Mediating effect of activities of daily living among patients with chronic obstructive pulmonary disease on caregiver ability and caregiver burden
LIU Wei1, GAO Xing1, WANG Danxin2, ZHANG Ling1, WANG Shiyuan1, LI Huiyan2
1. School of Nursing, Hainan Medical University, Haikou, Hainan 571199, China; 2. The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570102, China
Abstract：Objective To analyze the mediating effect of activities of daily living (ADL) among patients with chronic obstructive pulmonary disease (COPD) on caregiver ability and caregiver burden, so as to provide a basis for improving the quality of care. Methods From February 2024 to March 2025, COPD patients and their caregivers from the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in Haikou were selected using convenience sampling method. Data on the basic characteristics of both caregivers and patients were collected through questionnaire surveys. The Chinese version of the Family Caregiver Capacity Scale, the Chinese version of the Caregiver Burden Inventory, and the Barthel Index were used to assess caregiver ability, caregiver burden, and patients' ADL, respectively. The mediating effect of ADL among COPD patients on caregiver ability and caregiver burden was analyzed using the Process macro 4.0, with the significance tested via the Bootstrap method. Results A total of 348 caregivers were surveyed, among whom 274 (78.74%) were females and 74 (21.26%) were males. The majority of caregivers were aged 40 years and above, with 291 individuals (83.62%). The relationship between caregivers and patients was primarily that of being their children, with 185 individuals (53.16%). Correspondingly, 348 COPD patients were surveyed, and the predominant type of medical insurance was the New Rural Cooperative Medical Scheme, with 172 cases (49.43%). The median scores of caregiver ability, caregiver burden, and patients' ADL were 19.00 (interquartile range, 5.00), 47.00 (interquartile range, 8.00) and 45.00 (interquartile range, 15.00) points, respectively. Mediating analysis showed that caregiver ability directly affected caregiver burden, with an effect value of 0.693 (95%CI: 0.553-0.832). It also indirectly affected caregiver burden through the patients' ADL, with an effect value of 0.104 (95%CI: 0.029-0.179). This mediating effect accounted for 13.05% of the total effect. Conclusion The ADL of COPD patients played a mediating role between caregiver ability and caregiver burden, with caregiver ability exerting a significant positive indirect effect on caregiver burden through patients' ADL.
刘伟, 高星, 王丹心, 张灵, 王诗源, 李慧妍. 慢性阻塞性肺疾病患者生活自理能力在照护者照护能力与照护负担间的中介效应分析[J]. 预防医学, 2025, 37(11): 1151-1154,1159.
LIU Wei, GAO Xing, WANG Danxin, ZHANG Ling, WANG Shiyuan, LI Huiyan. Mediating effect of activities of daily living among patients with chronic obstructive pulmonary disease on caregiver ability and caregiver burden. Preventive Medicine, 2025, 37(11): 1151-1154,1159.
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