This theme includes design recommendations with regard to providing information access to informal caregivers to help them in their caregiving role. A total of 59% (26/44) of the articles reviewed were classified under this theme, and most (19/44, 43%) referred to information access for informal caregivers. This includes education and training opportunities tailored to informal caregivers’ needs, facilitating access to diverse resources and services, delivering personalized information, ensuring enhanced content formats and accessibility, and emphasizing clear language and clarity in communication.

In the literature reviewed, IT applications provided access to training opportunities to assist informal caregivers in developing their skills for effective caregiving [38,71]. Tailored resources, such as educational materials, classes, and programs were integrated to offer practical support and guidance [63,64]. Some applications also included provisions to facilitate advanced care planning as a crucial element in caregivers’ routines [42]. In addition, these applications facilitated access to peer-reviewed research, recognizing the importance of evidence-based insights and strategies for caregivers [63,64]. IT applications for informal caregivers had quick access to relevant links and references [45,53,62,68,70,72,74]. They facilitated the establishment of a common knowledge base among caregivers, fostering a shared understanding and effective care strategies [49,60]. In addition, these applications offered guidance on accessing formal services such as professional caregivers or housekeeping [63], acknowledging the importance of aiding informal caregivers in navigating available resources. Some IT applications also reported providing access to medical health records [76], which is important for informal caregivers in delivering comprehensive care. A few of these applications also had tailored web-based resources [53,62,72,77] specifically aimed at informal caregivers. These web-based resources may include materials such as information articles, guides, tutorials, or forums that provide information, tips, and assistance relevant to the needs and challenges faced by informal caregivers.

IT applications also prioritized delivering tailored information specific to caregivers’ unique situations [43,64]. Customizing information for caregivers consistently assisted them in their daily caregiving responsibilities [54]. In addition, these applications featured relevant personalized information addressing caregivers’ individual needs and challenges [43,56,64,79]. This tailored approach regarding IT applications emphasizes that caregivers prefer personalized over generic information. For instance, caregivers can benefit from personalized information based on the condition that they provide care for, their relationship with the relative, the stage of caregiving, location, and more. Furthermore, the emphasis on personalized information within these applications is indicative of the diverse and ever-changing nature of caregiving responsibilities. This is because the type of information and support may change based on the progression of the condition for which care is provided.

Various articles reviewed (4/44, 9%) discussed IT applications that emphasized delivering content to informal caregivers in varied formats, including video, audio, images, and snippets [59]. In addition, content in short text format was particularly valuable for informal caregivers as they preferred short and easily understandable information [70]. Moreover, the studies stressed the importance of illustrations and appropriate visuals [70] in aiding comprehension and engagement among informal caregivers. The dynamic information needs of informal caregivers require diverse content formats to accommodate their evolving requirements, ensuring accessibility and relevance to their caregiving tasks [73].

Numerous studies (3/44, 7%) stressed the importance of using good, easy, and appropriate language in content targeted at informal caregivers [59,70]. Simplicity and clarity are key, along with the need to avoid jargon that might hinder effective comprehension of information by caregivers [59,70]. Furthermore, the studies also indicated that a few applications focused on debunking illness myths [78], which is important for shaping caregivers’ understanding. In addition, caregivers actively sought knowledge and a comprehensive history of the illnesses they provide care for [78].

The functionalities required by caregivers from IT applications to facilitate community and peer support involved a diverse set of tools aimed at fostering connections and shared experiences among informal caregivers. In the 59% (26/44) of reviewed articles that were classified under this theme, these functionalities prioritized creating a sense of community and shared experiences [57,58], allowing caregivers to relate to and connect with others in similar situations. Peer support is crucial, enabling caregivers to gain insights and emotional reinforcement from their peers [41,42,53,58].

Moreover, the granularity of the information exchanged should also be considered, allowing caregivers to exchange comprehensive experiences and connect with peers [49]. Enabling the sharing of experiences among caregivers becomes vital for building social ties [38,40,47,55,68,74] and solidarity within the caregiving network [51-53]. Feedback from peer groups becomes an invaluable resource, providing diverse perspectives and guidance to caregivers facing similar challenges [59,63,67,71,73,75,78].

