Perceived stress and its determinants among primary caregivers of patients with schizophrenia: A cross-sectional study

This study investigates the perceived stress of primary caregivers of patients with schizophrenia and its influencing factors, providing scientific evidence for targeted intervention strategies. A questionnaire survey was conducted to collect data from 136 caregivers of schizophrenia patients at Quanzhou Third Hospital and Hainan Anning Hospital between January 2020 and December 2024. The Perceived Stress Scale (PSS) was used to assess caregivers' stress levels. Other factors, including Family Support Scale, Connor-Davidson Resilience Scale, Social Support Rating Scale, Economic Burden Scale, and Zarit Burden Interview, were also measured. Multiple linear regression analysis was employed to identify factors influencing perceived stress. The mean PSS score among caregivers was 28.94 ± 4.64, indicating a moderate stress level. In multivariable analysis (r2 = 0.42), caregiving ≥2 years was associated with an 8.51-point higher PSS score (b = 8.51, 95% confidence interval [CI] 3.75-13.26), poor self-rated health with a 5.38-point higher score (b = 5.38, 95% CI 0.69-10.07), and each 1-point increase in Zarit Burden Interview with a 0.124-point higher PSS (95% CI 0.040-0.208). Conversely, each 1-point increase in Connor-Davidson Resilience Scale and Social Support Rating Scale was associated with a 0.105-point (95% CI -0.181 to -0.030) and 0.188-point (95% CI -0.341 to -0.035) lower PSS score, respectively. Family support showed a marginal negative association (b = -0.757, 95% CI -1.525 to 0.011). Perceived stress among caregivers of patients with schizophrenia is shaped by both risk factors (caregiving duration, poor health, caregiving burden) and protective factors (resilience, social support, and family support). Interventions enhancing support systems, strengthening resilience, and alleviating burden may improve caregivers' quality of life.