Parallel Mediating Effects of Hope and Resilience on Caregiving Burden and Family Quality of Life Among Parkinson’s Family Caregivers

Heerak Choi; Minju Lee; Eun-Jeong Lee; Yunjung Kim

doi:10.1016/j.apmr.2026.02.363

This study aimed to examine the parallel mediating effects of hope and resilience on the relationship between caregiving burden and family quality of life among caregivers of patients with Parkinson’s Disease (PD). A cross-sectional observational study was conducted utilizing an online survey administered to 262 caregivers recruited from Prolific. Caregiver participants, recruited across the United States, participated in the survey. Of the 262 participants, 242 (92.4%) completed the survey. Missing data percentages ranged from 0.4% to 2.3%. The mean age was 41.1 years (SD=11.9). Average caregiving years and caregiving hours per week were 4 years (SD=2.9) and 24.6 hours (SD=19.9), respectively. Over half of the participants were male (59.5%), White (56.2%), who were children or grandchildren of patients with PD (66.1%), with incomes between $60,000 and $149,999 (59.9%). This study did not involve interventions. The measures used are as follows: Zarit Burden Interview-12 (Zarit et al., 1980; α=.91), Trait Hope Scale (Snyder et al., 1991; α=.88), Brief Resilience Scale (Smith et al., 2008; α=.88), and Family Quality of Life Scale (Hofman et al., 2006; α=.97). We used parallel mediation analysis using lavaan package (Rosseel, 2012) on R 4.4.1. Missing data, evaluated as missing at random, were addressed using full information maximum likelihood. Age (β =.11; p <.05), marital status (married; β =.18; p <.01), and additional assistance from family (β =.10; p <.05) were controlled and significantly associated with family quality of life. Significant parallel, partial mediating effects of hope (β = -.14; p <.01) and resilience (β = -.07; p <.05) were found on the relationship between caregiving burden and family quality of life. Older, married caregivers with extra caregiving assistance were likely to experience higher family quality of life. These significant demographics highlight the importance of adapting caregiving roles over time and receiving emotional and instrumental support. Caregiving burden was directly associated with family quality of life. Additionally, this relationship was partially mediated by reduced hope and resilience. Developing positive attributes—hope and resilience—can enhance caregivers’ positive self-perceptions and psychological strength, even in the face of hardships. Future research should replicate and extend these findings using larger, more diverse samples to strengthen generalizability and identify underlying psychosocial mechanisms.

Parallel Mediating Effects of Hope and Resilience on Caregiving Burden and Family Quality of Life Among Parkinson’s Family Caregivers

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