Family resilience, dyadic coping, and health-related quality of life among primary caregivers of hospitalized older adults with multimorbidity in Xinjiang, China: a latent profile and mediation analysis
- 1Department of Nursing, Xinjiang Medical University
- 2The Fourth Affiliated Hospital of Xinjiang Medical University
- 3Institute of Health Management, Xinjiang Medical University
Abstract
Background: Older adults with multiple chronic conditions impose a heavy caregiving burden on their families. However, little is known about how family resilience and dyadic coping are associated with caregivers' health-related quality of life (HRQoL). This study aimed to identify latent profiles of family resilience among primary family caregivers of hospitalized older adults with multimorbidity and to examine whether dyadic coping was indirectly associated with the relationship between family resilience and caregiver HRQoL within a hypothesized mediation model.
Methods: From October 2025 to June 2026, 572 primary family caregivers of older inpatients with multimorbidity were recruited from three tertiary hospitals in Xinjiang, China. Participants completed the Chinese version of the Family Resilience Assessment Scale (FRAS-C), the Dyadic Coping Inventory (DCI), and the 12-item Short Form Health Survey (SF-12). Latent profile analysis (LPA) was used to identify distinct profiles of family resilience. Univariate and multivariate logistic regression analyses were performed to determine factors distinguishing these profiles. Hypothesized mediation models using the bootstrap method were tested to estimate statistical indirect associations, with caregiver age, education level, monthly income, daily caregiving hours, and self-rated health as covariates.
Results: Three distinct family resilience profiles were identified: low (33.9%), middle (41.6%), and high (24.5%) family resilience. Using the low resilience group as the reference, statistically significant indirect associations through dyadic coping were observed between moderate resilience and physical HRQoL (indirect effect = 0.5825, 95% CI : 0.3317–0.8801), moderate resilience and mental HRQoL (indirect effect = 0.5103, 95% CI : 0.2701–0.7663), high resilience and physical HRQoL (indirect effect = 1.2105, 95% CI : 0.8039–1.7050), and high resilience and mental HRQoL (indirect effect = 1.0605, 95% CI : 0.6858–1.5003). Multivariate logistic regression showed that caregiver education level, monthly income, daily caregiving hours, self-rated health, and caregiver age were independent factors distinguishing the resilience profiles. Stratified analyses further showed that the positive associations between dyadic coping and HRQoL were consistent across spousal, child, and other caregiver subgroups.
Discussion: Findings were consistent with the hypothesized mediation model, showing indirect associations between family resilience and both physical and mental HRQoL through dyadic coping. Strengthening family resilience and promoting dyadic coping may be a promising approach to supporting caregivers' health outcomes.
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BibTeX
@article{wang2026family,
title = {{Family resilience, dyadic coping, and health-related quality of life among primary caregivers of hospitalized older adults with multimorbidity in Xinjiang, China: a latent profile and mediation analysis}},
author = {Weilong Wang and Runjia Zhang and Xuexia Yang and Yongle Pei and Zhengwei Luo and Xiaoxuan He and Shufeng Ren and Qianqian Jia and Jingwen Cai and Bo Zhang and Liang Liu and Wen Cai},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1916251},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1916251/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Family resilience, dyadic coping, and health-related quality of life among primary caregivers of hospitalized older adults with multimorbidity in Xinjiang, China: a latent profile and mediation analysis
AU - Weilong Wang
AU - Runjia Zhang
AU - Xuexia Yang
AU - Yongle Pei
AU - Zhengwei Luo
AU - Xiaoxuan He
AU - Shufeng Ren
AU - Qianqian Jia
AU - Jingwen Cai
AU - Bo Zhang
AU - Liang Liu
AU - Wen Cai
PY - 2026
DA - 2026/10/08
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1916251
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1916251/full
AB - Background: Older adults with multiple chronic conditions impose a heavy caregiving burden on their families. However, little is known about how family resilience and dyadic coping are associated with caregivers' health-related quality of life (HRQoL). This study aimed to identify latent profiles of family resilience among primary family caregivers of hospitalized older adults with multimorbidity and to examine whether dyadic coping was indirectly associated with the relationship between family resilience and caregiver HRQoL within a hypothesized mediation model. Methods: From October 2025 to June 2026, 572 primary family caregivers of older inpatients with multimorbidity were recruited from three tertiary hospitals in Xinjiang, China. Participants completed the Chinese version of the Family Resilience Assessment Scale (FRAS-C), the Dyadic Coping Inventory (DCI), and the 12-item Short Form Health Survey (SF-12). Latent profile analysis (LPA) was used to identify distinct profiles of family resilience. Univariate and multivariate logistic regression analyses were performed to determine factors distinguishing these profiles. Hypothesized mediation models using the bootstrap method were tested to estimate statistical indirect associations, with caregiver age, education level, monthly income, daily caregiving hours, and self-rated health as covariates. Results: Three distinct family resilience profiles were identified: low (33.9%), middle (41.6%), and high (24.5%) family resilience. Using the low resilience group as the reference, statistically significant indirect associations through dyadic coping were observed between moderate resilience and physical HRQoL (indirect effect = 0.5825, 95% CI : 0.3317–0.8801), moderate resilience and mental HRQoL (indirect effect = 0.5103, 95% CI : 0.2701–0.7663), high resilience and physical HRQoL (indirect effect = 1.2105, 95% CI : 0.8039–1.7050), and high resilience and mental HRQoL (indirect effect = 1.0605, 95% CI : 0.6858–1.5003). Multivariate logistic regression showed that caregiver education level, monthly income, daily caregiving hours, self-rated health, and caregiver age were independent factors distinguishing the resilience profiles. Stratified analyses further showed that the positive associations between dyadic coping and HRQoL were consistent across spousal, child, and other caregiver subgroups. Discussion: Findings were consistent with the hypothesized mediation model, showing indirect associations between family resilience and both physical and mental HRQoL through dyadic coping. Strengthening family resilience and promoting dyadic coping may be a promising approach to supporting caregivers' health outcomes.
SN - 2296-2565
ER -