Determinants of Self-Care Practices Among Family Caregivers of Older Adults with Chronic Illness: A Qualitative Descriptive Study

Background and Objectives Caregiver burden significantly impedes self-care, often resulting in poor health and increased vulnerability to chronic illness. Despite these risks, the underlying factors influencing caregivers’ self-care remain understudied. This qualitative descriptive study explored the context of caregiver self-care and identified perceived barriers and facilitators to practicing self-care. Research Design and Methods We conducted four focus groups with 14 caregivers primarily responsible for providing in-home care to older adults (≥ 65 years) with chronic illnesses. Focus groups were audio-recorded and transcribed. A hierarchical coding system was developed and refined using the focus group guide and preliminary transcript review. Coded transcripts were analyzed using an iterative inductive-deductive thematic approach based on established theories. Results Caregivers’ multi-dimensional definitions of self-care shaped their perceived barriers and facilitators. Three core determinants of self-care behaviors were identified: capability (caregivers’ psychological and physical health, and behavioral regulation); motivation (caregiver identity, emotions, and perceived control); and opportunity (social and environmental influences and resources). Caregivers recognized that self-care deficits negatively affect their clinical, behavioral, and psychosocial outcomes. These results informed the development of a conceptual framework for caregiver self-care. Discussion and Implications Findings underscore the importance of integrating caregivers’ own perceptions of self-care into support models. Interventions should transition toward personalized approaches that address both intrinsic psychological drivers and extrinsic environmental constraints. The framework derived from this study provides a theory-driven roadmap that informs future interventions, ensuring support systems align with caregivers’ unique needs and contexts to foster better self-care and ultimately enhance their health outcomes.