Engagement in dedicated caregiver groups [75] and the provision of virtual meeting spaces [57,75] were important functionalities, offering platforms for interactions and support irrespective of geographical limitations. This engagement could be in terms of reading other caregivers’ experiences, asking questions, answering questions, venting their frustrations, or just speaking with other caregivers in similar situations. In addition, facilitating face-to-face group engagements [45] and providing access to online forums [57,58] such as Facebook groups satisfies varying preferences, allowing caregivers to seek and extend support.

Improving access to support networks is crucial for the well-being of informal caregivers.

The capability to reach or access a care network is essential as it allows caregivers to connect with relevant support systems [43,53]. Finding peers and gaining access to social contacts of fellow caregivers enable the expansion of one’s support network, fostering connections and shared experiences [45].

The inclusion of a Pinboard feature serves as a valuable resource, allowing caregivers to gather and share pertinent information and resources [55]. Access to social media and messaging platforms becomes crucial, providing channels for communication and information exchange among caregivers [64]. In addition, having access to an interaction book [72] offers a centralized space for storing and sharing essential caregiving-related information.

This recommendation of providing reassurance through testimonials is crucial as it serves as a means to offer confidence and affirmation to caregivers in their caregiving journey. IT applications provide caregivers with reassurance, instilling a sense of trust and confidence [53]. In addition, providing a space for caregivers to incorporate useful testimonials regarding caregiving experiences becomes essential as it can offer insights and real-life experiences to guide fellow caregivers regarding available support services or useful tips [65].

This theme presents design recommendations that can assist in fostering informal caregivers’ well-being through IT applications, and 32% (14/44) of the articles reviewed were classified under this theme. There were 2 subthemes, namely, emotional and psychological support and physical health and lifestyle management. This theme presents various recommendations, which include physical, mental, emotional, and social support to ensure that caregivers receive comprehensive assistance and are better equipped to navigate the challenges of caregiving while ensuring their well-being.

Emotional and psychological support is essential for caregivers, which includes various well-being features. Focusing on assisting in enhancing informal caregivers’ well-being is crucial, acknowledging their important role [51,57,67]. It is imperative that caregivers feel empowered and have autonomy to enable them to navigate challenges independently and feel effective in their roles [44]. Accessing support opportunities and incorporating mindfulness and counseling was another feature provided in applications to help caregivers manage stress and emotional complexities [45]. The stress of caregiving requires strategies that balance the needs of both the caregiver and the care recipient [46,79]. In addition, some IT applications offered features like positive activity interaction, pleasant activity scheduling, gratitude journaling, and a “positive piggy bank,” all of which can help promote well-being [46]. Encouraging a positive, solution-oriented approach fosters resilience, enabling adaptive coping mechanisms when faced with challenges [51,57]. Using tools such as a life journal becomes beneficial for reflection and self-awareness, aiding in emotional processing and personal growth [72]. Moreover, accessing emotional support through interactive IT applications ensures easy accessibility and engagement, creating a supportive environment [71,73,78]. Encouraging self-care practices acknowledges the importance of caregivers prioritizing their well-being [71]. In addition, integrating mental health support becomes crucial, recognizing and addressing the psychological aspects of caregiving stress [63].

Physical health and lifestyle management include various components essential for caregivers’ and care recipients’ well-being. Incorporating entertainment such as music into IT applications becomes a creative way to boost engagement and enjoyment, contributing to caregivers’ physical and emotional wellness [38,48,73]. Sharing medical and well-being data becomes crucial for transparency and collaboration between caregivers and care recipients, reducing misunderstandings and distress while aiding informed decision-making [43]. In addition, focusing on physical well-being through exercise, diet, and nutrition becomes fundamental for promoting healthy lifestyles among caregivers [64,76]. Acknowledging the significance of financial aid as part of health management addresses the broader socioeconomic factors influencing well-being [62,72,79]. Recognizing and appreciating efforts becomes a motivating factor, reinforcing positive behaviors and fostering a supportive environment for caregivers to maintain their well-being [8].

This theme emphasizes the significance of robust communication channels for informal caregivers with formal health care professionals, beginning with comprehensive information about health care facilities. A total of 23% (10/44) of the articles reviewed were classified under this theme. Equipping caregivers with details about available facilities and services aids informed decision-making regarding patient care. Quick access to relevant contacts and references ensures prompt assistance, whereas encouraging interactions between caregivers and health care professionals facilitates necessary guidance and support.

