Caregiving burden and self-efficacy mediate the association between individual characteristics and depressive symptoms among husbands of Chinese breast cancer patients.

Abstract

Perceptions of caregiving burden and self-efficacy are found to be associated with well-being among husbands of breast cancer patients (BCP). However, little is known about how individual characteristics associate with such caregiving-related perceptions and cancer caregivers' well-being. This study examined the associations between two individual characteristics (male gender role norms and ambivalence over emotional expression (AEE)) and depressive symptoms among husbands of Chinese BCP, and the potential mediating roles of caregiving burden and self-efficacy in such associations. Participants (n = 176) were recruited in two hospitals in Weifang, China. Their endorsement of male gender role norms (e.g., "men should not ask for help"), AEE, caregiving burden, and depressive symptoms were measured in a cross-sectional survey. Path analysis results supported the proposed mediation model with satisfactory fit indices (χ2(2) = 2.73, p = .26, CFI = 1.00; IFI = 1.00; RMSEA = 0.05). Specifically, male gender role norms and AEE were associated with higher caregiving burden and lower caregiving self-efficacy, which in turn were associated with more depressive symptoms. Bootstrapping results supported that both male gender role norms (β = 0.16; 95%CI = 0.09, 0.25) and AEE had significant indirect effects on depressive symptoms (β = 0.11; 95%CI = 0.04, 0.18) via caregiving burden and self-efficacy, indicating that caregiving-related perceptions could mediate between individual characteristics and depressive symptoms. Male gender role norms and AEE might affect depressive symptoms among husbands of Chinese BCP through caregiving-related perceptions. Future interventions that reduce those husbands' barriers to express emotions, appreciate their commitment to take good care of their spouses, enhance caregiving skills, and reduce caregiving burden may decrease their depressive symptoms.