Exploring barriers to and facilitators of adaptation in family caregivers of stroke survivors: a qualitative study

Background The sudden transition into caregiving following a stroke presents significant challenges for family members, profoundly affecting their well-being and capacity to adapt. A comprehensive understanding of the barriers and facilitators involved is essential for the development of effective support mechanisms, particularly in resource-limited contexts. This study investigates these factors among family caregivers of stroke survivors in Iran. Methods This qualitative study employed conventional content analysis. Twelve participants were selected through purposive sampling with maximum variation. Data obtained from in-depth, semi-structured interviews were analyzed utilizing Graneheim and Lundman’s framework. Results Twelve family caregivers (9 women, 3 men; mean age 45 years) participated in the study. Analysis generated three integrative themes. First, caregivers described a multidimensional erosion of well-being, including physical exhaustion, psychological identity disruption, financial strain, and loss of personal space. Second, adaptation was mediated through culturally grounded meaning-making, kinship support, knowledge acquisition, and episodic healthcare assistance. Third, adaptation emerged as a dynamic balancing process in which caregivers managed cumulative burdens through active coping, identity reformation, and conditional growth within structurally limited support systems. Conclusion Caregiver adaptation following stroke reflects a dynamic balance between cumulative burden and contextually mediated reconstruction. Rather than signaling resolution of hardship, adaptation involves the conditional reorganization of identity, relationships, and everyday practices within structural constraints. Recognizing caregivers’ simultaneous vulnerability and resourcefulness offers a culturally grounded framework to inform responsive, context-sensitive caregiver support policies and interventions.