{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T09:03:49Z","timestamp":1784624629681,"version":"3.55.0"},"reference-count":41,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Fundamental Research Project for Universities, Department of Education of Liaoning Province, China","award":["LJ112410161014"],"award-info":[{"award-number":["LJ112410161014"]}]},{"name":"The APC was funded by Theory and Methodology of Regional Health Performance Evaluation in the Context of Implementing the Healthy China Strategy","award":["L21ZD015"],"award-info":[{"award-number":["L21ZD015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>With the rising incidence of hematologic malignancies (HMs) in recent years, caregivers of HMs patients have increasingly emerged as a significant factor affecting the treatment of these conditions. This study aimed to explore the association of coping strategies on the relationship between care burden and social support among family caregivers of HMs patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A questionnaire survey was conducted involving 207 family caregivers of hospitalized HMs patients in a tertiary hospital in Dalian from October 2023 to May 2024 and 200 valid responses were collected. We used hierarchical linear regression and parallel mediation model to assess the relationships and potential mediating effects among care burden, coping strategies, and social support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In our study, the care burden showed a medium level and average score was 44.21\u00a0\u00b1\u00a015.92. Positive coping strategies (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u00a0\u2212\u00a00.769,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) and social support (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u00a0\u2212\u00a00.654,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) showed a negative correlation with care burden, while negative coping strategies was significantly correlated with care burden (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.788,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). According to the mediating effect analysis after covariate adjustment, the relationships between social support and care burden were mediated by coping strategies in total samples and the indirect effect value was \u22120.955, accounted for 73.57% of the total effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Family caregivers of HMs patients with more negative coping strategies and less social support were significantly associated with higher levels of care burden. Coping strategies served as a partial parallel mediator between social support and care burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.21527","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:30:25Z","timestamp":1784622625000},"page":"e21527","source":"Crossref","is-referenced-by-count":0,"title":["Social support and care burden in family caregivers of patients with hematologic malignancies: a parallel mediation model of coping strategies"],"prefix":"10.7717","volume":"14","author":[{"given":"Xiaohe","family":"Fan","sequence":"first","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingsong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijie","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Hematology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotong","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yikun","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junfeng","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Ding","sequence":"additional","affiliation":[{"name":"School of Public Health, Dalian Medical University, Dalian, Liaoning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"issue":"10","key":"10.7717\/peerj.21527\/ref-1","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1001\/jama.2014.304","article-title":"Caregiver burden: a clinical review","volume":"311","author":"Adelman","year":"2014","journal-title":"Journal of the American Medical Association"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-2","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1186\/s12913-021-06340-4","article-title":"The effect of a supportive home care program on caregiver burden with stroke patients in Iran: an experimental study","volume":"21","author":"Ashghali\u00a0Farahani","year":"2021","journal-title":"BMC Health Services Research"},{"key":"10.7717\/peerj.21527\/ref-3","doi-asserted-by":"publisher","first-page":"e190168","DOI":"10.1590\/1982-0275202138e190168","article-title":"The psychological impact on family caregivers of children and adolescents with sickle cell anemia","volume":"38","author":"Caprini","year":"2021","journal-title":"Estudos de Psicologia (Campinas)"},{"issue":"11","key":"10.7717\/peerj.21527\/ref-4","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1007\/s00127-007-0242-8","article-title":"Caregiver burden and coping: a prospective study of relationship between burden and coping in caregivers of patients with schizophrenia and bipolar affective disorder","volume":"42","author":"Chadda","year":"2007","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-5","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1177\/13623613221081917","article-title":"Social support and links to quality of life among middle-aged and older autistic adults","volume":"27","author":"Charlton","year":"2023","journal-title":"Autism"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-6","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3233\/RNN-139008","article-title":"Psychobiology of social support: the social dimension of stress buffering","volume":"32","author":"Ditzen","year":"2014","journal-title":"Restorative Neurology and Neurosciences"},{"issue":"4","key":"10.7717\/peerj.21527\/ref-7","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1016\/j.neuroimage.2007.01.038","article-title":"Neural pathways link social support to attenuated neuroendocrine stress