Family Caregivers Challenges for Stroke Survivors in the Community: A Literature Review
DOI:
https://doi.org/10.53770/medica.v8i3.843Keywords:
Family Caregivers, Family Challenges, Community Nurses, Community Health Nursing, StrokeAbstract
Stroke is a chronic condition that significantly reduces the patient's quality of life and increases the need for support from family caregivers. This situation places the family as a crucial element in patient care, yet often presents significant challenges for family caregivers. This study aims to identify and describe the various challenges faced by families caring for stroke patients in the community. A literature review design was employed. Relevant articles published between 2020 and 2025 were retrieved from international databases including PubMed and ScienceDirect, using the keywords "family challenges" OR "family burden" AND "stroke" OR "stroke survivor." The inclusion criteria were determined using the PEO framework. A total of 346 articles were identified, and fifteen articles met the inclusion criteria for the review. The findings indicate that family caregivers of stroke patients face various challenges due to the complex demands of care, ranging from emotional stress at the time of diagnosis to physical and social challenges during home care. Challenges are further exacerbated when the patient experiences dysphagia, severe disability, or psychological problems such as depression and anxiety. Factors contributing to these challenges include the family caregiver's employment status, educational level, kinship relationship, social support, knowledge of stroke rehabilitation, the transition process from hospital to home, limited access to healthcare, and limited social activities. Caring for stroke patients presents significant challenges for families, who serve as the primary caregiver system and play a central role in community care. Interventions that support family caregivers through education, psychosocial support, and access to adequate health and rehabilitation services are crucial for community nurses to reduce caregiver burden and improve the quality of life for both family caregivers and stroke patients in the community.
References
Capili, B. (2020). How Does Research Start? American Journal of Nursing, 120(10), 41–44. https://doi.org/10.1097/01.NAJ.0000718644.96765.b3
Deepradit, S., Powwattana, A., Lagampan, S., & Thiangtham, W. (2023). Effectiveness of a family-based program for post-stroke patients and families: A cluster randomized controlled trial. International journal of nursing sciences, 10(4), 446–455. https://doi.org/10.1016/j.ijnss.2023.09.020
Dimunová, L., Soósová, M. S., Kardosová, K., Červený, M., & Belovičová, M. (2021). Quality of life in post-stroke patients. Kontakt, 23(3), 157–161. https://doi.org/10.32725/kont.2020.036
Giray, E., Eyigör, S., Çalık, Y., Gezer, İ. A., Sarı, A., Umay, E., Akaltun, M. S., Tıkız, C., Ünlü, Z., Vural, M., Aydeniz, B., & Karahan, A. Y. (2023). The family caregivers' burden of informal family caregivers for stroke patients with and without dysphagia: A multi-center, cross-sectional study in Türkiye. Turkish Journal of Physical Medicine and Rehabilitation, 69(4), 453–463. https://doi.org/10.5606/tftrd.2023.11894
Israfil, I. (2024). The Role of Family in Stroke Patients in The Community: A Narrative Review. Ahmar Metastasis Health Journal, 4(3), 154–159. https://doi.org/10.53770/amhj.v4i3.412
Israfil, I., Wulandari, S. K., Swarjana, I. K., Suyasa, I. G. P. D., Agustini, N. L. P. I. B., Pangruating Diyu, I. A. N., Putra, K. A. N., & Indrayani. N. L. D. (2024). Optimalisasi Peran Keluarga Melalui Edukasi dan Simulasi Terapi Relaksasi Autogenik sebagai Upaya Suportif Adaptif Pasien Stroke di Masyarakat [Optimizing the Role of Families Through Education and Autogenic Relaxation Therapy Simulations as an Adaptive Supportive Approach for Stroke Patients in the Community]. Ahmar Metakarya: Jurnal Pengabdian Masyarakat, 4(1), 96–102. https://doi.org/10.53770/amjpm.v4i1.268
Jaracz, K., Grabowska-Fudala, B., Jaracz, J., Moczko, J., Kleka, P., Pawlicka, A., & Górna, K. (2024). Family caregivers' burden after stroke: a 10-year follow-up study of Polish family caregivers for stroke patients. BMC Nursing, 23(1), 589. https://doi.org/10.1186/s12912-024-02251-x
Kaseke, F., Gwanzura, L., Kaseke, T., Musarurwa, C., Gori, E., Nyengerai, T., & Stewart, A. (2024). Family caregivers' burden among informal family caregivers of stroke survivors in Harare, Zimbabwe. South African Journal of Physiotherapy, 80(1), 1–12. https://doi.org/10.4102/sajp.v80i1.2080
Kotlega, D., Kobus-Kotlega, K., & Szczuko, M. (2025). Narrative Review on Post-Stroke Outcomes Through Recognition of Frailty, Sarcopenia, and Palliative Care Needs. Healthcare (Basel, Switzerland), 13(23), 3011. https://doi.org/10.3390/healthcare13233011
Khomarun, Subijanto, A. A., Nurhidayah, N., & Probandari, A. (2025). Devotion to Family: Coping Strategy to Reduce Burden of Caregiving Stroke Patients. Occupational Therapy International, 2025(1), 5517436. https://doi.org/10.1155/oti/5517436
Li, D., Guo, H., Sun, Y., Zhang, Z., & Liu, H. (2025). Knowledge, attitude, and practice of stroke patients’ family members towards stroke rehabilitation: A cross-sectional study. Journal of Stroke and Cerebrovascular Diseases, 34(2), 108177. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108177
Libório, M. P., Martins, C. A. P., Laudares, S., & Ekel, P. I. (2023). Method of preparing an international and national literature review for novice researchers. MethodsX, 10, 102165. https://doi.org/10.1016/j.mex.2023.102165
Lin, S., Wang, C., Wang, Q., Xie, S., Tu, Q., Zhang, H., Peng, M., Zhou, J., & Redfern, J. (2022). The experience of stroke survivors and family caregivers during hospital-to-home transitional care: A qualitative longitudinal study. International Journal of Nursing Studies, 130, 104213. https://doi.org/10.1016/j.ijnurstu.2022.104213
Ministry of Health of the Republic of Indonesia. (2024). Thematic Report on the 2023 Indonesia Health Survey: A Portrait of a Healthy Indonesia. Jakarta: Ministry of Health of the Republic of Indonesia.
