Mediating effect of spiritual coping strategies on caregiving burden and mental health in caregivers of Iranian patients with dementia

Abstract

Introduction: Dementia is a common cognitive disorder among elderly people requiring special care. Family carers of people with dementia (PWD) may experience mental health issues. This study examined whether spiritual coping is a mediator between the physical function of the patients and mental health status or caregiving burden in their carers. Methods: The caregivers of the PWD (n = 513) were assessed by the Instrumental Activities of Daily Living (IADL) and Spiritual Coping Strategies (SCS) questionnaires at baseline and Zarit Burden Interview, Short Form-12 (SF-12), and Hospital Anxiety and Depression Scale questionnaires at 6 months. The proposed model to assess the mediating effect of SCS was: SCS subscales as mediators, PWD's IADL as an independent variable, and mental health components as dependent variables. Using PROCESS SPSS Macro, the indirect effects of patients' IADL score on mental health-related variables in the caregivers were examined. Results: There were significantly negative associations between IADL score and mental health components (r > 0.3). SCS scores were negatively correlated with depression, anxiety, and caregiving burden (P < 0.001). Four models proposed to explain the indirect effects of spiritual coping on mental health variables revealed the spirituality as a significant mediator (0.28 ≤ R 2 ≤ 0.65; P < 0.001). The mediation effect of religious and nonreligious coping on mental health component in SF-12 was the highest (b = 0.57, 95% confidence interval [CI] [0.26, 0.98], b = 1.20, 95% CI [0.63, 1.84], respectively). Conclusion: Spiritual coping may be a mediator between the physical functioning of the patients and carers' mental health status and caregiving burden in Iran. Thus, further investigation is needed to show how these mediators may affect the mental health status of the caregivers.

Caregivers' Burden and Mental Health of the Caregivers of β-Major Thalassemia Patients: Mediating Role of Religious Coping

“…However, in the face of these challenges, positive religious coping emerges as a critical resource, as evidenced by the significant mediating effects it exhibits on the relationship between caregiver burden and mental health outcomes. This finding is consistent with the literature on caregiving in other contexts, such as dementia, where spiritual coping strategies significantly buffered the mental health impacts of caregiving (30,31). The preference for positive religious coping over negative coping mechanisms among caregivers of thalassemia patients further underscores the adaptive role of faith-based strategies in managing caregiver stress (8).…”

“…This dual role of caregiver burden highlights the complex dynamics caregivers navigate, balancing stress and coping mechanisms to maintain their mental health. Notably, the study also identified that positive religious coping significantly enhances psychological well-being and mitigates psychological distress (22,30), aligning with the hypothesis that positive religious coping acts as a mediating factor between caregiver burden and mental health outcomes. Previous studies, such as those by Anum & Dasti (22) and Chen et al (24), have similarly reported a negative correlation between caregiver burden and both mental and physical health, thereby reinforcing the general consensus that higher caregiver burdens are detrimental to health.…”

“…Caregivers accompanying patients for blood transfusions at these locations were approached. Instruments used for data gathering included the Zarit Caregiver's Burden Scale, the Brief Religious Coping Scale, and the Mental Health Inventory, all of which had authorized Urdu versions (24)(25)(26)(27)(28)(29)(30). Each participant was informed about the nature and purpose of the research, their right to withdraw at any point, and the confidentiality of their responses, which were solely for research use.…”