A Serial Mediation Model of Resilience Among Caregivers of Children With Autism

Importance: Resilience has been reported as a vital element against the high burden on caregivers of children with autism. However, the intricate mechanisms underlying the concurrent interplay of positive factors with resilience within this demographic group remain less understood. Objective: To construct a model to verify the sequential mediating influence of hope and gratitude in the relationship between perceived social support and resilience among caregivers of children with autism. Design: Cross-sectional study. Participants: A total of 193 caregivers of children with autism in mainland China. Outcomes and Measures: Data were collected using the Herth Hope Index, C-GQ-6 Gratitude Questionnaire, Perceived Social Support Scale, and Resilience Questionnaire for Parents of Children With Special Needs. The hypothesized mediating model was tested with Process 4.0 (Model 6) for SPSS (Version 26.0). Results: The relationship of perceived social support and resilience was mediated by hope, gratitude, and the hope-gratitude sequence. Hope exhibited a stronger mediation effect, accounting for 26.23% of the total effect. Conclusions and Relevance: The results indicated significant positive correlations between perceived social support, hope, gratitude, and resilience, with perceived social support strongly linked to the other three. This study has important implications for occupational therapy, suggesting strategies for resilience-focused interventions tailored to caregivers of children with autism. Plain-Language Summary: Resilience is essential for caregivers of children with autism. Studies show that parents of children with autism report having fewer social supports, reduced quality of life, and heightened mental health challenges, including anxiety, depression, and hopelessness. This research highlights the connections between caregivers' perceived social support, hope, gratitude, and resilience. Addressing caregiver social supports and mental health can enhance caregiver well-being as well as children's participation in meaningful activities. The findings suggest practical implications and insights for occupational therapy practitioners to strengthen and foster caregiver resilience and well-being in the autism community.