Introduction

International migration has been intensely increasing in recent decades. The International Organization for Migration (IOM), leading intergovernmental organization in the field of migration, published an official report indicating that the number of people in all categories of migratory processes had reached of 281 million in 2020, 3.6% of the global population (^{McAuliffe & Triandafyllidou, 2021}).

There are many categories to characterize and distinguish people who were displaced to other countries or territories: migrants, immigrants, refugees, and asylum seekers, among others (^{Santinho, 2016}). In this paper, the term “migrant” is chosen to refer to any person in an international migratory process. Even though this concept is not defined by international law, it is considered a generalist definition that covers the eminent fluidity of international displacements (^{McAuliffe & Triandafyllidou, 2021}). Additionally, it embraces the legal conditions of refugee or asylum seekers status (^{Cogo & Badet, 2013}).

Moving to another country or territory is considered a total phenomenon as it affects all the existential dimensions of people: political, economic, health, psychological, social, and religious (^{Sayad, 1998}). Thus, international migratory processes can inflict several multifactorial vulnerabilities on migrant populations, mainly in cases of forced displacement, due to several human rights violations (^{Granada et al., 2017}). From the very beginning of the geographic mobility process, people can suffer from stressful factors, such as physical and psychological violence, extortion, human trafficking, and insecurities related to the host country’s public policies. When migrants arrive in a new country or territory, they also frequently face low socioeconomic conditions, lack of social support, cultural inadaptation, linguistic barriers, and other types of marginalization (^{Prado & Araújo, 2019}).

The migration process for parents with children is particularly challenging, mainly because childcare implies specific and potentially stressful demands (^{Arakelyan & Ager, 2020}; ^{Ünver et al., 2021}). In this context, the concept of parental stress helps to understand the dynamics and difficulties faced by parents who experienced international migration processes with their children. It is conceptualized as the stress arising from situations related to parenting, particularly those related to how much they feel capable of fulfilling their parental role to address their children’s needs (^{Lee & Jeon, 2021}). This is also an important marker that is related to other psychological health conditions that arise from stressful events, such as migration conditions (^{Murphy et al., 2017}; ^{Ponguta et al., 2020}). Moreover, parents’ beliefs and values are determinants in parenting practices, which means that the stress experienced in the context of parenting can influence the way parents perceive and act upon their role in rearing children, and may get in conflict with cultural values present in their new allocation (^{Abidin, 1992}).

Currently, instruments adapted and validated in different cultures have been used to assess levels of the quantitative parental stress construct (^{Louie et al., 2017}). In cases of forced displaced people, the available evidence indicates that high levels of parental stress are related to an increase of anxiety, depression, PTSD, feelings of isolation and ineffectiveness in the parenting role, difficulty adapting to the new country, and greater family conflicts (^{Murphy et al., 2017}). Additionally, high levels of parental stress are more common in families with low socioeconomic status and low social support (^{Eltanamly et al., 2021}).

The quantitative data about parental stress in the same context has already been analyzed (^{Conte Gil et al., 2023}). In that systematic review, 21 articles were included (English, Spanish, and Portuguese) published between 2012 and 2021 that investigated quantitatively the relationship between parental stress and other variables, such as social support, acculturative orientations, parent-child relationship, and the mental health of caregivers. The results of that systematic review mainly showed the importance of social support in the host country for families in an international migration process. Furthermore, studies involving interventions presented an important reduction in parental stress and an increase in the social well-being of families who participated in the intervention programs. In this context, social support and welcoming actions for families show the most promising mechanism for reducing parental stress associated with migration (Conte Gil et al., 2023).

However, parental stress is a broad concept that affects families of the most different kinds and contexts, which may be difficult to comprehend solely through quantitative approaches (^{Brito & Faro, 2016}). To better understand these phenomena, it is important to develop studies that assess not only the stressors quantitatively but also the way parents and caregivers experience and perceive parental stress (^{Lim & Ogawa, 2014}). In particular, the phenomenon of immigration, especially involving families with children, is extremely complex and multifactorial.

Therefore, understanding the particularities of the phenomenon involving ethnic, racial, socio-economic, and religious aspects is fundamental when considering reception strategies for the migrant population (^{Granada et al., 2017}). Accordingly, qualitative studies that focus on subjective processes and experiences are essential to address the lack of this kind of evidence in the field. It is understood that qualitative studies can provide more in-depth and detailed data on these demands, mainly to contribute to the understanding of the current scenario and the development of broad public policies.

The growing movement of qualitative research has been gaining strength (^{Levitt et al., 2020}), especially in the field of mental health. These qualitative publications require a comprehensive understanding of their findings, so a meta-synthesis approach is a way to systematize and integrate these qualitative findings (^{Lachal et al., 2017}). It also offers valuable contributions by bringing together in-depth information about participants’ experiences and perspectives, while indicating possible gaps and relevant evidence for the implementation of assertive and relevant public policies (^{Tong et al., 2012}). Considering the above, this meta-synthesis aims to analyze articles with a qualitative focus (2012-2024) on the parental stress of those who experienced international migration processes with their children.

