Journal of Intellectual & Developmental Disability, 2012; Early Online: 1–9

ORIGINAL ARTICLE

Difficulties of care–work reconciliation: Employed and nonemployed
mothers of children with intellectual disability*

YUEH-CHING CHOU1, LI-YEH FU1, CHENG-YUN PU2 & HENG-HAO CHANG3
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1Institute of Health and Welfare Policy, Research Center for Health and Welfare Policy, National Yang-Ming University,

Taipei, Taiwan, 2Institute of Public Health, National Yang-Ming University, Taipei, Taiwan and 3Department of Sociology,
National Taipei University, Taipei, Taiwan

Abstract
Background Whether employed and nonemployed mothers of children with intellectual disability (ID) have different
experiences with reconciliation between care and work has rarely been explored.
Method A survey was conducted in a county in Taiwan and 487 mothers aged younger than 65 and having a child with
ID were interviewed face to face at their homes to explore whether there are different factors related to the reconciliation
between care and work among employed and nonemployed mothers.
Results Except for the common ground of mothers’ health and care demands, logistic regression revealed work flexibility
and care support were important for employed mothers. In contrast, the success of reconciliation for nonemployed mothers was determined by their individual characteristics (i.e., age, marital status, family income).
Conclusions Reconciliation policies for mothers with different employment statuses need to use different strategies.

Keywords: care–work reconciliation, caregiving, employment, intellectual disability, mother

Introduction
Most of the attention in care and work reconciliation research has been paid to working mothers,
and in particular mothers with young children as
they struggle to balance care and work. Compared tothe more universal but temporary demands of childcare that most mothers face, caring for a child withintellectual disability (ID) may lead to very different
experiences in care and work reconciliation because
it is a lifelong issue for mothers.
Having a child with a disability has been shownto have a critical effect on women’s employment(Heller, Caldwell, & Factor, 2007; Shearn & Todd,
2000; Traustadottir, 1991), but other factors suchas age, education, marital status, and income level
have also been found to be important factors associated with women’s involvement in the labour force(Yeandle, Bennett, Buckner, Shipton, & Suokas,
2006). Some mothers leave their paid work because

they do not have enough support for the long-term
caregiving such children need (Bourke-Taylor, Howie,& Law, 2011; Einam & Cuskelly, 2002; Shearn &Todd, 2000).Women’s health status is also related
to the level of conflict they experience between workand family life (Hutton & Hirst, 2000). In terms ofculture and gender issues, differences in attitudes
towards employment and motherhood and the division of labour between men and women within thehousehold are also significant factors associated withcare and work reconciliation among women (Gregory & Milner, 2008; Lewis, Kagan, & Heaton, 2000).
In order to improve and support women’s wellbeing
and labour force participation, support from welfare
systems and the labour market (e.g., care allowance,
daycare services, parental/care leave, part-time work
and work-time flexibility) to facilitate reconciliation
between family life and work is crucial (Duncan,
2002; Korpi, 2000).

*This manuscript was accepted under the Editorship of Ian Dempsey.
Correspondence: Li-yeh Fu, PhD, Institute of Health and Welfare Policy, Research Center for Health and Welfare Policy, National Yang-Ming University,
155, Li-Nong St., Sec.2, Peitou, Taipei, 11200 Taiwan. E-mail: lyfu@ym.edu.tw
ISSN 1366-8250 print/ISSN 1469-9532 online © 2012 Australasian Society for Intellectual Disability, Inc.
DOI: 10.3109/13668250.2012.704984

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2

Y.-C. Chou et al.

