The relationship between uncertainty in illness and caregiving capacity in primary caregivers of patients with first-time ischemic stroke: the roles of psychological adaptation and perceived social support.

BACKGROUND: In China, family members typically assume primary caregiving responsibilities for stroke patients after treatment. However, the onset of a first ischemic stroke often occurs abruptly, and caregivers, typically spouses, adult children, or other non-professionals, may assume this responsibility without psychological preparation or caregiving experience. This situation may be associated with higher uncertainty in illness. In turn, caregiving confidence may be reduced, potentially compromising caregiving capacity. Therefore, factors associated with primary caregivers' caregiving capacity should be examined to inform supportive strategies and reduce caregiver burden. METHOD: Standardized scales were used to assess primary caregivers' uncertainty in illness, psychological adaptation, perceived social support, and caregiving capacity. Correlations were analyzed, and mediation and moderation effects were tested. RESULT: Psychological adaptation (r = 0.708, p < 0.01) and perceived social support (r = 0.675, p < 0.01) were both positively correlated with caregiving capacity. Psychological adaptation partially mediated the association between uncertainty in illness and caregiving capacity, accounting for 29.98% of the total effect. Perceived social support significantly moderated the association between uncertainty in illness and psychological adaptation (β = -0.01, p < 0.001). In the low perceived social support group, uncertainty in illness showed a stronger negative association with psychological adaptation, whereas this association was attenuated in the high perceived social support group. CONCLUSION: Uncertainty in illness was negatively associated with caregiving capacity both directly and indirectly through psychological adaptation. Perceived social support may mitigate the adverse association between uncertainty in illness and psychological adaptation. Interventions aimed at reducing uncertainty in illness, enhancing psychological adaptation, and strengthening social support may help improve caregiving capacity among primary caregivers of patients with first-time ischemic stroke.