This study aimed to develop an analytical theoretical model of care burden's downstream effects on hemodialysis patients' family caregivers using grounded theory (Strauss-Corbin paradigm). From January to June 2023, 80 caregivers from three tertiary hospitals were selected via purposive and theoretical sampling. Semi-structured interviews collected qualitative data; the Zarit Burden Interview (ZBI) aided sampling (selecting those with mild-to-severe burden) and validation, not core quantitative analysis. NVIVO 12.0 supported three-level coding, with anonymized interview vignettes and trustworthiness strategies (triangulation, etc.) boosting transparency. Results identified five dimensions (mental health as core) and a dynamic transmission pathway forming a burden cycle, first revealing this mechanism to guide clinical multi-dimensional interventions.
Yin et al. (2026) studied this question.