In Taiwan, the vast majority of people with ID(95%) are provided with lifelong care by their natural families (Department of Statistics, Ministry ofInterior, Taiwan, 2007). These informal, unpaid carers are usually female and most often the person’s
mother (Chou, Pu, Kröger, & Fu, 2010). A family
subsidy, which targets families with members withdisability who live at home, is only available to lowincome families in Taiwan. Apart from low-income
families, persons with disability who use various
social services need to co-pay and the rate of copayment is also based on level of family income.
The amended Gender Equality Employment Act of2011 has, on principle, allowed employees to takeunpaid parental leave or unpaid leave to care forrelatives (Council of Labor Affairs, Executive Yuan
Taiwan, 2012). Continuing this trend, the amended
Employment Insurance Act of 2009 established agovernment subsidy of 60% of the salary of workers
who take parental leave for a maximum of 6 months,
but only for those parents with a child younger than
3 years old (Bureau of Labor Insurance, Councilof Labor Affairs, Executive Yuan Taiwan, 2012). In
addition to the limited government initiatives, reconciliation research in Taiwan has also been limited
and has not specifically addressed and comparedcare and work reconciliation among employed
and nonemployed mothers with an offspring with
ID, including the interrelationships between paid
employment, unpaid caring, attitudes toward gender roles, health status, and the wellbeing of thesemothers.
This study uses a sample of working-age mothers with a child with ID from a county in Taiwan
to examine the factors related to their difficulties in reconciling care and work and to compare
these between employed and nonemployed lifelong
mother-carers. To determine the presence andnature of difficulties in reconciling care and work
among employed and nonemployed mothers, fourgroups of these mothers were studied: (1) employed
mothers who reported having difficulties in reconciliation; (2) employed mothers who reported
no difficulties in reconciliation; (3) nonemployed
mothers who reported having difficulties in reconciliation; and (4) nonemployed mothers whoreported no such difficulties in reconciliation. The
presence or absence of difficulties in reconciliation
between care and work was measured by the participants’ reported perceptions.
Four research questions were identified:(1) For reconciliation between care and workfor employed mothers, are there differences
between those with and without difficulties

in terms of individual and family characteristics, care and work conditions, service use,
support from the father, formal and informal networks, and attitudes?
(2) For reconciliation between care and workfor nonemployed mothers, are there differences between those with and without difficulties in terms of individual and family
characteristics, care conditions, service use,
support from the father, formal and informal networks, and attitudes?
(3) Among those mothers having such difficulties, are there differences between employed
mothers and nonemployed mothers in termsof their individual and family characteristics,
care conditions, service use, support fromthe father, formal and informal networks,
and attitudes?
(4) Are there different factors associated with difficulties in reconciliation between employed
and nonemployed mothers in terms of mothers’ individual and family characteristics, careand work conditions, service use, support
from fathers, formal and informal networks,
and attitudes?

Methods
Data collection and participants
For the purposes of this study, the “working-age
mothers” that made up our study population were
defined as mothers younger than 65 years of age
whose child has an ID. We conducted a survey
with face-to-face interview on all of the workingage mothers of a child with ID, and with multiple
disabilities in addition to ID, in Hsinchu County.
Hsinchu County is composed of both urban andremote (mountainous) areas and has 517,641 residents (49% are female and 34% are women of working age), including aboriginal people (3.9% of the
population in the county) and immigrant spouses
from China and South Asia (2.5% of all immigrant
spouses in Taiwan; Hsinchu County Government,
Taiwan, 2012). Ethical approval for the study was
obtained from the Research Ethics Board at National
Yang-Ming University (IRB: 990077).
In Taiwan, disability welfare benefits are only
available to those who are diagnosed with disability, approved by the local government, and provided
with a disability certificate. We were not provided
with any information on who our study population
was or where they lived; we only knew that eachindividual was the mother of a child with ID. Thisis because the local authority is only able to provide

