Social media has emerged as a critical and common resource for family caregivers of people with dementia (PwD), offering new avenues for social support, information sharing, and social connection. Despite increasing attention to the well-being of caregivers, the mechanisms through which social media engagement contributes to successful caregiving outcomes remain insufficiently understood, particularly within the context of Chinese society where both social media adoption and the prevalence of dementia are rising. Basing on the Social Media Network Theory and Successful Caregiving Theory, this study aims to address this gap by developing and empirically validating a comprehensive research model that explains how different dimensions of social media engagement—namely, social use (building and maintaining relationships) and cognitive use (accessing and sharing information)—impact successful caregiving among family caregivers of PwD.

We employed a mix-method approach. First, a questionnaire-based survey was administered to a large sample of family caregivers in Shanghai and Hong Kong, focusing on their patterns of social media engagement, the development of guanxi networks, information access capability, and self-reported successful caregiving outcomes. The survey instruments were rigorously adapted from established scales and refined through expert consultation and pilot testing. Using Partial Least Squares Structural Equation Modeling (PLS-SEM), we tested a series of hypotheses regarding the mediating roles of guanxi networks and information access in the relationship between social media engagement and successful caregiving. The SEM results provided robust evidence that social use is positively associated with guanxi networks development (B=0.452, p<0.001) and cognitive uses is positively associated with information access (B=0.610, p<0.001). Furthermore, the information access (B=0.270, p<0.001) and Guanxi network (B=0.373, p<0.001) is positively associated with the successful caregiving (R2=0.375).

To further explore the complexity and heterogeneity of these relationships, we supplemented the SEM analysis with a two-step fuzzy set Qualitative Comparative Analysis (fsQCA). This case-oriented method enabled us to identify multiple sufficient configurations of social media engagement and mediators that lead to high levels of successful caregiving, thereby revealing causal asymmetry and conjunctural causality that traditional variable-oriented approaches may overlook. The two-step fsQCA results first supported the findings from the SEM analysis. Specifically, fsQCA analysis revealed two distinct sufficient configurations: (1) high cognitive use, strong guanxi networks, and effective information access (consistency=0.939); (2) high social use, strong guanxi networks, and effective information access (consistency=0.943). These findings indicate that successful caregiving can be achieved through either cognitive or social pathways, provided that both strong guanxi networks and effective information access are present.

Our study advances the theoretical understanding of caregiving success by integrating social media network and successful caregiving frameworks and demonstrates the methodological value of combining SEM and fsQCA in digital health research for family caregiver of PWD. The findings offer actionable recommendations for practitioners, social service providers, and technology developers seeking to design more effective interventions and digital media that empower family caregivers, which underscores the multifaceted and dynamic nature of caregiving success in the digital age.

 

This project is funded by GRF Ref. 17603923 and Natural Science Foundation of China (Grant No.: 72174118)

Dr. Xiaobo Ke is an Assistant Professor at The Education University of Hong Kong. He is also a Centre on Ageing Fellow at the Sau Po Centre on Ageing, The University of Hong Kong. Dr. Ke’s research explores the impacts of digital technologies in social, commercial, and behavioral contexts, focusing on esports, gamification for social good, and IT for geriatric caregiving.

 

Prof. Vivian W. Q. Lou is the Director of Sau Po Centre on Ageing, and Professor at Department of Social Work & Social Administration at The University of Hong Kong. Her research interests focus on family gerontology, in particular family caregiving for dementia, stroke, end-of-life older adults, and social adaptation and mental health of Chinese older adults and family caregivers. She has committed to cross-sector collaboration with community partners, social enterprises, and the market. Professor Lou is recognized as Healthy Ageing 50 leaders transforming the world to be a better place in which to grow older in 2022, Woman Change Maker in STEM in 2023, Ageing Asia global Ageing Influencer 2024, and Golden Age Foundation Smart Ageing Champion – Academia 2024.

 

Dr. Fan Yang is an Associate Professor in School of International and Public Affairs at Shanghai Jiao Tong University. His research is primarily on mental health of vulnerable groups, particularly left-behind children and frail older adults, and examines how social welfare policies can support these populations.