The Relationship between Stigma and Burden: A Case Study in Miaoli, Taiwan

The Relationship between Stigma and Burden: A Case Study in Miaoli, Taiwan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Relationship between Stigma and Burden: A Case Study in Miaoli, Taiwan Wu He-Pei, Chiu Yi-Wen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9359021/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study examined the relationship between stigma perception and caregiving burden among family caregivers of persons with dementia in Taiwan, a rapidly ageing society. A quantitative, cross-sectional survey design was used, adhering to the STROBE guidelines. A total of 268 primary caregivers were recruited from a dementia shared care center in rural Miaoli County, central Taiwan, using convenience sampling. Participants completed structured questionnaires including the Taiwanese version of the Family Stigma in Dementia Scale (TWFS-DS) and the Chinese Caregiver Burden Inventory (CCBI). Descriptive and inferential analyses showed that caregivers’ overall stigma perception was low-to-moderate (standardized mean = 45.63/100), with courtesy stigma (concern about others’ judgments) being more prominent than affiliate stigma (self-stigma). Caregiving burden was moderate (standardized mean = 51.28/100), with time burden and physical burden ranking highest. Caregiver age, marital status, years of caregiving, self-rated health, and the number of patients’ behavioural and psychological symptoms of dementia (BPSD) were significantly associated with perceived stigma. Caregiving burden was influenced by relationship quality with the patient, self-rated health, patient gender, dementia severity, and number of BPSD. In a multiple linear regression model adjusting for potential confounders, overall stigma perception was the strongest predictor of caregiving burden (β = 0.395, p < .001), followed by self-rated health status (β = 0.313, p < .001), explaining 42% of the total variance (adjusted R² = 0.406). These findings highlight that stigma – particularly courtesy stigma – is a modifiable and policy-relevant determinant of caregiver burden. We recommend integrating routine stigma screening into dementia case management, extending caregiver follow up to at least five years, and implementing population level anti stigma campaigns to foster dementia friendly communities. Such interventions are essential for sustainable family caregiving in ageing societies like Taiwan. dementia caregivers caregiving burden stigma courtesy stigma ageing policy Taiwan Introduction The world is undergoing an unprecedented demographic transition. By 2050, one in six people will be aged 65 years or over (United Nations, 2019). Population ageing brings a corresponding rise in age-related non-communicable diseases, among which dementia is one of the most consequential. According to the World Health Organization (WHO, 2022), more than 55 million people live with dementia globally, and this number is projected to reach 139 million by 2050. Dementia is a leading cause of disability and dependency among older adults, and its impact extends far beyond the diagnosed individual to families, caregivers, and entire health and social care systems. In Taiwan, population ageing is occurring at an accelerated pace. The proportion of people aged 65 years and above exceeded 14% in 2018 (aged society) and is expected to surpass 20% by 2025 (super-aged society) (National Development Council, 2020). The prevalence of dementia among community-dwelling older adults in Taiwan is approximately 8%, meaning that nearly 380,000 older persons will be living with dementia by 2025 (Taiwan Alzheimer’s Disease Association, 2021). In response, the government launched the “Dementia Prevention and Care Policy and Action Plan 2.0” (Ministry of Health and Welfare, 2022), which explicitly recognises the need to support family caregivers. However, despite these policy efforts, the experiences of caregivers — particularly the hidden burden of stigma — remain under-examined in the Taiwanese context. Dementia caregiving: a multidimensional burden Caring for a family member with dementia is qualitatively different from caring for a person with a physical disability. Dementia is progressive, and behavioural and psychological symptoms of dementia (BPSD) — such as agitation, delusions, hallucinations, depression, and sundowning — are common, affecting up to 80% of patients (Calsolaro et al., 2021). These symptoms are often unpredictable and distressing, forcing caregivers into a state of continuous vigilance. Previous research has consistently shown that dementia caregivers report higher levels of stress, depression, and physical health problems than caregivers of older adults without cognitive impairment (Brodaty & Donkin, 2009; Alzheimer’s Association, 2022). Caregiver burden is a multidimensional concept that includes time dependence, developmental sacrifices, physical strain, family relationship tension, and emotional distress (Novak & Guest, 1989; Liu et al., 2020). Stigma as a hidden burden Stigma is defined as a socially discrediting attribute that leads to devaluation, rejection, and discrimination (Goffman, 1963). The World Health Organization has described stigma as a “hidden burden of disease” because it can delay help-seeking, reduce treatment adherence, and worsen health outcomes (Kane et al., 2019). In dementia, stigma is pervasive: a global survey by Alzheimer’s Disease International (2022) found that two-thirds of people still incorrectly believe that dementia is a normal part of ageing rather than a medical condition. Such misconceptions fuel negative stereotypes, social exclusion, and even structural discrimination. Importantly, stigma does not only affect the person with dementia; it also “spreads” to family caregivers. Courtesy stigma (also called associative stigma) refers to the negative attitudes and behaviours that the public directs toward caregivers because of their association with a stigmatised person (Werner et al., 2012). Affiliate stigma refers to the internalisation of these external negative attitudes, leading to feelings of shame, self-blame, and social withdrawal (Chang et al., 2016). These two forms of stigma are conceptually distinct but empirically related. Caregivers who perceive high levels of public rejection may begin to devalue themselves, which can further undermine their mental health and caregiving capacity. The cultural context: “face”, filial piety and family responsibility The experience of stigma is not culturally neutral. In Chinese societies, including Taiwan, the concept of mianzi (face) — the social standing and reputation that one holds in the eyes of others — is of paramount importance (Lin, 2015). Illnesses that are perceived as “shameful” or “genetically tainted” may bring disgrace to the entire family. Moreover, the Confucian ethic of filial piety expects adult children to care for ageing parents with devotion. When a family member develops dementia, caregivers may feel that they have “failed” in their duty if the patient’s symptoms become publicly noticeable (e.g., wandering, inappropriate behaviour), or they may fear being blamed for the patient’s condition. On the other hand, the same cultural values that emphasise family solidarity and respect for elders might also protect caregivers from internalising stigma — because caregiving is seen as a natural obligation rather than a personal failure. This dual possibility makes the empirical study of stigma in Chinese cultural contexts particularly important. Stigma and caregiver burden: what do we know? Several studies have documented a positive association between stigma and caregiver burden in dementia. Werner et al. (2012) found that family stigma was significantly associated with higher burden among Israeli caregivers. Kahn et al. (2016) reported similar findings in the United States. In Asia, Su and Chang (2020) and Huang (2021) showed that affiliate stigma is a robust correlate of burden among Taiwanese dementia caregivers. More recently, Chen et al. (2023) demonstrated that BPSD influence caregiver mental health partly through the mediating role of affiliate stigma. A systematic review (Shi et al., 2024) confirmed that stigma is consistently associated with caregiver burden across different cultures and care settings. However, most existing studies have either treated stigma as a single construct or focused only on affiliate stigma. Few have simultaneously examined courtesy stigma and affiliate stigma and compared their relative contributions to caregiver burden. Moreover, studies conducted in Western societies may not fully capture the dynamics of stigma in East Asian contexts, where public perception of family reputation plays a larger role. In Taiwan, although the government has established dementia care centres and support programmes, the extent to which caregivers experience courtesy stigma — and how this differs from internalised stigma — remains unclear. Research gaps and objectives Based on the above, this study aimed to: ( 1 ) assess the levels of courtesy stigma and affiliate stigma among family caregivers of persons with dementia in Taiwan; ( 2 ) examine the levels of multidimensional caregiver burden; ( 3 ) explore the associations between stigma (both types) and caregiver burden; and ( 4 ) identify significant predictors of caregiver burden, with particular attention to the relative contribution of stigma compared to patient clinical characteristics (e.g., dementia severity, BPSD). We hypothesised that stigma would be positively correlated with caregiver burden and would be a stronger predictor than objective patient characteristics. Methods Study Design and Participants This cross-sectional, descriptive correlational study adhered to the STROBE guidelines. Participants were family caregivers of persons with dementia enrolled in the dementia care management centre of a regional hospital in Miaoli, Taiwan. Convenience sampling was used. Inclusion criteria were: ( 1 ) aged ≥ 20 years and having provided care for a family member with a confirmed diagnosis of dementia for at least three months; ( 2 ) being the primary caregiver (the family member who spent the most hours per week on caregiving tasks); ( 3 ) able to communicate in Mandarin, Taiwanese, or Hakka; and ( 4 ) willing to provide written informed consent. Exclusion criteria were: ( 1 ) paid caregivers; and ( 2 ) caregivers who self-reported a current psychiatric disorder or major depression. Sample size was estimated using G*Power 3.1.9.7 (α = 0.05, power = 0.80, 20 predictors, medium effect size f² = 0.15), yielding a minimum of 222 participants. Allowing for 20% attrition, the target was 266. A total of 322 questionnaires were distributed, and 268 valid questionnaires were returned (response rate 83.2%). Instruments Data were collected using three instruments: ( 1 ) the Taiwanese version of the Family Stigma in Dementia Scale (TWFS-DS); ( 2 ) the Chinese Caregiver Burden