Caring through crisis: a mixed-methods study on aphasia caregiving in Palestine

Purpose This study examined the challenges faced by caregivers of adults with post-stroke aphasia in Palestine – a critically underrepresented, low-resource context. It aimed to identify systemic gaps in support and highlight caregivers’ expectations for sustainable, culturally responsive aphasia care.Method A convergent mixed-methods design was used. Thirty Arabic-speaking family caregivers of adults with post-stroke aphasia participated in qualitative semi-structured interviews exploring service access, caregiver burden, coping strategies, and informal support practices. Quantitative variables were derived from coded themes and analyzed using statistical modeling, including cluster analysis and regression, to identify caregiver profiles and predictors of burden and satisfaction.Results Six core themes emerged: (1) barriers to care (e.g. access, cost), (2) emotional and physical burden, (3) stigma and misinformation, (4) informal support strategies (e.g. WhatsApp), (5) spiritual and cultural meaning-making, and (6) satisfaction and resilience. The quantitative analysis revealed three caregiver profiles: high burden/no access, moderate burden/adaptive coping, and low burden/spiritual support. Financial stress and lack of access strongly predicted strain, while informal tools and spiritual framing were associated with higher satisfaction.Conclusions Caregivers in Palestine face critical service gaps and frequently assume therapeutic and advocacy roles. Their informal, culturally rooted practices highlight the need to reconceptualize caregiver involvement in aphasia rehabilitation. Integrating these lived strategies into care models is essential for advancing equity in under-resourced settings.