The impact of family functioning on loneliness among women during home-based postpartum confinement (Zuo Yuezi): the mediating role of social connectedness

Objectives This study aimed to examine the association between family functioning and loneliness among women undergoing home-based postpartum confinement in China and to assess whether social connectedness, measured by the LSNS-6, statistically accounted for this association. Methods A cross-sectional survey was conducted among 507 postpartum women attending their 6-week follow-up visit at a maternal and child health hospital in Guangzhou, China. Participants completed the UCLA Loneliness Scale-8 (ULS-8), the Lubben Social Network Scale-6 (LSNS-6), and the Family APGAR Index. Pearson correlation analysis and mediation analysis using Hayes’ PROCESS macro (Model 4) with 5,000 bootstrap samples were performed, with stable postpartum income and parity included as covariates. Results The prevalence of loneliness was 27.4%. Family functioning was negatively associated with loneliness ( r = -0.514, p < 0.001). Higher LSNS-6 scores, indicating greater social connectedness and lower risk of social isolation, were associated with lower loneliness ( r = -0.428, p < 0.001) and better family functioning ( r = 0.419, p < 0.001). Mediation analysis suggested that Social Connectedness (LSNS-6) partially accounted for the association between family functioning and loneliness. Because the data were cross-sectional, this indirect pathway should be interpreted as statistical rather than causal mediation. The indirect association was significant ( B = -0.164, 95% CI: -0.229 to -0.107), accounting for 20.50% of the total association. Women without stable postpartum income and primiparous women reported significantly higher loneliness scores. Conclusion Loneliness was relatively common among women during home-based postpartum confinement and was associated with family functioning. Social Connectedness (LSNS-6) represented one statistical pathway linking family functioning to loneliness. Family-based support and strategies that facilitate social connectedness may be relevant to postpartum psychosocial care; however, the effectiveness of such interventions requires confirmation in longitudinal or experimental studies.