Abstract
BACKGROUND: The growing trend of international migration has significant socio-emotional implications for families left behind, particularly the left-behind parents. While much research focuses on the well-being of migrants, limited studies explore the psychological distress experienced by left-behind parents. This study assesses the prevalence and determinants of psychological distress among parents with emigrant offspring in Changunarayan Municipality, Nepal. METHOD: A mixed-methods cross-sectional study was conducted among 218 parents whose children had emigrated for at least six months. The quantitative phase involved a structured survey, where psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Pearson chi-square tests and multivariable logistic regression were performed to identify associated factors at a 5% level of significance. The qualitative phase included 16 in-depth interviews to explore emotional experiences and coping strategies. Thematic analysis, following Braun and Clarke's six-step framework, was used to identify key qualitative insights. RESULTS: The prevalence of psychological distress was 18.8%, with 8.3% experiencing mild distress, 5.0% moderate distress, and 5.5% severe distress. Multivariable analysis revealed that parents with multiple morbidities (aOR: 4.032, 95% CI: 1.633-9.938), those whose children were employed in labor-intensive jobs (aOR: 9.215, 95% CI: 1.499-56.645), and those perceiving low support from emigrant children (aOR: 3.828, 95% CI: 1.178-12.442) had significantly higher odds of psychological distress. Qualitative findings highlighted loneliness, parental worries, and uncertainty regarding children's return as key concerns. Social support, regular communication, and engagement in community activities were identified as coping strategies. CONCLUSION: A significant proportion of parents with emigrant children experience psychological distress, influenced by health conditions, migrant employment status, and perceived social support. Strengthening intergenerational communication, enhancing mental health services, and developing targeted support programs for left-behind parents are crucial in mitigating their distress.