ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1690840
This article is part of the Research TopicThe Formal and Informal Workforce for a Global Aging PopulationView all 20 articles
Prevalence and factors associated with depression, anxiety and stress among nursing home caregivers in China: A multi-center cross-sectional study
Provisionally accepted
- 1Universiti Malaya Faculty of Medicine, Federal Territory of Kuala Lumpur, Malaysia
- 2Fuzhou University, Fuzhou, China
- 3Henan University of Science and Technology, Luoyang, China
- 4The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
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Background: This study aimed to investigate the prevalence of depression, anxiety, and perceived stress among nursing home caregivers in China and to examine the associated factors. Methods: A multicenter cross-sectional study was conducted among 1,341 caregivers in nursing homes across Henan Province, China. Standardized instruments were applied, including the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and the 10-item Perceived Stress Scale (PSS-10). Descriptive statistics, univariate analysis, and multivariable logistic regression were performed to identify independent predictors of psychological distress. Results: The prevalence of depression and anxiety was 34.8% and 10.8%, respectively, while 49.6% of caregivers reported moderate-to-high levels of stress. Significant predictors included city region, type of nursing home, educational level, monthly income, working hours, night shifts, presence of chronic diseases, attention to mental health, and participation in psychological training. Higher education and moderate income were protective factors, whereas employment in rural private nursing homes, low engagement in mental health practices, and the presence of chronic diseases increased risks. Longer working hours and more frequent night shifts were unexpectedly associated with lower stress levels. Conclusions: Depression and stress represent the major psychological concerns among nursing home caregivers in China. Targeted interventions should prioritize routine mental health screening, workplace-based psychological support, and policy measures aimed at improving working conditions and access to training, thereby safeguarding caregiver well-being and supporting the sustainability of long-term care services.
Keywords: Nursing home caregivers, Depression, Anxiety, perceived stress, Long-Term Care
Received: 10 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 FAN, Chong, Xiaona, Ma, You, Ma and Chong Chin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Che Chong Chin, chechongchin@um.edu.my
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