Network structure of family management dimensions and psychosocial resources in families of children with transfusion-dependent beta-thalassemia

Abstract Background Families of children with transfusion-dependent β-thalassemia face ongoing challenges in disease management and family functioning. Family management and psychosocial resources may interact as a complex system, but their interrelationships remain insufficiently understood. This study aimed to examine the network structure of family management and psychosocial resources in families of children with transfusion-dependent β-thalassemia and to identify central and bridge nodes. Methods A cross-sectional study was conducted among primary caregivers of children with transfusion-dependent β-thalassemia. Of 214 caregivers initially recruited, 195 with complete data on 12 predefined network nodes were included in the final analysis. The network comprised six dimensions of the Chinese version of the Family Management Measure, together with disease knowledge, parenting self-efficacy, family intimacy, and three dimensions of perceived social support. A Gaussian graphical model was estimated using Graphical LASSO. Strength, Expected Influence, and Bridge Strength were calculated. Edge robustness and centrality stability were examined using bootstrap procedures. Results The network showed both within-community clustering and between-community connections. The strongest positive edges were observed between SS: Friends and SS: Others (partial correlation = 0.470), Family Intimacy and SS: Family (0.410), FM: Family Life Difficulty and FM: Management Burden (0.407), and FM: Condition-Related Worry and FM: Family Life Difficulty (0.371). The strongest negative edge was found between FM: Child Daily Life and FM: Family Life Difficulty (-0.331). FM: Family Life Difficulty had the highest Strength centrality (1.491), whereas FM: Parental Mutuality had the highest Bridge Strength (0.922). The correlation stability coefficient was 0.50 for both Strength and Bridge Strength, indicating good stability. Conclusions FM: Family Life Difficulty was the most central node in the network, and FM: Parental Mutuality was the key bridge node linking family management and psychosocial resources. These findings suggest that reducing family life difficulty and strengthening parental mutuality may be important targets for family-based interventions in transfusion-dependent β-thalassemia.