Aging is the process of growing old, which impacts the human body on both a biological and psychological level (Mitina & Zhavoronkov, 2020). The older adult’s function gradually deteriorates due to these changes, even though they are not always harmful (Aoyagi & Shephard, 1992; Murman, 2015). Considering the deteriorating function, it is essential to provide care for the older adults (Vincent et al., 2018). Besides, the aging population is one of the most pressing social issues in modern China (Goldstein & Goldstein, 1986; Guo & Zheng, 2018; Peng & Hu, 2011). Early in 2001, China entered an aging society (National Bureau of Statistics of the People's Republic of China [NBSPRC], 2002), and the population of the older adults had grown to over 190 million by 2020 (NBSPRC, 2021).
The Chinese society is facing aggravated eldercare stress with its declining fertility rates and increasing longevity (Luo et al., 2021). The old dependency ratio (ODR), one of the socioeconomic indicators, reflects the social consequences of an aging population (Ingham et al., 2009). By 2020, China's Old Dependency Ratio (ODR) had reached 19.7% (NBSPRC, 2021). This number implies that each one of the older adults must be taken care of by almost five people of working age (NBSPRC, 2021). Considering the significant pressure that eldercare may place on Chinese society, we must pay closer attention to eldercare.
Family Care
Traditionally, in China, it was the family member that had taken care of the older relatives (Glinskaya & Feng, 2018). Today, this pattern continues since the current eldercare in China is primarily based on family care (Dai, 2021; Zhou, 2020; Zhu & Wei, 2016). One of the reasons is the influence of Confucian philosophy, as Chinese culture attaches great significance to the core ethical value of filial piety (Carreiro, 2012; Zhan & Montgomer, 2003). In that way, it is the responsibility of adult children to provide support to their parents (Lam, 2006; Yi et., 2016). Besides, the Chinese government also highly advocates family-based eldercare by enacting laws and social policies (Dai, 2018; Dai, 2021; Ding, 2013; Nie, 2018). Moreover, Chinese society still does not possess sufficient capacity to take care of the older adults (Du et al., 2017; Meng et al., 2020). Therefore, rather than entirely relying on states and government, Chinese eldercare has a tight relationship with individual families' responsibilities (Liu & Sun, 2015).
Since family-based eldercare is the primary mode in China, family caregivers are mainly responsible for the care of older adults (Guo, 2021; Zhang & Mi, 2018). According to a study based on the 2014 China Longitudinal Aging Social Survey, the primary caregivers of the older adults are family members, including the spouse (39.5%), son (23.77%), daughter (15.24%), daughter-in-law (12.24%), son-in-law (0.33%), and others (Du et al., 2016). Here we can see, more than 90% of adults have to take care of the older adults (Pinquart & Sörensen, 2011). Although the spouse's portion ranks first in the list, we can still find that the total portion of adult children (son, daughter, daughter-in-law, and son-in-law) is higher than 50%. Therefore, it is plausible that adult children play a significant role in family caregiving for the older adults (Theixos, 2013). Admittedly, taking care of the older parents can be a positive experience and bring affective outcomes (Archbold, 1983; Cohen et al., 2002; Yuan, 2009). Nevertheless, adult children in China also could suffer greatly from the burden of eldercare that falls primarily on them (Li et al., 2020; Pei et al., 2017). For adult children still at working age, challenges of eldercare include significant financial and time demands, as well as negative experiences such as reduced social activity, impaired health conditions, stress, depression, and others (Pei et al., 2017; Chen et al., 2016; Friedmann & Buckwalter, 2014).
Caregiver Burden
Previous research has shown that caregiving is a stressful experience, inducing perceived burden onto caregivers (Conway, 2018; Donaldson et al., 1998; Yin, 2002; Zarit et al., 1985). Based on the various definitions in early studies using qualitative method describing changes in care for the older adults, this paper defines caregiver burden (CB) as caregivers' perception of the hardships they face in caring for older relatives, including their physical, psychological, financial, and social difficulties (Townsend, 1957; Zarit et al., 1986). If many stressful events may be regarded as a burden, they become caregiver burden when they come into caregivers' perceptions (Burger, 2010; Etters et al., 2008). In that way, many researchers believed that CB has arisen from a specific, non-objective, interpretative procedure (Zarit et al., 1980). For example, a recent meta-analysis showed that antecedents like insufficient financial resources, responsibility and role conflicts, and restricted social interactions could substantially increase the susceptibility of adult children to perceiving elevated levels of CB (Liu et al., 2020; Fink, 1995; Chen et al., 2016; Kayaalp et al., 2020; Goldstein et al., 2004; Pruchno & Resch, 1989; Zarit et al., 1980).
