The Impact of Perceived Stress on Depression Among Caregivers of Children With Enterostomy: The Moderating and Mediating Effects of Resilience and Perceived Social Support

感知压力对肠造口患儿照护者抑郁症的影响:韧性和感知社会支持的调节和中介作用

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Abstract

OBJECTIVE: This study aims to investigate the relationship between perceived stress and depressive symptoms among caregivers of children with enterostomy, as well as the mediating role of resilience and the moderating effect of perceived social support. The findings are anticipated to provide a scientific basis for promoting the rehabilitation of children, enhancing the mental health status of caregivers of children and developing clinical psychological nursing interventions. METHODS: A convenience sampling method was utilised to recruit 236 caregivers of children who had undergone enterostomy surgery and returned for follow-up visits. Various assessment scales were employed, including the Perceived Stress Scale, Connor-Davidson Resilience Scale, Depression Screening Scale and Perceived Social Support Scale. Pearson correlation analysis was performed to explore relationships among variables, while Process version 4.1 was applied to test mediation and moderation effects. RESULTS: A highly significant positive correlation was identified between perceived stress and depression among caregivers (r = 0.450, p < 0.01). Conversely, a conspicuously negative correlation was detected between perceived stress and resilience (r = -0.352, p < 0.01). Both resilience (r = -0.774, p < 0.01) and perceived social support (r = -0.416, p < 0.01) demonstrated significant negative correlations with levels of depression. Furthermore, resilience functioned as a mediator in the relationship between perceived stress and depression, with the mediating effect accounting for 47.2% (95% CI: 0.140, 0.323). Additionally, perceived social support moderated the pathway from resilience to depression within the mediation model (β = -0.206, p < 0.01; 95% CI: -0.411, -0.003). CONCLUSION: Elevated levels of resilience and enhanced perceived social support from the environment may serve as effective strategies for mitigating perceived stress and depression. Additionally, these factors contribute to improving mental well-being among caregivers of children with enterostomy. PATIENT/PUBLIC CONTRIBUTIONS: The caregivers of children with enterostomy were surveyed to collect relevant data.

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