STRESS LEVELS AMONG CAREGIVERS OF CHILDREN WITH SPECIAL NEEDS: LITERATURE REVIEW
DOI:
https://doi.org/10.36916/jkm.v11i1.496Keywords:
Caregiver, Caregiver Burden, Children with Special Needs, Interventions, Stress LevelsAbstract
Background: Caregivers of children with special needs are at risk of experiencing psychological stress due to complex and long-term caregiving demands. Intensive care requirements and environmental factors may increase caregiver burden.
Purpose: This study was conducted to identify and understand the extent of stress experienced by caregivers of special needs children.
Methods: This study employed a literature review design using the PCC (Population, Concept, Context) approach. Articles were retrieved from PubMed, Scopus, EBSCO, and ScienceDirect using predefined keywords. Inclusion criteria were articles published between 2020–2025, written in Indonesian or English, and available in full text. The selection process followed PRISMA guidelines, resulting in 9 eligible articles. Data were analyzed descriptively.
Results: The findings indicate that caregivers of children with special needs tend to experience moderate to high stress levels. Contributing factors include child-related conditions (behavioral problems and limited independence) and caregiver-related factors such as low social support and ineffective coping strategies. Caregiving burden and limited personal time also contribute to increased stress.
Implications: These findings highlight the importance of caregiver-focused interventions in managing stress. The results can serve as a basis for developing nursing interventions and future research on caregiver stress management.
Keywords: Caregiver; Children with special needs; Stress Levels
References
Abeasi, D. A., Nkosi, N. G., Badoe, E., & Adjeman, J. (2024). Caring by default: experiences of caregivers of children with developmental disabilities in Ghana mirrored in the context of the stress process model. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02142-1
Anggraini, S., Lanawati, L., & Berek, A. H. (2022). Pengalaman Emosional Menjadi Caregiver Anak Berkebutuhan Khusus di Panti Asuhan Bhakti Luhur Banjarmasin. Jurnal Keperawatan Suaka Insan (JKSI), 7(2), 169–177. https://doi.org/10.51143/jksi.v7i2.358
Appah, J., Senoo-dogbey, V. E., Wuaku, D. A., Akpagloh, M. C., Armah, D., & Laari, L. (2025). Exploring the Coping Resources of Caregivers with Children Diagnosed with Autism Spectrum Disorders in Southern. Sage Open Pediatric, 12. https://doi.org/10.1177/30502225251374932
Balachandran, K. P., & Bhuvaneswari, M. (2024). Expressed Emotion in Families of Children with Neurodevelopmental Disorders : A Mixed-Method Approach. Annals of Neurosciences, 31(2), 105–114. https://doi.org/10.1177/09727531231181014
Cardoso, A. L., Silva-Junior, G. O., Bastos, L. F., Cesar, A. L. M., Serrano, L. G., Dziedzic, A., & Picciani, B. L. S. (2023). Preliminary Assessment of the Quality of Life and Daily Burden of Caregivers of Persons with Special Needs : A Questionnaire-Based , Cross-Sectional Survey. International Journal of Environmental Research and Public Health, 20(3). https://doi.org/10.3390/ijerph20032012
Cheng, A. W. Y., & Lai, C. Y. Y. (2023). Parental stress in families of children with special educational needs : a systematic review. Frontiers in Psychiatry, 14, 1198302. https://doi.org/10.3389/fpsyt.2023.1198302
Chukwuemeka, N. A., & Obioha, W. C. (2024). Burden of care and mental health of informal caregivers of children with developmental disabilities in Sub ‑ Saharan Africa : the moderating role of resilience. Discover Psychology, 4. https://doi.org/10.1007/s44202-024-00178-7
