Abstract
AIM: To investigate the impact of parenting stress in both fathers and mothers on the quality of life (QoL) of children with down syndrome (DS) and the mediating effect of family adaptation. DESIGN: This cross-sectional study was conducted between April 2023 and August 2023. METHODS: A total of 106 father-mother dyads of children with DS aged 2-12 years in South Korea were included. The parents independently completed questionnaires assessing parenting stress, family adaptation, and their children's QoL. The Actor-Partner Interdependence Mediation Model was used for the dyadic analysis. RESULTS: The direct effect of parenting stress on children's QoL was not significant; however, the indirect effect of family adaptation was significant. Fathers' parenting stress indirectly influenced their children's QoL through their own and their mothers' family adaptations. Conversely, mothers' parenting stress indirectly influenced their children's QoL through their own family adaptation, although the mediating effect of fathers was not statistically significant. CONCLUSIONS: Higher family adaptation in both fathers and mothers was associated with an improved QoL in children with DS. The pathways through which parents influenced their children's QoL differed but were interdependent. Therefore, dyadic interventions aimed at improving family adaptation in both fathers and mothers may help improve the QoL of children with DS. IMPACT: This is the first study to examine parental influence on children's QoL based on dyadic interactions among fathers, mothers, and children with DS. This study highlights the importance of assessing and promoting fathers' and mothers' levels of family adaptation to improve the QoL of children with DS. Nurses should consider effective dyadic interventions for families that include both parents to maximise improvements in the QoL of children with DS. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contributions. REPORTING METHOD: This study adhered to the STROBE guidelines for cross-sectional studies.