Inventory (CCBI); and ( 3 ) a demographic questionnaire. To reduce social desirability bias, the scales were renamed during administration as “Caregivers’ Attitudes Toward Dementia Scale” and “Caregivers’ Perceptions of Caring for Persons with Dementia”. TWFS-DS (Huang, 2021) is a 32-item, 7-point Likert scale (1 = strongly disagree to 7 = strongly agree) comprising two subscales: courtesy stigma (16 items) and affiliate stigma (16 items). Four items are reverse-scored. Total scores range from 32 to 224; higher scores indicate greater stigma. In the present sample, Cronbach’s α was 0.909 (courtesy: 0.891; affiliate: 0.802). CCBI (Kuo et al., 2014) is a 23-item, 4-point Likert scale (1 = strongly disagree to 4 = strongly agree) assessing five dimensions: time-dependence burden (5 items), developmental burden (5 items), physical burden (4 items), family relationship burden (5 items), and emotional burden (4 items). Total scores range from 23 to 92; higher scores indicate greater burden. Cronbach’s α in this study was 0.921. Demographic questionnaire captured caregiver characteristics (gender, age, marital status, education, relationship to care recipient, co-residence, years of caregiving, weekly caregiving hours, self-rated health, number of chronic conditions, perceived relationship quality with care recipient, availability of substitute caregiver) and care recipient characteristics (gender, age, dementia severity by Clinical Dementia Rating [CDR], years since diagnosis, presence and number of BPSD). Data Collection Procedures Data were collected between September 2022 and January 2023. Two strategies were used: face-to-face interviews at the clinic (168 valid) and postal questionnaires distributed via a private online support group for dementia caregivers (100 valid). Each questionnaire was assigned a unique identification number. Questionnaires with missing responses were excluded. Ethical Considerations This study was conducted in accordance with the Declaration of Helsinki. Approval was obtained from the Institutional Review Board of Chung Shan Medical University Hospital (approval No. CS2-22147). All participants provided written informed consent. Statistical Analysis Data were analysed using SPSS version 22.0. Descriptive statistics summarised participant characteristics. Independent-samples t-tests and one-way ANOVA with Scheffé post-hoc comparisons were used. Pearson’s correlation examined relationships between stigma and burden. Multiple linear regression (forced entry) identified predictors of caregiver burden. Variance inflation factor (VIF < 2) indicated no multicollinearity. All tests were two-tailed with α = 0.05. Results Participant Characteristics Of the 268 participants, the majority were female (68.7%), with a mean age of 54.0 ± 12.2 years. Most were married (71.6%) and had a college education or above (41.8%). Most were adult children of the care recipient (64.9%) and lived with the care recipient (70.9%). Mean caregiving duration was 3.3 ± 2.6 years, and average weekly caregiving hours were 55.2 ± 49.3. Regarding self-perceived health, 43.7% rated their health as fair, and 37.3% reported a very good relationship with the care recipient. Most caregivers (63.1%) reported no chronic diseases, and 64.9% had alternative caregivers. Care recipients were predominantly female (60.1%) with a mean age of 79.9 ± 8.1 years. The majority had mild dementia (CDR = 1, 40.3%), followed by moderate (31.7%) and severe (19.0%). Mean time since diagnosis was 3.8 ± 2.9 years. BPSD were present in 78.0% of care recipients. Stigma Perception The mean total stigma score was 119.60 ± 20.95. After standardisation to a 0–100 scale, overall stigma was 45.63, indicating a low-to-moderate level. Courtesy stigma (M = 61.22 ± 9.52; standardised = 47.10) was higher than affiliate stigma (M = 48.68 ± 14.06; standardised = 34.04). The three highest-scoring items were all from the courtesy stigma domain: “Most people in society feel aversion toward dementia caregivers” (M = 5.04); “Most people in society do not feel embarrassed when interacting with dementia caregivers” (reverse-scored; M = 4.75); and “Most people in society ignore dementia caregivers” (M = 4.71). The three lowest-scoring items were affiliate stigma items: “I feel I have poor personal hygiene” (M = 2.60); “I feel inferior” (M = 2.65); and “I feel less worthy than others” (M = 2.74). Caregiving Burden The mean total burden score was 58.38 ± 9.53 (standardised = 51.28), reflecting moderate burden. Subscale standardised scores showed: time burden (70.20), physical burden (61.09), developmental burden (53.73), family relationship burden (40.87), and emotional burden (35.90). The highest-scoring items were “I need to constantly watch over the care recipient” (M = 3.34), “I need to help the care recipient accomplish many daily tasks” (M = 3.16), and “The care recipient is dependent on me” (M = 3.16). Differences in Stigma and Burden Across Variables Significant differences in stigma were found for caregiver age, marital status, years of caregiving, self-rated health, and number of BPSD (p < 0.05). Caregivers with poorer perceived health and those caring for patients with more BPSD reported higher stigma. For burden, significant differences were found for perceived relationship quality, self-rated health, care recipient gender, dementia severity, and number of BPSD (p < 0.05). Notably, delusions were associated with higher courtesy stigma, while behavioural disturbances were associated with higher affiliate stigma. Correlation Between Stigma and Caregiving Burden Pearson correlation showed a significant positive correlation between overall stigma and total burden (r = 0.511, p < 0.01). Both courtesy stigma (r = 0.412) and affiliate stigma (r = 0.503) were positively correlated with total burden. Time burden was not significantly correlated with any stigma measure (r = 0.102, p = 0.096). Predictors of Caregiving Burden Multiple linear regression (F[6,261] = 31.450, p < 0.001) explained 42% of the variance (adjusted R² = 0.406). Overall stigma was the strongest predictor (β = 0.395, p < 0.001), followed by caregiver self-rated health (β = 0.313, p < 0.001), number of BPSD (β = 0.130, p = 0.011), and care recipient gender (β = 0.110, p = 0.022). Perceived relationship quality and dementia severity were not significant in the final model. Discussion Stigma Perceptions: Courtesy Stigma Exceeds Affiliate Stigma This study found that overall stigma among Taiwanese dementia caregivers was low-to-moderate, with courtesy stigma higher than affiliate stigma. This pattern reflects the cultural importance of “face” ( mianzi ) and the belief that “family matters should not be disclosed publicly”. Caregivers are highly attuned to societal judgments but appear less likely to internalise these attitudes into self-devaluation, possibly because they view caregiving as a familial duty rather than a personal failure. The lowest-scoring affiliate stigma items (“poor personal hygiene”, “feeling inferior”, “feeling less worthy than others”) support this interpretation. Notably, specific BPSD subtypes had differential effects: delusions were associated with higher courtesy stigma, while behavioural disturbances (e.g., aggression, wandering) were associated with higher affiliate stigma. Publicly noticeable symptoms may trigger more perceived public rejection, whereas internalised shame may be more related to disruptive behaviours that caregivers feel responsible for. Caregiver Burden: Time and Physical Burden Dominate Caregiver burden was moderate, with time burden highest (70.2%) and emotional burden lowest (35.9%). Caregivers provided an average of 55.2 hours of care per week — far exceeding the 22–26 hours reported in Western samples. The low emotional burden may reflect Hakka cultural norms that emphasise stoicism, family solidarity, and suppression of negative emotional displays. Thus, the low emotional burden score likely under-represents true emotional distress. Stigma as the Strongest Predictor of Burden Stigma was the strongest predictor of caregiver burden (β = 0.395), exceeding objective factors such as dementia severity and BPSD count. This supports the social-psychological framework of Link and Phelan (2001), which conceptualises stigma as a process of labelling, stereotyping, separation, and status loss. For dementia caregivers, stigma functions not only as a direct source of burden but also as a magnifying mechanism, amplifying the psychological impact of caregiving demands. Policy and Practice Implications Based on the findings, we propose the following recommendations for ageing policy in Taiwan and similar contexts: Extend case management duration. Currently, Taiwan’s integrated dementia care centres follow caregivers for only 2–3 years after diagnosis. Stigma and burden peak at 1–5 years of caregiving and coincide with moderate dementia (CDR = 2). We recommend extending follow-up to at least five years, with increased monitoring frequency for high-risk groups. Incorporate routine stigma and health screening. Clinicians should routinely assess caregivers for stigma-related distress using validated instruments (e.g., TWFS-DS). Caregivers who are married, in the early caregiving phase, with poor self-rated health, or caring for persons with multiple BPSD should be prioritised for targeted psychosocial support. Develop family-centred support groups. Current support groups often target only the primary caregiver. Involving all adult household members in care planning discussions could reduce affiliate stigma and improve family dynamics. Launch population-level anti-stigma campaigns. Because courtesy stigma was more prominent than affiliate stigma, public education should focus on reducing societal aversion and social exclusion of dementia caregivers. Campaigns delivered through schools, media, and community organisations can help build dementia-friendly communities. Strengthen respite and home care services. Time burden was the highest subscale. Accessible and affordable formal home care services — including respite care, day care, and in-home help — are urgently needed, particularly in rural areas. Align with the Dementia Policy Guidelines 2.0. We recommend adding a specific performance indicator: “percentage of caregivers screened for stigma and burden annually”. The goal of “building a dementia-friendly society” should explicitly address courtesy stigma through community-based participatory interventions. Limitations Several limitations should be acknowledged. First, the convenience sample from a single hospital in rural Miaoli limits generalisability. Second, the cross-sectional design precludes causal inference. Third, self-reported questionnaires may introduce social desirability bias. Fourth, important variables such as long-term care service utilisation, employment of foreign domestic workers, and caregiver employment status were not assessed. Fifth, the study was conducted in a Hakka cultural region, and cultural specificity may