The Mediating Effect of Spiritual Well-Being on the Relationship between Social Support and Depression among Family Caregivers of Patients with Cancer Undergoing Chemotherapy

Objectives: This study aimed to examine the mediating effect of spiritual well-being on the relationship between social support and depression among family caregivers of cancer patients (FCPC) undergoing chemotherapy. Materials and Methods: A total of 180 families of cancer patients participated in this study, meeting the following inclusion criteria: Individuals aged 18–65 years, providing care for a patient with cancer in 4 months, residing with the patient and demonstrating no communication difficulties. Convenience sampling was conducted in two hospitals located in Yogyakarta and Jember, Indonesia, from May to August 2024. A valid and reliable self-reported structured questionnaire was used to collect data on depression, spiritual well-being and social support. The characteristic respondent questionnaire was also used. The unpaired t-test, analysis of variance and Pearson correlation were used to examine the relationships between depression and respondent characteristics, as well as the correlations among depression, spiritual well-being and social support. In addition, the Statistical Package for the Social Sciences (SPSS) PROCESS macro version 4.2 was used to examine the mediating factor model hypothesis confirmation. Results: The results showed that, based on the correlational test, spiritual well-being and social support were interconnected. The occupational status of the respondents correlated with depression. Social support positively affected spiritual well-being (B = 0.245; P < 0.001), and spiritual well-being was negatively affected by depression (B = −0.248; P < 0.001). In addition, social support was directly affected by depression (B = −0.236; P < 0.001). Bootstrap analysis supported the relationship between social support and depression with spiritual well-being as a mediating factor (B = −0.061; P < 0.05). Conclusion: This study indicated that social support was a significant predictor of depression in FCPC undergoing chemotherapy, with spiritual well-being acting as a mediating factor. Therefore, nurses should integrate spiritual nursing care and incorporate significant others to mitigate depression. Future studies are needed to explore further mediators and develop specific interventions for reducing depression.