Evidence mapPaperPMID 42229969Full record

ArticleBMJ open2026

Prevalence and psychosocial correlates of depression, anxiety and stress among caregivers of children with childhood-onset systemic lupus erythematosus in China: a cross-sectional study.

Yuqing He, Tian Xu, Xia Zhou, Xiaoni Chai, Xiangmin Tan, Li Li, Jiayuan Peng, Ting Pan, Yi Zeng, Jingfei Tang and 3 more

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Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

13 authors.

Yuqing He *School of Nursing, Changsha Medical University, Changsha, China.
Tian Xu *Xiangya School of Nursing, Central South University, Changsha, China.
Xia ZhouDepartment of Nursing, Xiangya Hospital of Central South University, Changsha, China.
Xiaoni ChaiInternational School of Nursing, Hainan Vocational University of Science and Technology, Haikou, China.ORCID http://orcid.org/0000-0002-0261-3797
Xiangmin TanSchool of Rural Health, Monash University, Victoria, Victoria, Australia.
Li LiXiangya School of Nursing, Central South University, Changsha, China.ORCID http://orcid.org/0000-0002-6569-6008
Jiayuan PengXiangyin Campus of Xiangxing College, Hunan University of Chinese Medicine, Yueyang, China.
Ting PanXiangya School of Nursing, Central South University, Changsha, China.
Yi ZengSchool of Nursing, Changsha Medical University, Changsha, China.
Jingfei TangDepartment of Orthopedics, Movement System Injury and Repair Research Center, Xiangya Hospital, Central South University, Changsha, China.
Ka Yan HoSchool of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.ORCID http://orcid.org/0000-0003-3953-9065
Huan Wen *Department of Urology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China smnjw2008@126.com 13606058983@163.com.
Mei Sun *School of Nursing, Changsha Medical University, Changsha, China smnjw2008@126.com 13606058983@163.com.ORCID http://orcid.org/0000-0001-5341-0845

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate the prevalence of depression, anxiety and stress among primary caregivers of children with childhood-onset systemic lupus erythematosus (cSLE) in China and to explore their psychosocial correlates based on the stress process model.

designA cross-sectional study.

setting3 tertiary public hospitals in Hunan Province, China.

participants242 primary caregivers were invited, and 211 completed the study (87.2% response rate). Convenience sampling was used. Eligible participants were unpaid adult caregivers (aged ≥18 years) of children (aged <18 years) with cSLE, providing care for >1 month. Exclusion criteria included inability to complete questionnaires independently, cognitive impairment due to major physical or mental disorders and current participation in other psychological interventions. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes (depression, anxiety and stress) were measured using the Depression Anxiety and Stress Scale-21. Correlates included threat/challenge appraisal, coping style and perceived social support.

resultsAmong 211 caregivers (mean age 40.55±8.22 years; 77.3% female), 31.8% reported depression, 27.0% anxiety and 24.2% stress. Higher threat appraisal was consistently associated with depression (regression coefficients (B) =1.012, p<0.001), anxiety (B=0.514, p<0.001) and stress (B=1.091, p<0.001). A higher number of hospitalisations was associated with higher depression (B=0.118, p=0.005) and anxiety (B=0.099, p=0.012). Anxiety and stress were also associated with younger child age (anxiety: B=-0.339, p=0.028; stress: B=-0.393, p=0.024), lower challenge appraisal (anxiety: B=-0.252, p=0.044; stress: B=-0.421, p=0.002) and negative coping (anxiety: B=0.492, p<0.001; stress: B=0.311, p=0.019).

conclusionsCaregivers of children with cSLE face substantial psychological distress, with threat perception and negative coping as key modifiable correlates. Interventions to reshape cognitive appraisal and promote adaptive coping, alongside expanded health insurance coverage and optimised caregiving role distribution, are needed to alleviate caregiver burden.

Indexed as

AnxietyCaregiversDepressionLupus Erythematosus, SystemicStress, PsychologicalAdaptation, PsychologicalAdolescentAdultChildChinaCoping SkillsCross-Sectional StudiesFemaleHumansMaleMiddle AgedCaregiversNursing CareNursing researchPaediatric nephrologyPsychosocial InterventionStress, Psychological

Identifiers

PMID42229969
PMCPMC13239586

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.