limit cross-regional applicability. Future research should adopt longitudinal designs, include urban-rural comparisons, and incorporate mixed methods. Study Limitations Despite the significant findings, several limitations of this study should be acknowledged. First, the cross-sectional design limits the ability to establish causal relationships between dementia-related stigma and caregiving burden. Second, the study participants were recruited through convenience sampling from a single integrated dementia care center in Miaoli County . Although Miaoli offers a representative case of the semi-rural, rapidly ageing demographic in central Taiwan, the findings may not be fully generalizable to the entire population of Taiwan , especially those in highly urbanized metropolitan areas like Taipei or Kaohsiung. Third, the data relied on self-reported measures, which may be subject to social desirability bias. Future research should employ multi-center, longitudinal designs with a broader geographical scope to further validate these findings and their implications for ageing policy across different cultural and urban-rural contexts in Taiwan. Conclusion This study provides robust evidence that stigma perception — particularly courtesy stigma — is the strongest modifiable predictor of caregiving burden among Taiwanese dementia caregivers, explaining a substantial proportion of burden variance independently of disease severity and caregiver health. The positive correlation between stigma and burden across multiple domains underscores the pervasive impact of stigma. In the context of rapid population ageing in Taiwan and globally, addressing stigma is not only a clinical imperative but also a policy priority. We recommend integrating routine stigma screening into dementia case management, extending caregiver follow-up to at least five years, and implementing population-level anti-stigma campaigns to foster dementia-friendly communities. Such interventions can reduce caregiver burden, improve quality of life for both caregivers and persons with dementia, and support sustainable family caregiving in ageing societies. Declarations Funding: The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board of Chung Shan Medical University Hospital (No. CS2-22147). Author Contribution He-Pei Wu: Conceptualization, Methodology, Data collection, Writing - original draft.Yi-Wen Chiu: Conceptualization, Formal analysis, Supervision, Writing - review & editing. 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Liu, S., Li, C., Shi, Z., Wang, X., Zhou, Y., Liu, S., Liu, J., Yu, T., & Ji, Y. (2017). Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer's disease caregivers in China. Journal of Clinical Nursing, 26(9-10), 1291–1300. https://doi.org/10.1111/jocn.13601 Peng, M. M., Ma, Z., & Ran, M. S. (2022). Family caregiving and chronic illness management in schizophrenia: positive and negative aspects of caregiving. BMC Psychology, 10(1), 83. https://doi.org/10.1186/s40359-022-00794-9 Chang, C. C., Su, J. A., & Lin, C. Y. (2016). Using the Affiliate Stigma Scale with caregivers of people with dementia: Psychometric evaluation. Alzheimer's Research & Therapy, 8(1), 1-8. Ebrahim, O. S., Al-Attar, G. S., Gabra, R. H., & Osman, D. M. (2020). Stigma and burden of mental illness and their correlates among family caregivers of mentally ill patients. Journal of the Egyptian Public Health Association, 95(1), 1-9. Lin, Y.-X. (2015). Exploring the stigma of mental illness from the perspective of Chinese face culture. Tzu Chi Journal , (13), 5–12. (in Chinese) Tables Table 1. Demographic Characteristics of Caregivers and Care Recipients N=268 Variable Number Percentage (%) Mean ± SD Caregiver Demographic Characteristics Gender Female 184 68.66 Male 84 31.34 Age ≦44 years 57 21.27 54±12.19 45-54 years 84 31.34 55-64 years 77 28.73 ≧65 years 50 18.66 Marital status Married 192 71.64 Unmarried 76 28.36 Chronic disease Yes 99 36.94 No 169 63.06 Education Level Elementary school or below 23 8.58 Secondary school 91 33.96 College or above 154 57.46 Relationship to Care Recipient Spouse 39 14.55 Child 174 64.93 Son-/Daughter-in-law 36 13.43 Other 19 7.09 Living Arrangement Living with care recipient 190 70.90 Not living with care recipient 78 29.10 Years of caregiving Less than 1 year 19 7.09 3.31±2.64 1–3 years 105 39.18 3–5 years 73 27.24 5 years or more 71 26.49 Weekly caregiving hours <24hours 98 36.57 55.17±49.33 24–72 hours 101 37.69 72–120 hours 32 11.94 ≧120hours 37 13.81 Having substitute caregiver Yes 174 64.93 No 94 35.07 Perceived Relationship with Care Recipient Excellent 100 37.31 Good 97 36.19 Fair 59 22.01 Poor 9 3.36 Very Poor 3 1.12 Self-Rated Health Excellent 39 14.55 Good 67 25.00 Fair 117 43.66 Poor 40 14.93 Very Poor 5 1.87 Care Recipient (Person with Dementia) Demographic Characteristics Gender Female 161 60.07 Male 107 39.93 Age ≦69 years 31 11.57 79.96±8.13 70-79 years 84 31.34 ≧80 years 153 57.09 Dementia Severity CDR 0.5 24 8.96 CDR 1 108 40.30 CDR 2 85 31.72 CDR 3 51 19.03 Years since Diagnosis <1 year 16 6.00 3.81±2.88 1– 3 years 133 49.60 3–5 years 59 22.00 ≧ 5 years 60 22.39 Behavioral and Psychological Symptoms of Dementia (BPSD) Yes 209 77.99 No 59 22.01 Number of BPSD Symptoms None 59 22.01 1 65 24.25 2 61 22.76 3 41 15.30 ≧4 42 15.67 Table 2. Stigma and Caregiver Burden Scores N=268 Variable Domain Mean ± SD Standardized Score Stigma Total Stigma Score 119.60±20.95 45.63 Courtesy stigma 61.22±9.52 47.10 Affiliate stigma 48.67±14.06 34.04 Caregiver Burden Total Caregiver Burden 58.38±9.53 51.28 Time Burden 15.53±2.38 70.20 Developmental Burden 13.06±2.89 53.73 Physical Burden 10.72±2.50 61.09 Family Relationship Burden 11.13±2.71 40.87 Emotional Burden 7.95±2.20 35.90 Table 3. Differences in Caregiver Demographics, Stigma Perception, and Caregiver Burden N=268 Variable Stigma Perception t/F Caregiver Burden t/F Total Score Courtesy Stigma Affiliate Stigma Total Burden Time Burden Developmental Burden Physical Burden Family Relationship Burden Emotional Burden Gender 1.28 0.53 1.13 2.95 0.88 1.43 2.65 0.36 0.18 Age 3.23* 2.96* 3.03* 1.20 3.54* 3.24* 0.54 0.91 2.75* Marital Status 5.83* 3.13 7.11** 0.44 2.80 0.25 0.82 4.69* 3.48 Education Level 0.03 0.83 0.38 1.61 4.33* 3.77* 0.60 0.04 3.71* Relationship with Care Recipient 0.97 0.28 1.99 0.41 0.61 1.09 0.18 1.81 1.10 Living Arrangement 0.36 0.31 1.72 0.00 0.85 0.02 0.01 0.05 3.46 Years of Caregiving 3.21* 1.08 4.35** 1.43 3.51* 0.71 0.89 2.22 4.94** Weekly Caregiving Hours 1.15 0.55 1.71 1.76 4.90** 2.34 1.37 0.45 0.71 Self-perceived Relationship with Care Recipient 1.79 0.10 3.70** 5.13** 0.46 8.10*** 1.78 4.28** 6.82*** Self-perceived Health Status 4.61** 2.85* 5.04** 17.98*** 3.98** 13.82*** 20.23*** 8.73*** 7.35*** Chronic Disease 1.44 1.00 1.49 0.63 1.76 0.25 0.09 0.42 4.79* Availability of Substitute Caregiver 0.02 0.02 0.10 0.05 0.36 0.85 1.71 0.87 0.53 Care Recipient Gender 1.11 0.76 1.00 5.36* 7.77** 1.01 9.12** 5.69* 0.06 Care Recipient Age 2.77 5.15** 1.64 2.19 2.07 2.99 2.79 1.29 0.06 Dementia Severity 2.29 1.74 2.88* 6.59*** 5.38* 6.86*** 3.21* 2.59 2.82* Years Since Dementia Diagnosis 1.35 0.84 1.67 2.49 3.55* 1.21 2.10 2.18 2.53 Presence of BPSD 1.31 1.37 2.14 2.52 0.02 1.90 0.82 4.48* 0.67 Number of BPSD 3.43* 2.48* 3.54** 6.29*** 2.7* 4.90*** 5.40*** 2.73* 3.46** Note：* p＜0.05; ** p＜0.01; ***p＜0.001 Table 4. Multiple Linear Regression Analysis of Factors Predicting Caregiver Burden Predictor Unstandardized Coefficient Standardized Coefficient t p F VIF B SE ß Constant 1.098 0.119 9.207 0.000*** 31.450 Care Recipient Gender 0.093 0.040 0.110 2.297 0.022* 1.032 Self-perceived Relationship with Care Recipient 0.025 0.024 0.055 1.062 0.289 1.215 Self-perceived Health Status 0.134 0.023 0.313 5.852 0.000*** 1.285 Dementia Severity 0.031 0.23 0.067 1.342 0.181 1.115 Number of BPSD 0.034 0.013 0.130 2.559 0.011** 1.165 Total Stigma Score 0.243 0.030 0.395 8.209 0.000*** 1.088 Note：R 2 =0.420, Adjusted R 2 =0.406 Table 5. Correlations Between Stigma Perception and Caregiver Burden 構面 Total Stigma Courtesy Stigma Affiliate Stigma Total Burden Time Burden Developmental Burden Physical Burden Family Relationship Burden Emotional Burden Total Stigma Score 1 0.869*** 0.942*** 0.511*** 0.102 0.392*** 0.338*** 0.553*** 0.522*** Courtesy Stigma 1 0.653*** 0.412*** 0.118 0.330*** 0.341*** 0.409*** 0.331*** Affiliate Stigma 1 0.503*** 0.076 0.377*** 0.286*** 0.570*** 0.575*** Total Burden 1 0.621*** 0.858*** 0.821*** 0.812*** 0.597*** Time Burden 1 0.487*** 0.503*** 0.289*** 0.039 Developmental Burden 1 0.696*** 0.580*** 0.366*** Physical Burden 1 0.541*** 0.292*** Family Relationship Burden 1 0.594*** Emotional Burden 0.594*** 1 Note：***p<0.001 Additional Declarations No competing interests reported. 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By 2050, one in six people will be aged 65 years or over (United Nations, 2019). Population ageing brings a corresponding rise in age-related non-communicable diseases, among which dementia is one of the most consequential. According to the World Health Organization (WHO, 2022), more than 55\u0026nbsp;million people live with dementia globally, and this number is projected to reach 139\u0026nbsp;million by 2050. Dementia is a leading cause of disability and dependency among older adults, and its impact extends far beyond the diagnosed individual to families, caregivers, and entire health and social care systems.\u003c/p\u003e \u003cp\u003eIn Taiwan, population ageing is occurring at an accelerated pace. The proportion of people aged 65 years and above exceeded 14% in 2018 (aged society) and is expected to surpass 20% by 2025 (super-aged society) (National Development Council, 2020). The prevalence of dementia among community-dwelling older adults in Taiwan is approximately 8%, meaning that nearly 380,000 older persons will be living with dementia by 2025 (Taiwan Alzheimer\u0026rsquo;s Disease Association, 2021). In response, the government launched the \u0026ldquo;Dementia Prevention and Care Policy and Action Plan 2.0\u0026rdquo; (Ministry of Health and Welfare, 2022), which explicitly recognises the need to support family caregivers. However, despite these policy efforts, the experiences of caregivers \u0026mdash; particularly the hidden burden of stigma \u0026mdash; remain under-examined in the Taiwanese context.\u003c/p\u003e\n\u003ch3\u003eDementia caregiving: a multidimensional burden\u003c/h3\u003e\n\u003cp\u003eCaring for a family member with dementia is qualitatively different from caring for a person with a physical disability. Dementia is progressive, and behavioural and psychological symptoms of dementia (BPSD) \u0026mdash; such as agitation, delusions, hallucinations, depression, and sundowning \u0026mdash; are common, affecting up to 80% of patients (Calsolaro et al., 2021). These symptoms are often unpredictable and distressing, forcing caregivers into a state of continuous vigilance. Previous research has consistently shown that dementia caregivers report higher levels of stress, depression, and physical health problems than caregivers of older adults without cognitive impairment (Brodaty \u0026amp; Donkin, 2009; Alzheimer\u0026rsquo;s Association, 2022). Caregiver burden is a multidimensional concept that includes time dependence, developmental sacrifices, physical strain, family relationship tension, and emotional distress (Novak \u0026amp; Guest, 1989; Liu et al., 2020).