Association between perception of stigma and caregiver burden among mothers of children with cleft lip and palate surgeries and the mediating role of psychological resilience

Abstract

Abstract Cleft lip and palate (CLP) are common congenital conditions necessitating surgical intervention, often imposing significant emotional and social challenges on caregivers, particularly mothers. This study, conducted between August 2023 and May 2025, enrolled 146 mother–child dyads (each comprising a child scheduled for CLP surgery and their mother) to investigate caregiver burden, perceived stigma, psychological resilience, and social support through structured assessments and one-on-one interviews. Results revealed that elevated levels of perceived stigma were associated with increased caregiver burden. Contrary to expectations, higher stigma correlated with reduced psychological resilience, which subsequently mediated heightened caregiver stress even after controlling for clinical and demographic covariates. Notably, social support did not demonstrate a mitigating effect on stigma’s impact, suggesting caregivers may experience persistent isolation despite accessible assistance. These findings underscore the critical need for targeted interventions addressing stigma and enhancing resilience to alleviate caregiver burden. The study highlights the importance of fostering supportive environments for families managing CLP, as mitigating stigma and strengthening resilience can substantially improve quality of life for both caregivers and children.

Keywords

• Cleft lip and palate
• Caregiver burden
• Family stigma
• Psychological resilience