This thesis investigates the concept and experience of resilience among mothers of adolescents with intellectual disabilities (ID) in Thailand. This topic remains underexplored despite growing international attention to caregiver well-being. The caregiving journey for mothers of adolescents with ID is complex, particularly during adolescence, a developmental stage associated with increased behavioural challenges, emotional demands and growing concerns about the future. In Thailand, the cultural expectations of maternal caregiving, combined with limited disability support, intensify these challenges. This is the first known study to test McCubbin’s model of resilience in this population and context, contributing original insights into the factors that shape and sustain resilience among Thai mothers of adolescents with ID. This study aims to understand how resilience is developed and sustained in this population, identify key factors that influence it, and provide evidence-based recommendations to strengthen support mechanisms in the Thai context. Using McCubbin and McCubbin’s Resiliency Model as a guiding theoretical framework, this study employs a multi-method approach that combines a systematic review, a quantitative survey, and qualitative interviews. The framework informs both the study’s design and analysis, enabling a comprehensive exploration of resilience processes within this specific cultural and caregiving context. This study comprises three methodologically distinct but conceptually related studies. The first component was a systematic review of peer-reviewed literature examining the factors associated with resilience in parents of children with ID. This review synthesised 27 studies, revealing that resilience is a multifaceted process influenced by both internal and external protective factors. Key factors include problem-solving, social support, self-efficacy, hope, parental health, educational socioeconomic stability, cultural beliefs, and religious faith. The findings emphasise that while adversity is a shared experience among parents of children with ID, Individuals’ adaptation and thriving are shaped by personal and environmental resources. The second component of this thesis was a quantitative study that examined McCubbin’s model of resilience in Thai mothers of adolescents with ID. Using a cross-sectional survey design, data were collected from a sample of mothers at the Rajanukul Institute in Thailand. Standardised instruments were used to assess resilience through adaptation, perception of illness, perceived social support, coping, and caregiving burden. Statistical analyses, including Structural Equation Modelling (SEM), were used to examine the relationships among several key variables influencing maternal resilience. The results indicate that coping was associated with maternal resilience, suggesting that resilient mothers were more likely to adopt effective coping strategies. Social support was associated with maternal stress and resilience. Resilience was also associated with maternal stress. Debt and having a child with severe or profound ID significantly increased stress, highlighting socioeconomic and caregiving burdens as key sources of psychological strain. Furthermore, stress was positively associated with negative perceptions of ID, which also had a direct impact on coping and was influenced by the severity of the child’s disability. The model in this study provides a valuable framework for informing interventions to support maternal resilience. The third and final component was a qualitative study involving semi-structured interviews with 12 Thai mothers of adolescents with ID. Thematic analysis of the interviews revealed six overarching themes: (1) Becoming a mother of a child with ID, (2) Finding my way, (3) Navigating through the challenges, (4) Support system, (5) Holding on to faith, and (6) Forward-thinking strategies. Many participants acknowledged the emotional hardship and stigma associated with raising a child with ID, but also shared stories of personal growth, increased patience, and strengthened family bonds. Importantly, the qualitative findings highlighted how resilience is not a trait but a process continually influenced by shifting circumstances, relationships, and external support. The findings from the three studies highlight that a complex interplay of personal and contextual factors shapes maternal resilience in caring for adolescents with ID. While some mothers demonstrate or develop strong internal coping strategies, others remain vulnerable due to limited social support, financial difficulties, and insufficient access to services. In Thailand, where formal caregiving support is limited and caregiving roles are heavily gendered, mothers often shoulder the primary caregiving burden with limited external assistance. This study makes several key contributions to the existing literature. First, it provides an integrated understanding of resilience among mothers of adolescents with ID, combining evidence from the global literature with data grounded in the Thai cultural context. Second, it offers a model of resilience that can inform early screening and the development of tailored support programs for mothers. Third, it provides rich qualitative insights that capture the lived experiences of mothers, offering a voice to a group that is often overlooked in research and policy discussions. This study has important implications for nursing practice, mental health services, and policy development. In the future, interventions aimed at enhancing resilience in mothers of adolescents with ID must consider not only psychological strategies but also broader social and cultural determinants of resilience. Community-based support programs, caregiver education, and policies that promote inclusive health and education services can play a critical role in improving maternal well-being. Furthermore, acknowledging mothers' strengths and agency, rather than viewing them solely as vulnerable, can help build more respectful and effective support systems. In conclusion, this thesis deepens the understanding of maternal resilience within Thailand’s unique cultural and socioeconomic context, underscoring the importance of holistic, culturally tailored interventions. It lays the foundation for future research and practical initiatives to support caregivers in low- and middle-income countries, where such knowledge is urgently needed.
Wattana Tejakum (Thu,) studied this question.