Developing a conceptual framework for family caregiver preparedness in stroke care: A scoping review

Abstract

Background & Aim: Family caregivers of stroke survivors often assume complex responsibilities with limited preparation, while evidence on how best to support them remains fragmented. This review aimed to map evidence on family caregiver preparedness in stroke care and use the findings to develop a conceptual framework. Methods & Materials: A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to guidance for scoping reviews. MEDLINE via Ovid, PubMed, Scopus, ProQuest, and ScienceDirect were searched for peer-reviewed English-language studies published from 2014 to 2025. Quantitative, qualitative, and mixed-methods studies examining preparedness, related frameworks, tools, or interventions were included. Studies involving paid caregivers, paediatric stroke, or psychosocial outcomes without reference to preparedness were excluded. Findings were synthesised descriptively and thematically. Results: Twenty-two studies met the inclusion criteria. Four examined frameworks, assessment tools, or interventions, and 18 reported preparedness levels and associated factors. Preparedness was generally low to moderate. Three contextual domains shaped caregiving demands: stroke survivor clinical characteristics, caregiving roles and responsibilities, and family caregiver characteristics. Psychosocial and emotional factors and social and supportive resources moderated the relationship between demands and preparedness. These domains were integrated into a framework describing preparedness as a changing balance between caregiving demands and available resources across the stroke care continuum. Conclusion: Family caregiver preparedness is multidimensional and changes over time. The proposed framework may support assessment, follow-up, and intervention design, but requires empirical and stakeholder validation.