responses","volume":"35","author":"Eisenberger","year":"2007","journal-title":"NeuroImage"},{"issue":"2","key":"10.7717\/peerj.21527\/ref-8","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.jtcme.2023.10.004","article-title":"Curcumin in treatment of hematological cancers: promises and challenges","volume":"14","author":"Entezari","year":"2024","journal-title":"Journal of Traditional and Complementary Medicine"},{"key":"10.7717\/peerj.21527\/ref-9","volume-title":"Manual for the ways of coping questionnaire","author":"Folkman","year":"1988"},{"issue":"2","key":"10.7717\/peerj.21527\/ref-10","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1002\/gps.538","article-title":"Gender differences in burden and depression among informal caregivers of demented elders in the community","volume":"17","author":"Gallicchio","year":"2002","journal-title":"International Journal of Geriatric Psychiatry"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-11","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jncc.2024.01.006","article-title":"Cancer incidence and mortality in China","volume":"4","author":"Han","year":"2022","journal-title":"Journal of the National Cancer Center"},{"issue":"10","key":"10.7717\/peerj.21527\/ref-12","doi-asserted-by":"publisher","first-page":"4283","DOI":"10.1007\/s00520-016-3261-8","article-title":"Burden and happiness in head and neck cancer carers: the role of supportive care needs","volume":"24","author":"Hanly","year":"2016","journal-title":"Support Care Cancer"},{"key":"10.7717\/peerj.21527\/ref-13","doi-asserted-by":"publisher","first-page":"1194774","DOI":"10.3389\/fpubh.2023.1194774","article-title":"Caring load and family caregivers\u2019 burden in China: the mediating effects of social support and social exclusion","volume":"11","author":"Hu","year":"2023","journal-title":"Frontiers in Public Health"},{"issue":"7","key":"10.7717\/peerj.21527\/ref-14","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1177\/1533317513494446","article-title":"Coping strategy and caregiver burden among caregivers of patients with dementia","volume":"30","author":"Huang","year":"2015","journal-title":"American Journal of Alzheimer\u2019s Disease & Other Dementias\u00ae"},{"issue":"8","key":"10.7717\/peerj.21527\/ref-15","doi-asserted-by":"publisher","first-page":"6923","DOI":"10.1007\/s00520-022-07089-0","article-title":"Family caregiver ambassador support for caregivers of patients with newly diagnosed hematological cancer: a feasibility study","volume":"30","author":"Husted Nielsen","year":"2022","journal-title":"Support Care Cancer"},{"issue":"2","key":"10.7717\/peerj.21527\/ref-16","doi-asserted-by":"publisher","first-page":"204","DOI":"10.4103\/apjon.apjon_53_20","article-title":"Identification of psychological and social problems in caregivers of individuals diagnosed with hematologic malignancy","volume":"8","author":"Karacan","year":"2021","journal-title":"Asia-Pacific Journal of Oncology Nursing"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-17","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s40164-021-00198-2","article-title":"A global, regional, and national survey on burden and quality of care index (QCI) of hematologic malignancies: global burden of disease systematic analysis 1990-2017","volume":"10","author":"Keykhaei","year":"2021","journal-title":"Experimental Hematology & Oncology"},{"issue":"2","key":"10.7717\/peerj.21527\/ref-18","doi-asserted-by":"publisher","first-page":"e041862","DOI":"10.1136\/bmjopen-2020-041862","article-title":"Mediating effect of coping style on the relationship between clinical leadership and quality of work life among nurses in tertiary-level hospitals in China: a cross-sectional study","volume":"11","author":"Li","year":"2021","journal-title":"BMJ Open"},{"key":"10.7717\/peerj.21527\/ref-19","doi-asserted-by":"publisher","first-page":"1180317","DOI":"10.3389\/fpsyt.2023.1180317","article-title":"Factors related to the quality of life of family cancer caregivers","volume":"14","author":"Liu","year":"2023","journal-title":"Frontiers in Psychiatry"},{"issue":"4","key":"10.7717\/peerj.21527\/ref-20","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.3390\/ijerph17041351","article-title":"Association of formal and informal social support with health-related quality of life among Chinese rural elders","volume":"17","author":"Lu","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"5","key":"10.7717\/peerj.21527\/ref-21","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1080\/07317115.2019.1572039","article-title":"The impact of risk and resistance factors on quality of life in caregivers of individuals with dementia","volume":"43","author":"Morrison","year":"2020","journal-title":"Clinical Gerontologist"},{"key":"10.7717\/peerj.21527\/ref-22","volume-title":"Caregiving in the United States 2020","author":"National Alliance\u00a0for Caregiving, AARP","year":"2020"},{"key":"10.7717\/peerj.21527\/ref-23","doi-asserted-by":"publisher","first-page":"1104250","DOI":"10.3389\/fpubh.2023.1104250","article-title":"Social support, positive caregiving experience, and caregiver burden in informal caregivers of older adults with dementia","volume":"11","author":"Nemcikova","year":"2023","journal-title":"Frontiers in Public Health"},{"issue":"12","key":"10.7717\/peerj.21527\/ref-24","doi-asserted-by":"publisher","first-page":"e943\u201355","DOI":"10.1016\/S2468-2667(23)00166-6","article-title":"National and subnational trends in cancer burden in China, 2005-20: an analysis of national mortality surveillance data","volume":"8","author":"Qi","year":"2023","journal-title":"Lancet Public Health"},{"key":"10.7717\/peerj.21527\/ref-25","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1146\/annurev-psych-010419-050754","article-title":"Family caregiving for older adults","volume":"71","author":"Schulz","year":"2020","journal-title":"Annual Review of Psychology"},{"issue":"3","key":"10.7717\/peerj.21527\/ref-26","doi-asserted-by":"publisher","first-page":"298","DOI":"10.4103\/0973-1075.164890","article-title":"Association of coping styles with quality of life in cancer patients","volume":"21","author":"Shakeri","year":"2015","journal-title":"Indian