{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T03:35:42Z","timestamp":1769657742200,"version":"3.49.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PROAP"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Parental stress is a critical yet understudied dimension of childhood total blindness, a condition that imposes substantial developmental, emotional, and functional challenges on families. This cross-sectional study assessed parenting stress, maternal health symptoms, and children\u2019s functional vision-related quality of life in 81 mothers of children aged 0 to 12 years with total congenital blindness. Parenting stress was assessed in the full sample using the Parenting Stress Index\u2013Fourth Edition (PSI-4). Children\u2019s functional vision-related quality of life was evaluated in age-specific subsamples using the Quality of Family Vision Impact (QFVI-3 for children aged 0\u20133 years and QFVI-7 for children aged 3\u20137 years). All participants also completed a sociodemographic and maternal health survey. Total Parent Stress showed moderately elevated percentile scores (mean \u2248 67), with the highest PSI-4 subdomains in Adaptability, Depression, and Health. Approximately 21% of mothers scored within the clinical range for high stress. Maternal symptoms including sadness, insomnia, headaches, forgetfulness, and musculoskeletal pain were significant (all p &lt; 0.01). QFVI global scores indicated moderate impairments in functional vision-related quality of life across age groups. Life Stress demonstrated a small-to-moderate negative correlation with QFVI-7, suggesting that cumulative environmental stressors may adversely affect children\u2019s functional outcomes. Several factors were associated with more favorable outcomes. Among children under three years of age, maternal engagement in physical activity was associated with higher QFVI scores, whereas among children aged 3\u20137 years, school attendance was associated with higher functional vision-related quality of life scores. In contrast, sociodemographic disadvantage, limited access to educational adaptations, and reduced maternal participation in work or leisure activities were associated with higher levels of parental stress. These findings highlight the importance of multidisciplinary, family-centered care incorporating psychosocial assessment, early stimulation, orientation and mobility support, and maternal mental health interventions in pediatric ophthalmology.<\/jats:p>","DOI":"10.3390\/ijerph23020162","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:04:46Z","timestamp":1769612686000},"page":"162","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parental Stress, Maternal Health, and Children\u2019s Vision-Related Quality of Life in Total Childhood Blindness: A Cross-Sectional Study"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4545-0019","authenticated-orcid":false,"given":"Julio Cesar","family":"Souza-Silva","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo Campus, University of S\u00e3o Paulo (USP), S\u00e3o Paulo 05409-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviane Matias da Costa","family":"Souza","sequence":"additional","affiliation":[{"name":"School of Psychology, Est\u00e1cio de S\u00e1 University, Goi\u00e2nia 74063-010, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6752-930X","authenticated-orcid":false,"given":"Thallita de Freitas","family":"Ramos","sequence":"additional","affiliation":[{"name":"University Unit of Ceres, State University of Goi\u00e1s, Ceres 76300-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7210-6934","authenticated-orcid":false,"given":"Cleusa Alves","family":"Martins","sequence":"additional","affiliation":[{"name":"School of Nursing, Federal University of Goi\u00e1s (UFG), Goi\u00e2nia 74605-080, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3139-5784","authenticated-orcid":false,"given":"Edinamar Aparecida Santos da","family":"Silva","sequence":"additional","affiliation":[{"name":"School of Nursing, Federal University of Goi\u00e1s (UFG), Goi\u00e2nia 74605-080, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-032X","authenticated-orcid":false,"given":"Marco T\u00falio Ant\u00f4nio","family":"Garciazapata","sequence":"additional","affiliation":[{"name":"Institute of Tropical Pathology and Public Health, Department of Tropical Medicine and Dermatology, Federal University of Goi\u00e1s (UFG), Goi\u00e2nia 74605-050, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6759-5289","authenticated-orcid":false,"given":"Milton Ruiz","family":"Alves","sequence":"additional","affiliation":[{"name":"Hospital das Cl\u00ednicas, Faculty of Medicine, University of S\u00e3o Paulo (HC-FMUSP), S\u00e3o Paulo 05409-000, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0861-9655","authenticated-orcid":false,"given":"Maria Alves","family":"Barbosa","sequence":"additional","affiliation":[{"name":"School of Nursing, Federal University of Goi\u00e1s (UFG), Goi\u00e2nia 74605-080, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2007). Global Data on Visual Impairments, World Health Organization."