Subjective Well-being
Not surprisingly, CB significantly influences caregivers' subjective well-being (SWB) (Cummins, 2001; Fekete et al., 2017; Werner & Shulman, 2013). Also known as subjective quality of life, the definition of SWB incorporates the degree of perceived happiness, aggregate life satisfaction across a number of life domains, and positive affect or mental state (Cummins, 2001; Werner & Shulman, 2013; Diener, 1984). Several studies have found that CB profoundly impacts caregivers' mental well-being (Buchanan et al., 2010; Griffin et al., 2017; Yu et al., 2021; Burger, 2010; Etters et al., 2008; Zarit et al., 1980). Specifically, many caregivers reported the experience of psychological problems and the feeling of depression, anger, worry, guilt, and anxiety (Mellon & Northouse, 2001; Soltys & Tyburski, 2020). In addition, compared with the general population, family caregivers had more anxiety/depression and were more prone to mental impairment (Song et al., 2011). Caregiving for older adults, especially by adult children, has been associated with increased stress and burden, often negatively impacting the caregivers' SWB (Liu, 2018; Shakeel et al., 2015; Verbakel et al., 2018). It can be speculated that the higher the CB that caregivers have perceived, the lower the SWB they possess.
However, the experience of caregiving is not uniformly negative, as suggested by Miller (1989) who found that caregivers, despite reporting high stress, also reported high satisfaction from their role. This highlights the dual nature of the caregiving experience. Other studies also found that caregivers may suffer a degree of burden while still reporting an adequate level of SWB (Chappell & Reid, 2002; Werner & Shulman 2013; Yu et al., 2015). This phenomenon implies that when facing a heavy burden of care, some caregivers maintain a certain degree of SWB while others are adversely influenced. Considering this phenomenon, one might ask, “What might have protected caregivers from the negative effects of CB and maintained caregivers’ SWB even under high levels of stress ?” The answer to this question lies in identifying the potential factors that may operate under the mechanism which ameliorates CB and facilitates SWB.
Sense of Coherence
The Sense of Coherence (SOC) theory by Antonovsky (1987) claims that individuals who possess a strong SOC, viewing their life experiences as comprehensible, manageable, and meaningful, are better equipped to handle tension and stress in a health-promoting manner. The concept of SOC is composed of three components: comprehensibility, meaningfulness, and manageability (Eriksson & Lindstrom, 2005). Comprehensibility is the cognitive component of SOC since it allows people to understand their surroundings (Eriksson & Lindstrom, 2006). With SOC's motivational component, meaningfulness, people can gain meaning from their surroundings (Eriksson & Lindstrom, 2006). As for the instrumental component, manageability, people may choose to handle the situation on their own or seek help from the social network (Eriksson & Lindstrom, 2005). Overall, SOC reflects how well an individual copes with adverse experiences from an adaptive dispositional orientation (Hammond & Niedermann, 2010). Therefore, SOC can be conceptualized as a protective psychological resource that may buffer caregivers against the detrimental effects of CB on their well-being. According to a systematic meta-analysis, SOC is a determinant of caregiver well-being and may protect caregivers from severe psychological distress and CB (del-Pino-Casado et al., 2019). Indeed, SOC was significantly associated with SWB and plays a vital role in psychological adjustment to stress (Lu et al., 2019; del-Pino-Casado et al., 2019). What’s more, it was found that SOC and CB was negatively associated with each other from a meta-analysis on caregiving conducted by del-Pino-Casado and colleagues (2019). Consequentially, SOC may be conducive for adult children to maintain an adequate level of SWB in the face of CB, or even explain some positive aspects of caregiving such as affective outcomes and role satisfaction (Ekwall et al., 2007; Archbold, 1983; Cohen et al., 2002; Yuan, 2009; Miller, 1989).
Hypothesis
Previous research investigated the associations between CB and SWB as well as between SWB and SOC. However, the interconnectedness between the three elements and the underlying mechanism of how CB and SOC may work together to influence on SWB have been underexplored. The current study examines the relationship between CB and SOC when they impact on SWB with the following hypotheses: 1) Replicating the results of previous studies, CB on its own would be negatively associated with SWB, while SOC would be positively associated with SWB, 2) building on the results of previous studies that SOC may counteract the adverse impact of CB, a high level of SOC may correlated with a low level of perceived CB in adult-child caregivers, and 3) CB and SOC may mutually suppress each other in their effects on SWB, that is, CB and SOC may be revealed to have stronger correlations with SWB when they are concomitantly considered to be predictors of SWB compared to when they are considered in separate models to predict SWB. The current study hopes to provide valuable insights into the interplay of CB and SOC and their net effects on SWB, which have profound implications for developing more robust interventions aiming at enhancing adult-child caregivers’ SWB.