How care burden affects loneliness in primary family caregivers of patients with enterostomy: Affiliate stigma and family care satisfaction as mediators
Yuan He, Chenfei Qu, Limin Meng, Guoliang Yin, Chao Liu, Minrui Zhang, Ruoyuan Xu, Xiaobo Zhang, Shuyan NingAbstract
Objective:
This study aimed to explore the mechanisms through which care burden influences loneliness among primary family caregivers of enterostomy patients, with a focus on the mediating roles of affiliate stigma and family care satisfaction.
Methods:
A cross-sectional survey was conducted among primary family caregivers of enterostomy patients at three Class A Tertiary Hospitals in Jiangxi and Shandong, China, from November 2024 to May 2025. Measurements included the Zarit Burden Interview(ZBI), UCLA Loneliness Scale (ULS-8), Affiliate Stigma Scale (ASS), and the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR). Mediation analysis was performed using PROCESS Model 6 and bootstrap methods.
Results:
A total of 322 primary family caregivers were included in this study. Mediation analysis identified three pathways through which care burden affected loneliness: direct effect of care burden on loneliness (β=0.0633); indirect effect via affiliate stigma (β=0.0642, 44.86% of total effect); and chain mediation effect through affiliate stigma and family care satisfaction(β=0.0084, 5.87% of total effect).
Conclusions:
Care burden contributes to loneliness both directly and indirectly through affiliate stigma and reduced family care satisfrs of Patients with Enterostomy: Affiliate Stigma and Family Care Satisfaction as Mediators.