Methodology

This meta-synthesis followed the systematic recommendations proposed by two different protocols: the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA (^{Page et al., 2021}) for selection and inclusion of the studies, and ^{Lachal et al. (2017}) guidelines for analysis and synthesis of the reported findings. Searches were carried out in seven international databases: Scopus, Web of Science, PsycInfo, VHL Portal, MEDLINE/CINAHL, EMBASE, and Cochrane Library, using the following descriptors in English: [migra* and parental stress], [immigra* and parental stress], and [refug* and parental stress].

The search was limited to articles published in English, Spanish, and Portuguese from 2012 to October 2024. The first draft of this meta-synthesis was completed in 2022, which included papers from 2012 to 2021. The reason for the selection of this period was to cover the ten-year publication of the articles on the subject, which is a criterion commonly used in review articles. However, from an update of the paper, the years 2022, 2023, and 2024 (until October) were included to cover all available literature previous to the publication of this manuscript.

The articles included in this review met the following criteria: 1)focused on parents’ stress of those who experienced migration processes with their children; 2)empirical qualitative studies; and 3)made explicit the international migration context of the participants. In the Selection stage, articles were categorized through the Rayyan software. After excluding duplicates, the first and second authors of the present article read the titles and abstracts and made an initial selection of articles based on the inclusion criteria. Disagreements among decisions were solved by a third author (Leclerc et al., 2014). In the Eligibility stage, the articles were fully read and included for analysis, considering the same criteria previously described.

Initially, 2931 documents were found. After the steps taken, 24 articles were included for analysis. The details of this process, considering the stages of Identification, Selection, Eligibility, and Inclusion are available in Figure 1.

After the Inclusion stage, three authors evaluated each article independently. Firstly, the quality of the articles was assessed based on the criteria of the Critical Appraisal Skills Programme (CASP) for meta-synthesis (^{Lachal et al., 2017}). Secondly, the articles were analyzed according to their objectives, methodological aspects, and main results regarding parental stress.

Source: Own elaboration.

Figure 1 Flowchart of the Inclusion of Articles 

Results

Discussion

The objective of this meta-synthesis was to analyze scientific articles on parental stress within international migration processes. The migration of families with children is a growing issue that will demand even more from researchers to carry out studies in various contexts, cultures, and life realities, especially to approach parents’ experiences deeply from a qualitative perspective (^{Brito & Faro, 2016}). Several factors involved in this process have already been highlighted in the studies’ focus on the present review.

Additionally, a significant increase in papers published on the subject from 2022 onwards was observed. It is conjectured that this is primarily associated with the closing of borders during the COVID-19 pandemic in 2020 (^{United Nations High Commissioner for Refugees [UNHCR], 2020}) and the outbreak of geopolitical conflicts in the West, such as the war between Ukraine and Russia (World Economic Forum [WEF], 2022), as well as the current genocide of the Palestinian people (^{Jamshidi, 2024}) and related conflicts. All these global broadcast situations may have directed greater interest among researchers in the issues surrounding international migration processes.

Initially, it is emphasized that qualitative studies analyze aspects that are not possible to explore through quantitative methods, mainly due to the standardized instruments used in data collection (^{Günther, 2006}). In perspective, the present meta-synthesis focused on qualitative studies, several of which investigated parenthood experiences and perceptions, transitions, impacts, and challenges through interviews and focus groups-both widely used instruments in qualitative study designs (^{Turato, 2005}).

The psychological aspects assessed in the studies were diverse, indicating the complexity of the research issues in this area. The analyzed studies encompassed a range of objectives related to psychosocial factors and their impacts. For instance, war and displacement stressors, coping mechanisms among refugee families, psychological distress, and social isolation in a migrant pregnant woman. Their results demonstrate the complexity of migration experiences, mainly regarding parental stress, which can present itself in many ways and levels (^{Murphy et al., 2017}).

Regarding the methodological aspects of the included studies, the criteria adopted for this meta-synthesis (^{Lachal et al., 2017}) considered that the quality of the articles was high. The gaps recurrently found in the papers are related firstly to clarifying ethical issues, and secondly, to considering the relationship between the researcher and participants, which is an intrinsic issue for qualitative research. Consequently, ethical considerations are essential, especially those related to the impact of the research on participants in studies that investigate sensitive topics such as forced displacement. There is a need to emphasize the importance of considering the possible negative impacts of evoking vulnerable populations’ suffering and traumatic memories without a clear plan of action to help them address possible migration effects still present in their lives (^{Taquette & Souza, 2022}).

