Grief and Psychopathology in Bereaved Caregivers of Palliative Care Patients: The Mediating and Moderating Roles of Distress, Burden and Social Support

ABSTRACT Aim(s) This study examines the mediating roles of distress, burden and social support, as well as the moderating effect of social support, in the relationship between the risk of prolonged grief and psychopathology in bereaved family caregivers of palliative care patients. Design A cross‐sectional study was conducted with 125 bereaved family caregivers. Validated assessment tools and the PROCESS macro in SPSS were used for mediation and moderation analyses. Results Emotional burden mediated the relationship between prolonged grief risk and psychopathology, while distress and physical burden did not. Instrumental social support was a key mediator, highlighting the protective role of practical assistance, whereas emotional social support did not show significant mediation. Both types of social support moderated the relationship, buffering the negative impact on mental health. Conclusions Findings underscore the complex interactions between bereavement risk factors and psychopathology. Addressing emotional burden and enhancing social support may help reduce mental health risks in bereaved caregivers. Implications for the Profession and/or Patient Care Healthcare professionals in palliative care should implement targeted interventions to reduce burden and strengthen support systems for bereaved caregivers. Nursing‐led initiatives focused on emotional burden reduction may mitigate psychopathology risks. Impact Findings are relevant for healthcare professionals in palliative care and those designing interventions for bereaved caregivers. Emotional burden mediated the relationship between prolonged grief and psychopathology, while instrumental and emotional social support moderated its effects. Reporting Method This study adhered to STROBE guidelines for cross‐sectional research. Patient or Public Contribution Beyond caregiver participation in data collection, patients and healthcare professionals contributed to study design, protocol development and dissemination.