Demšar, A., & Bakracevic, K. (2023). Depression , Anxiety , Stress , and Coping Mechanisms among Parents of Children with Autism Spectrum Disorder Parents of Children with Autism Spectrum Disorder. International Journal of Disability, Development and Education, 70(6), 994–1007. https://doi.org/10.1080/1034912X.2021.1947474
Dharanidharan, D., & Kuruveettissery, S. (2025). Parental Perspectives on Stress and Challenges in Raising Autistic Children : A Meta ‑ Synthesis. Journal of Psychosocial Rehabilitation and Mental Health, 12(1), 125–141. https://doi.org/10.1007/s40737-024-00420-4
Du, X., Gao, S., Zhao, X., & Chen, X. (2024). The effect of cognitive reappraisal on emotion recognition in mothers of children with special needs. Acta Psychologica, 248, 104401. https://doi.org/10.1016/j.actpsy.2024.104401
Folkman, S. (2020). Stress: Appraisal and Coping. In M. D. Gellman (Ed.), Encyclopedia of Behavioral Medicine (pp. 2177–2179). Springer International Publishing. https://doi.org/10.1007/978-3-030-39903-0_215
Gentles, S. J., McLaughlin, J., & Schneider, M. A. (2024). Stress among caregivers of autistic children : Conceptual analysis and verification using two qualitative datasets. PloS One, 1–19. https://doi.org/10.1371/journal.pone.0312391
Gillespie‐Smith, K., Goodall, K., Mcconachie, D., Herwegen, J. Van, Crawford, H., Ballantyne, C., Richards, C., Gallagher, T., Joanna, M., Grace, M., Outhwaite, L., Marriott, E., Steindorsdottir, F., & Christie, H. (2025). A longitudinal study of psychological distress during an dafter COVID‐19 restrictions in caregivers of children with intellectual disability in the UK. JCPP Advances, 5(3), e12261. https://doi.org/10.1002/jcv2.12261
Gu, X., Shan, X., Wang, L., Gao, W.-Y., & Liu, X.-Q. (2023). Prevalence of psychological problems among caregivers of children and adolescents with neurodevelopmental disorders during the COVID-19 pandemic: A meta-analysis and systematic review. Research in Developmental Disabilities, 143, 104632. https://doi.org/10.1016/j.ridd.2023.104632
Hughes, J., Roberts, R., Tarver, J., Warters-louth, C., Zhang, B., Southward, E., Shaw, R., Edwards, G., Waite, J., & Pearson, E. (2024). ‘It wasn’t the strategies on their own’: Exploring caregivers’ experiences of accessing services in the development of interventions for autistic people with intellectual disability. Autism, 28(5), 1231-1244. https://doi.org/10.1177/13623613231196084
Jang, S. J., Han, J.-S., Bang, M. H., & Ahn, J.-W. (2022). Effects of a Sociodrama-based Communication Enhancement Program on Mothers of Children with Neurodevelopmental Disorders: A Pilot Study. Asian Nursing Research, 16(2), 114–123. https://doi.org/10.1016/j.anr.2022.03.005
Khoirunnisa, Aquino, A., Parestorian, P. H., & Kurniawan, K. (2023). Strategi Coping Stress Orang Tua yang Memiliki Anak Berkebutuhan Khusus: A Scoping Review. Jurnal Keperawatan Jiwa(JKJ): Persatuan Perawat Nasional Indonesia, 11(1), 110–120. https://doi.org/10.26714/jkj.11.1.2023.110-120
Koumoutzis, A., Cichy, K. E., Jenkins, M. D.-, & Blankemeyer, M. (2021). Age Differences and Similarities in Associated Stressors and Outcomes Among Young , Midlife , and Older Adult Family Caregivers. The International Journal of Aging and Human Development, 92(4), 431–449. https://doi.org/10.1177/0091415020905265
Krisnandari, A. A. I. W., Rahyanti, N. M. S., & Sriasih, N. K. (2024). Hubungan Beban dengan Kualitas Hidup Caregiver dalam Merawat Anak Berkebutuhan Khusus. Jurnal Gema Keperawatan, 17(2), 162–174. https://doi.org/10.33992/jgk.v17i2.3835
Kurniasih, E., Basuni, D. R., & Widia, C. (2023). Koping Stres Orang Tua yang Memiliki Anak Berkebutuhan Khusus Di SLB ABC Kota Tasikmalaya. Jurnal Keperawatan Galuh, 5(1), 1–12. https://doi.org/10.25157/jkg.v5i1.9584