Muhrodji, P., Wicaksono, H. D. A., Satiti, S., Trisnantoro, L., Setyopranoto, I., & Vidyanti, A. N. (2022). Roles and problems of stroke caregivers: a qualitative study in Yogyakarta, Indonesia. F1000Research, 10, 380. https://doi.org/10.12688/f1000research.52135.2
O’Callaghan, G., Fahy, M., O’Meara, S., Lindblom, S., von Koch, L., Langhorne, P., Galvin, R., & Horgan, F. (2024). Experiences and preferences of people with stroke and family ccaregivers around supports provided at the transition from hospital to home: a qualitative descriptive study. BMC Neurology, 24(1), 1–13. https://doi.org/10.1186/s12883-024-03767-0
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, 1-9. https://doi.org/10.1136/bmj.n71
Paryono, P., Ar Rochmah, M., Setyopranoto, I., & Trisnantoro, L. (2022). Postacute-Stroke Management Problems in Home Care Service: A Qualitative Single-Centered Study in Yogyakarta, Indonesia. Journal of Neurosciences in Rural Practice, 13(1), 50–59. https://doi.org/10.1055/s-0041-1740613
Poomalai, G., Prabhakar, S., Jagadesh, N. S., Geetha, M. P., & SJ, N. (2023). Functional ability and health problems of stroke survivors: an explorative study. Cureus, 15(1), e33375. https://doi.org/10.7759/cureus.33375
Pourhasan, K., & Vasli, P. (2025). Explaining the multifaceted experiences of family caregivers of stroke survivors: a qualitative study in Iran. BMJ open, 15(5), e097463. https://doi.org/10.1136/bmjopen-2024-097463
Rago, C., Virgolesi, M., Curcio, F., Vellone, E., Alvaro, R., Veronese, M., & Pucciarelli, G. (2025). Insights into the home transition: A qualitative study on stroke survivors’ experiential journey. Journal of Vascular Nursing, 43(3), 106–113. https://doi.org/10.1016/j.jvn.2025.05.002
Risal, M., & Sali, A. (2021). Relationship Between Family Support and Self-Care Among Non-Hemorrhagic Stroke Patients. Nurse and Health: Jurnal Keperawatan, 10(2), 284–291. https://doi.org/10.36720/nhjk.v10i2.244
Tiwari, S., Joshi, A., Rai, N., & Satpathy, P. (2021). Impact of Stroke on Quality of Life of Stroke Survivors and Their Caregivers: A Qualitative Study from India. Journal of neurosciences in rural practice, 12(4), 680–688. https://doi.org/10.1055/s-0041-1735323
Stiexs, A., & Chayati, N. (2021). Study of physical, psychological, and spiritual impact of family caregivers in home-based stroke treatment: A systematic review. Open Access Macedonian Journal of Medical Sciences, 9(T4), 236–239. https://doi.org/10.3889/oamjms.2021.5795
Tunsi, A. Y., Tammar, A., Wahbah, J., Al-Marhoon, F., Al-Mashjary, J., Alaamri, M., Alhofaian, A., & Alharazi, R. (2025). An Exploration of the Experiences of Informal Family Caregivers of Stroke Patients in Saudi Arabia; A Qualitative Study. SAGE Open Nursing, 11, 1-11. https://doi.org/10.1177/23779608251354903
WHO. (2024). Stroke, Cerebrovascular accident. Geneva: WHO. Retrieved from https://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/
Xu, L., Liu, S., Luo, M., Li, M., & Wang, C. (2025). Social alienation and influencing factors among family caregivers of stroke patients in China: a cross-sectional study. Frontiers in Psychiatry, 16(June), 1–10. https://doi.org/10.3389/fpsyt.2025.1544692
Ye, Q., Yang, Y., Li, J., Wang, T., & Liu, N. (2024). How does family resilience develop among stroke survivors and their family caregivers? A mixed-method study using a chain mediating model. International Journal of Nursing Studies Advances, 7(September), 100246. https://doi.org/10.1016/j.ijnsa.2024.100246
Yuliana, S., Yu, E., Rias, Y. A., Atikah, N., Chang, H. J., & Tsai, H. T. (2023). Associations among disability, depression, anxiety, stress, and quality of life between stroke survivors and their family caregivers: An Actor-Partner Interdependence Model. Journal of Advanced Nursing, 79(1), 135–148. https://doi.org/10.1111/jan.15465
Yusrini, Y., Susanti, H., Wardani, I. Y., & Fitriani, N. (2019). Family experience in providing support and the achieving of post-stroke late adulthood development. Enfermería Clínica, 29, 900-904. https://doi.org/10.1016/j.enfcli.2019.04.137
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