{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:00:51Z","timestamp":1790694051922,"version":"4.1.0"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["R42MC45808"],"award-info":[{"award-number":["R42MC45808"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with special healthcare needs (CSHCN) often require complex, ongoing, and coordinated care. Mothers frequently serve as primary caregivers and may experience elevated stress related to managing their child\u2019s medical needs and navigating healthcare systems. Healthcare experiences may shape how medical complexity relates to maternal stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examined maternal stress as the primary outcome in relation to children\u2019s medical complexity and healthcare experiences, including care coordination, family-centered care, and shared decision-making, while accounting for sociodemographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study used a cross-sectional design and secondary analysis of nationally representative survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were drawn from the 2016-2020 National Survey of Children\u2019s Health (NSCH), including 18,190 mothers of CSHCN. Mothers provided information on their child\u2019s medical complexity, healthcare experiences, maternal stress, and sociodemographic characteristics, including child race\/ethnicity, sex, age, family structure, number of children, federal poverty level, and community setting. Path analysis and bootstrapping were conducted in Mplus 8.8 to examine direct and indirect associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher medical complexity in CSHCN was significantly associated with increased maternal stress. Significant indirect associations were observed through care coordination and family-centered care. Additionally, several sociodemographic factors were significantly associated with both healthcare experiences and maternal stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher medical complexity was associated with greater maternal stress, with modest indirect associations through care coordination and family-centered care. These findings suggest the potential relevance of coordinated and family-centered healthcare experiences for maternal well-being among families of CSHCN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261491867","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:54:44Z","timestamp":1790351684000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal stress in families of children with special healthcare needs: The role of healthcare experiences"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7467-1275","authenticated-orcid":false,"given":"Hye-Jung","family":"Yun","sequence":"first","affiliation":[{"name":"Florida State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9518-4960","authenticated-orcid":false,"given":"Celia Tseyen","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3669-3473","authenticated-orcid":false,"given":"Ming","family":"Cui","sequence":"additional","affiliation":[{"name":"Florida State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia B.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Florida State University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"e_1_3_7_2_2","article-title":"Children and Youth with Special Health Care Needs 2022-2023: NSCH Data Brief","author":"Health Resource and Services Administration","year":"2025","unstructured":"Health Resource and Services Administration. 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