The moderating role of care duration in the relationship between caregiving competence and burden among family caregivers in hospice care.
Caregiving competence is considered an important protective factor in reducing the burden of family caregivers in hospice care. However, whether this relationship is influenced by caregiving duration remains unclear. Previous studies have typically treated caregiving duration as a single quantitative indicator, overlooking potential differences arising from distinct temporal structures.
To examine the moderating role of caregiving duration in the relationship between caregiving competence and caregiver burden, with particular attention to two temporal structures: daily caregiving hours and continuous caregiving duration.
Family caregivers of patients receiving hospice care at a secondary hospital in Wenzhou between January 1 and July 31, 2025, were recruited using a convenience sampling method. A total of 345 caregivers participated in the study and completed a general information questionnaire, the Family Caregiver Task Inventory (FCTI), and the Zarit Burden Interview (ZBI-22). Spearman correlation analysis was performed to examine associations among the variables, and the SPSS PROCESS macro was used to test moderating effects.
Caregiving competence was significantly negatively correlated with caregiver burden (r = -0.876, P < 0.01). Daily caregiving hours (r = 0.604, P < 0.01) and continuous caregiving duration (r = 0.388, P < 0.01) were both positively associated with caregiver burden. Moderation analysis showed that daily caregiving hours had no significant moderating effect (B = 0.007, P = 0.563), whereas continuous caregiving duration significantly moderated the relationship (B = 0.0270, P = 0.004). Simple slope analysis indicated that the protective effect of caregiving competence on burden was stronger among caregivers with shorter caregiving duration (B = -1.609, P < 0.001) and weakened as caregiving duration increased (B = -1.374, P < 0.001).
The negative association between caregiving competence and burden may be influenced by caregiving time structure. Daily duration did not modify this association, but total cumulative time showed a trend toward a negative association with burden. Thus, cumulative caregiving length, not daily intensity, may be key. Public health practice should focus on long-term family caregivers and explore phased support based on caregiving trajectories to reduce caregiving-related mental health risks and improve hospice care system sustainability.
To examine the moderating role of caregiving duration in the relationship between caregiving competence and caregiver burden, with particular attention to two temporal structures: daily caregiving hours and continuous caregiving duration.
Family caregivers of patients receiving hospice care at a secondary hospital in Wenzhou between January 1 and July 31, 2025, were recruited using a convenience sampling method. A total of 345 caregivers participated in the study and completed a general information questionnaire, the Family Caregiver Task Inventory (FCTI), and the Zarit Burden Interview (ZBI-22). Spearman correlation analysis was performed to examine associations among the variables, and the SPSS PROCESS macro was used to test moderating effects.
Caregiving competence was significantly negatively correlated with caregiver burden (r = -0.876, P < 0.01). Daily caregiving hours (r = 0.604, P < 0.01) and continuous caregiving duration (r = 0.388, P < 0.01) were both positively associated with caregiver burden. Moderation analysis showed that daily caregiving hours had no significant moderating effect (B = 0.007, P = 0.563), whereas continuous caregiving duration significantly moderated the relationship (B = 0.0270, P = 0.004). Simple slope analysis indicated that the protective effect of caregiving competence on burden was stronger among caregivers with shorter caregiving duration (B = -1.609, P < 0.001) and weakened as caregiving duration increased (B = -1.374, P < 0.001).
The negative association between caregiving competence and burden may be influenced by caregiving time structure. Daily duration did not modify this association, but total cumulative time showed a trend toward a negative association with burden. Thus, cumulative caregiving length, not daily intensity, may be key. Public health practice should focus on long-term family caregivers and explore phased support based on caregiving trajectories to reduce caregiving-related mental health risks and improve hospice care system sustainability.
Authors
Yang Yang, Yu Yu, Xu Xu, Zhou Zhou, Wu Wu, Wen Wen, Lin Lin, Shen Shen, Wang Wang
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