Factors Associated with Caregiving and Mental Stress among Family Caregivers for People with Disabilities: A Cross-sectional Survey of 40,600 Chinese Households

Family caregivers in East Asian societies such as Hong Kong bear a significant share of care responsibilities for individuals with disabilities due to rising disability prevalence, limited formal services, and cultural norms rooted in filial piety. This study examines factors associated with caregiving provision, weekly caregiving hours, and mental stress among family caregivers in Hong Kong households. We used data from the 2019-2020 Hong Kong General Household Survey (n = 40,600) and applied logistic regression (caregiving provision) and ordinal logistic regression (caregiving hours, mental stress). Analyses were adjusted for care recipient needs, caregiver characteristics, and contextual factors. Disability types were classified using the International Classification of Functioning, Disability and Health (ICF) framework. Among weighted respondents from households including individuals with disabilities in Hong Kong, 14.5% were identified as family caregivers. Caregiving was significantly associated with being female (adjusted odds ratio [aOR] = 1.64, 95% CI = 1.49-1.82) and unmarried (aOR = 1.17, 95% CI = 1.02-1.34). Female (aOR = 1.33, 95% CI = 1.12-1.59) and assisting with activities of daily living (ADLs) were associated with longer weekly caregiving hours (aOR = 2.54, 95% CI = 2.12-3.04). Severe self-reported mental stress was associated with female (aOR = 1.39, 95% CI = 1.15-1.69), assisting with ADLs (aOR = 1.99, 95% CI = 1.62-2.44), and caring for family members with mental health disability (aOR = 2.00, 95% CI = 1.64-2.43). While other ICF-based disability types were not significant in multivariate models, some showed associations in univariate analysis. These findings highlight the need for targeted caregiver support policies that address gendered expectations and disability-specific burdens.