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStigma as a hidden burden\u003c/h2\u003e \u003cp\u003eStigma is defined as a socially discrediting attribute that leads to devaluation, rejection, and discrimination (Goffman, 1963). The World Health Organization has described stigma as a \u0026ldquo;hidden burden of disease\u0026rdquo; because it can delay help-seeking, reduce treatment adherence, and worsen health outcomes (Kane et al., 2019). In dementia, stigma is pervasive: a global survey by Alzheimer\u0026rsquo;s Disease International (2022) found that two-thirds of people still incorrectly believe that dementia is a normal part of ageing rather than a medical condition. Such misconceptions fuel negative stereotypes, social exclusion, and even structural discrimination.\u003c/p\u003e \u003cp\u003eImportantly, stigma does not only affect the person with dementia; it also \u0026ldquo;spreads\u0026rdquo; to family caregivers. \u003cb\u003eCourtesy stigma\u003c/b\u003e (also called associative stigma) refers to the negative attitudes and behaviours that the public directs toward caregivers because of their association with a stigmatised person (Werner et al., 2012). \u003cb\u003eAffiliate stigma\u003c/b\u003e refers to the internalisation of these external negative attitudes, leading to feelings of shame, self-blame, and social withdrawal (Chang et al., 2016). These two forms of stigma are conceptually distinct but empirically related. Caregivers who perceive high levels of public rejection may begin to devalue themselves, which can further undermine their mental health and caregiving capacity.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eThe cultural context: “face”, filial piety and family responsibility\u003c/h3\u003e\n\u003cp\u003eThe experience of stigma is not culturally neutral. In Chinese societies, including Taiwan, the concept of \u003cem\u003emianzi\u003c/em\u003e (face) \u0026mdash; the social standing and reputation that one holds in the eyes of others \u0026mdash; is of paramount importance (Lin, 2015). Illnesses that are perceived as \u0026ldquo;shameful\u0026rdquo; or \u0026ldquo;genetically tainted\u0026rdquo; may bring disgrace to the entire family. Moreover, the Confucian ethic of filial piety expects adult children to care for ageing parents with devotion. When a family member develops dementia, caregivers may feel that they have \u0026ldquo;failed\u0026rdquo; in their duty if the patient\u0026rsquo;s symptoms become publicly noticeable (e.g., wandering, inappropriate behaviour), or they may fear being blamed for the patient\u0026rsquo;s condition. On the other hand, the same cultural values that emphasise family solidarity and respect for elders might also protect caregivers from internalising stigma \u0026mdash; because caregiving is seen as a natural obligation rather than a personal failure. This dual possibility makes the empirical study of stigma in Chinese cultural contexts particularly important.\u003c/p\u003e\n\u003ch3\u003eStigma and caregiver burden: what do we know?\u003c/h3\u003e\n\u003cp\u003eSeveral studies have documented a positive association between stigma and caregiver burden in dementia. Werner et al. (2012) found that family stigma was significantly associated with higher burden among Israeli caregivers. Kahn et al. (2016) reported similar findings in the United States. In Asia, Su and Chang (2020) and Huang (2021) showed that affiliate stigma is a robust correlate of burden among Taiwanese dementia caregivers. More recently, Chen et al. (2023) demonstrated that BPSD influence caregiver mental health partly through the mediating role of affiliate stigma. A systematic review (Shi et al., 2024) confirmed that stigma is consistently associated with caregiver burden across different cultures and care settings.\u003c/p\u003e \u003cp\u003eHowever, most existing studies have either treated stigma as a single construct or focused only on affiliate stigma. Few have simultaneously examined courtesy stigma and affiliate stigma and compared their relative contributions to caregiver burden. Moreover, studies conducted in Western societies may not fully capture the dynamics of stigma in East Asian contexts, where public perception of family reputation plays a larger role. In Taiwan, although the government has established dementia care centres and support programmes, the extent to which caregivers experience courtesy stigma \u0026mdash; and how this differs from internalised stigma \u0026mdash; remains unclear.\u003c/p\u003e\n\u003ch3\u003eResearch gaps and objectives\u003c/h3\u003e\n\u003cp\u003eBased on the above, this study aimed to: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) assess the levels of courtesy stigma and affiliate stigma among family caregivers of persons with dementia in Taiwan; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) examine the levels of multidimensional caregiver burden; (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) explore the associations between stigma (both types) and caregiver burden; and (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) identify significant predictors of caregiver burden, with particular attention to the relative contribution of stigma compared to patient clinical characteristics (e.g., dementia severity, BPSD). We hypothesised that stigma would be positively correlated with caregiver burden and would be a stronger predictor than objective patient characteristics.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Participants\u003c/h2\u003e \u003cp\u003e This cross-sectional, descriptive correlational study adhered to the STROBE guidelines. Participants were family caregivers of persons with dementia enrolled in the dementia care management centre of a regional hospital in Miaoli, Taiwan. Convenience sampling was used.\u003c/p\u003e \u003cp\u003eInclusion criteria were: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) aged\u0026thinsp;\u0026ge;\u0026thinsp;20 years and having provided care for a family member with a confirmed diagnosis of dementia for at least three months; (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) being the primary caregiver (the family member who spent the most hours per week on caregiving tasks); (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) able to communicate in Mandarin, Taiwanese, or Hakka; and (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) willing to provide written informed consent. Exclusion criteria were: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) paid caregivers; and (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) caregivers who self-reported a current psychiatric disorder or major depression.\u003c/p\u003e \u003cp\u003eSample size was estimated using G*Power 3.1.9.7 (α\u0026thinsp;=\u0026thinsp;0.05, power\u0026thinsp;=\u0026thinsp;0.80, 20 predictors, medium effect size f\u0026sup2; = 0.15), yielding a minimum of 222 participants. Allowing for 20% attrition, the target was 266. A total of 322 questionnaires were distributed, and 268 valid questionnaires were returned (response rate 83.2%).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInstruments\u003c/h3\u003e\n\u003cp\u003eData were collected using three instruments: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) the Taiwanese version of the Family Stigma in Dementia Scale (TWFS-DS); (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) the Chinese Caregiver Burden Inventory (CCBI); and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) a demographic questionnaire. To reduce social desirability bias, the scales were renamed during administration as \u0026ldquo;Caregivers\u0026rsquo; Attitudes Toward Dementia Scale\u0026rdquo; and \u0026ldquo;Caregivers\u0026rsquo; Perceptions of Caring for Persons with Dementia\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTWFS-DS\u003c/b\u003e (Huang, 2021) is a 32-item, 7-point Likert scale (1\u0026thinsp;=\u0026thinsp;strongly disagree to 7\u0026thinsp;=\u0026thinsp;strongly agree) comprising two subscales: courtesy stigma (16 items) and affiliate stigma (16 items). Four items are reverse-scored. Total scores range from 32 to 224; higher scores indicate greater stigma. In the present sample, Cronbach\u0026rsquo;s α was 0.909 (courtesy: 0.891; affiliate: 0.802).\u003c/p\u003e \u003cp\u003e \u003cb\u003eCCBI\u003c/b\u003e (Kuo et al., 2014) is a 23-item, 4-point Likert scale (1\u0026thinsp;=\u0026thinsp;strongly disagree to 4\u0026thinsp;=\u0026thinsp;strongly agree) assessing five dimensions: time-dependence burden (5 items), developmental burden (5 items), physical burden (4 items), family relationship burden (5 items), and emotional burden (4 items). Total scores range from 23 to 92; higher scores indicate greater burden. Cronbach\u0026rsquo;s α in this study was 0.921.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDemographic questionnaire\u003c/b\u003e captured caregiver characteristics (gender, age, marital status, education, relationship to care recipient, co-residence, years of caregiving, weekly caregiving hours, self-rated health, number of chronic conditions, perceived relationship quality with care recipient, availability of substitute caregiver) and care recipient characteristics (gender, age, dementia severity by Clinical Dementia Rating [CDR], years since diagnosis, presence and number of BPSD).\u003c/p\u003e\n\u003ch3\u003eData Collection Procedures\u003c/h3\u003e\n\u003cp\u003eData were collected between September 2022 and January 2023. Two strategies were used: face-to-face interviews at the clinic (168 valid) and postal questionnaires distributed via a private online support group for dementia caregivers (100 valid). Each questionnaire was assigned a unique identification number. Questionnaires with missing responses were excluded.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003e This study was conducted in accordance with the Declaration of Helsinki. Approval was obtained from the Institutional Review Board of Chung Shan Medical University Hospital (approval No. CS2-22147). All participants provided written informed consent.