Caregiver Burden and Its Influencing Factors Among Primary Caregivers of Children with Cleft Lip and/or Palate

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Objective: To investigate the caregiver burden and its sociodemographic influencing factors among primary caregivers of children with cleft lip and/or palate (CL/P), thereby providing empirical evidence for reducing caregiver burden in this population. Methods: A cross-sectional survey design was employed. A total of 377 primary caregivers of preschool children with CL/P who attended the Oral Surgery Department at Guangzhou Women and Children's Medical Center between March and December 2025 were enrolled using consecutive convenience sampling. Data were collected using a self-designed general demographic questionnaire and the Chinese version of the Zarit Burden Interview-12 (ZBI-12). Multivariable ordinal logistic regression was conducted to identify factors associated with caregiver burden. Results: The overall caregiver burden was notably high, with 51.5% of caregivers experiencing moderate-to-severe or severe burden. Multivariable ordinal logistic regression analysis revealed that, compared with families having three or more children, families with one child showed significantly lower odds of higher caregiver burden (OR = 0.38, P = 0.016), as did families with two children (OR = 0.48, P = 0.045). Compared with caregivers of children aged 1-3 years, caregivers of infants aged 0-1 year had higher risk of elevated burden (OR = 0.45, P = 0.021). Furthermore, compared with caregivers of children with cleft lip and palate, caregivers of children with isolated cleft lip (OR = 0.13, P = 0.001) and isolated cleft palate (OR = 0.17, P = 0.001) showed significantly lower odds of higher burden levels. Conclusion: Primary caregivers of children with CL/P commonly experience elevated levels of burden. The number of children, child age, and type of orofacial cleft represent significant determinants of caregiver burden. Clinical practice should implement stratified management and individualized supportive interventions targeting highrisk families, enhancing social support and psychological resilience to promote family functioning optimization and effectively alleviate caregiver burden.

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