The Double-Edged Sword of Intergenerational Support: A Cross-Sectional Study on Caregiver Burden Among Chinese Families Caring for Stroke Survivors with Disabilities

Objective: This cross-sectional study examined the association between intergenerational support (IGS) and caregiver burden (CB) among Chinese family caregivers of stroke survivors with persistent disabilities and explored potentially modifiable factors associated with CB. Methods: In a cross-sectional survey of 683 stroke survivors (≥ 6 months post-discharge) and their primary family caregivers, we assessed sociodemographic and caregiving characteristics, functional disability (Katz ADL), intergenerational support (adapted IGSS), caregiver burden (CBI), and caregiver self-efficacy (GSES). Multiple linear regression was used to examine factors independently associated with caregiver burden. Results: The mean caregiver burden score was 44.72 ± 17.57. Higher burden was associated with patient dementia (B = 6.316, p < 0.001), greater disability severity (B = 3.103, p = 0.006), only-child status (B = 4.260, p = 0.003), and higher education of the involved adult child (university: B = 16.204, p < 0.001). Lower burden was associated with higher child income (B = − 1.869, p = 0.036), stronger IGS (B = − 0.556, p = 0.002), and greater caregiver self-efficacy (B = − 5.411, p < 0.001). Conclusion: Family caregivers of stroke survivors with disabilities in China experience substantial caregiver burden. Patient dementia, greater disability severity, only-child status, and higher education of the involved adult child were associated with higher burden, whereas higher child income, stronger intergenerational support, and greater caregiver self-efficacy were associated with lower burden. These findings suggest that family-centered support, caregiver self-efficacy enhancement, and services for high-risk families may serve as hypotheses for future intervention development.