{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:02:07Z","timestamp":1777384927111,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AG069936"],"award-info":[{"award-number":["R01AG069936"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32NR009356"],"award-info":[{"award-number":["T32NR009356"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although previous research has highlighted the protective effect of social support in caregiving contexts, further investigation is needed to understand its complex roles in modifying and explaining the impact of caregiver stressors. This cross-sectional study assessed family caregivers\u2019 social support, digital literacy, and caregiving-related stressors, examining their relationships and impact on mental health outcomes (anxiety and depressive symptoms). Specifically, we investigated (1) whether digital literacy interacted with stressors to influence caregivers\u2019 perceived social support and (2) whether social support mediates the relationship between caregiver stressors and mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 308 caregivers of people living with dementia receiving hospice care using structured assessments, including validated measures of social support, digital literacy, anxiety, depressive symptoms, and key sociodemographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The direct and total effects of caregiver stressors on mental health outcomes were statistically significant, whereas the indirect effects mediated by social support were not. Although tangible support was individually associated with both outcomes, the overall mediating effect of social support was not accounted for by either emotional\/informational or tangible support alone. The moderating effect of digital literacy was also not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The association between caregiver stressors and mental health appears to be more directly driven than mediated by social support. The absence of significant indirect or moderating effects highlights the complexity of these relationships and underscores the need for future research to explore additional pathways, contextual influences, and conditions under which aspects of social support or digital literacy may exert greater impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091251406573","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T14:18:03Z","timestamp":1765117083000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining Social Support and Digital Literacy Among Caregivers of People Living With Dementia Receiving Hospice Services"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7504-5934","authenticated-orcid":false,"given":"Hannah","family":"Cho","sequence":"first","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liming","family":"Huang","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1691-7836","authenticated-orcid":false,"given":"Justine S.","family":"Sefcik","sequence":"additional","affiliation":[{"name":"Drexel University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy A.","family":"Hodgson","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Hirschman","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1100-9524","authenticated-orcid":false,"given":"Karla","family":"Washington","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8354-0859","authenticated-orcid":false,"given":"Debra Parker","family":"Oliver","sequence":"additional","affiliation":[{"name":"Washington University in St. Louis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Demiris","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"},{"name":"University of Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Global Action Plan on the Public Health Response to Dementia 2017\u20132025","author":"World Health Organization","year":"2017","unstructured":"World Health Organization. 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