Larson, E., Mattie, R. L., & Riffkin, S. A. (2024). Assessment of Acceptability, Usage, and Impact on Caregivers of Children With Autism’s Stress and Mindfulness: Multiple-Method Feasibility Study of the 5Minutes4Myself App’s Mindfulness Module. JMIR Human Factors, 11, e54171. https://doi.org/10.2196/54171
Liu, W., Thompson, P. A., Gray, K. M., & Hastings, R. P. (2024). Child behavior problems and parental psychological distress in Chinese families of children with autism : The putative moderating role of parental social support and cultural values. Autism Research, 17(5), 1016–1026. https://doi.org/10.1002/aur.3125
Naicker, V. V, Hedley, D., & Bury, S. M. (2024). Does hope mediate the relationship between parent’s resolution of their child’s autism diagnosis and parental stress. Frontiers in Psychology, 15, e1443707. https://doi.org/10.3389/fpsyg.2024.1443707
Ni’matuzahroh, Suen, M. W., Ningrum, V., Widayat, Yuniardi, M. S., Hasanati, N., & Wang, J.-H. (2021). The Association between Parenting Stress, Positive Reappraisal Coping, and Quality of Life in Parents with Autism Spectrum Disorder (ASD) Children: A Systematic Review. Healthcare, 10(1), 52. https://doi.org/10.3390/healthcare10010052
Saputri, M. A., Widianti, N., Lestari, S. A., & Hasanah, U. (2023). Ragam Anak Berkebutuhan Khusus. Childhood Education: Jurnal Pendidikan Anak Usia Dini, 4(1), 38–53. https://doi.org/10.53515/cej.v4i1.4986
Setiawan, I. (2020). A to Z Anak Berkebutuhan Khusus (D. Esti Restiani (ed.)). CV Jejak, anggota IKAPI.
Sevgi, G., & Ayran, G. (2024). Investigating the caregiving burden and stress of mothers with children with special needs. Journal of Pediatric Nursing: Nursing Care of Children and Families, 77, e538–e545. https://doi.org/10.1016/j.pedn.2024.05.020
Solaja, O. A., & Olaogun, A. A. (2025). Caregiver burden of carers of children with cerebral palsy in selected hospitals, Southwestern Nigeria. BMC Nursing, 24(1), 1001. https://doi.org/10.1186/s12912-025-03664-y
Syed, I. H., Awan, W. A., & Syeda, U. B. (2021). Caregiver Burden among Parents of Hearing Impaired and Intel-lectually Disabled Children in Pakistan. Iranian Journal of Public Health, 49(2), 249–256. https://pmc.ncbi.nlm.nih.gov/articles/PMC7231703/
Tang, C. S.-K., Yu, I. C.-Y., Ng, K.-H., & Kwok, H. S.-H. (2025). An ecological approach to caregiver burnout: interplay of self-stigma, family resilience, and caregiver needs among mothers of children with special needs. Frontiers in Psychology, 16, e1518136. https://doi.org/10.3389/fpsyg.2025.1518136
Westlake, F., Westlake, M., & Totsika, V. (2024). A systematic review and meta-analysis of the effectiveness of interventions targeting the parent – child relationship in families of children with an intellectual disability. Journal of Applied Research in Intellectual Disabilities, 37(6), e13273. https://doi.org/10.1111/jar.13273
Whelan, S., Caulfield, N., O’Doherty, S., Mannion, A., & Leader, G. (2025). Parental experiences of raising an autistic child in Ireland : A qualitative thematic analysis. Autism, 29(2), 395–407. https://doi.org/10.1177/13623613241277040
Yesilkaya, M., & Magallo, E. (2024). Parental Stress Related to Caring for a Child With Autism Spectrum Disorder and the Benefit of Mindfulness-Based Interventions for Parental Stress : A Systematic Review. Sage Open, 14(2). https://doi.org/10.1177/21582440241235033
Zinkevich, A., Uthoff, S. A. K., Wirtz, M. A., Boenisch, J., Sachse, S. K., Bernasconi, T., Feldhaus, M., & Ansmann, L. (2022). Burden of informal caregivers of people without natural speech: a mixed-methods intervention study. BMC Health Services Research, 22(1), 1549. https://doi.org/10.1186/s12913-022-08824-3
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