Predictive cultural model for family caregivers of older people with musculoskeletal pain in East Coast Malaysia

Abstract

Malaysia’s ageing population faces a high prevalence of chronic musculoskeletal pain, particularly among older adults, placing significant demands on family caregivers. Despite a lack of culturally tailored caregiving models, Malaysians continue to embrace strong cultural values that place family-centered care and filial piety at the heart of the caregiving experience. This study aimed to develop a predictive cultural model for caregivers of older adults with chronic musculoskeletal pain in East Coast Malaysia. This cross-sectional study recruited a total of 290 caregivers from community settings and administered validated instruments to assess caregiving strain (M-CSI), attitudes, needs (FIN–Importance), and healthcare providers’ cultural competency attributes. Data were analysed using descriptive statistics, multivariate regression, and structural equation modelling. Multivariate analysis discovered protective factors included the ability to maintain routines/traditions, knowledge of the care recipient’s health, care aligned with cultural values, caregiving confidence, and healthcare staff involvement. Higher strain was associated with greater involvement of significant others, stronger connections to community resources, and comfort in sharing personal information with providers. The structural model explained 57.1% of the variance in caregiver challenges, indicating a moderate explanatory power for the model and highlighting the complex interplay between cultural beliefs, caregiving needs, and healthcare interactions. The proposed model emphasises culturally sensitive practices, clear health communication, and caregiver empowerment to reduce burden and enhance care quality. These results can guide the development of targeted, culturally integrated interventions and policies to support caregiver well-being and improve outcomes for older adults in multicultural settings, particularly in Malaysia.