Stress and coping experiences of primary caregivers in managing pain among children with juvenile idiopathic arthritis: A qualitative descriptive study.

PURPOSE: Pain is a prominent stressor in juvenile idiopathic arthritis (JIA) caregiving. This study described how primary caregivers in China appraised and managed JIA-related pain, guided by the Lazarus-Folkman Transactional Model of Stress and Coping. DESIGN AND METHODS: This single-center qualitative descriptive study recruited 12 primary caregivers from the Children's Hospital of Chongqing Medical University in Chongqing, China through maximum variation purposive sampling. Semi-structured interviews were analyzed using directed content analysis, with inductive coding for data not captured by the a priori framework. Code saturation was reached by the tenth interview and confirmed through two additional interviews; reporting followed COREQ. RESULTS: Four interrelated domains were identified: pain-related threat appraisal; resource appraisal and practical constraints; coping responses, including home-based care, environmental adjustment, emotional regulation, and parent-child collaboration; and adaptation outcomes marked by coexisting competence growth and persistent burden. Three inductive findings-traumatic psychological imprints, environmental and activity adjustments, and parent-child collaborative coping-extended the explanatory scope of the framework. Duration-group patterns were exploratory and descriptive rather than evidence of longitudinal change. CONCLUSIONS: Caregivers' accounts were broadly consistent with the Lazarus-Folkman model while adding context-specific experiences. The four domains should be understood as interrelated rather than as a fixed sequence or causal pathway. Transferability should be interpreted cautiously given the single-center, tertiary-care sample. PRACTICE IMPLICATIONS: Pediatric nurses can use these findings to inform caregiver education, rehabilitation referral, peer support, and psychosocial assessment, while adapting support to local feasibility and resource constraints.