The mediating role of problem-focused coping in the associatop between caregiving burden and life satisfaction among caregivers of children with epilepsy

Hamidizadeh, Saeed; Parviniannasab, Ali Mohammad

Volume 14, Issue 2 (6-2026) jmsthums 2026, 14(2): 75-87 | Back to browse issues page

Mendeley

Zotero

RefWorks

Hamidizadeh S, Parviniannasab A M. The mediating role of problem-focused coping in the associatop between caregiving burden and life satisfaction among caregivers of children with epilepsy. jmsthums 2026; 14 (2) :75-87
URL: http://jms.thums.ac.ir/article-1-1456-en.html

The mediating role of problem-focused coping in the associatop between caregiving burden and life satisfaction among caregivers of children with epilepsy

Saeed Hamidizadeh¹

, Ali Mohammad Parviniannasab ^*¹

1- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract: (10 Views)

Background & Aim: Caregiver burden undermines life satisfaction among caregivers of children with epilepsy. Problem-focused coping is one of the factors that may serve as a protective factor against caregiver burden; however, the potential mechanisms underlying this association remain unclear. Therefore, this study aimed to investigate the potential mediating role of problem-focused coping in the relationship between caregiver burden and life satisfaction.
Methods: This descriptive-correlational study was conducted in two teaching hospitals affiliated with Shiraz University of Medical Sciences and Larestan University of Medical Sciences. The study population consisted of family caregivers of children under 18 years of age with epilepsy, from whom 184 participants were recruited using convenience sampling. Data were collected using the Caregiver Burden Questionnaire, the Satisfaction with Life Scale, and the Problem-Focused Coping Questionnaire. Mediation analysis was performed using Hayes’ PROCESS macro (Model 4) in SPSS version 27.
Results: The mean age of the parents was 36.51 ± 8.87 years, while the children was 7.23 ± 5.13 years. Path analysis revealed that caregiver burden had a significant negative direct effect on life satisfaction (β=−0.28). In addition, caregiver burden had a significant negative direct effect on problem-focused coping (β=−0.33). Finally, the indirect effect of caregiver burden on life satisfaction through problem-focused coping was significant (β= −0.03, p <0.01).
Conclusion: Healthcare providers, particularly nurses, can play a pivotal role in improving caregivers' life satisfaction by implementing interventions aimed at promoting positive coping strategies and enhancing caregivers’ ability to use strategies for reducing caregiver burden. Such interventions may be delivered within the framework of structured programs, including psychological intervention programs.

Keywords: Life Satisfaction, Caregiver Burden, Coping Skills, Epilepsy

Full-Text [PDF 367 kb] (9 Downloads)

Type of Study: Research | Subject: Special
Received: 2025/11/6 | Accepted: 2026/02/14 | Published: 2026/10/19

References

1. Almarwani BM, Alamri SA, Alamri AA, Badawi AS, Khawaji ZY, Akhwan AM, et al. Understanding Public Knowledge, Attitudes, and Awareness Toward Seizure Episodes Among Residents of Madinah: A Saudi Cross‐Sectional Study. Behavioural Neurology. 2025;2025(1):2142400. [DOI:10.1155/bn/2142400]

2. Adamu A, Chen R, Li A, Xue G. Epilepsy in Asian countries. Acta Epileptologica. 2023;5(1):25. [DOI:10.1186/s42494-023-00136-1]

3. Pakdaman H, Harandi AA, Gharagozli K, Alaeddini F, Esfandani A, Mirbehbahani SH, et al. Epilepsy lifetime prevalence in Iran: a large population-based national survey. Scientific Reports. 2021;11(1):9437. [DOI:10.1038/s41598-021-89048-z]

4. Tsamakis K, Teagarden DL, Villarreal HK, Evans L, Morton ML, Janocko NJ, et al. Depression and anxiety in caregivers of patients with functional seizures. Epileptic Disorders. 2023;25(2):200-8. [DOI:10.1002/epd2.20014]

5. Atan G, Oruç FG, Atan K. The relationship between caregiver burden and life satisfaction in caregivers of individuals with epilepsy: An example in eastern Turkey. Epilepsy & Behavior. 2025;164:110275. [DOI:10.1016/j.yebeh.2025.110275]

6. Bastawrous M. Caregiver burden-A critical discussion. International journal of nursing studies. 2013;50(3):431-41. [DOI:10.1016/j.ijnurstu.2012.10.005]

7. Abd El-Mouty SM, Salem NM. Burden and quality of life among caregivers to children with epilepsy. Am J Nurs Res. 2019;7(5):817-23.

8. Oliveira MC, Lima EM, de Paiva MLN, Valente KDR. Factors associated with caregiver burden of adults with epilepsy in a middle-income country. Seizure. 2022;98:1-7. [DOI:10.1016/j.seizure.2022.03.015]

9. Kaçan H, Sakız H. Impact of a psychoeducation on caregiver burden, internalized stigma, anxiety, and coping in caregivers of children with epilepsy: a randomized pilot study. Nursing & Health Sciences. 2025;27(2):e70095. [DOI:10.1111/nhs.70095]

10. Endler NS, Parker JDA, Ridder DTD, van Heck GL. Coping inventory for stressful situations: Multi-Health systems Incorporated; 1990.

