title: Caring for disabled older adults with musculoskeletal conditions: A transactional model of caregiver burden, coping strategies, and depressive symptoms.
abstract: OBJECTIVE
  This study investigated the mediating role of coping strategies in the relationship between caregiver burden and depressive symptoms among family caregivers caring for disabled older adults with musculoskeletal (MSK) conditions.
  
  
  METHODS
  The cross-sectional data were from a quota sampling of 494 pairs of disabled older adults and their primary family caregivers in Shanghai, China. The disabled older adults had MSK conditions and limitations in activities of daily living. The mean ages of the older adults and their caregivers were 83.9 and 62.6 years. Path analysis was conducted to test the proposed hypotheses.
  
  
  RESULTS
  Caregivers of adults with MSK conditions were more likely to use active coping to handle time dependence (β [SD]=0.182 [0.055]) and physical burden (β [SD]=0.226 [0.071]) and to use avoidant coping to handle developmental burden (β [SD]=0.414 [0.061]). Both coping strategies were used to handle social burden(active: β [SD]=0.179 [0.078]; avoidant: β [SD]=0.241 [0.073]). Experiencing emotional burden reduced the likelihood of using both coping strategies (active: β [SD]=-0.266 [0.066]; avoidant: β [SD]=-0.373 [0.062]). Active coping had a protective impact on depressive symptoms (β [SD]=-0.228 [0.050]), whereas avoidant coping had an adverse impact on depressive symptoms (β [SD]=0.232 [0.053]).
  
  
  CONCLUSIONS
  The findings confirm the mediating effects of coping strategies in the relationship between caregiver burden and depressive symptoms.
authors.affiliation: Department of Social Work, School of Sociology and Population Studies, Renmin University of China, No. 59 Zhongguancun St., Haidian District, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Lu
authors.affiliation: School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Liu
authors.affiliation: Medical Social Services, Changi General Hospital, 2 Simei Street 3, Singapore.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Social Work & Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam Road, Hong Kong. Electronic address: wlou@hku.hk.
authors.forename: Vivian W Q
authors.initials: VW
authors.lastname: Lou
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000523:psychology*; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*
keywords: Caregiver burden; China; Coping strategies; Depressive symptoms; Disabled older adults; Musculoskeletal conditions