Journal of Palliative Care"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-27","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s40359-020-00402-8","article-title":"Prevalence of depression and anxiety and correlations between depression, anxiety, family functioning, social support and coping styles among Chinese medical students","volume":"8","author":"Shao","year":"2020","journal-title":"BMC Psychology"},{"issue":"4","key":"10.7717\/peerj.21527\/ref-28","doi-asserted-by":"publisher","first-page":"100382","DOI":"10.1016\/j.apjon.2024.100382","article-title":"Fear of cancer recurrence and associated factors in family caregivers of patients with hematologic malignancy receiving chemotherapy: a latent profile analysis","volume":"11","author":"Sheng","year":"2024","journal-title":"Asia-Pacific Journal of Oncology Nursing"},{"issue":"5","key":"10.7717\/peerj.21527\/ref-29","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1159\/000210092","article-title":"Burden of caregivers of people with stroke: evolution and predictors","volume":"27","author":"Vincent","year":"2009","journal-title":"Cerebrovascular Diseases"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-30","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1111\/inm.13081","article-title":"The effect of prosocial behaviours on Chinese undergraduate nursing students\u2019 subjective well-being: the mediating role of psychological resilience and coping styles","volume":"32","author":"Wan","year":"2023","journal-title":"International Journal of Mental Health Nursing"},{"issue":"5","key":"10.7717\/peerj.21527\/ref-31","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1111\/ijn.12458","article-title":"Depression, caregiver burden and social support among caregivers of retinoblastoma patients in China","volume":"22","author":"Wang","year":"2016","journal-title":"International Journal of Nursing Practice"},{"issue":"3","key":"10.7717\/peerj.21527\/ref-32","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1080\/00981389.2013.873515","article-title":"Social support sources, types, and generativity: a focus group study of cancer survivors and their caregivers","volume":"53","author":"Wong","year":"2014","journal-title":"Social Work in Health Care"},{"key":"10.7717\/peerj.21527\/ref-33","first-page":"98","article-title":"The theoretical basis and research application of the Social Support Rating Scale","volume":"2","author":"Xiao","year":"1994","journal-title":"Journal of Clinical Psychiatry"},{"key":"10.7717\/peerj.21527\/ref-34","first-page":"53","article-title":"A preliminary study on the reliability and validity of the Simplified Coping Style Questionnaire","volume":"2","author":"Xie","year":"1998","journal-title":"Chinese Journal of Clinical Psychology"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-35","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1186\/s12877-024-05014-0","article-title":"Validating interRAI Chinese self-reported carer needs (SCaN) assessment and predicting caregiving distress among informal Chinese caregivers of older adults","volume":"24","author":"Xu","year":"2024","journal-title":"BMC Geriatrics"},{"key":"10.7717\/peerj.21527\/ref-36","doi-asserted-by":"publisher","first-page":"809272","DOI":"10.3389\/fpsyg.2022.809272","article-title":"Social support and job satisfaction in kindergarten teachers: the mediating role of coping styles","volume":"13","author":"Yang","year":"2022","journal-title":"Frontiers in Psychology"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-37","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1186\/s12912-023-01587-0","article-title":"Self-efficacy and well-being in the association between caregiver burden and sleep quality among caregivers of elderly patients having multiple chronic conditions in rural China: a serial multiple mediation analysis","volume":"22","author":"Yang","year":"2023","journal-title":"BMC Nursing"},{"key":"10.7717\/peerj.21527\/ref-38","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.pedn.2023.08.011","article-title":"The mediating effect of sense of coherence on the caregiver ability-caregiver burden relationship for caregivers of children with liver transplantation in China","volume":"73","author":"Zhang","year":"2023","journal-title":"Journal of Pediatric Nursing"},{"issue":"7","key":"10.7717\/peerj.21527\/ref-39","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1007\/s11136-021-02793-6","article-title":"Social support and quality of life among rural family caregivers of persons with severe mental illness in Sichuan Province, China: mediating roles of care burden and loneliness","volume":"30","author":"Zhang","year":"2021","journal-title":"Quality of Life Research"},{"issue":"1","key":"10.7717\/peerj.21527\/ref-40","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1186\/s12877-024-04768-x","article-title":"Blessing or curse: the role of authoritarian filial piety and self-efficacy in caregiver gains among Chinese family caregivers caring for physically impaired older adults","volume":"24","author":"Zhang","year":"2024","journal-title":"BMC Geriatrics"},{"issue":"12","key":"10.7717\/peerj.21527\/ref-41","first-page":"5723","article-title":"Concerns of and coping strategies by parents of pediatric liver transplant recipients: a qualitative study from China","volume":"7","author":"Zhang","year":"2014","journal-title":"International Journal of Clinical and Experimental Medicine"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/21527.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/21527.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/21527.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/21527.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:30:28Z","timestamp":1784622628000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/21527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":41,"alternative-id":["10.7717\/peerj.21527"],"URL":"https:\/\/doi.org\/10.7717\/peerj.21527","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"article-number":"e21527"}}