Can the Use of Telehealth Guidance Services Reduce Depressive Symptoms Among Family Caregivers of Older Adults with Cognitive Impairment? A Moderated-Mediation Model.

Background: Family caregivers of older adults with cognitive impairment commonly encounter heavy care burdens and elevated mental health risks, particularly depressive symptoms. This study aimed to explore the association between telehealth guidance service use and depressive symptoms among family caregivers of older adults with cognitive impairment, and to further examine the mediating role of caregiving competence and the moderating role of psychological resilience. Methods: A cross-sectional survey of 491 family caregivers of older adults with cognitive impairment was conducted from August to October 2023. Descriptive statistics, correlation analysis, linear regression analysis, and moderated-mediating-effect analysis were employed. Results: Among the participants, only 17.31% reported using telehealth guidance services. Mean scores for caregiving competence, psychological resilience, and depressive symptoms were 3.04 ± 0.48, 27.11 ± 7.54, and 9.69 ± 1.46, respectively. Telehealth service use was positively associated with caregiving competence, and both telehealth service use and caregiving competence were negatively associated with depressive symptoms. The interaction between psychological resilience and caregiving competence was also significantly negatively associated with depressive symptoms (p < 0.01). Conclusions: Telehealth guidance service use is directly and indirectly negatively associated with depressive symptoms via caregiving competence. Psychological resilience moderates the relationship between caregiving competence and depressive symptoms. These findings contribute to a better understanding of factors linked to mental health among family caregivers of older adults with cognitive impairment.