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Difficulties of care–work reconciliation
a list of people who are diagnosed with disability,
including those with ID or those with multiple disabilities (including ID).
The above limitation to the available information
meant that we needed to screen the listed citizens
of Hsinchu County with ID or multiple disabilities(MD) including ID (MD  ID) to reach our study
population. This was carried out by approaching themothers of a child or adult identified with ID or withMD  ID, where the person was aged 50 or younger(otherwise his or her mother was assumed to beolder than 65). The study population screened wasthat provided by the Hsinchu County Government,
which is one of 25 local authorities in Taiwan. The
screening involved making individual telephone calls
to the person with ID whose mother was assumed tobe younger than 65. If the mothers fitted the criteria,
we invited them to join our study and asked whether
they would allow us to interview them at home.
A total of 1,823 persons aged 50 or younger with
ID or with MD  ID were listed, and 706 of themhad a mother younger than 65 (some had no mothers,some mothers were 65 and older, and some were notcontactable). Between the initial telephone call andthe survey interview, 219 mothers did not take partin the interview due to illness (n  57), or because
the mother declined to be interviewed (n  162). In
the end, 487 (70%) of these individuals’ working-age
mothers took part in our study and completed theinterview survey at their homes.
First, we sent an invitation letter by post to
the families with a member with ID (including
MD  ID) aged 50 or younger, which was sent by
the principal researcher’s affiliated institution andthe county government. This was followed by a telephone call, during which informed consent for theinterview was obtained from those mothers younger
than 65 who were willing to participate. Structured
interviews were then conducted at the participants’home between January and May 2011 by one of 16
trained interviewers, who read through the questionnaire and recorded the answer to each question. Allof the interviewers had completed 5 hours of interviewer training prior to beginning this survey interview. During the data collection, three senior social
workers working with people with ID were employed
to supervise the interviewers, review the data, checkfor missed questions or answers, and make corrections to the questionnaires that the interviewers
completed.
As presented in Table 1, the mean age of the participating mothers’ children with ID was 18.9 years(SD  8.1); 93% of these mothers’ children with ID
lived with their families, and a very small proportion of them used social services (e.g., 6.4% and3

Table 1. Characteristics of mothers with a child with ID andthe characteristics of their children (N ⴝ 487)
VariablesM

SD (Range)

Age of child with ID (years)
Gender of child with ID
Male
FemaleLevel of disability of childwith ID
Profound/severe
Moderate/mild
Type of service used by child
Residential services
Daycare services
Mother age
Mother education
Primary school and below
JuniorSeniorUniversity and beyond
Marital status
Unmarried/separated/divorced/widowed
Married/cohabitation
Mother employment statuse
Full-time employment
Part-time employment
Not employed
Employment typeSelf-employed
Public sector
Private sector
Family income (NT$)a, e
Below 20,000
20,001–40,000
40,001–60,000
60,001–80,000
Over 80,000
Hours of caregiving (weekly)
Hours of work (weekly)
Combining care and work
Very difficult
DifficultSomewhat difficult
Somewhat easy
Easy
Very easy
HealthbFormal supportc
Informal supportc
Father helpc
Attitudes to employment/
motherhoodd
QOL (overall)b18.9

8.1 (4–42)n (%)

308 (63.2)
179 (36.8)

79 (16.2)
408 (83.8)
31 (6.4)
43 (8.8)
46.0

8.6 (22–65)
130 (26.7)
145 (29.8)
176 (36.1)
36 (7.4)
73 (15.0)414 (85.0)
206 (42.4)
57 (11.7)
223 (45.9)
60 (22.8)
18 (6.8)185 (70.3)
118 (24.5)
193 (40.1)
104 (21.6)
49 (10.2)
17 (3.5)

38.5 34.9 (0–168)
24.0 25.4 (0–105)
81 (16.6)
103 (21.1)
180 (37.0)
60 (12.3)
50 (10.3)
13 (2.7)
3.0
5.6
13.9
2.3
35.5

0.9 (1–5)
3.1 (0–18)
5.4 (0–34)
1.1 (0–3)
3.6 (21–48)

88.9 13.9 (51–124)

a1 US dollar  29 Taiwanese dollars (5/2011). b1  very dissatisfied,2  dissatisfied, 3  somewhat satisfied, 4  satisfied, and 5  verysatisfied. c0  never asked for help/inappropriate to answer, 1  not
helpful, 2  helpful, and 3  very helpful. d1  strongly disagree,
2  disagree, 3  neither disagree nor agree, 4  agree, and 5 strongly
agree. eMissing case(s).

