Mediating and moderating roles of individual resilience, caring ability and social support: a cross-sectional study on the association between family resilience and caregiving burden among primary family caregivers of cancer patients in China

个体韧性、照护能力和社会支持的中介和调节作用:一项关于中国癌症患者主要家庭照护者家庭韧性与照护负担之间关系的横断面研究

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Abstract

OBJECTIVES: This study aimed to evaluate the caregiving burden among primary caregivers of cancer patients, clarify the relationship between family resilience and caregiving burden, and explore the mediation and moderation effects. DESIGN: A cross-sectional study design was used. SETTING: The study was conducted at a specialised tumour hospital in Harbin, China. PARTICIPANTS: The study included a sample of 402 primary family caregivers of patients with cancer. Ultimately, 367 participants completed valid questionnaires, yielding a response rate of 91.2%. OUTCOME MEASURES: Participants completed scales evaluating caregiving burden, caring abilities, individual resilience, family resilience and social support. We performed structural equation modelling to analyse mediation and moderation effects. RESULTS: Out of 367 responses, approximately 50% of primary family caregivers reported moderate to severe caregiving burden. Family resilience was found to reduce caregiving burden (β=-0.386, p=0.005), while individual resilience fully mediated the relationship between family resilience and caregiving burden (95% CI -0.659 to -0.161). Caring ability moderated both the first and second halves of the mediating path. Furthermore, social support doubly moderated the moderating role of caring ability in both the first and second halves of the mediating path. CONCLUSIONS: This study demonstrated the mediating role of individual resilience and the moderating roles of caring ability and social support in the relationship between family resilience and caregiving burden. We suggest that medical institutions should enhance caregiving training and psychological counselling services. Additionally, the government should collaborate with medical institutions and social organisations to improve social welfare policies and the medical insurance system.

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