Effect of disability severity on home‐based care quality among families with Uygur and Kazakh disabled older adults in far western rural China: A cross‐sectional study.

Aims: To explore how family functioning and family resilience mediate the relationship between disability severity and quality of home‐based care among families with disabled older adults. Methods: A cross‐sectional survey was conducted with 431 families with Uygur and Kazakh disabled older adults in Xinjiang, China, in 2020. The data were collected using the Katz Activity of Daily Living Scale; Mini‐Mental State Examination; Family Adaptation, Partnership, Growth, Affection and Resolve Index Scale; Family Resilience Assessment Scale; and Family Caregiving Consequences Inventory Scale. All mediation effects were estimated in SPSS26.0. Results: Disability severity, family functioning and family resilience were all significantly correlated with home‐based care quality. Disability severity had a 46.16% direct effect on home‐based care quality and a 53.84% indirect effect on home‐based care quality independently and in series through family functioning and family resilience. Conclusions: Disability severity directly affected home‐based care quality and had an indirect influence via family functioning and family resilience. Multidisciplinary care teams should focus on families with disabled older adults and help them improve family functioning and family resilience by implementing targeted interventions, so as to improve home‐based care quality. Summary statement: What is already known about the topic? Literature has clarified that social support and caregiver competence mediate the path relationship between disability severity and home‐based care quality from the perspective of individuals.Long‐term care for disabled older adults affects not only informal caregivers but also the whole family.The role of the family, such as family functioning and family resilience, in the whole process remains unclear. What this paper adds? Findings indicated relationships between disability severity, family functioning, family resilience and home‐based care quality.Disability severity can indirectly influence home‐based care quality not only through family functioning or family resilience but also through family functioning affecting family resilience. The implications of this paper Findings indicate that community nurses should not only pay attention to disabled older adults and their informal caregivers but also consider the impact of family functioning and family resilience when formulating interventions to improve the quality of home‐based care.When disabled older adults are transferred from hospitals to home, community rehabilitation nurses should intervene as early as possible, providing guidance on rehabilitation training and daily living skills for disabled older adults to restore and maintain function and prevent complications.Community nurses can conduct case counselling services for family members to understand and satisfy their care needs, enhancing their confidence, cohesion and problem‐solving abilities to improve the quality of home‐based care. [ABSTRACT FROM AUTHOR]