Health literacy and care burden in family caregivers of patients undergoing hemodialysis: a cross-sectional study in southeast Iran

Background Family caregivers of patients undergoing hemodialysis face significant challenges that may lead to increased caregiving burden. Health literacy has been suggested as a key factor influencing caregivers’ ability to manage responsibilities effectively. However, limited evidence exists on the relationship between health literacy and caregiving burden in this population. This study aimed to examine the relationship between health literacy and caregiving burden among family caregivers of patients receiving hemodialysis in Kerman, Iran. Methods A descriptive-analytical cross-sectional study was conducted in 2024 with 217 family caregivers recruited from Shafa Hospital and Javad-al-Aemeh Dialysis Clinic. Data were collected using a demographic questionnaire, the Health Literacy for Iranian Adults (HELIA) instrument, and the Caregiver Burden Inventory (CBI). Descriptive and inferential statistics, including t-test, ANOVA, correlation analysis, and multiple regression, were applied using SPSS version 22. Results The mean caregiver age was 38.7 ± 8.7 years, and 60.6% were female. The mean health literacy score was 82.56 ± 14.28 (adequate), and the mean caregiving burden score was 52.22 ± 13.23 (moderate). Care burden was significantly higher among female caregivers, those caring for older patients, caregivers of patients with diabetes, and caregivers of patients undergoing more frequent dialysis sessions (p < 0.05). Regression analysis indicated that dialysis frequency, caregiver gender, and patient age predicted 46% of the variance in caregiver burden. No significant overall correlation was found between health literacy and caregiving burden, though a weak association emerged between the “understanding” dimension of health literacy and time-related caregiving stress. Conclusions While caregivers demonstrated adequate health literacy, it did not independently reduce caregiving burden. Instead, systemic factors such as dialysis frequency, gender roles, and patient age were stronger determinants of burden. Interventions to alleviate caregiver strain should therefore extend beyond health literacy enhancement and address psychosocial support, gender-sensitive strategies, and tailored assistance for families managing high-intensity dialysis schedules.