Furthermore, cultural issues, language, nationality, or religion are factors that affect the experiences of the participants and researchers, and can only be considered from a qualitative perspective. Thus, the data collected in this study design are developed through the bond established between the researcher-participant relationship (^{Tillman, 2002}). Although this is essential to be considered, only one study from this review [19] included information about the researcher who carried out the interviews. In this case, researchers and participants shared the same ethnic, cultural, and religious background as the participants. According to the authors, this allowed a more culturally sensitive approach, providing a better understanding of the experiences reported by the participants. For future studies, this is an important aspect to consider as the identification between researcher-participants may not only influence data collection but data analyses as well (Tillman, 2002).

Among the participants, this meta-synthesis shows, on the one hand, that nearly all the studies reviewed included solely mothers. This demonstrates how the maternal role remains predominant in access aspects related to family and parental care of children (Valiquette-Tessie et al., 2019). While, on the other hand, only one study [24] focused on the presence of the father, including a widowed father. These results may indicate an attempt to more expressively include the father’s role in parental care and family dynamics. Despite this, more than half of the studies consider families where the parents (mother and father) are together. For future research, assessing the perceptions of other caregivers (e.g., only fathers and grandparents) may be important to understand if and how they experience parental stress compared to the mothers’ perspective.

Regarding the migratory flow, most of the participants’ countries of origin (such as Syria, Sudan, Zimbabwe, Pakistan, and India) faced a war context, political instability, extreme poverty, and high social vulnerability problems. Historically, the South-North migratory flow was more common and occurred on a larger scale, mainly due to the better living standards, and economic and structural conditions of the seeking countries. However, nowadays most migration flows are South-South (^{UNHCR, 2020}). In addition, another factor related to South-South migration is the cultural similarities shared between the country of origin and the host country. Although this may be related to their colony/colonized history, it is possible to think that this provides certain feelings of belonging for migrants, something that may work as a coping mechanism against stressful situations (^{Leal & Harder, 2021}).

Examining the overall characteristics of the migrant families, several of those who indicated experiencing parental stress also presented low socioeconomic levels. There is consensus in the literature that socioeconomic status is a critical predictor of a range of lower health and illness conditions (^{Baum et al., 1999}), negatively impacting levels of general stress, mental health problems (^{Algren et al., 2018}), and distress related to parenting (Nagy et al., 2022). In cases of migrant parents, who are frequently under several vulnerabilities and acculturation processes from the resettlement itself (^{Prado & Araújo, 2019}), the experience of parental stress is even more intense when they have low socioeconomic status (^{Yan, 2022}). This reinforces the importance of creating public policies, especially for families that have experienced more vulnerable situations in their countries of origin, that might provide opportunities for them to reduce financial struggles and promote better living conditions in the host country.

The results also revealed that cultural disparities usually worsen parental stress feelings. Dealing with a new culture leads to acculturative processes, which can cause different stressors for parents (^{Berry, 1986}). Parents may attempt to maintain their cultural identity through their children, teaching them their values and living practices (^{Roubeni et al., 2015}). In this context, children can identify closely with their parental cultural orientations (^{Vietze et al., 2020}). However, acculturation gaps may still be rising between parents and children (Berry, 1986; ^{Telzer, 2010}). In cases where children absorb more values from the host culture rather than the native one, parents might be concerned about their children losing their cultural heritage, which can potentially increase parent-child conflict (^{Deng & Marlowe, 2013}).

Moreover, children can behave as cultural and language translators for their parents and caregivers, which can make parents feel that their authority is threatened due to a certain parent-child role reversal (^{Timshel et al., 2017}). This could lead to further conflicts and harsh parenting practices, as parents attempt to regain control (^{Rasmi et al., 2017}). As seen in two studies [18, 20] included in this meta-synthesis, this may be one of the core reasons why parents find it hard to rear a child in a different culture. This challenge may be reduced through a close follow-up of families’ experiences by mental health services, to make them diminish these relationship’s asymmetries.

Social support was another factor that was recurrently associated with parental stress. There is a consensus that social support is a protective factor for families in situations of forced displacement (^{Kim, 2018}; ^{Liu et al., 2020}). The studies reviewed revealed the potential role of social support in mitigating stress impacts on migrant parents, especially during the early years of resettlement. Creating or expanding social networks is crucial to reduce migrant families’ psychological suffering and burden, while improving parent-children relationships and the general well-being of the family during the critical period of readaptation (^{Kim, 2018}; ^{Stewart et al., 2008}). Additionally, these networks may also help to insert migrant populations into social structures and programs, including schools and government services (^{Liu et al., 2020}).

