The mediating effect of social support on the relationship between perceived stress and quality of life among shidu parents in China

Background “Loss-of-only-child family” refers to the family in which the only child died and the mother has passed her child-bearing age. The parents who are unable to reproduce or do not foster other children are known as “shidu parents” in China. This study aimed to estimate the quality of life (QOL) and the mediating role of social support between perceived stress and QOL in Chinese shidu parents. Methods 502 shidu parents were recruited in Shenyang city. Shidu parents were asked to complete a questionnaire including the MOS item short from health survey (SF-36), the perceived stress scale-10 (PSS-10) and the functional social support questionnaire (FSSQ). Hierarchical linear regression was performed to assess the associations among perceived stress, social support and QOL. Asymptotic and resampling strategies were used to explore the mediating role of social support. Results The mean score of PCS and MCS was 64.83 ± 22.66 and 59.36 ± 21.83, respectively. Perceived stress was found to be negatively associated with both PCS (β = − 0.21, p < 0.001) and MCS (β = − 0.28, p < 0.001), while social support was positively associated with both PCS (β = 0.32, p < 0.001) and MCS (β = 0.32, p < 0.001). For shidu parents, the proportion of mediation of social support between perceived stress and QOL was 36.85% for PCS and 29.45% for MCS, respectively. Conclusions Perceived stress was associated with QOL and social support had a partially mediating effect between perceived stress and QOL in Chinese shidu parents. Low PCS and MCS of shidu parents highlight the need of timely developing interventions to reduce stress and reinforce social support to further improve their QOL.

Study on Cerebral White Matter Microstructural Integrity of Parents Who Lost Their Only Child

Background The parents who lost their only child and do not bear or adopt another child are known as Shidu parents in China. They have a higher risk of developing mental disorders, such as post-traumatic stress disorder (PTSD) or depression. Evaluating the neurobiological mechanisms of the development of early emotional symptoms might provide an understanding of mental diseases in Shidu parents. Objective The present study aimed to investigate the microstructural integrity of white matter (WM) in Shidu parents without any diagnosis of mental illness based on diffusion tensor imaging (DTI). Methods This study consisted of Shidu parents and well-matched healthy controls (HCs). No significant differences were detected with respect to the gender ratio, age, and education level. All participants underwent DTI sequence, tested by the symptom check-list 90 (SCL_90), to assess the psychological status. Also, a whole-brain tract-based spatial statistics (TBSS) approach was used to examine the microstructural integrity of WM tracts in each participant. Results Compared to HCs, the Shidu group showed reduced fractional anisotropy (FA) in the left uncinate fasciculus (UF), superior longitudinal fasciculus (SLF), and increased radial diffusion (RD) and mean diffusion (MD) in the same WM regions. In the Shidu group, the FA value in the left UF were significantly correlated with SCL_90 subscale scores, including anxiety, depression, and interpersonal sensitivity (all p<0.005), while a negative correlation was established between FA values in the left UF and traumatic time (p=0.024). Furthermore, Shidu women had reduced FA in the left UF while the Shidu men had reduced FA in the left SLF.Conclusions The WM integrity in Shidu parents is disrupted even without PTSD and depression, and such microstructural changes varied with gender, which might be associated with the gender differences in emotion regulation strategies. Importantly, the compromised integrity of left UF might contribute to the emotion dysregulation in Shidu parents, leading to a range of emotional symptoms, thereby partially explaining why these parents are more prone to various mental disorders than HCs.

The mediating effect of social support on the relationship between perceived stress and quality of life among shidu parents in China

Background: “Loss-of-only-child family” refers to the family in which the only child died and the mother has passed her child-bearing age. The parents who are unable to reproduce or do not foster other children are known as “shidu parents” in China. This study aimed to estimate the quality of life (QOL) and the mediating role of social support between perceived stress and QOL in Chinese shidu parents.Methods: 502 shidu parents were recruited in Shenyang city. Shidu parents were asked to complete a questionnaire including the MOS item short from health survey (SF-36), the Perceived Stress Scale-10 (PSS-10) and the Functional Social Support Questionnaire (FSSQ). Hierarchical linear regression was performed to assess the associations among perceived stress, social support and QOL. Asymptotic and resampling strategies were used to explore the mediating role of social support.Results: The mean score of PCS and MCS was 64.83 ± 22.66 and 59.36 ± 21.83, respectively. Perceived stress was found to be negatively associated with both PCS (β=-0.21, p < 0.001) and MCS (β=-0.28, p < 0.001), while social support was positively associated with both PCS (β = 0.32, p < 0.001) and MCS (β = 0.32, p < 0.001). For shidu parents, the proportion of mediation of social support between perceived stress and QOL was 36.85% for PCS and 29.45% for MCS, respectively.Conclusions: Perceived stress was associated with QOL and social support had a partially mediating effect between perceived stress and QOL in Chinese shidu parents. Low PCS and MCS of shidu parents highlight the need of timely developing interventions to reduce stress and reinforce social support to further improve their QOL.

Exploring the lived experience of older Chinese “Shidu” parents who lost their only child: A phenomenology study

The purpose of this study was to explore lived experiences of older “Shidu” parents in China. A qualitative phenomenology study using Colaizzi’s method was employed in a major metropolitan city in China. 8 individuals from 5 families participated in this study. Participants were parents who had lost their only child. 3 participants were male and 5 were female. Four major themes emerged from the data: (1) “Shidu” means excessive grief, and facing spiritual dilemma; (2) “Shidu” often results in withdrawal from society, and social disorder to some extent; (3) Irrational perception on “Shidu” will cause more harmful feelings, like self-blame, guilt, low self-worth; and (4) “Shidu” means loss of support, and worrying about how to manage life after the death of their only child. The findings revealed that the older “Shidu” parents felt a strong desire to express their need for psychosocial support and understanding. These findings are related to the traditional Chinese culture that a child is the center of the family.