Multilevel influences on family caregiver burden in diabetic foot ulcer care: a qualitative study

To explore multilevel determinants of caregiver burden in the care of people with diabetic foot ulcers in China and guide culturally relevant support in non-Western settings. Sixteen family caregivers of patients with diabetic foot ulcers were purposively recruited from four medical institutions in Shanghai. Data were collected through semi-structured interviews and analyzed using hybrid thematic analysis framed by the Social Ecological Model. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). Four themes and twelve subthemes were identified: (1) Individual Capacities and Internal Struggles; (2) Interpersonal Strain and Social Support Challenges; (3) Health System Deficiencies and Access Barriers; (4) Policy Limitations and Cultural Burden . Caregiver burden in care of patients with diabetic foot ulcers is influenced by personal, family, institutional, and cultural factors. Context-sensitive approaches that integrate system reforms, community support, and cultural norms are needed, with insights from China informing care strategies in other non-Western settings. Not applicable.