Self‐Efficacy, Caregiver Reactions and Burnout Among Informal Caregivers in Palliative Care: A Cross‐Sectional Mediation Study

PURPOSE: This study was conducted to identify the factors influencing caregiving self-efficacy, caregiver response and burnout among individuals providing care to palliative care patients; to examine the relationship among these three variables and to assess the mediating role of caregivers' self-esteem in this relationship. METHOD: This cross-sectional study included 77 informal caregivers caring for inpatients in the palliative care clinic of a training and research hospital. Data were collected using the Personal Information Form, the Revised Caregiver Self-Efficacy Scale (RCSE), the Caregiver Reaction Assessment Scale (CRA) and the Burnout Scale (BM). Variables were analysed using descriptive statistics as well as the Hayes PROCESS macro via the bootstrapping method. RESULTS: Overall, 81.8% of caregivers were < 65 years old, 79.2% were married and 77.9% were women. Caregivers providing care for their parents represented 36.4%. Of those receiving care, 87% were bedridden and only 23.7% received professional home care services. Significant positive correlations were found between caregiving self-efficacy and caregivers' self-esteem, while significant negative correlations were found between caregiving self-efficacy and burnout levels. Caregivers' self-esteem played a statistically significant role in partially mediating the relationship between caregiving self-efficacy and burnout. Additionally, participants who received external care support and had no history of falls among the patients they cared for in the past 6 months had higher self-efficacy and lower burnout. CONCLUSION: This study demonstrated that informal caregivers' self-efficacy and self-esteem were important psychosocial resources that buffer the development of burnout among caregivers. In this context, it was recommended that family-centred nursing interventions and psychosocial support protocols focus on simultaneously strengthening caregivers' self-efficacy and self-esteem. RELEVANCE TO CLINICAL PRACTICE: This study demonstrates that burnout among informal caregivers is associated with self-efficacy and self-esteem. Caregivers' self-esteem may act as a potential protective buffer in this relationship. Thus, regularly assessing the levels of self-efficacy, burnout and self-esteem among informal caregivers can facilitate the early identification of those at risk of burnout. By strengthening self-efficacy and self-esteem through education, counselling and psychosocial support, caregivers can prevent burnout, thereby supporting the sustainability of care. IMPACT STATEMENT: Caregiver burnout needs to be assessed from multiple angles. Caregivers' self-esteem emerges as a potential vital factor in preventing burnout among informal caregivers. These insights offer clear clinical goals for the early identification and targeted support of at-risk informal caregivers. NO PATIENT OR PUBLIC CONTRIBUTION: Informal caregivers contributed to the study solely as participants by completing the research measure tools. They were not involved as research partners in the design, conduct, analysis or interpretation of the data, or in the preparing of the manuscript.