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were analysed using SPSS version 22.0. Descriptive statistics summarised participant characteristics. Independent-samples t-tests and one-way ANOVA with Scheff\u0026eacute; post-hoc comparisons were used. Pearson\u0026rsquo;s correlation examined relationships between stigma and burden. Multiple linear regression (forced entry) identified predictors of caregiver burden. Variance inflation factor (VIF\u0026thinsp;\u0026lt;\u0026thinsp;2) indicated no multicollinearity. All tests were two-tailed with α\u0026thinsp;=\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eParticipant Characteristics\u003c/h2\u003e \u003cp\u003eOf the 268 participants, the majority were female (68.7%), with a mean age of 54.0\u0026thinsp;\u0026plusmn;\u0026thinsp;12.2 years. Most were married (71.6%) and had a college education or above (41.8%). Most were adult children of the care recipient (64.9%) and lived with the care recipient (70.9%). Mean caregiving duration was 3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6 years, and average weekly caregiving hours were 55.2\u0026thinsp;\u0026plusmn;\u0026thinsp;49.3. Regarding self-perceived health, 43.7% rated their health as fair, and 37.3% reported a very good relationship with the care recipient. Most caregivers (63.1%) reported no chronic diseases, and 64.9% had alternative caregivers.\u003c/p\u003e \u003cp\u003eCare recipients were predominantly female (60.1%) with a mean age of 79.9\u0026thinsp;\u0026plusmn;\u0026thinsp;8.1 years. The majority had mild dementia (CDR\u0026thinsp;=\u0026thinsp;1, 40.3%), followed by moderate (31.7%) and severe (19.0%). Mean time since diagnosis was 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9 years. BPSD were present in 78.0% of care recipients.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eStigma Perception\u003c/h2\u003e \u003cp\u003eThe mean total stigma score was 119.60\u0026thinsp;\u0026plusmn;\u0026thinsp;20.95. After standardisation to a 0\u0026ndash;100 scale, overall stigma was 45.63, indicating a low-to-moderate level. Courtesy stigma (M\u0026thinsp;=\u0026thinsp;61.22\u0026thinsp;\u0026plusmn;\u0026thinsp;9.52; standardised\u0026thinsp;=\u0026thinsp;47.10) was higher than affiliate stigma (M\u0026thinsp;=\u0026thinsp;48.68\u0026thinsp;\u0026plusmn;\u0026thinsp;14.06; standardised\u0026thinsp;=\u0026thinsp;34.04). The three highest-scoring items were all from the courtesy stigma domain: \u0026ldquo;Most people in society feel aversion toward dementia caregivers\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;5.04); \u0026ldquo;Most people in society do not feel embarrassed when interacting with dementia caregivers\u0026rdquo; (reverse-scored; M\u0026thinsp;=\u0026thinsp;4.75); and \u0026ldquo;Most people in society ignore dementia caregivers\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;4.71). The three lowest-scoring items were affiliate stigma items: \u0026ldquo;I feel I have poor personal hygiene\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;2.60); \u0026ldquo;I feel inferior\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;2.65); and \u0026ldquo;I feel less worthy than others\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;2.74).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eCaregiving Burden\u003c/h2\u003e \u003cp\u003eThe mean total burden score was 58.38\u0026thinsp;\u0026plusmn;\u0026thinsp;9.53 (standardised\u0026thinsp;=\u0026thinsp;51.28), reflecting moderate burden. Subscale standardised scores showed: time burden (70.20), physical burden (61.09), developmental burden (53.73), family relationship burden (40.87), and emotional burden (35.90). The highest-scoring items were \u0026ldquo;I need to constantly watch over the care recipient\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;3.34), \u0026ldquo;I need to help the care recipient accomplish many daily tasks\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;3.16), and \u0026ldquo;The care recipient is dependent on me\u0026rdquo; (M\u0026thinsp;=\u0026thinsp;3.16).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eDifferences in Stigma and Burden Across Variables\u003c/h2\u003e \u003cp\u003eSignificant differences in stigma were found for caregiver age, marital status, years of caregiving, self-rated health, and number of BPSD (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Caregivers with poorer perceived health and those caring for patients with more BPSD reported higher stigma. For burden, significant differences were found for perceived relationship quality, self-rated health, care recipient gender, dementia severity, and number of BPSD (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Notably, delusions were associated with higher courtesy stigma, while behavioural disturbances were associated with higher affiliate stigma.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eCorrelation Between Stigma and Caregiving Burden\u003c/h2\u003e \u003cp\u003ePearson correlation showed a significant positive correlation between overall stigma and total burden (r\u0026thinsp;=\u0026thinsp;0.511, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Both courtesy stigma (r\u0026thinsp;=\u0026thinsp;0.412) and affiliate stigma (r\u0026thinsp;=\u0026thinsp;0.503) were positively correlated with total burden. Time burden was not significantly correlated with any stigma measure (r\u0026thinsp;=\u0026thinsp;0.102, p\u0026thinsp;=\u0026thinsp;0.096).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of Caregiving Burden\u003c/h2\u003e \u003cp\u003eMultiple linear regression (F[6,261]\u0026thinsp;=\u0026thinsp;31.450, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) explained 42% of the variance (adjusted R\u0026sup2; = 0.406). Overall stigma was the strongest predictor (β\u0026thinsp;=\u0026thinsp;0.395, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), followed by caregiver self-rated health (β\u0026thinsp;=\u0026thinsp;0.313, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), number of BPSD (β\u0026thinsp;=\u0026thinsp;0.130, p\u0026thinsp;=\u0026thinsp;0.011), and care recipient gender (β\u0026thinsp;=\u0026thinsp;0.110, p\u0026thinsp;=\u0026thinsp;0.022). Perceived relationship quality and dementia severity were not significant in the final model.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eStigma Perceptions: Courtesy Stigma Exceeds Affiliate Stigma\u003c/h2\u003e \u003cp\u003eThis study found that overall stigma among Taiwanese dementia caregivers was low-to-moderate, with courtesy stigma higher than affiliate stigma. This pattern reflects the cultural importance of \u0026ldquo;face\u0026rdquo; (\u003cem\u003emianzi\u003c/em\u003e) and the belief that \u0026ldquo;family matters should not be disclosed publicly\u0026rdquo;. Caregivers are highly attuned to societal judgments but appear less likely to internalise these attitudes into self-devaluation, possibly because they view caregiving as a familial duty rather than a personal failure. The lowest-scoring affiliate stigma items (\u0026ldquo;poor personal hygiene\u0026rdquo;, \u0026ldquo;feeling inferior\u0026rdquo;, \u0026ldquo;feeling less worthy than others\u0026rdquo;) support this interpretation.\u003c/p\u003e \u003cp\u003eNotably, specific BPSD subtypes had differential effects: delusions were associated with higher courtesy stigma, while behavioural disturbances (e.g., aggression, wandering) were associated with higher affiliate stigma. Publicly noticeable symptoms may trigger more perceived public rejection, whereas internalised shame may be more related to disruptive behaviours that caregivers feel responsible for.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eCaregiver Burden: Time and Physical Burden Dominate\u003c/h2\u003e \u003cp\u003eCaregiver burden was moderate, with time burden highest (70.2%) and emotional burden lowest (35.9%). Caregivers provided an average of 55.2 hours of care per week \u0026mdash; far exceeding the 22\u0026ndash;26 hours reported in Western samples. The low emotional burden may reflect Hakka cultural norms that emphasise stoicism, family solidarity, and suppression of negative emotional displays. Thus, the low emotional burden score likely under-represents true emotional distress.\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eStigma as the Strongest Predictor of Burden\u003c/h2\u003e \u003cp\u003eStigma was the strongest predictor of caregiver burden (β\u0026thinsp;=\u0026thinsp;0.395), exceeding objective factors such as dementia severity and BPSD count. This supports the social-psychological framework of Link and Phelan (2001), which conceptualises stigma as a process of labelling, stereotyping, separation, and status loss. For dementia caregivers, stigma functions not only as a direct source of burden but also as a magnifying mechanism, amplifying the psychological impact of caregiving demands.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003ePolicy and Practice Implications\u003c/h2\u003e \u003cp\u003eBased on the findings, we propose the following recommendations for ageing policy in Taiwan and similar contexts:\u003c/p\u003e \u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eExtend case management duration.\u003c/b\u003e Currently, Taiwan\u0026rsquo;s integrated dementia care centres follow caregivers for only 2\u0026ndash;3 years after diagnosis. Stigma and burden peak at 1\u0026ndash;5 years of caregiving and coincide with moderate dementia (CDR\u0026thinsp;=\u0026thinsp;2). We recommend extending follow-up to at least five years, with increased monitoring frequency for high-risk groups.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eIncorporate routine stigma and health screening.\u003c/b\u003e Clinicians should routinely assess caregivers for stigma-related distress using validated instruments (e.g., TWFS-DS). Caregivers who are married, in the early caregiving phase, with poor self-rated health, or caring for persons with multiple BPSD should be prioritised for targeted psychosocial support.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDevelop family-centred support groups.\u003c/b\u003e Current support groups often target only the primary caregiver. Involving all adult household members in care planning discussions could reduce affiliate stigma and improve family dynamics.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eLaunch population-level anti-stigma campaigns.\u003c/b\u003e Because courtesy stigma was more prominent than affiliate stigma, public education should focus on reducing societal aversion and social exclusion of dementia caregivers. Campaigns delivered through schools, media, and community organisations can help build dementia-friendly communities.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eStrengthen respite and home care services.\u003c/b\u003e Time burden was the highest subscale. Accessible and affordable formal home care services \u0026mdash; including respite care, day care, and in-home help \u0026mdash; are urgently needed, particularly in rural areas.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003e Align with the Dementia Policy Guidelines 2.0.\u003c/b\u003e We recommend adding a specific performance indicator: \u0026ldquo;percentage of caregivers screened for stigma and burden annually\u0026rdquo;. The goal of \u0026ldquo;building a dementia-friendly society\u0026rdquo; should explicitly address courtesy stigma through community-based participatory interventions.