# Is Perceived Family Cohesion Associated with Family Caregiver Role and Caregiver-Related Characteristics? A Comparison of Spousal and Adult-Child Caregivers

## TL;DR

Adult-child caregivers feel more family unity than spousal caregivers, and factors like health and support help explain this difference.

## Contribution

This study identifies caregiver-related characteristics as mediators of family cohesion differences between spousal and adult-child caregivers.

## Key findings

- Adult-child caregivers reported significantly higher perceived family cohesion than spousal caregivers.
- Caregiver-related characteristics mediate the relationship between caregiver role and family cohesion.
- Interventions targeting health, support, and family involvement can reduce cohesion perception gaps.

## Abstract

What are the main findings?
Adult-child caregivers reported higher family cohesion than spousal caregivers.Caregiver-related characteristics mediate caregiver role and family cohesion.

Adult-child caregivers reported higher family cohesion than spousal caregivers.

Caregiver-related characteristics mediate caregiver role and family cohesion.

What are the implications of the main findings?
Interventions that strengthen caregivers’ physical health, social support, self-efficacy, and family involvement in caregiving can equalize the perception of family cohesion between spousal caregivers and adult-child caregivers.

Interventions that strengthen caregivers’ physical health, social support, self-efficacy, and family involvement in caregiving can equalize the perception of family cohesion between spousal caregivers and adult-child caregivers.

Background: Spousal caregivers and adult-child caregivers are the main sources of informal care of patients with dementia. They are primarily responsible for providing daily assistance, emotional support, and long-term care within the family. Methods: A cross-sectional survey was conducted in June 2024 in Nanjing, Jiangsu Province, China. A total of 410 family caregivers (154 spousal and 256 adult-child caregivers) participated. Perceived family cohesion was measured using the Family Adaptability Cohesion Scale, Second Edition, Chinese version (FACES II-CV). Caregiver-related characteristics included the following: caregivers’ self-reported physical health, social support, self-efficacy, and the number of family members assisting in caregiving. Results: (1) adult-child caregivers reported significantly higher perceived family cohesion than spousal caregivers (p < 0.001); (2) regression analyses revealed that caregiver role and caregiver-related characteristics were positively associated with perceived family cohesion (all p < 0.05); and (3) mediation analyses revealed that caregiver-related characteristics mediate the relationship between caregiver role and perceived family cohesion, with mediating effects of 0.109, 0.293, 0.087 and 0.174, respectively. Conclusions: Given that caregiver-related characteristics act as mediators of family cohesion, interventions should focus on strengthening caregivers’ physical health, social support, self-efficacy, and family involvement in caregiving to equalize the perception of family cohesion between spousal caregivers and adult-child caregivers.