},{"key":"ref_2","unstructured":"Ottaiano, J., \u00c1vila, M., Umbelino, C., and Taleb, A. (2019). As Condi\u00e7\u00f5es de Sa\u00fade Ocular no Brasil\u20142019, Conselho Brasileiro de Oftalmologia (CBO)."},{"key":"ref_3","first-page":"760","article-title":"Stress in health and disease","volume":"73","author":"Selye","year":"1973","journal-title":"Am. J. Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1001\/jama.298.14.1685","article-title":"Psychological stress and disease","volume":"298","author":"Cohen","year":"2007","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Vismara, L., Roll\u00e8, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora, S., Neri, E., Prino, L.E., Odorisio, F., and Trovato, A. (2016). Perinatal parenting stress, anxiety, and depression outcomes in first-time mothers and fathers: A 3- to 6-months postpartum follow-up study. Front. Psychol., 7.","DOI":"10.3389\/fpsyg.2016.00938"},{"key":"ref_6","unstructured":"Lutz, F.L. (2012). Parenting Stress Index, Fourth Edition: Professional Manual, Psychological Assessment Resources."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/j.ajo.2004.05.010","article-title":"Development of a children\u2019s visual function questionnaire (CVFQ)","volume":"138","author":"Felius","year":"2004","journal-title":"Am. J. Ophthalmol."},{"key":"ref_8","unstructured":"Lopes, M.C. (2009). Tradu\u00e7\u00e3o, Adapta\u00e7\u00e3o Cultural e Valida\u00e7\u00e3o do Question\u00e1rio de Fun\u00e7\u00e3o Visual Infantil (QFVI), Universidade Federal de S\u00e3o Paulo."},{"key":"ref_9","unstructured":"Souza-Silva, J.C. (2020). Avalia\u00e7\u00e3o do Estresse Parental e Qualidade de Vida de Crian\u00e7as com Cegueira Total, Universidade Federal de Goi\u00e1s."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"Declaration of Helsinki: Ethical principles for medical research involving human subjects","volume":"310","author":"Association","year":"2013","journal-title":"JAMA"},{"key":"ref_12","first-page":"744","article-title":"Ophthalmic workload and low-vision services for children","volume":"17","author":"Speedwell","year":"2003","journal-title":"Eye"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2014). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), APA.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/biomet\/52.3-4.591","article-title":"An analysis of variance test for normality (complete samples)","volume":"52","author":"Shapiro","year":"1965","journal-title":"Biometrika"},{"key":"ref_15","unstructured":"Hollander, M., Wolfe, D.A., and Chicken, E. (2013). Nonparametric Statistical Methods, Wiley."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.2307\/1412159","article-title":"The proof and measurement of association between two things","volume":"15","author":"Spearman","year":"1904","journal-title":"Am. J. Psychol."},{"key":"ref_17","unstructured":"Team, R.C. (2023). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/dmcn.13633","article-title":"Parenting stress, anxiety, and depression in mothers with visually impaired infants: A cross-sectional and longitudinal cohort analysis","volume":"60","author":"Sakkalou","year":"2018","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jaapos.2013.10.013","article-title":"Prevalence of attention-deficit\/hyperactivity disorder among children with vision impairment","volume":"18","author":"DeCarlo","year":"2014","journal-title":"J. AAPOS"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Schappin, R., Wijnroks, L., and Uniken Venema, M. (2013). Rethinking stress in parents of preterm infants: A meta-analysis. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0054992"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/0145482X0610000203","article-title":"Play behaviors in visually impaired children","volume":"100","author":"Celeste","year":"2006","journal-title":"J. Vis. Impair. Blind."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s40279-013-0090-5","article-title":"Physical activity and stress","volume":"44","author":"Sinha","year":"2014","journal-title":"Sports Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2307\/2137335","article-title":"Overweight and depression","volume":"35","author":"Ross","year":"1994","journal-title":"J. Health Soc. Behav."},{"key":"ref_24","first-page":"136","article-title":"Parenting stress","volume":"32","author":"Taanila","year":"2002","journal-title":"Child. Care Health Dev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/ijn.12458","article-title":"Depression, caregiver burden and social support among caregivers of retinoblastoma patients in China","volume":"22","author":"Wang","year":"2016","journal-title":"Int. J. Nurs. Pract."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/2\/162\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:10:40Z","timestamp":1769613040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/2\/162"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["ijerph23020162"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23020162","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}