest the importance of evaluating FQOL predictors across specific domains, revealing that both giving and receiving support -- particularly emotional support -- play crucial roles in strengthening family interactions and parenting. Moreover, economic stability and maternal education level are essential for emotional and material well-being within these families.
The family is a complex social system of relationships and functions of individual members that interact and affect the needs of all its members (Ling et al., 2022; Summers et al., 2005). This means that it is important to meet the needs of all the family members, not just the needs of children with disabilities (McCarthy & Guerin, 2022). However, for children with disabilities, the family plays an important role (Samuel et al., 2012). Parents may be given more responsibilities for providing care to children with Intellectual Disability (ID) (Lunsky et al., 2017), who are more likely to develop psychological problems, such as depression, anxiety, and stress (Arzeen et al., 2020; Nam & Park, 2017; Sharma et al., 2021; Scherer et al., 2019). Thus, these negatives could simultaneously affect the quality of life (QOL) of individuals with disabilities and their families (Vernhet et al., 2022). However, the presence of a child with ID in the family may have some advantages, such as increased family unity, tolerance, and happiness (Beighton & Wills, 2019; Lakhani et al., 2013).
In past decades, researchers on ID had focused on family well-being, using a comprehensive approach for studying the well-being of children with ID and their families (Ferrer et al., 2017). In addition to understanding the impact of services and support provided to families (Ferrer et al., 2017; Park et al., 2003), and meeting their individual and family needs (Vanderkerken et al., 2019), assessment of Family Quality of Life (FQOL) is important for maintaining family functioning (Rillotta et al., 2012; Dizdarevic et al., 2022). The results of a scoping review by Alnahdi et al. (2022) indicated that FQOL is usually measured via environmental (proximal as well as distal) and economic factors. According to Summers et al. (2005), FQOL consists of five dimensions: family interaction, parenting, emotional well-being, physical/material well-being, and disability-related support.
FQOL studies on families with ID have examined the relationship between these dimensions and the characteristics of family members, such as socioeconomic variables, as well as the characteristics related to children with disabilities (Alnahdi et al., 2022; Ferrer et al., 2017). The impact of health and economic hardships have been identified as strong factors affecting family well-being (Olsson & Hwang, 2008). Household income was a predictor of household satisfaction with FQOL (Ferrer et al., 2017; Hu et al., 2012; Mas et al., 2016). Further, the family type -- parents living together or one of the spouses having another partner -- was identified as an important factor in the family's satisfaction with FQOL (Giné et al., 2015; Mas et al., 2016). Higher parental educational levels have been associated with higher levels of FQOL (Vilaseca et al., 2017). Additionally, the type (Alnahdi & Schwab, 2024) and severity of the disability were important predictors of FQOL (Hu et al., 2012; Ferrer et al., 2017).
Some studies indicate that in addition to social support, resilience could play a mediating role in the adaptation of families with disabilities (Norizan & Shamsuddin 2010; Migerode et al., 2012). Resilience is the maintenance of mental health despite negative traumatic events (Kalisch et al., 2015). It is an essential component of strength in transcending life's difficulties and overcoming them (Egan et al., 2024; Rajan & John, 2017). The results of a meta-analysis conducted by Iacob et al. (2020) on the factors associated with resilience among family caregivers of children with developmental disabilities found that social support was the strongest factor associated with resilience. Likewise, Fereidouni et al. (2021) found higher resilience to be an important predictor of QOL in mothers of children with disabilities, which indicates that social support and resilience may be strongly associated with QOL. Savari et al., (2021) study confirmed the positive relationship between social support, resilience, and QOL in parents of children with disabilities. Families achieve greater resilience through parents' positive perceptions of their children with disabilities, which arise from providing them with appropriate educational support and meeting their needs (Rajan & John, 2017).
Studies on the factors affecting the FQOL of families with ID in the Gulf region remain limited. Alnahdi & Schwab, (2024) confirmed that in line with previous literature, in the Kingdom of Saudi Arabia too, monthly income, and type and severity of the disability are important predictors of FQOL for families, including a family member with ID. The study also showed that younger and less-educated mothers were more satisfied with their FQOL (Author, 2024). Altamimi (2012) found that social support provided to parents of children with disabilities was associated with FQOL. Furthermore, the results of a study conducted in Qatar on mothers of children with ID indicated that receiving/giving social support was an important predictor of mothers' QOL, whereas resilience was not (Hassanein et al., 2021). Alwhaibi et al. (2020) concluded that mothers of children with disabilities require social and vocational support to improve their QOL.
This study explores the variables that might be associated with the FQOL of Saudi Arabian families of children with disabilities. It investigates the association between receiving/giving social support (emotional and instrumental support) for families, and resilience association with FQOL, as hypothesized by previous studies (Fereidouni et al., 2021; Hassanein et al., 2021; Savari et al., 2021). It also examines the associations of variables hypothesized by previous literature as being related to the characteristics of the family (parents' education, monthly income), and those of children with disabilities (type and severity of the disability) on FQOL (Ferrer et al., 2017; Hu et al., 2012; Mas et al., 2016; Vilaseca et al., 2017), with the difference in the sample in this study, and its inclusion of all family members. Overall, this study aims to provide deeper and more comprehensive insights into FQOL, and its associated variables within Saudi Arabia.