The impact of maternal adverse childhood experiences on children's quality of life: the moderating role of self-esteem and the mediating role of maternal quality of life

Introduction This study examined the impact of maternal adverse childhood experiences (ACEs) on their children's overall quality of life (QoL), focusing on the mediating role of maternal QoL and the moderating role of maternal self-esteem. Understanding these intergenerational pathways can provide valuable insights for designing interventions that promote family well-being. Methods A secondary data analysis was conducted using data from the 2018 National Child Life Experience Survey in South Korea. Participants included 930 mothers who had experienced at least one type of childhood adversity. A descriptive and correlational research design was employed, and statistical analyses were performed using the PROCESS macro to test mediation and moderation effects. Results Higher levels of maternal ACEs were significantly associated with lower QoL in both mothers and their children. Maternal QoL partially mediated this relationship, indicating that adverse childhood experiences affect children's well-being indirectly through maternal health. Moreover, maternal self-esteem moderated the negative effects of maternal ACEs on children's QoL, serving as a psychological protective factor. Discussion These findings highlight the critical importance of maternal psychological health in mitigating the intergenerational transmission of adversity. Strengthening maternal self-esteem and emotional well-being could buffer the negative impact of early adversity on families. Public health and nursing strategies that integrate mental health promotion and family-based interventions are essential to improve long-term outcomes for children in families affected by maternal ACEs.