Caring load and family caregivers’ burden in China: the mediating effects of social support and social exclusion
Open accessAbstract
Objective: Caring for older adults with disabilities is a source of stress for family caregivers, and the lack of social support and the pressure of social exclusion might aggravate family caregiver burden. This study aimed to examine the association between caring load and family caregivers' burden, as well as the mediating effects of social support and social exclusion. Methods: Data used in this study was derived from the nationally representative database of the aged population in China, and 3,125 households with disabled old adults and their home-bound caregivers were eventually selected for this analysis. Regression methods and mediation analysis methods were employed in this study. Results: The results indicated that there was a significant positive association between caring load and the caregiver burden, and specifically, social support intensity (rather than social support breadth) and passive social exclusion (rather than active social exclusion) played partial mediating effects. Furthermore, the contributions of mediating effects of social support intensity and passive social exclusion were 13-15 and 27-29%, respectively, and the total contribution of mediating effects was about 35-38%. Conclusion: Family caregivers' burden should be paid more attention to in the large population with rapidly aging speed like China, and more guidance services as well as support should be provided to family caregivers. In addition, it is crucial to focus on the community's social support and social exclusion in public policy innovation.
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In China, based on traditional Confucian filial values and relatively low levels of social security, the care of older adults with serious illnesses or disabilities is primarily undertaken by family members.
“In China, based on traditional Confucian filial values and relatively low levels of social security, the care of older adults with serious illnesses or disabilities is primarily undertaken by family members (52).”
From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [52]
The Introduction (page not provided) says family caregivers provide most care for older adults with disabilities in China and links this to filial piety and an imperfect social security system. It does not establish the same claim for older adults with serious illnesses who do not have disabilities. (LLM, conf=0.86)
Experimental — accuracy not yet measuredChina has a tradition of filial piety that spans thousands of years, with family-based care long dominating the older adult care system.
“China has a tradition of filial piety that spans thousands of years, with family-based care long dominating the older adult care system (52).”
From Caring alone: older adult care burdens, practices, and structural imbalances among China's one-child generation (2025) · cites this paper as [52]
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Xiang, S., Xiang, H., Ren, Q., & Deng, Q. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1694636 · Cited by 6 · see citing works
- Authors
- Hu, H., Hu, X., & Xu, Y.
- Affiliations
- Renmin University of China (CN)
- Beijing Normal University (CN)
- ORCID
- Venue
- Frontiers in Public Health
- Publisher
- Frontiers Media SA
- Published
- 2023-09-22
- Volume
- 11
- Pages
- 1194774-1194774
- ISSN
- 2296-2565 (ISSN-L)
- PMC
- PMC10556706
- OpenAlex
- W4386959656
- Cited by
- 35
- References
- 31
- Citations by year
- 2026: 19 · 2025: 15 · 2024: 1
- FWCI
- 15.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Public Health (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Renmin University of China (19XNB015)
- National Office for Philosophy and Social Sciences
- Fundamental Research Funds for the Central Universities
- Topics
- Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Health Professions › General Health Professions › Aging, Elder Care, and Social Issues
- Keywords
- family caregiver burden, social support, social exclusion, older adults with disabilities, mediating effect, population aging, China
- MeSH terms
- Aged, China, Persons with Disabilities, Disabled Persons, Humans, Social Isolation, Social Support, Caregivers
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