Abstract
BACKGROUND: Caregiving for people with dementia imposes significant psychological and physical burdens on family caregivers, which may affect overall family functioning. This study aimed to examine whether mutuality statistically mediates the relationship between caregiver burden and family resilience among Chinese dementia caregivers. METHODS: This cross-sectional research was conducted from October 2022 to December 2023 across two tertiary hospitals in Henan Province, China. A total of 296 family caregivers of people with dementia participated in the study. Caregivers completed the Chinese versions of the Zarit Burden Interview, the Mutuality Scale, and the Family Resilience Assessment Scale. Pearson correlations were used to examine associations between caregiver burden, mutuality, and family resilience. Structural equation modeling was performed in AMOS 24.0 to assess the mediating role of mutuality. RESULTS: Caregiver burden was negatively associated with mutuality (p <.01) and family resilience (p <.01). Mutuality (total score) and its four dimensions demonstrated positive correlations with family resilience (p <.01). Furthermore, mutuality significantly mediated the relationship between caregiver burden and family resilience (p <.01), with a mediating effect of 39.0%. CONCLUSIONS: This study suggests that mutuality may be an important relational process associated with both caregiver burden and family resilience in dementia caregiving. Public health interventions may benefit from strengthening the caregiver-care recipient relationship to reduce psychological burden and enhance family resilience. Community-based programs and caregiver support initiatives that foster mutual understanding and positive interactions may be particularly effective in promoting the health and well-being of both caregivers and patients.