4

Y.-C. Chou et al.

8.8% of their children with ID used residential or
daycare/day services, respectively). The 487 mothers
participating in this study had a mean age of 46.0
years (SD  8.6); the majority (85.0%) of the mothers were married and living with spouses. Half of themothers (54.1%) had paid employment (42.4% ofthem full-time and 11.7% part-time). More than halfof all of the participating mothers (74.7%) repliedthat they had difficulties with combining both careand work.

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Dependent variables
Difficulty in reconciliation between care and work
was measured by the question, “In general, how easy
or difficult is it for you to combine paid work and caring for your child with ID?” (1  very easy, 2  easy,
3  somewhat easy, 4  somewhat difficult, 5  difficult,and 6  very difficult). Some participants did nothave a paid job at the time of the interview but, as
the question asked about their difficulties “in general,” they were able to answer this question basedon their earlier experiences and future anticipations(the Chinese/Taiwanese language does not have past,present, and future tenses).
Explanatory variables
Mothers were asked about their own age, marital status, years of education completed, health status, andfamily income. Mothers’ marital status was coded as
married (including cohabitation) or single (including widowed, divorced, and separated). Mothers’
age and education were coded as interval variables.
Mothers’ health and family income were coded asordinal categories, with a higher rank indicating ahigher level of health and a higher family income.
The hours of caregiving spent on the offspringwith ID weekly was measured by the question, “Howmany hours do you spend looking after offspring with
ID per week?” and defined as a continuous variable.
The mothers’ paid work was determined by whether
they had a paid job including external employment,
self-employment (e.g., managing own company,
babysitting, outsourcing work at home), and casualwork. If the mothers answered “yes” or “sometimes
yes and sometimes no,” they were then asked whether
their paid work was full-time or part-time, including
how many hours were spent weekly on average. The
mothers were also asked whether their employers
knew they had a child with ID, and if the mothers
answered “yes” or “maybe,” they were asked how
helpful the employers were in allowing the motherto take care of their offspring with ID (from none
to very much). In order to determine whether themothers’ paid work was flexible enough for motherscaring for a young or adult child with ID, the question asked was, “How much flexibility do you havein your work schedule to handle caregiving to yourchild with ID?” (4  a lot of flexibility, 3  some flexibility, 2  hardly any flexibility, and 1  no flexibility
at all). The hours of paid work weekly were defined
as a continuous variable.
The mothers’ formal and informal support wasmeasured using a translated Chinese version of the
Family Support Scale (Dunst, Jenkins, & Trivette,
1984), which consists of two major categories ofsocial support: informal (i.e., help from parents,
parents-in-law, relatives, children, friends, babysitters, neighbours, parents, colleagues, and friends
from church) and formal (i.e., help from health professionals, school teachers, staff from a service center, social workers, parental groups, social groups,
and people from other authorities). A higher scoreindicates greater support (α .73 and .60 for informal and formal support, respectively). Fathers’ help
was measured by the question, “Is your husband/
partner helpful for caring for your child with ID?”(0  never asked for his help, 1  not helpful, 2  helpful,and 3  very helpful).
We used the items from the questionnaires of The
International Social Survey Program (ISSP) 2002
Taiwan version (International Social Survey Program, 2010) to measure mothers’ attitudes toward
employment and motherhood. The Taiwan version
consists of 12 items and two parts: attitudes toward
employment and attitudes toward womanhood in
the family. A higher score indicates more negative
attitudes toward women’s employment and a higher
level of traditional attitudes toward women’s roles.
To determine whether the mother and her childwith ID used support services (i.e., day services,
daycare, and residential services), we asked whether
they knew of each of the types of services (this wascoded as yes or no). If the answer was yes to a typeof service, they were asked whether they had usedthat service.
The mothers’ quality of life (QOL) was assessedwith the WHOQOL-BREF Taiwan version scale,
which contains 28 items among four domains: Physical, Psychological, Social Relationships, and Environment. A higher score indicates a better QOL(á .93 for the overall scale in this study; for moredetails about the scale, see Chou et al., 2010).
Data analysis
The individual mother was the unit of analysis. We
analysed the results using the Statistical Package forSocial Sciences (SPSS), Version 18.0. Descriptive