Offering information about hospitals in IT applications provides caregivers essential knowledge, enabling them to take quick action during emergencies [45]. IT applications can be instrumental in sharing critical hospital information, such as location, phone number, and services offered. Caregivers were also interested in accessing hospital-specific navigation in the applications [45]. Providing quick references and details of health care contact persons in the applications can ensure quick assistance when required [45]. Facilitating communication with health care professionals through the applications establishes a crucial link between caregivers and expert advice, supporting informed decision-making [47]. IT applications can help coordinate caregiving and healthcare-related tasks for care recipients by streamlining caregiving responsibilities and improving the efficiency of care provision [50]. In addition, guidance in accessing formal services through IT applications bridges the gap between caregivers and available support systems, ensuring comprehensive care [58]. Caregivers can also benefit from timely feedback from health care professionals using the applications, enhancing the quality of care by incorporating expert advice and recommendations [59]. Leveraging referrals to specialized resource persons using IT applications assists in expanding the support network, providing access to specialized knowledge and guidance [65]. Transparent communication through the IT applications about the care recipient’s health condition becomes crucial for informed decision-making [63]. In addition, guidance in finding appropriate care facilities and accessing facility information using IT applications can contribute to the overall well-being of care recipients [63].

First, formal support, including caregiver assistance and respite care [71,73], provides essential relief and specialized aid to caregivers, ensuring uninterrupted and high-quality care while allowing caregivers crucial moments to relax and recuperate. In addition, receiving help at the right time holds immense significance, guaranteeing assistance precisely when it is most needed, thereby maximizing the efficiency of support services [79].

Facilitators of using IT applications emerged as one of the major themes. In this section, we present the facilitators of using IT applications by informal caregivers. A total of 95% (37/39) of the articles reviewed were classified under this theme.

Several studies (11/39, 28%) highlighted the usefulness of the information provided by IT applications in assisting caregivers in patient care [93,98,101,105,108,111-115,117]. The studies showed that the information was delivered through various formats, including videos, PDFs, and web pages, covering topics such as patient care, external resources, and the health care system. Caregivers emphasized the value of information on exercise, diet, and medication management, such as handling elevated blood sugar with an endocrinologist’s help [113]. Dementia caregivers appreciated receiving timely, customized information, which helped them understand and cope with illness-related changes and plan for future treatments [114]. The information modules provided quick, accessible advice when needed [115]. Technology-savvy caregivers expressed the need for increased web-based access to accommodate their schedules [113]. Caregivers also valued information on supportive resources, including local support groups and national charities [117]. These resources offered crucial details on medication management and legal rights. Navigating complex medical insurance was a significant challenge, requiring additional support [113]. Another study highlighted the importance of resource links, such as power of attorney information, to help caregivers manage new responsibilities such as financial and health care decisions [114].

In several studies (17/39, 43%), caregivers consistently highlighted the usefulness and significance of the social support received through various forms in different IT applications [87,91,93,95-99,102,103,106-108,110,114,116,117]. Caregivers appreciated web-based platforms’ interactive services, which connected them with others facing similar challenges [110]. They recommended improving the web-based community-building process to enhance interaction and create a more engaging social environment. Social interaction with those facing similar caregiving challenges was valued as it allowed them to share experiences and find mutual support. Many caregivers found comfort in personal conversations even when problems could not be solved, knowing that they were not alone [117]. While caregivers liked the discussion forums, they suggested promoting popular posts and adding open-ended boards and features such as small chat rooms or focused caregiver cohorts [107].

Caregivers acknowledged the importance of support to improve their well-being, recognizing that the stress associated with caregiving often led to their compromised health and quality of life [91,93,99,100,102,106,108-110,112,114,116,118]. Caregivers acknowledged that the stress of caregiving contributed to physical and psychological issues, affecting their ability to provide care [112]. IT applications encouraged self-reflection, exploration of feelings, care strategies, and goal setting [106,110]. Several studies (6/39, 15%) highlighted that caregivers viewed IT applications as beneficial for psychological well-being, promoting empowerment, competence, and validation [91,93,99,100,114,116]. Using IT applications may also reinforce a sense of competence among working caregivers, helping them meet caregiving demands and see the positive aspects of their situation [93].

