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Social support and subjective burden in caregivers of adults and older adults: A meta-analysis

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del-Pino-Casado, Rafael, Frías-Osuna, Antonio, Palomino-Moral, Pedro A., Ruzafa-Martínez, María, Ramos-Morcillo, Antonio J.·2018·PLOS ONE
DOI 10.1371/journal.pone.0189874PMC PMC5749735
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Abstract

BACKGROUND: Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant. OBJECTIVE: The purpose of this review is to analyse the relationship of perceived and received social support with subjective burden among informal caregivers of an adult or older adult. METHODS: A systematic search was carried out up to September 2017 in the following databases: MEDLINE (PubMed), CINAHL, EMBASE, PsycINFO), Scopus and ISI Proceedings, and a meta-analysis was performed with the results of the selected and included studies. RESULTS: Fifty-six studies were included in the meta-analysis, which provided 46 independent comparisons for perceived support and 16 for received support. Most of these studies were cross-sectional. There was a moderate, negative association of perceived social support on subjective burden (r = -0.36; CI 95% = -0.40, -0.32) and a very small, negative association of received support on subjective burden (r = -0.05; CI 95% = -0.095, -0.001). CONCLUSIONS: 1) perceived and received support are not redundant constructs, 2) the relationships between social support and subjective burden depend on whether the social support is measured as perceived or received, 3) the relationship of perceived social support with subjective burden has a bigger effect size than that of received social support, the relation between received support and subjective burden being clinically irrelevant, 4) perceived social support may be a good predictor of subjective burden. IMPLICATIONS OF KEY FINDINGS: Our findings broadly support interventions promoting social support in caregivers to prevent or alleviate subjective burden, and specifically, to intervene on the promotion of perceived social support more than on the promotion of received social support when preventing or alleviating burden.

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  • Social support has been shown to protect against caregiver burden, particularly among dementia caregivers.

    “Additionally, social support has been shown to protect against caregiver burden, particularly among dementia caregivers24,25.”

    From Examining burden among caregivers of community-dwelling older adults in Lebanon (2025) · cites this paper as [25]

    The Results (Perceived social support; Received social support, page unavailable) report that greater social support is associated with less subjective caregiver burden. The paper includes dementia-caregiver studies, but it does not establish that the association is particularly strong in dementia caregivers. Because most included studies were cross-sectional, the findings also do not establish that support causally protects against burden. (LLM, conf=0.88)

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  • The negative association found between subjective caregiver burden and social support is consistent with findings from a meta-analysis and a systematic review on informal caregivers of older adults.

    “The negative association found between subjective caregiver burden and social support is consistent with findings from a meta-analysis and a systematic review on informal caregivers of older adults22,25, both of which identified social support as a significant predictor of reduced subjective burden.”

    From Examining burden among caregivers of community-dwelling older adults in Lebanon (2025) · cites this paper as [25]

    The Abstract (Results) reports negative associations between subjective burden and both perceived and received social support, consistent with the citing sentence. The Discussion calls perceived support a possible good predictor, but says the predominantly cross-sectional evidence cannot establish a causal sequence; it does not establish that social support predicts a reduction in burden. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
del-Pino-Casado, R., Frías-Osuna, A., Palomino-Moral, P. A., Ruzafa-Martínez, M., & Ramos-Morcillo, A. J.
ORCID
del-Pino-Casado, Rafael
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2018-01-02
Volume
13
Issue
1
Pages
e0189874
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0189874
PMC
PMC5749735
OpenAlex
W2782468054
Cited by
272
References
16
Citations by year
2026: 35 · 2025: 36 · 2024: 33 · 2023: 45 · 2022: 42 · 2021: 34 · 2020: 24 · 2019: 21 · 2018: 1
FWCI
4.96
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Hispana (publishedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
  • Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
Keywords
social support, caregiver burden, perceived social support, received social support, informal caregivers, older adults, caregiver adaptation, caregiver interventions
MeSH terms
Aged, Humans, Middle Aged, Social Support, Caregivers

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