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Difficulties of care–work reconciliation
analysis was used for the characteristic data. The χ2
test was used for comparisons of categorical data;owing to concerns about small sample size, nonparametric statistics (the Mann–Whitney U test) wereused to examine continuous variables with respect
to whether different groups of mothers had difficulties with care and work reconciliation among thegroups.
The dependent variables (difficulties for care andwork reconciliation) were skewed. In particular, fornonemployed mothers, the responses were skewed
towards the first three categories (very difficult, difficult, and somewhat difficult). Thus, we dichotomised
the dependent variables (Frostholm et al., 2005;
Hosmer & Lemeshow, 2000) in logistic regression
analyses to examine the association between thedependent variables and the independent variables(the mother’s age, education, marital status, health,family income, service use, hours of caregiving,
hours of work, employer support, work flexibility,
formal support, informal support, father’s help, andattitudes toward employment and motherhood).

Results
Participants’ characteristics and groups’ comparison
As shown in Table 2, among employed mothers,
68.1% had difficulties in reconciliation between careand work (G1), and 82.5% nonemployed mothers
replied they had the same difficulties (G3).
The comparison between employed mothers having and not having difficulties with care and work
reconciliation found that there were significant differences between the groups (G1 and G2) in termsof the mothers’ health, family income, hours of caregiving, work flexibility, attitudes toward work andmotherhood, and QOL. However, a statistical comparison revealed no significant differences between
the two groups in terms of mothers’ age, education,
marital status, service use, hours of work, employer
support, both formal and informal support, andfathers’ help.
In comparing nonemployed mothers who reported
difficulties versus no difficulties (G3 and G4) in careand work reconciliation, we found significant differences between the two groups in the areas of mothers’ age, mothers’ marital status, mothers’ health,family income, hours of caregiving, fathers’ help
and QOL. In contrast, mothers’ education, service
use, both formal and informal support, and attitudes
were not significant sources of difference between
these two groups.
We also examined difficulties with care and work
reconciliation in employed mothers and nonemployed5

mothers (G1 and G3) and found significant differences between these two groups on mothers’ age,mothers’ education, mothers’ health, family income,hours of caregiving, informal support, work andmotherhood attitudes, and QOL.
Factors associated with mothers’ difficulties
with care and work reconciliation
Table 3 reports the results of logistic regression
analyses to identify factors related to having difficulties with care and work reconciliation among theemployed and nonemployed mothers. Regression
models for both groups were statistically significant and predicted 77.8% to 83.6% of the variance,
respectively. The Nagelkerke R2 (i.e., the pseudo R2
that explains the proportion of the variation explainedby the model, which has been widely used for logistic
regressions) in the two models was 42.3% and 28.6%,
respectively. Among employed mothers, their health,hours of caregiving, work flexibility, formal support,
informal support, and fathers’ help were significantly
associated with having difficulties in care and work
reconciliation. Among nonemployed mothers, using
11 independent variables, we found that age, marital
status, family income, health and hours of caregiving of mothers were significantly related to having
difficulties in care and work reconciliation.
Discussion
Hours of caregiving for the child with ID by themothers in this study varied widely from 0 to 168 hours
weekly. This suggests that some of the mothers, evenwhen their child with ID was sleeping, did not feel
free from care work. Three quarters of all employed
and nonemployed mothers in this study replied thatthey had difficulties combining care and work.
Regardless of employment status (i.e., employed
or nonemployed), the 25% of mothers in this study
who reported no difficulties combining care and work
(G2 and G4 in Table 2) were those mothers withgood health, high family income, low care demands
from their child with ID, and a high QOL. This suggests that the mothers’ experience of the reconciliation between care and work may be related to theirsocial demographic background and wellbeing. The
current findings partly support a recent study (Chouet al., 2010) which was conducted with mothers withan adult child with ID and found that nonemployed
mothers were more likely to be older, to have a lower
level of education and family income, and to havea lower level of health status and social support.
For example, the analysis for G1 and G3 in Table 2
showed that those having difficulties with care and*p .05. **p .01. ***p .001.

aMann–Whitney U test. bCohen’s d.

