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(1) To determine the mediating effects of children's transition readiness, which reflects self-management skill acquisition, and family resilience on the relationship between parenting stress and the quality of life (QOL) of parents and children with spina bifida (SB). (2) To conduct an exploratory analysis of the differences in the mediating pathways based on the presence of SB-related clinical characteristics.
A cross-sectional study.
Data were collected from a single centre in South Korea between October 2022 and July 2024. Participants included children aged 7–13 years diagnosed with myelomeningocele, lipomyelomeningocele or tethered cord syndrome, along with their parents. Statistical analysis was conducted using SPSS and the MEDYAD macro for actor–partner interdependence mediation model analysis.
Family resilience significantly mediated the relationship between parenting stress and both child and parent QOL. However, transition readiness was not a significant mediator in the overall sample. Among children with SB-related clinical characteristics, transition readiness significantly mediated the association between parenting stress and child QOL. In contrast, family resilience mediated the relationship between parenting stress and parent QOL. No significant mediators were found in children without SB-related clinical characteristics.
This study highlights the mediating role of family resilience and transition readiness in improving the QOL of children with SB, particularly those with clinical characteristics. The findings suggest that interventions should be tailored to address both family resilience and transition readiness, especially for children with SB-related clinical challenges.
These findings are valuable for nurses supporting children with SB, as the results highlight the importance of transition education tailored to SB-related clinical characteristics. In particular, nurse-led transition education may play a key role in enhancing transition readiness and improving the QOL of children with SB who have clinical characteristics.
None.
STROBE Checklist for cross-sectional studies.
To investigate factors affecting the quality of life of parents of children with spina bifida and examine how family resilience mediates between parental depression and quality of life.
Cross–sectional study.
Secondary data analysis was performed using first-year data from a five-year spina bifida cohort project (2022–2026) in South Korea. The study included 162 parents of children aged 4–12 years with spina bifida. Data were collected using the Korean version of the Family Resiliency Scale, the Center for Epidemiologic Studies Depression Scale, and the WHO Quality of Life Scale.
Factors were found to have a statistically significant influence on the quality of life of parents of children with spina bifida: the child's need for enemas, parental stress, parental depression, and family resilience. Baron & Kenny's mediation analysis and bootstrap analysis in SPSS further confirmed that family resilience plays a mediating role between parental depression and quality of life. The indirect effect of parental depression on quality of life through family resilience was statistically significant, with a 95% confidence interval of [−0.2615, −0.0516].
The quality of life of parents with children with spina bifida is significantly influenced by both their child's daily symptom management and their psychological health. Family resilience plays a positive mediating role between parental depression and quality of life.
These findings support a two-track approach to family resilience building programs and the development of core intervention strategies to enhance the quality of life in spina bifida families.
This study adhered to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
There was no direct patient involvement in the study design, data collection, or analysis.
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