Parenting stress and depressive symptoms in the family caregivers of children with genetic or rare diseases: The mediation effects of coping strategies and self-esteem

OBJECTIVE: To elucidate how parenting stress influence depressive symptoms in the family caregivers of children with genetic or rare diseases by examining the mediation effects of coping strategies (problem-focused, emotion-focused, and dysfunctional coping) and self-esteem. MATERIALS AND METHODS: In total, 100 family caregivers were recruited and administered a questionnaire assessing demographics and study measures. We used the PROCESS for SPSS macro with 10,000 bootstrapped samples and a 95% confidence interval to test the proposed mediation models. RESULTS: Increased parenting stress was associated with more depressive symptoms, partially via dysfunctional coping, but not problem- or emotion-focused coping strategies. The serial multiple mediation pathway (parenting stress → low self-esteem → dysfunctional coping → depressive symptoms) was not significant, whereas the indirect effect of via dysfunctional coping alone had a significantly partial mediation effect. CONCLUSIONS: Dysfunctional coping strategies may explain the parenting stress–depressive symptom relationship. The goals of psychosocial medical care for family caregivers were suggested.