Age M(SD)
Education M(SD)
Marital status (with spouse) n(%)
Health M(SD)Family income n(%)
 NT$20,000
NT$20,000–40,000
 NT$40,000
Used daycare or residential
services n(%)
Weekly caregiving hours M(SD)Weekly work hours M(SD)
Employer support M(SD)Work flexibility M(SD)Formal support M(SD)Informal support M(SD)Father help M(SD)Work/motherhood attitudes(M/SD)QOL (M/SD)

Variables
45.8 (7.2)
10.0 (3.4)
70 (83.3)
3.5 (0.7)
11 (13.1)
28 (33.3)
45 (53.6)
10 (11.9)
21.8 (22.5)
43.2 (14.6)
2.4 (1.7)
3.1 (0.9)
5.6 (3.5)
16.0 (6.6)
2.4 (1.0)
34.1 (3.7)
98.6 (11.4)

34 (19.0)80 (44.7)
65 (36.3)
33 (18.4)
36.9 (31.7)
45.2 (17.5)
2.4 (1.6)
2.4 (0.9)
6.0 (3.0)
14.6 (5.1)
2.2 (1.1)
35.2 (3.8)
87.6 (11.6)

G2: Notdifficult(n  84;
31.9%)

44.2 (8.0)
10.1 (2.9)
151 (84.4)
3.0 (0.8)

G1: Difficult(n  179;
68.1%)

1.0

 6.51***

 1.64
 1.55
 1.56
 2.10*

0.6
0.1
0.0
0.8
0.1
0.2
0.2
0.3

 4.10*** 0.96
 0.12
 5.79***

7.03*
1.78

0.2
0.0

 1.62
 0.210.05
 4.75***
0.7

db

Za/χ2

Employed mothers (n  263)

Table 2. Mothers’ care and work reconciliation characteristics (N ⴝ 486)

84.63 (14.55)

5.4 (2.9)
12.6 (4.8)
2.3 (1.0)
36.12 (3.3)

49.3 (39.2)

66 (36.3)
72 (39.6)
44 (24.2)
24 (13.0)

46.79 (9.5)
9.07 (3.2)
165 (89.7)
2.74 (0.9)

G3: Difficult(n  184;
82.5%)

94.2 (13.2)

5.1 (3.0)
13.3 (5.0)
1.9 (1.3)
36.2 (3.5)

31.4 (32.9)

7 (20.0)
12 (34.3)
16 (45.7)
2 (5.1)50.2 (7.9)
8.3 (3.1)
27 (69.2)
3.2 (0.8)

G4: Notdifficult(n  39;
17.5%)

 3.83***

 0.868 1.05
 2.15*
 0.10 3.10**

7.44*
1.96

 2.21*
 1.340
11.24**
 3.00**Za/χ2Nonemployed mothers (n  223)

Care and work reconciliation

0.7

0.1
0.1
0.3
0.0

0.5

0.5

0.4
0.2

db

87.6 (11.6)

36.9 (31.7)
45.2 (17.5)
2.4 (1.6)
2.4 (0.9)
6.0 (3.0)
14.6 (5.1)
2.2 (1.0)
35.2 (3.8)

34 (19.0)80 (44.7)
65 (36.3)
33 (18.4)

44.2 (8.0)
10.1 (2.9)
151 (84.4)
3.0 (0.8)

84.6 (14.6)

5.4 (2.9)
12.6 (4.8)
2.3 (1.0)
36.2 (3.3)

49.3 (39.2)

66 (36.3)
72 (39.6)
44 (24.2)
24 (13.0)

46.8 (9.5)
9.1 (3.2)
165 (89.7)
2.7 (0.9)

G3: Nonemployed(n  184)

0.2
0.4
0.1
0.3
0.2

 1.96*

0.3

0.4

0.3
0.3

db

 1.77
 3.57**
 1.60 2.37*

 3.18**14.68**
1.99

 2.46*
 3.38**2.28
 2.74**Za/χ2Mothers having difficulty (n  363)
G1:
Employed(n  179)

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6
Y.-C. Chou et al.

