Social support and depressive symptoms among family caregivers of older people with disabilities in four provinces of urban China: the mediating role of caregiver burden

Yaqin Zhong,Stephen Nicholas,Jian Wang

doi:10.1186/s12877-019-1403-9

Abstract

BackgroundTo examine the relationship between social support and depressive symptoms of Chinese family caregivers of older people with disabilities, and to evaluate the role of caregiver burden as a potential mediator of that relationship.MethodsA survey questionnaire was completed face-to-face by 567 primary family caregivers of older people with disabilities in four provinces in China. Covariates that may affect depressive symptoms, such as the characteristics of disabled people (socio-economic factors, functional and cognitive capacity) and caregivers (caregiver duration and self-rated health of caregivers) were collected. Social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS); depressive symptoms were assessed by the shortened 10 item version of Center for Epidemiological Studies Depression scale (CES-D); and the caregiver burden was assessed by the Zarit Burden Interview (ZBI).ResultsThe prevalence of depressive symptoms among caregivers was 37.7%. Higher levels of social support was negatively associated with lower depressive symptoms. This relationship was partially mediated by the caregiver burden, where higher levels of the caregiver burden were negatively associated with depressive symptoms. Furthermore, caregivers who were women, spent extended time in caregiving and were in poor health, reported significantly higher depressive symptoms.ConclusionsOur results indicated that social support was negatively associated with depressive symptoms in family caregivers and in the caregiver burden. The caregiver burden partially mediated the social support-depressive symptoms association. Interventions for family caregivers should include increasing social support, health monitoring and structured interventions to reduce the caregiver burden and attenuate family caregivers’ depressive symptoms.

Highlights

To examine the relationship between social support and depressive symptoms of Chinese family caregivers of older people with disabilities, and to evaluate the role of caregiver burden as a potential mediator of that relationship
In model 4, all possible covariates were controlled and the results indicated that social support was negatively associated with depressive symptoms, while the caregiver burden was positively associated with depressive symptoms
When we took the type of family caregiver-older disabled persons relationship into consideration, we found an association with social support and caregiver burden for spouses and adult child caregivers

Summary

Introduction

To examine the relationship between social support and depressive symptoms of Chinese family caregivers of older people with disabilities, and to evaluate the role of caregiver burden as a potential mediator of that relationship. Care of family members with disabilities at home is very common and is a reflection of Chinese culture, especially represented by familism and filial piety [2, 3]. There are positive aspects to caregiving at home, including bringing family members closer together and confirming the cultural expectations of respecting and caring for family members in Chinese society [4]. Like other groups prone to depression, such as individuals with other mental disorders, alcohol and substance users, those suffering chronic illnesses or abuse or traumatic events, and those with a genetic predisposition to depression, family caregivers to older family members with disabilities form a unique sub-group “at risk” of depression [6]

Methods

Results

Discussion

Conclusion