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eSeveral limitations should be acknowledged. First, the convenience sample from a single hospital in rural Miaoli limits generalisability. Second, the cross-sectional design precludes causal inference. Third, self-reported questionnaires may introduce social desirability bias. Fourth, important variables such as long-term care service utilisation, employment of foreign domestic workers, and caregiver employment status were not assessed. Fifth, the study was conducted in a Hakka cultural region, and cultural specificity may limit cross-regional applicability. Future research should adopt longitudinal designs, include urban-rural comparisons, and incorporate mixed methods.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eStudy Limitations\u003c/h2\u003e \u003cp\u003eDespite the significant findings, several limitations of this study should be acknowledged. First, the cross-sectional design limits the ability to establish causal relationships between dementia-related stigma and caregiving burden. Second, the study participants were recruited through convenience sampling from a single integrated dementia care center in \u003cb\u003eMiaoli County\u003c/b\u003e. Although Miaoli offers a representative case of the semi-rural, rapidly ageing demographic in central Taiwan, the findings \u003cb\u003emay not be fully generalizable to the entire population of Taiwan\u003c/b\u003e, especially those in highly urbanized metropolitan areas like Taipei or Kaohsiung. Third, the data relied on self-reported measures, which may be subject to social desirability bias. Future research should employ multi-center, longitudinal designs with a broader geographical scope to further validate these findings and their implications for ageing policy across different cultural and urban-rural contexts in Taiwan.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study provides robust evidence that stigma perception \u0026mdash; particularly courtesy stigma \u0026mdash; is the strongest modifiable predictor of caregiving burden among Taiwanese dementia caregivers, explaining a substantial proportion of burden variance independently of disease severity and caregiver health. The positive correlation between stigma and burden across multiple domains underscores the pervasive impact of stigma. In the context of rapid population ageing in Taiwan and globally, addressing stigma is not only a clinical imperative but also a policy priority. We recommend integrating routine stigma screening into dementia case management, extending caregiver follow-up to at least five years, and implementing population-level anti-stigma campaigns to foster dementia-friendly communities. Such interventions can reduce caregiver burden, improve quality of life for both caregivers and persons with dementia, and support sustainable family caregiving in ageing societies.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e \u003cp\u003e Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board of Chung Shan Medical University Hospital (No. CS2-22147).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eHe-Pei Wu: Conceptualization, Methodology, Data collection, Writing - original draft.Yi-Wen Chiu: Conceptualization, Formal analysis, Supervision, Writing - review \u0026amp; editing.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWHO (2022) World failing to address dementia challenge. Retrieved July 12, 2022, from https://www.who.int/news/item/02-09-2021-world-failing-to-address-dementia-challenge\u003c/li\u003e\n\u003cli\u003eTaiwan Alzheimer\u0026rsquo;s Disease Association. (2021). \u003cem\u003eEstimation of dementia population in Taiwan.\u003c/em\u003e Retrieved from http://www.tada2002.org.tw/About/IsntDementia#bn1 (in Chinese)\u003c/li\u003e\n\u003cli\u003eNational Development Council. (2020). Aging timeline. 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Scandinavian Journal of Caring Sciences, 33(2), 336-341. https://doi.org/10.1111/scs.12626\u003c/li\u003e\n\u003cli\u003eYıldız, M., Demir, Y., Kırcalı, A., \u0026amp; İncedere, A. (2021). Caregiver burden in schizophrenia and autism spectrum disorders: A comparative study. \u003cem\u003ePsychiatry Investigation, 18\u003c/em\u003e(12), 1180\u0026ndash;1187. https://doi.org/10.30773/pi.2021.0165\u003c/li\u003e\n\u003cli\u003eRahmani, F., Roshangar, F., Gholizadeh, L., \u0026amp; Asghari, E. (2022). Caregiver burden and the associated factors in the family caregivers of patients with schizophrenia. Nursing Open, 9(4), 1995\u0026ndash;2002. https://doi.org/10.1002/nop2.1205\u003c/li\u003e\n\u003cli\u003eGreco, A., Pancani, L., Sala, M., Annoni, A. M., Steca, P., Paturzo, M., D\u0026apos;Agostino, F., Alvaro, R., \u0026amp; Vellone, E. (2017). Psychometric characteristics of the caregiver burden inventory in caregivers of adults with heart failure. European Journal of Cardiovascular Nursing, 16(6), 502\u0026ndash;510. https://doi.org/10.1177/1474515117693890\u003c/li\u003e\n\u003cli\u003eV\u0026aacute;zquez, F. L., Otero, P., Sim\u0026oacute;n, M. A., Bueno, A. M., \u0026amp; Blanco, V. (2019). Psychometric properties of the Spanish version of the caregiver burden inventory. International Journal of Environmental Research and Public Health, 16(2), 217.\u003c/li\u003e\n\u003cli\u003eAung, T. N. N., Aung, M. N., Moolphate, S., Koyanagi, Y., Supakankunti, S., \u0026amp; Yuasa, M. (2021). Caregiver burden and associated factors for the respite care needs among the family caregivers of community dwelling senior citizens in Chiang Mai, Northern Thailand. International Journal of Environmental Research and Public Health, 18(11), 5873.\u003c/li\u003e\n\u003cli\u003eChiang, H.-W., \u0026amp; Chen, Y.-Y. (2008). Taiwanese Hakka fathers\u0026rsquo; perceptions of fatherhood and child-rearing beliefs: A study of fathers with school-aged children. Journal of Family Education and Counseling, (5), 61\u0026ndash;80. (in Chinese)\u003c/li\u003e\n\u003cli\u003eKarakis, I., Janocko, N. J., Morton, M. L., Groover, O., Teagarden, D. L., Villarreal, H. K., Loring, D. W., \u0026amp; Drane, D. L. (2020). Stigma in psychogenic nonepileptic seizures. Epilepsy \u0026amp; behavior, 111, 107269. https://doi.org/10.1016/j.yebeh.2020.107269\u003c/li\u003e\n\u003cli\u003eMa, Y., Lee, L. Y., \u0026amp; Zhang, X. (2023). Affiliate stigma and related factors among parents of autism spectrum condition: A pilot study from mainland China. Autism \u0026amp; Developmental Language Impairments, 8, 23969415231168567.\u003c/li\u003e\n\u003cli\u003eVan den Bossche, P., \u0026amp; Schoenmakers, B. (2022). The impact of dementia\u0026apos;s affiliate stigma on the mental health of relatives: a cross section survey. Frontiers in Psychology, 12, 789105.\u003c/li\u003e\n\u003cli\u003eWang, H., Yue, H., Wang, Z., Lu, M., \u0026amp; Feng, D. (2023). The relationship between patient-family caregiver congruence/incongruence in acceptance of illness and family caregivers\u0026apos; anticipatory grief. Psycho-Oncology, 32(5), 751\u0026ndash;759. https://doi.org/10.1002/pon.6121\u003c/li\u003e\n\u003cli\u003eGergia, L., Stevens, B.A., Baldwin, S.D., \u0026amp; Lynn, E.M. (1991). Stress and Behavior Management in Long-term Care. Baltimor: National Health Publishing.\u003c/li\u003e\n\u003cli\u003eWallhagen, M. I. (1992). Caregiving demands: Their difficulty and effects on the well-being of elderly caregivers. Sch Inq Nurs Pract, 6(2), 111-127.\u003c/li\u003e\n\u003cli\u003eAndren, S., \u0026amp; Elmst\u0026aring;hl, S. (2008). The relationship between caregiver burden, caregivers\u0026rsquo; perceived health and their sense of coherence in caring for elders with dementia. Journal of Clinical Nursing, 17(6), 790-799.\u003c/li\u003e\n\u003cli\u003eLiu, S., Li, C., Shi, Z., Wang, X., Zhou, Y., Liu, S., Liu, J., Yu, T., \u0026amp; Ji, Y. (2017). Caregiver burden and prevalence of depression, anxiety and sleep disturbances in Alzheimer\u0026apos;s disease caregivers in China. Journal of Clinical Nursing, 26(9-10), 1291\u0026ndash;1300. https://doi.org/10.1111/jocn.13601\u003c/li\u003e\n\u003cli\u003ePeng, M. M., Ma, Z., \u0026amp; Ran, M. S. (2022). Family caregiving and chronic illness management in schizophrenia: positive and negative aspects of caregiving. BMC Psychology, 10(1), 83. https://doi.org/10.1186/s40359-022-00794-9\u003c/li\u003e\n\u003cli\u003eChang, C. C., Su, J. A., \u0026amp; Lin, C. Y. (2016). Using the Affiliate Stigma Scale with caregivers of people with dementia: Psychometric evaluation. Alzheimer\u0026apos;s Research \u0026amp; Therapy, 8(1), 1-8.\u003c/li\u003e\n\u003cli\u003eEbrahim, O. S., Al-Attar, G. S., Gabra, R. H., \u0026amp; Osman, D. M. (2020). Stigma and burden of mental illness and their correlates among family caregivers of mentally ill patients. Journal of the Egyptian Public Health Association, 95(1), 1-9.\u003c/li\u003e\n\u003cli\u003eLin, Y.-X. (2015). Exploring the stigma of mental illness from the perspective of Chinese face culture. \u003cem\u003eTzu Chi Journal\u003c/em\u003e, (13), 5\u0026ndash;12. (in Chinese)\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Demographic Characteristics of Caregivers and Care Recipients\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;N=268\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"3\" cellpadding=\"0\" width=\"566\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 262px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean \u0026plusmn; SD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 562px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregiver Demographic Characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e68.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e31.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≦44 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e21.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e54\u0026plusmn;12.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 45-54 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e31.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 55-64 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e28.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≧65 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e18.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e71.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Unmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e28.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e36.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e63.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Elementary school or below\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e8.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Secondary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e33.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; College or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e57.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRelationship to Care Recipient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Spouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e14.