Family support in enhancing well-being of caregivers for older adults with chronic conditions in rural China

The prevalence of chronic diseases among older adults has increased with the ageing population. Multiple chronic conditions (MCC), defined as the coexistence of two or more chronic diseases in an individual, are significant predictors of mortality and are common among older adults. Older patients with MCC have an increasing need for care, which is primarily provided by informal caregivers.

Research has found that compared with caregivers in developed regions or countries, rural caregivers in China have a higher caregiver burden and therefore warrant special attention. Subjective well-being refers to an individual's self-determined appraisal of overall quality of life and emotional states across several dimensions. Considering that impairment of subjective well-being is associated with various adverse health outcomes, it should be protected.

It has been reported that higher caregiver burden was associated with lower subjective well-being, but the mechanism underlying this association remains unclear. In a new study published in Healthcare and Rehabilitation, an international team of researchers offered new insights into how caregiver burden affected the subjective well-being of caregivers of older adults with multiple chronic conditions (MCC), particularly in rural China, where external resources are more limited. They found that self-efficacy and family support were full parallel mediators of the relationship between caregiver burden and subjective well-being.

"We were particularly struck by the extent to which family support outweighed self-efficacy in its mediating role," says first author Ziyue Yang. "This suggested that for caregivers in rural settings, external support from family may be even more crucial than internal belief in one’s own capabilities." 

Indeed, family support accounted for nearly three times the indirect effect explained by self-efficacy, highlighting the importance of family in Chinese rural care landscape.

"Our findings provided actionable evidence that improving the subjective well-being of caregivers requires a comprehensive approach, including building caregiving skills, providing financial or respite support, promoting stress-relief strategies, and fostering mutual support among family members," adds Yang.

This study has practical importance for healthcare providers and policymakers seeking to better support caregivers in contexts of growing chronic disease burden and population aging.

Contact author details: 

Yufang Guo, School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan 250012, Shandong, China guoyf@sdu.edu.cn

Funder: 

This study was funded by Shandong University, as part of the undergraduate innovation and entrepreneurship training program.

Conflict of interest:

The authors declare no conflicts of interest.

See the article: 

Ziyue Yang, et al., Effect of caregiver burden on subjective well-being among caregivers of older patients with multiple chronic conditions in Chinese rural areas, Healthcare and Rehabilitation, Volume 1, Issue 4, 2025, https://doi.org/10.1016/j.hcr.2025.100049.