11. Çolak B, Kahriman I. Evaluation of family burden and quality of life of parents with children with disability. The American Journal of Family Therapy. 2023;51(2):113-33. [DOI:10.1080/01926187.2021.1941421]

12. Singer H, Clarke EB, Schiltz HK, Lord C. Caregivers and Coping: Well-Being, Depression, and Coping Strategies Among Caregivers of Young Adults With Developmental Disability. American Journal on Intellectual and Developmental Disabilities. 2025;130(1):41-62. [DOI:10.1352/1944-7558-130.1.41]

13. Lai S-T, Tan W-Y, Wo MC-M, Lim K-S, Ahmad SB, Tan C-T. Burden in caregivers of adults with epilepsy in Asian families. Seizure. 2019;71:132-9. [DOI:10.1016/j.seizure.2019.07.008]

14. Abdelaziz EM, Alsadaan N, Alqahtani M, Elsharkawy NB, Ouda MMA, Ramadan OME, et al. Effectiveness of cognitive behavioral therapy (CBT) on psychological distress among mothers of children with autism spectrum disorder: the role of Problem-Solving appraisal. Behavioral Sciences. 2024;14(1):46. [DOI:10.3390/bs14010046]

15. Folkman S. Stress: appraisal and coping. Encyclopedia of behavioral medicine: Springer; 2020. p. 2177-9. [DOI:10.1007/978-3-030-39903-0_215]

16. Wolf EJ, Harrington KM, Clark SL, Miller MW. Sample size requirements for structural equation models: An evaluation of power, bias, and solution propriety. Educational and psychological measurement. 2013;73(6):913-34. [DOI:10.1177/0013164413495237]

17. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. The gerontologist. 1980;20(6):649-55. [DOI:10.1093/geront/20.6.649]

18. Rajabi-Mashhadi MT, Mashhadinejad H, Ebrahimzadeh MH, Golhasani-Keshtan F, Ebrahimi H, Zarei Z. The Zarit Caregiver Burden Interview Short Form (ZBI-12) in spouses of veterans with chronic spinal cord injury, validity and reliability of the Persian version. Archives of bone and joint surgery. 2015;3(1):56.

19. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. Journal of personality assessment. 1985;49(1):71-5. [DOI:10.1207/s15327752jpa4901_13]

20. Maroufizadeh S, Ghaheri A, Samani RO, Ezabadi Z. Psychometric properties of the satisfaction with life scale (SWLS) in Iranian infertile women. International journal of reproductive biomedicine. 2016;14(1):57. [DOI:10.29252/ijrm.14.1.57]

21. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research: Springer publishing company; 2010.

22. Bilgehan T, Bağrıaçık E, Sönmez M. Factors affecting care burden and life satisfaction among parents of children with type 1 diabetes. Journal of Pediatric Nursing. 2024;77:e394-e400. [DOI:10.1016/j.pedn.2024.05.002]

23. Young S, Walter S, Wang K, Piamjariyakul U, Lewis F. The influence of spirituality on caregiver burden and quality of life in older adult informal caregivers. Geriatric Nursing. 2024;58:127-34. [DOI:10.1016/j.gerinurse.2024.05.013]

24. Settineri S, Rizzo A, Liotta M, Mento C. Caregiver's burden and quality of life: Caring for physical and mental illness. International Journal of Psychological Research. 2014;7(1):30-9. [DOI:10.21500/20112084.665]

25. Carona C, Silva N, Crespo C, Canavarro MC. Caregiving burden and parent-child quality of life outcomes in neurodevelopmental conditions: The mediating role of behavioral disengagement. Journal of clinical psychology in medical settings. 2014;21:320-8. [DOI:10.1007/s10880-014-9412-5]

26. Baran G. The burden of care and life satisfaction of the Turkish mothers of children with cancer. Journal of Client-Centered Nursing Care. 2018;4(4):175-84. [DOI:10.32598/jccnc.4.4.175]

27. Huang M-F, Huang W-H, Su Y-C, Hou S-Y, Chen H-M, Yeh Y-C, Chen C-S. Coping strategy and caregiver burden among caregivers of patients with dementia. American Journal of Alzheimer's Disease & Other Dementias®. 2015;30(7):694-8. [DOI:10.1177/1533317513494446]

28. Akpan-Idiok PA, Ehiemere IO, Asuquo EF, Chabo JAU, Osuchukwu EC. Assessment of burden and coping strategies among caregivers of cancer patients in sub-Saharan Africa. World journal of clinical oncology. 2020;11(12):1045. [DOI:10.5306/wjco.v11.i12.1045]

29. Hamama-Raz Y, Hamama L. Quality of life among parents of children with epilepsy: a preliminary research study. Epilepsy & Behavior. 2015;45:271-6. [DOI:10.1016/j.yebeh.2014.12.003]