Caregiving burden and self-efficacy mediate the association between individual characteristics and depressive symptoms among husbands of Chinese breast cancer patients

  • Nelson C. Y. Yeung
  • Lili Ji
  • Yiwei Zhang
  • Guohua LuEmail author
  • Qian LuEmail author
Original Article



Perceptions of caregiving burden and self-efficacy are found to be associated with well-being among husbands of breast cancer patients (BCP). However, little is known about how individual characteristics associate with such caregiving-related perceptions and cancer caregivers’ well-being. This study examined the associations between two individual characteristics (male gender role norms and ambivalence over emotional expression (AEE)) and depressive symptoms among husbands of Chinese BCP, and the potential mediating roles of caregiving burden and self-efficacy in such associations.


Participants (n = 176) were recruited in two hospitals in Weifang, China. Their endorsement of male gender role norms (e.g., “men should not ask for help”), AEE, caregiving burden, and depressive symptoms were measured in a cross-sectional survey.


Path analysis results supported the proposed mediation model with satisfactory fit indices (χ2(2) = 2.73, p = .26, CFI = 1.00; IFI = 1.00; RMSEA = 0.05). Specifically, male gender role norms and AEE were associated with higher caregiving burden and lower caregiving self-efficacy, which in turn were associated with more depressive symptoms. Bootstrapping results supported that both male gender role norms (β = 0.16; 95%CI = 0.09, 0.25) and AEE had significant indirect effects on depressive symptoms (β = 0.11; 95%CI = 0.04, 0.18) via caregiving burden and self-efficacy, indicating that caregiving-related perceptions could mediate between individual characteristics and depressive symptoms.


Male gender role norms and AEE might affect depressive symptoms among husbands of Chinese BCP through caregiving-related perceptions. Future interventions that reduce those husbands’ barriers to express emotions, appreciate their commitment to take good care of their spouses, enhance caregiving skills, and reduce caregiving burden may decrease their depressive symptoms.


rds: Depressive symptoms Caregiving burden Self-efficacy Gender role norms Ambivalence over emotional expression 


Funding information

This study was supported by the 2014 American Psychological Association Dissertation Research Award grant (PI: Nelson Yeung) and the College of Liberal Arts and Social Sciences (CLASS) Research Outreach Grant at the University of Houston (PI: Qian Lu).

Compliance with ethical standards

The authors also have full control of all primary data and agree to allow the journal to review the data if requested. The study was approved by the relevant institutional review boards.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The JC School of Public Health and Primary CareThe Chinese University of Hong KongSha TinHong Kong
  2. 2.Department of Medical NursingWeifang Medical UniversityWeifangChina
  3. 3.Department of Health Disparities ResearchThe University of Texas MD Anderson Cancer CenterHoustonUSA

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