Family caregivers’ preferences for the use of telerehabilitation among stroke survivors: a qualitative study

Telerehabilitation enables stroke survivors to undergo rehabilitation at home, further alleviating the multifaceted pressures faced by their family caregivers. However, evidence regarding family caregivers’ adoption of telerehabilitation for stroke survivors remains limited, with few studies exploring the factors influencing their use. This study aimed to investigate the factors influencing caregivers’ preferences for telerehabilitation among stroke survivors. A qualitative descriptive design was adopted. Fifteen family caregivers of stroke survivors in China were recruited using purposive sampling, and data were collected through semistructured interviews. The interview transcripts were analyzed using Braun & Clarke’s thematic analysis method. Two main themes emerged. Factors promoting telerehabilitation use included: (1) family co-decision-making, where collective negotiation and resource allocation shaped adoption; (2) regional differences, with urban caregivers prioritizing efficiency and trust transfer, whereas rural caregivers valued basic accessibility and social network intermediaries; and (3) integration of traditional filial piety culture with modern technology, leading to a “hybrid model” combining remote rehabilitation with hands-on care to resolve ethical anxieties. Barriers to use included: (1) lack of system development, with fragmented and immature platforms failing to replicate traditional all-in-one care models; (2) insufficient national policy support and government promotion, notably the absence of medical insurance coverage and public awareness campaigns; and (3) high costs, including upfront equipment expenses and ongoing fees not reimbursed by insurance. Family caregivers’ preferences for telerehabilitation are shaped by a multi-layered system of family decision-making, cultural ethics, and policy context. To enhance adoption, policymakers should integrate telerehabilitation into medical insurance schemes, develop unified and comprehensive service platforms, and launch targeted promotion efforts—particularly in rural areas. Future interventions should move beyond techno-centric approaches toward context-sensitive strategies that align with China’s sociocultural realities.