Stressor, Coping, Resources and Potentially Harmful Behaviors by Family Caregivers of Cognitively Impaired Older Adults in China: The Mediation Role of Caregiver Burden

As an early warning indicator of elder abuse, caregiver potentially harmful behaviors (PHB) are well studied in developed countries. However, very little is known about PHB in developing countries among caregivers of older adults with cognitive impairment. Applying the Double ABCX model, this study aimed to explain how caregiver PHB are affected by stressor (care recipients’ memory and behavioral disturbance), coping (positive coping and negative coping), and resources (social support and family income), with a focus on the mediating role of perceptions of stress (caregiver burden). The survey sample included 300 family caregivers of cognitively impaired older adults from three urban communities in Wuhan, China. We used hierarchical multiple regressions to examine the relationship between PHB and associated factors. Baron and Kenny’s approach and bootstrap analysis were applied to examine the mediating effects of caregiver burden. PHB was positively associated with care recipient’s memory and behavioral disturbance and negative coping, and negatively related to family income. Additionally, care recipient’s memory and behavioral disturbance, negative coping, and social support had an indirect effect on PHB through caregiver burden. But the direct and indirect effect of positive coping strategies on PHB are mixed and complicated. This study affirms the applicability of a comprehensive framework (i.e., Double ABCX model) to explain PHB. The dynamic roles of different factors in relation to PHB provided multiple points that intervention measures can target to assist implications for Chinese family caregivers to prevent abusive behaviors.