The Caregiver Burden Of Parkinson's Disease:a Multiple Mediator Model Analysis Based On The Partial Least Squares Structural Equation Modeling

Objective:In order to explore if the caregiver's social support and self-efficacy mediated the relationship between patient factors and caregiver factors simultaneously,multiple mediating effects were introduced into the study so as to analysis the factors affecting the burden of caregivers on patients with Parkinson's disease(PD)comprehensively.Finally,based on the results above,we intend to provide a basis for the development of targeted interventions to reduce the burden on caregivers of PD patients.Methods:Using the cross-sectional study method,112 pairs of patients diagnosed with PD and their caregivers from the First Affiliated Hospital of Shanxi Medical University were investigated.Besides collecting their basic information,we also interviewed the patients with scales include Unified Parkinson's Disease Rating Scale,modified Hoehn and Yahr Stage,Mini-Mental State Examinaton,Geriatric Depression Scale and The Mos 36-item Short Form Health Survey.Then we interviewed their caregivers for Zarit Burden Inventory,Hospital Anxiety Depression Scale,The Self-efficacy Scale as well as Social Support Rating Scale.We applied Partial Least Squares Structural Equation Modeling(PLS-SEM)to analysis the multiple mediating effects of the social support and self-efficacy.Results:PLS-SEM results showed that the education level is the influence factor for caregiver depression(?=-0.257,p<0.01),Patient cognition is a contributor to caregiver burden(?=-0.412,p<0.01)and caregiver depression(?=-0.324,p<0.01).Patient motor function is the influence factor of caregiver burden(?=0.334,p<0.01).Self-efficacy of caregivers is a partial mediator on the path of patient motor function and caregiver burden(VAF=0.741)\caregiver anxiety(VAF=0.498)\caregiver depression(VAF=0.471).Social support for caregivers is a partial mediator in the path of patients' motor function and caregiver self-efficacy(VAF=0.247).Caregivers social support and self-efficacy are two chain mediating variables in which patient motor function impacts caregiver burden(VAF=0.768)and caregiver depression(VAF=0.510).Caregiver social support and self-efficacy are full mediators of patient motor function affecting caregiver anxiety(VAF=8.692).Conclusions:The multiple mediator affect proposed in this study explores the mechanism of action between cognition,depression and motor function in parkinsonian patients and caregiver burden,anxiety and depression.Caregiver's self-efficacy acts as a mediator variable that patient motor function affecting caregiver burden\caregiver anxiety and caregiver depression.The worse the motor function of the patient,the lower the self-efficacy of the caregiver and the heavier the burden on the caregiver.Therefore,raising the level of caregivers' self-efficacy helps to reduce the caregiver burden and caregiver depression\anxiety.Social support and self-efficacy of caregivers also serve as two chain mediators for the burden of caregivers and caregiver depression on patient motor function,When patients have poor motor function,caregivers experience low levels of social support,the level of self-efficacy is also reduced,the caregiver burden is increased,Therefore,at the same time raising the level of caregivers' social support and self-efficacy is also an approach to reduce the burden on caregivers.