AUTHOR=Fan Zhi-Ru , Chong Mei Chan , Xiaona Zheng , Jing Ma , You Yan Li , Ma Lili , Che Chong Chin 

TITLE=Prevalence and factors associated with depression, anxiety and stress among nursing home caregivers in China: a multi-center cross-sectional study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1690840

DOI=10.3389/fpubh.2025.1690840

ISSN=2296-2565

ABSTRACT=BackgroundThis study aimed to investigate the prevalence of depression, anxiety, and perceived stress among nursing home caregivers in China and to examine the associated factors.MethodsA 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.ResultsThe 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.ConclusionDepression 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.