Stress and coping among dual caregivers in China: a grounded theory study of intergenerational caregiving

Objectives To examine how adults who simultaneously care for older adults and children aged 0–6 years experience competing demands, mobilize resources, and negotiate caregiving decisions in two Chinese cities. Methods We conducted a qualitative grounded theory study with 23 dual caregivers in Shanghai and Xi’an. Participants were recruited from an online questionnaire pool and interviewed using a semi-structured guide. Interview transcripts were analyzed through constant comparison and iterative coding. Results The analysis generated a feedback process linking continuous and competing care demands, secondary strains, conditional resources, and negotiated outcomes. Overlapping, urgent, and difficult-to-substitute tasks extended strain into work, finances, psychological wellbeing, and family relationships. Family help, formal and market services, and self-regulation widened caregivers’ room for action only when they were accessible, reliable, affordable, and matched to specific tasks. Caregivers formed four changeable strategy configurations and made varied adjustments to work, further childbearing, and future planning. Conclusion Dual caregiving is a dynamic process in which competing demands, resource allocation, and strategy adjustment reinforce one another. Continuous, affordable, and time-matched support may strengthen families’ capacity to sustain care.