The moderated mediation effect of caregiving stress and social support in the relationship between behavioral and psychological symptoms of dementia and caregiver burden in Oman: a cross-sectional study.

BACKGROUND: Caregivers of individuals presenting behavioral and psychological symptoms of dementia (BPSD) experience substantial emotional, physical, and psychological distress, potentially compromising their health status and caregiving capacity. This burden manifests through a complex interplay of factors, including symptom severity, caregiving-related stress levels, and social support accessibility. Our study investigated the moderated mediation effects of caregiving stress and social support on the BPSD-caregiver burden relationship within the Omani context. METHODS: This cross-sectional study included 100 caregivers of patients with BPSD from Al Masarra Hospital and Sultan Qaboos University Hospital in Oman. Validated instruments were used: Zarit Burden Interview (ZBI-22) for caregiver burden, Abe's BPSD Score (ABS) for neuropsychiatric symptoms, Caregiver Reaction Scale (CRS) for caregiving stress, and Multidimensional Scale of Perceived Social Support (MSPSS) for social support. RESULTS: The proposed model demonstrated a sound fit (PCMIN/DF = 2.612). Statistical analysis revealed a significant positive correlation between BPSD severity and caregiver burden (p < 0.01). Caregiving stress emerged as a significant mediator in this relationship, with its effect moderated by social support availability. Furthermore, caregiver burden showed significant associations with dementia progression stage (β = 0.42, p < 0.001) and intensity of care requirements (β = 0.38, p < 0.01). CONCLUSIONS: The research highlights the complex nature of caregiver burden in BPSD, indicating that caregiver stress increases the connection between BPSD and burden, while social support moderates this association. Specific interventions must incorporate stress reduction approaches, address patient-specific care needs, and enhance caregiver support systems to effectively reduce burden.