Investigating the coping mechanisms and strategies adopted by migrants to mitigate feelings of stress is an important issue, which was targeted in four studies included in this meta-synthesis [5, 6, 13, 16]. A fifth one [12] addressed the different phases of the migratory process and also stated the use of these mechanisms in migrants to face problems related to international migratory processes. Most of the strategies reported were of a religious and spiritual nature. Regardless of nationality, ethnicity, or religion, the results converge to the importance of spirituality and religiosity as a way of diminishing the difficulties faced in the host country, whether through belief and contact with a transcendental being, sacred readings, and prayers, or even the support received by religious communities.

The literature recognizes the use of religious beliefs and behaviors to face difficult life situations (^{Vitorino et al., 2018}). People in vulnerable situations can turn to faith to cope with physical, psychological, and socioeconomic hardships, or even to seek explanations and make sense of their problems (^{Gil et al., 2020}). There is strong evidence indicating that religious involvement and spiritual practices are related to better health rates (Page et al., 2020), including populations undergoing international migration processes (^{Maier et al., 2022}; ^{Pandya, 2018}). Therefore, when proposing public hosting policies, it is essential to consider migrants’ health strategies because it can recognize and strengthen the religious and spiritual dimensions of their worldviews and practices.

Lastly, two studies focused [17, 19] on the specificities of the children with ASD diagnosis and parenting in the international migration context. Both indicated that ASD is another potential stressor in parenting and family lives. Regional evidence indicates that lower economic and social resources migrants can jeopardize the access to diagnosis and treatment of ASD (^{Magaña et al. 2013}; ^{Zamora et al. 2016}). Ethnic and cultural backgrounds must be considered for effective social support interventions in migrant families (^{Stewart et al., 2015}). Getting to know the culture, motivations for migration, and real demands of international migration people are aspects to consider before planning public policies for these populations. With so many aspects involved in the migration process, taking into account the intersectionality of factors impacting this process is mandatory to have a smoother transition for the families.

Conclusion

Based on the results of the present meta-synthesis, it is possible to conclude that it is essential for host countries to develop public policies to address parental stress, mainly due to the high levels of tension present in those families. Parental stress in this context is more complex than for natives as it involves the responsibility of parental care during a challenging and highly stressful time in their lives. Therefore, when creating support programs, the first step should be understanding the issues involved in the experience of migrant families.

Regarding the limitations of the present study, one of them is the challenge to define parental stress qualitatively, which may have been reflected in the number of articles found in the database searches. Even so, it is believed that it is essential to systematically gather qualitative data about the stress experienced by parents during an international migration process, especially to comprehend better how they experience it and also understand the complex network of its psychosocial effects.

Another limitation is that this paper focused on synthesizing the findings on parental stress from the perspective of caregivers only. It would be highly recommended for future studies to analyze the literature on parental stress or maybe harsh parenting from the perspective of children and adolescents under international migratory processes, including those who stayed at the country of origin and their caregivers. Accordingly, it is also highly recommended that other psychosocial concepts, such as depression, anxiety, post-traumatic stress disorders, and their relationship with international migration processes should also be reviewed, from both parental and children’s perspectives.

For future empirical studies, it is suggested that South-South migrations should also be addressed, as only one investigation with such scope was found that could be included in this review. For instance, Haiti and Venezuela are currently experiencing migratory flows, where families are moving to Latin American countries. Apart from some language and cultural similarities, parents are also probably facing challenges regarding their parenting responsibilities.

The number of forced displaced people has risen in the past decades. These rates may keep increasing exponentially, either as a result of natural disasters and predictable climate change, or even as a result of humanitarian crises and war conflicts (WEF, 2022). Another example is the actual invasion of Ukraine by Russia of 2022, which has caused the most fast-moving population migration in Europe in the last 30 years (^{Sacchi, 2022}). Data shows that around 6.5 million people have already left the country. Most Ukrainian migrants who fled were women and children since men were forced to integrate the country’s defense forces. Another example is the Palestine genocide, which may involve other countries like Syria, Lebanon, and Israel (^{Jamshidi, 2024}), which is demanding parents and children to flee from their territory under terrorism threats (Baldin & Ramos, 2023). In any of the cited cases, parents and caregivers under these circumstances may experience an intensification of parental stress and other psychosocial aspects related to parenting responsibilities.

Other kinds of forced displacement are increasing. For instance, global income inequality, impoverishment of vulnerable populations, and religious or nationalist-ethnic conflicts will drive millions of people to move to other territories in the next few years (WEF, 2022). This should make host countries prepare in advance to receive these forcibly displaced people. The importance for mental health professionals, academics, and researchers to pay attention to these problems and populations is highlighted.

Carrying out research and reviewing available literature about parenting psychosocial aspects in this context are essential for helping families in the migration process. This meta-synthesis aimed to call attention to and address the need to map the current qualitative evidence about parental stress, one of several issues associated with the psychological aspects of the migration process. This may provide a basis for the development of future public policy strategies to cope with and mitigate parental stress, with the potential to impact children’s development.