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e64.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Son-/Daughter-in-law\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e13.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e7.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving Arrangement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;Living with care recipient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e70.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp;Not living with care recipient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e29.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears of caregiving\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Less than 1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e7.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e3.31\u0026plusmn;2.64\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 1\u0026ndash;3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e39.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 3\u0026ndash;5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e27.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 5 years or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e26.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeekly caregiving hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026lt;24hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e36.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e55.17\u0026plusmn;49.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 24\u0026ndash;72 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e37.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 72\u0026ndash;120 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e11.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≧120hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e13.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHaving substitute caregiver\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e64.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e35.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerceived Relationship with Care Recipient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Excellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e37.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e36.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Fair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e22.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e3.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Very Poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-Rated Health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Excellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e14.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Good\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e25.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Fair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e43.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e14.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Very Poor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 562px;\"\u003e\u003cstrong\u003eCare Recipient (Person with Dementia) Demographic Characteristics\u003c/strong\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e60.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e39.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≦69 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e11.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e79.96\u0026plusmn;8.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 70-79 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e31.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≧80 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e57.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDementia Severity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; CDR 0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e8.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; CDR 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e40.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; CDR 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e31.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; CDR 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e19.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears since Diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026lt;1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e6.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e3.81\u0026plusmn;2.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 1\u0026ndash; 3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e49.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 3\u0026ndash;5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e22.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≧ 5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e22.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBehavioral and Psychological Symptoms of Dementia (BPSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; Yes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e77.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e22.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of BPSD Symptoms\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; None\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e22.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e24.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e22.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e15.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 149px;\"\u003e\n \u003cp\u003e\u0026nbsp; ≧4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e15.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 97px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Stigma and Caregiver Burden Scores\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eN=268\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eDomain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003eStandardized Score\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eStigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eTotal Stigma Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e119.60\u0026plusmn;20.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e45.63\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eCourtesy stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e61.22\u0026plusmn;9.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e47.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eAffiliate stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e48.67\u0026plusmn;14.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e34.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eCaregiver Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eTotal Caregiver Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e58.38\u0026plusmn;9.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e51.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eTime Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e15.53\u0026plusmn;2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e70.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eDevelopmental Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e13.06\u0026plusmn;2.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e53.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003ePhysical Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e10.72\u0026plusmn;2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e61.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eFamily Relationship Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e11.13\u0026plusmn;2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e40.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 163px;\"\u003e\n \u003cp\u003eEmotional Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e7.95\u0026plusmn;2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 138px;\"\u003e\n \u003cp\u003e35.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Differences in Caregiver Demographics, Stigma Perception, and Caregiver Burden\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eN=268\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"3\" cellpadding=\"0\" width=\"616\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStigma Perception t/F\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 381px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaregiver Burden t/F\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCourtesy Stigma\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAffiliate Stigma\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Burden\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime Burden\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDevelopmental Burden\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical Burden\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily Relationship Burden\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmotional Burden\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e3.23*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e2.96*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e3.03*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.54*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e3.24*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2.75*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e5.83*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e7.11**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e2.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e4.69*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.33*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e3.77*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3.71*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRelationship with Care Recipient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving Arrangement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3.46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears of Caregiving\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e3.21*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e4.35**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.51*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e4.94**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeekly Caregiving Hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.90**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-perceived Relationship with Care Recipient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e3.70**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e5.13**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e8.10***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e4.28**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e6.82***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-perceived Health Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e4.61**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e2.85*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e5.04**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e17.98***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.98**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e13.82***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e20.23***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e8.73***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e7.35***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic Disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e4.79*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAvailability of Substitute Caregiver\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e0.