The caregivers' experiences in growth hormone therapy for short stature: A qualitative meta-synthesis

Caregivers of children with short stature undergoing growth hormone therapy face substantial physical, emotional, and social burdens. However, qualitative evidence on their experiences remains fragmented across studies and cultural contexts. This meta synthesis aimed to systematically integrate existing qualitative findings to generate a comprehensive understanding of caregivers' experiences and support needs.

This qualitative meta-synthesis was conducted and reported following the PRISMA 2020 statement and the ENTREQ guidelines. A systematic search was conducted in 10 databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, ProQuest, China National Knowledge Internet, Wanfang, VIP Database, and Chinese BioMedical Literature Database) from inception to December 6, 2025. Qualitative and mixed-methods studies were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the JBI checklist. Thematic synthesis was employed to analyze and integrate findings.

Fifteen studies involving 648 caregivers were included. Seventy-six findings were synthesized into four overarching themes: (1) disease cognition and adaptation process; (2) emotional burden; (3) multidimensional challenges; and (4) external support needs. Caregivers' emotional distress was synergistic, and practical challenges evolved across children's developmental stages.

Caregivers of children on growth hormone therapy endure complex, cumulative burdens that require systematic and culturally sensitive responses. Healthcare professionals should adopt family centered approaches, provide tailored emotional and practical support, and facilitate integrated professional and peer support networks. These findings provide an evidence base for developing targeted interventions and informing pediatric nursing policy. The protocol for this systematic review was prospectively registered in PROSPERO (CRD420261435912).