Anxiety mediates the relationship between caregiver burden and preparedness in individuals with acquired brain injury: meta-analytic structural equation modeling

Informal caregivers of individuals with acquired brain injury (ABI) often lack adequate preparedness for caregiving. Caregiver burden may reduce preparedness, with anxiety potentially mediating this relationship. However, these associations remain unclear. This study aims to analyze the relationships between caregiver burden, anxiety, and preparedness, and to explore the mediating role of anxiety. This study systematically searched seven databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and China Biology Medicine Disc, from inception to June 6, 2024. Meta-analytic structural equation modeling (MASEM) combines concepts of meta-analysis and structural equation modeling (SEM) to integrate correlation or covariance matrices. A summary correlation matrix was estimated using a random-effects model and incorporated into SEM to examine the associations among caregiver burden, anxiety, and preparedness. 13,610 articles were screened for MASEM analysis, and 27 studies were included. The MASEM results showed significant correlations among the three variables (all <i>p</i> &lt; 0.001). Additionally, anxiety partially mediated the relationship between burden and preparedness (β= −0.147, 95% CI [−0.226, −0.083]). Research using the MASEM method observed that heightened caregiver burden and anxiety potentially reduce preparedness, with anxiety significantly mediating the relationship between caregiver burden and preparedness.