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCare Recipient Gender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e5.36*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e7.77**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e9.12**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e5.69*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCare Recipient Age\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e2.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e5.15**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e2.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDementia Severity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e2.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2.88*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e6.59***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e5.38*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e6.86***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e3.21*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e2.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2.82*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears Since Dementia Diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e1.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.55*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of BPSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e2.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e2.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e1.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e4.48*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of BPSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e3.43*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e2.48*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\n \u003cp\u003e3.54**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e6.29***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e2.7*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e4.90***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e5.40***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e2.73*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e3.46**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote：* p＜0.05; ** p＜0.01; ***p＜0.001\u003c/p\u003e\n\u003cp\u003eTable 4. Multiple Linear Regression Analysis of Factors Predicting Caregiver Burden\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePredictor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 122px;\"\u003e\n \u003cp\u003eUnstandardized Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 85px;\"\u003e\n \u003cp\u003eStandardized Coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003et\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003ep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003eVIF\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003eB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026szlig;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e9.207\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.000***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e31.450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eCare Recipient Gender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.040\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e2.297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.022*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eSelf-perceived Relationship with Care Recipient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eSelf-perceived Health Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e5.852\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.000***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.285\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eDementia Severity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.115\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNumber of BPSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e2.559\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.011**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.165\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eTotal Stigma Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.395\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e8.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.000***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.088\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote：R\u003csup\u003e2\u003c/sup\u003e=0.420, Adjusted R\u003csup\u003e2\u003c/sup\u003e=0.406\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Correlations Between Stigma Perception and Caregiver Burden\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"653\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e構面\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eTotal Stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eCourtesy Stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eAffiliate Stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eTotal Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eTime Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eDevelopmental Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003ePhysical Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eFamily Relationship Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003eEmotional Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003eTotal Stigma Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.869***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.942***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.511***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.392***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.338***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.553***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.522***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003eCourtesy Stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.653***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.412***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.330***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.341***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.409***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.331***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003eAffiliate Stigma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.503***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.377***\u003c/p\u003e\n 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style=\"width: 65px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.696***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.580***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.366***\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003ePhysical Burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n 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65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e0.594***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote：***p\u0026lt;0.001\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"dementia caregivers, caregiving burden, stigma, courtesy stigma, ageing policy, Taiwan","lastPublishedDoi":"10.21203/rs.3.rs-9359021/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9359021/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study examined the relationship between stigma perception and caregiving burden among family caregivers of persons with dementia in Taiwan, a rapidly ageing society. A quantitative, cross-sectional survey design was used, adhering to the STROBE guidelines. A total of 268 primary caregivers were recruited from a dementia shared care center in rural Miaoli County, central Taiwan, using convenience sampling. Participants completed structured questionnaires including the Taiwanese version of the Family Stigma in Dementia Scale (TWFS-DS) and the Chinese Caregiver Burden Inventory (CCBI). Descriptive and inferential analyses showed that caregivers\u0026rsquo; overall stigma perception was low-to-moderate (standardized mean\u0026thinsp;=\u0026thinsp;45.63/100), with courtesy stigma (concern about others\u0026rsquo; judgments) being more prominent than affiliate stigma (self-stigma). Caregiving burden was moderate (standardized mean\u0026thinsp;=\u0026thinsp;51.28/100), with time burden and physical burden ranking highest. Caregiver age, marital status, years of caregiving, self-rated health, and the number of patients\u0026rsquo; behavioural and psychological symptoms of dementia (BPSD) were significantly associated with perceived stigma. Caregiving burden was influenced by relationship quality with the patient, self-rated health, patient gender, dementia severity, and number of BPSD. In a multiple linear regression model adjusting for potential confounders, overall stigma perception was the strongest predictor of caregiving burden (β\u0026thinsp;=\u0026thinsp;0.395, p \u0026lt; .001), followed by self-rated health status (β\u0026thinsp;=\u0026thinsp;0.313, p \u0026lt; .001), explaining 42% of the total variance (adjusted R\u0026sup2; = 0.406). These findings highlight that stigma \u0026ndash; particularly courtesy stigma \u0026ndash; is a modifiable and policy-relevant determinant of caregiver burden. We recommend integrating routine stigma screening into dementia case management, extending caregiver follow up to at least five years, and implementing population level anti stigma campaigns to foster dementia friendly communities. Such interventions are essential for sustainable family caregiving in ageing societies like Taiwan.\u003c/p\u003e","manuscriptTitle":"The Relationship between Stigma and Burden: A Case Study in Miaoli, Taiwan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-05 15:07:15","doi":"10.21203/rs.3.rs-9359021/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0eefc080-c3f9-4fdb-b2b3-af72e1f6590f","owner":[],"postedDate":"May 5th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-05T04:34:06+00:00","index":23,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T15:07:15+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-05 15:07:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9359021","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9359021","identity":"rs-9359021","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}