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☐ ☆ ✇ Journal of Clinical Nursing

Caregiver‐Related Risk Factors Contributing to Abuse Tendency in Nursing Homes: A Structural Equation Model

Por: Jin Huang · Yeqin Yang · Yingying Chen · Meng Wang · Huiyun Luo · Bingjie Fan — Julio 11th 2025 at 09:00

ABSTRACT

Aims and Objectives

To identify modifiable caregiver factors influencing abuse tendency in Chinese nursing homes and delineate pathways for intervention.

Background

Discerning the risk factors associated with elder abuse is paramount for enhancing prevention and intervention strategies.

Design

Cross sectional study.

Methods

Using validated tools (Caregiver Abuse Screen, Maslach Burnout Inventory, Fatigue Scale-14, Barthel Index), 241 caregivers from 24 nursing homes in Wenzhou City, Zhejiang Province, China were surveyed. Structural equation modelling analysed the direct/indirect pathways linking caregiving stress, caregiving difficulty, job burnout and abuse tendency.

Results

The prevalence of abuse tendency amongst caregivers in the previous year was 40.7%. The model explained 83% of the total variance in abuse tendency. The best-fitting model indicated that abuse tendency was directly affected by job burnout. Caregiving difficulty and stress indirectly affected abuse tendency through job burnout.

Conclusions

This study identified job burnout as a modifiable mediator linking caregiving difficulties, caregiving stress, and abuse tendency amongst nursing home caregivers. To disrupt the pathways to abuse tendency, clinical administrators should prioritise routine burnout screening coupled with structured resilience-building programmes. Simultaneously, optimising staffing ratios and enhancing caregiving competencies may foster safer care environments for caregivers and residents.

Relevance to Clinical Practise

This study identified job burnout as a direct driver of abuse tendency, providing information for clinical managers and targeted interventions to mitigate elder abuse risk. Additionally, it revealed the indirect effects of caregiving difficulty and stress via job burnout, emphasising the need to optimise staffing allocation and workflow design to foster system-level improvements in caregiver mental health and service quality.

Reporting Method

The study adhered to the STROBE checklist of observational surveys.

Patient or Public Contribution

Caregivers voluntarily completed questionnaires.

Impact Statement

This study identifies job burnout, caregiving difficulty, and caregiving stress as key risk factors for abuse tendency amongst nursing home caregivers. The validated model demonstrates the direct and indirect effects of these factors on abuse tendency, emphasising the need for targeted interventions to prevent and mitigate abuse.

☐ ☆ ✇ Journal of Clinical Nursing

Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment

Por: Haiyan Sun · Shuqiao Chen · Xi Chen · Qin Yang · Hu Zhang · Chintana Wacharasin · Pornpat Hengudomsub — Diciembre 18th 2023 at 11:06

Abstract

Background

While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience.

Aim

To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months.

Design

An observational longitudinal study.

Methods

A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting.

Results

Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time.

Conclusions

Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions.

Relevance to Clinical Practice

Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer.

Patient or Public Contribution

The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.

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