Exploring family caregivers' experiences of caring for stroke survivors: A systematic review and meta-synthesis

Background Stroke results in significant long-term disability among survivors worldwide, imposing a heavy caregiving burden on family caregivers and posing severe challenges to their physical and mental health. However, existing research lacks systematic integration of recent qualitative evidence, hindering a deep understanding of their authentic caregiving experiences. Objective This study aims to explore the caregiving experiences of family caregivers of stroke survivors through a systematic review and meta-synthesis, focusing on their challenges, coping strategies, and unmet needs. Methods Following the PRISMA guidelines, we searched four databases (Academic Search Complete, APA PsycArticles, CINAHL Complete, MEDLINE) for English-language qualitative studies published between 2019 and 2024. The PEO framework was used to determine search terms, the Crowe Critical Appraisal Tool (CCAT) was employed to assess study quality, and thematic content analysis was applied to extract and synthesize findings from included studies. The research protocol has been registered in the Prospective Register of Systematic Reviews (PROSPERO) with the registration number: CRD420251064698. Results Eight studies involving 165 family caregivers were included. Analysis yielded five themes: (1)Overwhelming daily caregiving demands: involving high-intensity physical care and constant safety monitoring; (2)Heavy psychological and emotional burdens: manifested as sudden anger outbursts and mental health issues; (3)Inescapable family burdens: encompassing financial strain and strained family relationships; (4)Reduced social participation: leading to identity crises and social isolation; (5)Needs and challenges in support services: caregivers urgently require psychological support and skills training, yet existing services face issues of accessibility, professionalism, and information asymmetry. Conclusion Family caregivers endure multidimensional burdens during long-term caregiving, particularly the underrecognized issues of sudden emotional outbursts and sustained hypervigilance. Future support strategies should prioritize providing systematic, professional, and intelligent psychological interventions, skills training, and technological aids. Additionally, enhancing the accessibility and standardization of social support services is essential to alleviate caregiver burdens and improve care quality.