Difficulties of care–work reconciliation

7

Table 3. Logistic regression analysis of mothers having difficulties in care and work reconciliation
Model 1 Employed mothersa (n  248c)

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Predictive variables
Mother age
Mother education
Carer marital status(single)HealthFamily income
Used daycare or
residential services
Hours of caregiving
Formal support
Informal support
Father help
Work/motherhood
attitudes
Hours of work
Employer support
Work flexibility
Model χ2
Percentage correct
Nagelkerke R2Model 2 Nonemployed mothersb (n  213d)

B

SE B

Odds ratio

B

SE B

Odds ratio

 0.020.04
 1.20

0.03
0.06
0.66

0.98
1.04
0.30

 0.06*0.03
 1.47*

0.03
0.07
0.74

0.94
1.03
0.23

 0.95***
 0.05
0.25

0.25
0.27
0.49

0.39
0.95
1.29

 0.85**
 0.84**
0.92

0.30
0.31
0.83

0.42
0.43
2.51

0.03***
0.18**
 0.10* 0.49*
0.09

0.01
0.07
0.04
0.25
0.05

1.03
1.20
0.90
0.61
1.10

0.02*
 0.030.00
0.14
 0.00

0.01
0.08
0.05
0.25
0.07

1.02
0.98
1.00
1.15
1.00

0.01
0.00
 0.80***

0.01
0.11
0.20

1.01
1.00
0.45
89.39***
77.8.423

39.44***
83.6.286

a14 independent variables. b11 independent variables; hours of work, work flexibility, and employer support were excluded. cMissing:

15 cases. dMissing: 10 cases.
*p  .05. **p  .01. ***p  .001.

work reconciliation among nonemployed mothers
were more disadvantaged than their employed counterparts. It is probable that when informal caregiving
interferes with the carer’s employment, then it will
negatively affect the carer’s income and employment-related benefits and increase noneconomic
costs (Fast, Williamson, & Keating, 1999); this may
result in a decline in certain aspects of the carer’s
QOL. The current study also showed that motherswith a low socioeconomic status were less likely to
be involved in the labour force because of difficulties in finding an appropriate way of combining careand work.
All in all, the current study not only demonstrates that there are differences between employed
and nonemployed mothers in terms of the mothers
having difficulties with care and work reconciliation,
but also suggests that for those mothers who are
not involved in labour force participation, their careand work reconciliation may be affected by complex
reasons such as having vulnerable individual capital(i.e., age, low level of education, and family income).
Thus the capability of care and work reconciliation
for these nonemployed mothers is more pronounced
than for employed mothers. The current findings
also clarify the differences, in terms of having andnot having difficulties in care and work reconciliation, between those employed and nonemployed

mothers who have a lifelong caregiving responsibility. Based on the findings of this study, reconciliation policies and services also need to be concernedwith nonemployed mothers, particularly those who
do not have strong individual capital and those whohave a young or an adult child with ID who has highsupport needs.
Except for the areas of mothers’ health and hoursof caregiving, the regression analyses in Table 3
revealed that there were different predictors of the
difficulties of care and work reconciliation among
the employed mothers and nonemployed mothers.
For example, work flexibility and support networks
were critical factors related to the employed mothers’ difficulties with reconciliation. In contrast, fornonemployed mothers, their individual capital (i.e.,age, marital status, and family income) was more
likely to be associated with their perception of difficulties with reconciliation. The findings imply that
support for employed mothers and nonemployed
mothers in reconciling care and work needs to havedifferent strategies. For example, in order to support
employed mothers to maintain their participation in
the labour market, intervention in how to share care
responsibilities and make their paid work more flexible would be important. This finding suggests that
Taiwan’s government needs to provide more comprehensive and accessible social services for these

