Parental Sensemaking, Resilience, and Child Quality of Life in Families of Children with Cerebral Palsy in Urban Indonesia

Cerebral Palsy (CP) presents multidimensional challenges that disrupt children’s physical functioning and family dynamics. In urban Indonesia, families often face constraints in accessing rehabilitation, inclusive education, and community support. This study examined how parental sensemaking predicts parenting resilience, child Quality of Life (QoL), and family communication in families raising children with CP, and identified which construct shows the relatively strongest association with family communication.

A cross-sectional observational study was conducted between July and September 2025 at hospitals and rehabilitation clinics in Jakarta and Depok, Indonesia. Purposive sampling recruited 300 parents or guardians of children aged 7–15 years diagnosed with CP. Validated Likert-type instruments were used to measure parental understanding, parenting resilience, child quality of life, and family communication. Data were analyzed using IBM SPSS Statistics 28 for descriptive statistics and correlations, and Partial Least Squares Structural Equation Modeling (PLS-SEM) in SmartPLS 4 to estimate measurement and structural models. Model quality was assessed through indicator loadings, Average Variance Extracted (AVE), composite reliability (CR), Cronbach's α, Heterotrait–Monotrait Ratio (HTMT), and bootstrap path estimation.

All hypothesized paths were statistically significant but small in magnitude. Parental sensemaking predicted parenting resilience (β = 0.173, p = 0.002), child QoL (β = 0.167, p = 0.010), and family communication (β = 0.146, p = 0.012). Parenting resilience predicted family communication (β = 0.146, p = 0.020), whereas child QoL showed the largest standardized association with family communication (β = 0.234, p < 0.001). The model explained a modest proportion of variance in family communication (R² = 0.137).

These findings indicate that parental sensemaking functions as one of several cognitive mechanisms associated with resilience, perceived child QoL, and communicative harmony in families of children with CP, while child QoL shows the relatively strongest association with family interaction. The small effect sizes and low R² values suggest that many other contextual, structural, and relational factors contribute to family communication and adaptation.

Parental sensemaking, parenting resilience, and child QoL are modestly associated with family communication in Indonesian families of children with CP. Interventions that integrate sensemaking-oriented psychoeducation with policies supporting child QoL (e.g., continuity of therapy, inclusive schooling, and accessible mobility) may help strengthen family adaptation, but the cross-sectional design and modest effects underscore the need for longitudinal, cross-cultural research on family communication in the context of disability.