The mediating roles of caregiver social support and self-efficacy on caregiver burden in Parkinson's disease

Background: Most studies in Parkinson's disease (PD) have focused on the direct effects of social support and self-efficacy on caregiver burden. This study aimed to test our prediction that caregiver self-efficacy and social support were two chaining mediator variables on the paths for patient factors affecting caregiver burden, caregiver anxiety, and depression. Method: We enrolled patients with PD and their caregivers from the First Affiliated Hospital of Shanxi Medical University in China between July and December 2017. Patients completed scales evaluating their cognition, motor function, and depression. Caregivers completed scales evaluating social support, self-efficacy, anxiety, depression, and caregiver burden. We applied Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze the mediating effects. Results: Caregiver self-efficacy was a partial mediator on the path of patient motor function effects on caregiver burden (Variance Accounted For, VAF = 0.741), caregiver anxiety (VAF = 0.498) and caregiver depression (VAF = 0.471). Social support for caregivers was a partial mediator on the path for patient motor function effects on caregiver self-efficacy (VAF = 0.247). Caregiver social support and self-efficacy were two chaining mediator variables on the pathway for patient motor function effects on caregiver burden (VAF = 0.768) and caregiver depression (VAF = 0.510). Limitations: Our sample only met the minimum sample size requirement for the PLS-SEM and we only focused on a part of variables we collected. Conclusions: Our prediction has been validated in this study. And this work supports the decision-making of health authorities and policymakers in managing caregiver social support and caregiver self-efficacy with the aim of reducing caregiver burden in PD.