Caregiver burden and psychological distress among family caregivers of people with dementia: the mediating roles of family resilience and sense of coherence

Background Family caregivers of people with dementia often experience substantial psychological distress due to the burden associated with long-term caregiving. Although previous studies have identified an association between caregiver burden and psychological distress, the roles of adaptive resources in this association remain insufficiently understood. This study aimed to examine the association between caregiver burden and psychological distress and to explore the independent and sequential mediating roles of family resilience and sense of coherence (SOC) among family caregivers of people with dementia. Methods In this cross-sectional study, we recruited 305 family caregivers of people with dementia from two tertiary hospitals in Henan Province, China. Data were collected using the Chinese versions of the Zarit Burden Interview, Family Resilience Assessment Scale, Sense of Coherence Scale, and 10-item Kessler Psychological Distress Scale. Pearson’s correlation analysis was conducted to examine the associations among caregiver burden, family resilience, SOC, and psychological distress. The direct and indirect effects were examined using sequential mediation analysis with Model 6 of the SPSS PROCESS macro version 4.2. Results Significant correlations were found between the measured variables (each p < 0.001). Family resilience and SOC each demonstrated significant indirect associations in the relationship between caregiver burden and psychological distress. In addition, a significant sequential indirect association through family resilience and SOC was identified, accounting for 5.4% of the total effect. Conclusion Family resilience and SOC were important mediating resources in the association between caregiver burden and psychological distress among family caregivers of people with dementia. The findings highlight the interconnected roles of family-level and individual-level psychological resources in caregivers’ psychological adaptation to dementia caregiving stress. Interventions targeting family resilience and SOC may represent potential approaches for supporting caregivers’ psychological well-being, warranting further investigation through longitudinal and intervention studies.