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8

Y.-C. Chou et al.

mothers who are now involved in the labour market.
Meanwhile, the government and employers need towork together to initiate friendly labour policies, suchas offering paid care leave and making employment
hours flexible. Alternatively, to support nonemployed
mothers who are able to re-enter the labour force,the promotion of their individual capital becomes a
crucial area of focus. This means that financial support and vocational training services should be madeavailable to these nonemployed mothers.
As pointed out as above, mothers’ health and hoursof caregiving were the two factors significantly related
to the mothers’ difficulties in care and work reconciliation in both groups. On the other hand, mothers’
education, service use, and attitudes were not significant factors related to the mothers’ difficulties withcare and work reconciliation among both employed
and nonemployed mothers, although mothers’ education and attitudes showed a significant difference
when the differences between employed and nonemployed mothers having difficulties in such reconciliation were compared. Service use and attitudes
were also not strong predictors of the reconciliation
outcome. As discussed previously, a very limited
number of the mothers with children with ID usedsocial services, and the users need to co-pay to use
such services; use or its absence for these lifelong
mother-carers did not make a significant differencein terms of care and work reconciliation.
This study showed that the outcome of reconciliation between care and work for mothers witha young or an adult child with ID is related to themother’s individual and family characteristics, careand work conditions, social support, and attitudes.
Further, that reconciliation for employed mothers
was more likely to relate to their work conditions andcare support, while the nonemployed mothers’ individual and family capital was more predominantly
associated with their perceptions of such reconciliation. Mothers’ health and the care demands of theirchildren with ID were strong predictors of reconciliation, regardless of the mother’s employment status.
Finally, nonemployed mothers who perceived they
had reconciliation difficulties were the most vulnerable when compared to the other three groups.
Our study has several implications for state policies
and for research concerning persons with disability
and family carers, particularly for those mothers withlifelong caregiving responsibilities. First, healthcare
and social care research must focus more attention
on work/family reconciliation for lifelong mothercarers with a young or an adult child with disability,in particular those nonemployed mothers with limited individual capital. However, supporting mothers
to combine care work and employment is not yet

institutionalised in legislation and policies in Taiwan.
Second, care and work reconciliation policies need
to be initiated to promote incentives that support
mothers’ employment choices. Third, for employed
mothers, such policies should include providing
universal and comprehensive social services that themothers are able to use and can afford to use andto increase the percentage of employers who allow
flexible work practices for employed mothers withcare responsibilities. Alternatively, promoting individual capital is important for nonemployed mothers
entering or returning to the labour force.
The sample of this study is drawn from just one
local authority (Hshinchu County), so the results
may not be generalised to the rest of Taiwan’s population. Furthermore, generalisation to those mothers
who had never worked before they got married orgave birth to a child with ID is uncertain. In addition,
we only used a single item to measure the mothers’
perception of difficulties in care and work reconciliation, which is another limitation (Loo, 2002).This
study is the first within Taiwanese society focusing
on the outcome of care–work reconciliation and its
related factors among mothers with a child with ID
in terms of a comparison between mothers with different employment statuses. Future studies using
national and cross-national representative samples
including use of multiple-item scales to provide amore comprehensive understanding of care and work
reconciliation issues for lifelong mother-carers, both
employed and nonemployed, are thus warranted.
Acknowledgements
The authors thank the research ethics board of the
National Yang-Ming University for their careful
examination and approval of this study (code number: 990077). Appreciation goes to Tyra Twomey forher editorial assistance. Most of all we would like tothank all the participants who gave up their time andtook part in our interviews.
Declaration of interest: The authors report noconflicts of interest. The authors alone are responsible for the content and writing of the paper.
This paper draws on data collected for a project
funded by the National Science Council in Taiwan(NSC99-2621-M-010-001), in collaboration with
the WoCaWo project (https://www.jyu.fi/ytk/laitokset/
yfi/en/research/projects/wocawo).
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