Moreno-Andrade et al. (2026)
respuesta, promover la resiliencia del cuidador y mitigar el impacto del cuidado continuo mediante
un enfoque holístico de salud pública.
Palabras claves: Salud pública, niños, discapacidad, cuidador.
Abstract
Comprehensive care for children with disabilities requires shifting the focus from the child's
biomedical condition to the socio-familial dynamics, where the primary caregiver, usually the
mother, is the fundamental but most vulnerable pillar. Globally, the World Health Organization
(
2
WHO) estimates that 16% of the population lives with a disability, while UNICEF estimates that
40 million children have physical, sensory, or cognitive limitations. In the Americas, this
percentage rises to 19.4%, reflecting structural disparities that disproportionately burden
households. Around 80% of care is provided informally by family members who dedicate between
6
and 12 hours daily without adequate training or institutional support. This continuous work
generates a multidimensional phenomenon of overload, distinguishable in objective dimensions
time invested, physical demands, and financial costs) and subjective dimensions (stress,
(
emotional strain, guilt, and mental exhaustion). Regional statistics highlight the magnitude of the
problem: between 60% and 75% of caregivers in countries like Mexico, Colombia, and Chile
report moderate to high caregiver burden, accompanied by a significant decline in their mental
health and quality of life. In Ecuador, where 54,512 children and adolescents have some form of
disability (31.38% physical), and particularly in the province of Chimborazo, socioeconomic
barriers and the limited access to specialized services exacerbate this daily strain. Faced with
this scenario, the caregiver's ability to adapt depends on their coping resources—cognitive and
behavioral mechanisms for managing stress—and on sociodemographic variables such as
educational level, social support network, and job stability. A clear problem emerges: while
healthcare systems concentrate their resources on the clinical management of the child, the
caregiver's health and well-being remain invisible, perpetuating a gap in care. Therefore, this
research addresses the level of caregiver burden and coping strategies among caregivers of
children with physical disabilities. Using the Zarit Burden Interview as a validated instrument to
measure perceived burden in its physical, emotional, and social components, this study seeks to
diagnose this reality in order to inform nursing intervention proposals. The central purpose is to
strengthen responsiveness, promote caregiver resilience, and mitigate the impact of continuous
care through a holistic public health approach.
Keywords: Public health, children, disability, caregiver.
estabilidad emocional de quienes
1. Introducción
asumen su atención, especialmente
del cuidador principal.
Esta investigación nace de la
necesidad de entender la
Abordar el problema desde este
enfoque nos permite reconocer que
el agotamiento del cuidador no es un
simple cansancio pasajero, sino un
fenómeno complejo que depende de
muchos factores: la red de apoyo
con la que cuenta, la situación
económica, los valores culturales y
discapacidad no solo como una
condición que afecta al niño, sino
como una realidad que transforma a
toda la familia. Cuando un hijo
convive con una discapacidad, el
impacto va más allá de sus
limitaciones físicas o funcionales: se
alteran las rutinas, la economía del
hogar, las dinámicas familiares y la