Family caregiver burden in first-ever ischaemic stroke patients in relation to self-efficacy, family functioning and family intimacy: a cross-sectional survey

The overburdening of family carers of stroke patients is a globalised problem, and how to reduce the burden on family carers by improving their self-efficacy through family support systems deserves the attention of healthcare providers. To investigate the current status of family caregiver burden, self-efficacy, family functioning and family intimacy in first-ever ischaemic stroke patients in terms of the factors affecting family caregiver burden, and also to analyse the relationship between family caregiver burden, self-efficacy, family functioning and family intimacy, and to explore the statistically significant indirect effect of the relationship between family functioning and family intimacy in the relationship between family caregiver burden and self-efficacy. This cross-sectional study is reported in accordance with the STROBE guidelines. This questionnaire survey was conducted within four tertiary hospitals in Xianyang, Shannxi Province, China. Based on informed consent, a convenience sampling method was used to distribute questionnaires to 946 family caregivers of first-ever ischemic stroke from May 2024 to October 2024, and 915 valid questionnaires were collected. Using IBM SPSS27.0, the data were analysed to perform descriptive statistics, analysis of variance (ANOVA), multiple enter method regression analysis, Spearman’s correlation analysis and PROCESS plug-in for indirect effect analysis. (1) The median family caregiver burden score was 40 (32, 53), while the mean score of their self-efficacy was 25.188 ± 5.609, the mean score of family intimacy was 51.578 ± 8.796, and the median score of family functioning was 7 (5, 10). (2) Family caregiver burden was significantly negatively correlated with their self-efficacy, family intimacy, and family functioning, with r coefficients of -0.510, -0.465, and − 0.519, respectively. (3) Percentile bias-corrected Bootstrap method test showed significant indirect effect of family intimacy, ab =-0.251, BootstrapSE = 0.034, 95% CI = (-0.321, -0.186). The contribution of the indirect effect to the total effect was ab/c = 20.85%. The percentile bias-corrected Bootstrap method test showed a significant indirect effect of family functioning, a’b’ = -0.276, BootstrapSE = 0.034, 95% CI = (-0.347, -0.214). The contribution of the indirect effect to the total effect was a’b’/c = 22.92%. Comparison of the indirect effects of family intimacy and functioning reveals C1 = 0.025, BootstrapSE = 0.049, 95% CI = (-0.072, 0.124). Family caregiver burden and self-efficacy of patients with first-ever ischaemic stroke were at a moderate level, and family intimacy was low but family functioning was good. Family caregiver burden was significantly negatively associated with their self-efficacy, family intimacy and family functioning. The main influences affecting family carers were self-efficacy, family intimacy and family functioning, patient’s age, level of self-care, and length of illness, caregiving daily caregiving hours and health status. Both family intimacy and family functioning may play a statistically significant indirect effect in the relationship between family caregiver burden and self-efficacy.