Prevalence and Associated Factors of Anxiety and Depression Among Primary Caregivers of Children With Haematological Malignancies: A Cross-sectional Study

BACKGROUND: Primary caregivers of children with hematological malignancies endure immense physical and psychological stress, however their mental health status remains under-recognized in clinical settings. This study aimed to investigate the prevalence of anxiety and depression among these caregivers and to identify their independent associated factors, providing evidence for targeted nursing interventions. METHODS: A cross-sectional survey was conducted involving 200 primary caregivers recruited from the Department of Haematology, Children's Hospital of Soochow University. Demographic and clinical data were collected alongside psychological assessments using the Hospital Anxiety and Depression Scale (HADS), the Memorial Symptom Assessment Scale (MSAS), and the Multidimensional Scale of Perceived Social Support (MSPSS). Univariate analyses and multivariable logistic regression models were employed to determine the associations between potential predictors and psychological distress outcomes. RESULTS: The study revealed a substantial burden of psychological morbidity. Specifically, 52.00% of caregivers exhibited anxiety and 42.50% showed symptoms of depression. Multivariable analysis further identified distinct risk profiles for each condition. Anxiety was independently associated with shorter time since diagnosis (odds ratio (OR) = 0.66, 95% confidence interval (CI): 0.47-0.92, per 6 months), greater child symptom burden (OR = 1.22, 95%: CI 1.03-1.46, per 10 points increase), and social support (OR = 0.48, 95% CI: 0.32-0.71, per 10 points). Conversely, depression was significantly associated with sociodemographic factors including educational level (OR = 0.34, 95% CI: 0.13-0.89, for college degree or above) and single marital status (OR = 3.97, 95% CI: 1.35-11.69), in addition to symptom burden (OR = 1.55, 95% CI: 1.25-1.91, per 10 points) and social support (OR = 0.31, 95% CI: 0.19-0.50, per 10 points). Furthermore, sensitivity analyses highlighted that the frequency recent hospitalizations were consistently associated with higher levels of both anxiety and depression. CONCLUSIONS: Caregivers of children with haematological malignancies experience exhibits a high prevalence of anxiety and depression. Anxiety appears to be more closely related to acute clinical stressors and temporal factors, whereas depression is more closely related to persistent social and demographic disadvantages. Effective management of paediatric symptoms and the strengthening of multi-dimensional social support systems are essential. Future interventions should be tailored to the specific risk profiles of caregivers to improve their overall well-being.