Mediating Effect of Spiritual Coping Strategies on Caregiving Burden and Mental Health in Caregivers of Iranian Patients with Dementia

Introduction: Dementia is a common cognitive disorder among elderly people requiring special care. Family carers of people with dementia (PWD) may experience mental health issues. This study examined whether spiritual coping is a mediator between the physical function of the patients and mental health status or caregiving burden in their carers. Methods: The caregivers of the PWD (n = 513) were assessed by the Instrumental Activities of Daily Living (IADL) and Spiritual Coping Strategies (SCS) questionnaires at baseline and Zarit Burden Interview, Short Form-12 (SF-12), and Hospital Anxiety and Depression Scale questionnaires at 6 months. The proposed model to assess the mediating effect of SCS was: SCS subscales as mediators, PWD’s IADL as an independent variable, and mental health components as dependent variables. Using PROCESS SPSS Macro, the indirect effects of patients’ IADL score on mental health-related variables in the caregivers were examined. Results: There were significantly negative associations between IADL score and mental health components (r 0.3). SCS scores were negatively correlated with depression, anxiety, and caregiving burden (P 0.001). Four models proposed to explain the indirect effects of spiritual coping on mental health variables revealed the spirituality as a significant mediator (0.28 ≤ R2 ≤ 0.65; P 0.001). The mediation effect of religious and nonreligious coping on mental health component in SF-12 was the highest (b = 0.57, 95% confidence interval [CI] [0.26, 0.98], b = 1.20, 95% CI [0.63, 1.84], respectively). Conclusion: Spiritual coping may be a mediator between the physical functioning of the patients and carers’ mental health status and caregiving burden in Iran. Thus, further investigation is needed to show how these mediators may affect the mental health status of the caregivers.