Caregiving Competence and Caregiver Burden in Home-Based Palliative Cancer Care: A Cross-Sectional Path Analysis

Purpose To examine the direct association between caregiving competence and caregiver burden and the serial indirect pathway through perceived social support, resilience, and depressive symptoms among family caregivers of patients with cancer receiving home-based palliative care. Methods This cross-sectional study included 496 primary family caregivers in Türkiye. Participants completed validated measures of caregiving competence, perceived social support, resilience, depressive symptoms, and caregiver burden. Associations were examined using Pearson correlations and observed-variable path analysis. Indirect effects were tested with 5000 bias-corrected bootstrap samples. A sensitivity model adjusted for caregiver age, sex, education, total caregiving duration, and daily caregiving time. Results Caregiving competence was negatively correlated with caregiver burden (r = −0.448, P < 0.001) and positively correlated with perceived social support (r = 0.393, P < 0.001). Model fit was acceptable to good (χ 2 /df = 2.838, CFI = 0.966, TLI = 0.932, RMSEA = 0.061). Competence retained a direct negative association with burden (β = −0.324, P < 0.001), and the serial indirect association was significant (β = −0.018, 95% bias-corrected bootstrap CI, −0.022 to −0.014). The direct (β = −0.302) and serial indirect (β = −0.016) associations remained significant after covariate adjustment. The model explained 27.2% of the variance in caregiver burden. Conclusion Greater caregiving competence was associated with lower burden directly and through a small serial psychosocial pathway. Prospective studies should evaluate multicomponent caregiver support that combines practical preparation with support mobilization, resilience-oriented care, and depression screening.