Parenting stress among parents of outpatients with precocious puberty: a cross-sectional survey

Abstract

Background: Precocious puberty imposes notable psychological pressure on parents, yet specific patterns of their parenting stress and related influencing factors remain insufficiently explored. This study aimed to evaluate the parenting stress among parents of outpatients with precocious puberty, to provide insights for clinical nursing care. Method: A cross-sectional study was conducted between January 2024 and June 2025, enrolling parents of outpatients diagnosed with precocious puberty. Data were collected using the Parenting Stress Index to assess parenting stress levels and a self-designed questionnaire for sociodemographic information. Results: A total of 236 parents were included. The mean total parenting stress score was 114.85 ± 19.02 points, exceeding the high-stress threshold and indicating pronounced strain. The Parental Distress dimension scored highest (41.02 ± 8.40), followed by Difficult Child (38.18 ± 7.99) and Parent-Child Dysfunctional Interaction (36.79 ± 8.22). Parenting stress showed significant positive associations with maternal caregiver status, rural residence, lower parental education, divorced marital status, lower household income, and a greater number of children. Multiple regression analysis revealed that family income, number of children, marital status, residence, and educational level collectively explained 58.7% of stress variance (R²=0.587, P<0.001). Conclusion: Parents of children with precocious puberty face significantly elevated stress, with notable sociodemographic disparities. These findings suggest that tailored support strategies—potentially including personalized psychological counseling, simplified disease education, enhanced social support connections, and family-centered approaches—may be beneficial to reduce stress, strengthen parental coping skills, and improve overall care for affected children.