Caregiver activation: a concept analysis

As health care shifts toward person-centred models, informal family caregivers increasingly manage complex, long-term conditions. However, caregiver activation has been applied across oncology, dementia, paediatric, and chronic care settings without consensus regarding its definition or core components.

To clarify the concept of caregiver activation by systematically analysing its defining attributes, antecedents, and consequences, and to provide a practical framework for identifying caregivers who may benefit from tailored support to enhance engagement and improve care-recipient outcomes.

Eleven databases were searched from inception to October 2025, including PubMed, Web of Science, Embase, Ovid, the Cochrane Library, the Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Wanfang Data, the Chinese Science and Technology Journal Database, the Chinese Medical Database, and the Chinese Biomedical Literature Database. Dictionaries, including the Cambridge Dictionary, Merriam-Webster, the Collins English Dictionary, and the Modern Chinese Dictionary, were also consulted.

Walker and Avant's eight-step concept analysis guided the study. Two reviewers independently screened and extracted data, and disagreements were resolved through discussion with a third investigator.

A total of 19,572 records were retrieved, of which 51 studies were ultimately included. Caregiver activation comprised four interrelated attributes: care capabilities, care autonomy, care resilience, and self-efficacy in care provision. Key antecedents included care-recipient dependency, caregiver-clinician collaboration, insufficient caregiving proficiency, and caregiver burden. Higher caregiver activation was associated with improved health service utilization, enhanced caregiver well-being, and better care management practices.

Caregiver activation is a multidimensional and dynamic process that is central to optimizing outcomes for both caregivers and care recipients. The clarified framework may support identification of caregivers who could benefit from targeted education and tailored services, and may inform development of digital health tools and broader strategies to strengthen caregiver engagement and care-recipient outcomes.

Not registered.