Objectives
  This study aimed to compare accessibility to the health services in Brazilian CSHCN (children with special health care needs) with non-CSHCN living in Japan and the parenting stresses of the parents of both groups of children, as well as to examine if the children’s being CSHCN is a factor of increasing the parenting stresses of their mothers.
Methods
  A questionnaire was administered to 130 Brazilian mothers in Japan of children between 3-6 years of age living in Aichi Prefecture, and analyzed the valid answers of 73.The questionnaire was constructed with background information, CSHCN Screener^©, children’s health care service needs, and PSI/SF (Parenting Stress Index Short Form). We evaluated the differences between CSHCN and non-CSHCN, and conducted a multiple linear regression analysis on the parenting stress scores.
Results
  Nine out of 73 children were identified as CSHCN including four with asthma, three with autism, one with chronic bronchitis, and one with cardiac hypertrophy. Although all CSHCN had family doctors, their mothers had unmet needs for specific health care services, especially dental care, rehabilitation and consultation of specialists. There were three mothers of non-CSHCN who had delayed or forgone care.
  The average score of PSI in all mothers was: TS (Total Stress)＝60.2, PD(Parental Distress)＝22.0, P-CDI(Parent-Child Dysfunctional Interaction)＝16.9, DC(Difficult Child)＝21.7. DC score was significantly higher in CSHCN than in non-CSHCN. Three determinants of elevated TS score were having CSHCN or children with chronic diseases, experiencing severe economic difficulties, and having a husband who did not speak Japanese.
Conclusions
  The study revealed that Brazilian mothers with CSHCN in Japan were not disadvantaged in terms of access to health services, but had unmet needs in some specific areas. Although the mothers of CSHCN showed relatively low levels of total parenting stress, they had significantly higher levels of stress on the difficult child characteristics. Attention for the stress of the mothers of CSHCN is required.