From Synthesis to Case: Resilience, Burden, and Quality of Life Among Mental Illness Caregivers

Abstract

Background: This study investigates the role of resilience and its interplay with caregiver burden and quality of life (QoL) among family caregivers of individuals with mental illness. The research combines a systematic review of global studies with an empirical case study conducted in Kunshan, China. Objectives: The study aims to (1) Assess resilience levels among caregivers and their associations with sociodemographic and caregiving factors. (2) Examine the relationships between resilience, caregiver burden, and QoL, with a focus on potential mediating mechanisms. Methods: The systematic review included 18 cross-sectional studies, synthesizing global evidence on the relationships between resilience, caregiver burden, and QoL. The case study involved 40 caregivers at a psychiatric rehabilitation station in Kunshan, China, using the Brief Resilience Scale (BRS), Zarit Burden Interview (ZBI-12), and a single-item QoL measure. Results: The systematic review found consistent negative correlations between resilience and burden, and positive associations between resilience and QoL. In the case study, 85% of caregivers exhibited moderate resilience, and 82.5% reported high to severe burden. Resilience significantly predicted lower burden, but did not directly predict QoL. Mediation analysis revealed that caregiver burden fully mediated the resilience-QoL relationship. Conclusions: This study underscores resilience as a key protective factor in caregiving, highlighting its indirect effect on QoL through burden reduction. The findings stress the need for culturally tailored interventions to strengthen caregiver resilience, particularly in non-Western contexts like China.