The possibility of communicating and receiving support from health care providers was highly valued in IT applications [95,96,106,109,113]. The studies indicated that caregivers needed IT applications to include professional support from physicians and nurses along with easy web-based appointment scheduling for tailored health information [110]. They often requested improved communication with health care providers to seek reassurance on patient care decisions [113]. Some IT applications offered videoconferencing with other caregivers and health care professionals, which was highly appreciated [95,109]. Caregivers had positive views on group and video conferencing for support and communication, with studies noting improvements in anxiety, depression, and physical health as a result of these interactions with health care professionals [109].

In several IT applications, caregivers found the education and training provided to take care of patients highly useful and helpful for their caregiving responsibilities [88,90,92,94,95,98,102,104,109,111,114,115]. Education and training were provided to caregivers in various forms across different studies. An interesting example involved creating different activities to engage both caregivers and care recipients [115]. Caregivers felt motivated to try out new activities in the applications and adapt them to the personal preferences and possibilities of the relatives they cared for. Participants engaged in activities such as playing ball, watching the news together, decorating the house for Easter, wrapping wool, or looking at photo albums. In addition, most participants expressed satisfaction with the way in which the activities were displayed and described [115].

Caregivers participating in various studies found valuable information and functions that aided them in performing daily-life activities [87,98,106,108,111,114]. For instance, a daily care activity checklist was perceived as useful [106]. One study highlighted the effectiveness of using a timeline to organize caregiving activities, with caregivers appreciating a dedicated care book that provided contact details and practical care insights [87]. In addition, information on coping strategies for patients with dementia was valuable for caregivers in managing daily activities and fostering better interactions [98].

Caregivers found IT applications to be useful as they offered easily accessible, cost-effective, flexible, and time-efficient solutions. These applications gave caregivers quick access to useful features, ensured smooth functionality, and helped save time during their interactions with other caregivers or healthcare professionals [89,92-94,96,105]. Caregivers found that these IT applications were easy to use and flexible and aligned well with their daily-life activities [105]. One major benefit of IT applications was their accessibility at all times, allowing users to access them when needed and at their convenience in their busy schedules [92]. Caregivers were thankful for customer support as it significantly improved their ability to access and use the IT applications with greater ease and efficiency [106,109].

The theme of barriers to using IT applications explores the challenges faced by informal caregivers in using IT applications for their caregiving tasks. These barriers were privacy and autonomy concerns; lack of trust in IT applications; lack of time to use eHealth interventions; IT infrastructure problems; user interface issues; lack of digital competence; overwhelming, insufficient, and generic content; and reluctance to adopt and use technology. Understanding these barriers is crucial for enabling informal caregivers to effectively leverage IT applications to support their caregiving responsibilities and enhance the quality of care provided to their loved ones. A total of 49% (19/39) of the articles reviewed were classified under this theme.

Various studies (4/39, 10%) highlighted caregivers’ concerns about privacy and autonomy [87,92,96,117]. Caregivers expressed apprehension regarding the security of their information on web-based platforms and stressed the importance of increasing their privacy levels [87,117]. Patients viewed therapists’ access to their data not as a breach of privacy but as a motivating factor. However, health care professionals identified internet connections lacking privacy assurances as a barrier to using a web-based platform, emphasizing the necessity for secure data transport [92].

Several studies (3/39, 8%) highlighted that the lack of trust in the credibility and accuracy of the information provided through IT applications negatively impacted caregivers’ perceptions of their use [89,110,117]. There was extensive discussion about the crucial need for trust in information sources, emphasizing their reliability and legitimacy [89,117]. It is not just the provision of health-related information that matters—establishing trust and credibility is also crucial [117]. Another study identified factors such as a clear layout, interactive features, owner authority, ease of use, and quality content influencing trust in health programs. Caregivers specifically highlighted the importance of layout, owner authority, and content as elements promoting trust [89].

Caregivers expressed a strong interest in using the system yet faced difficulties in finding the time to engage with it, attributed to the demanding nature of caregiving and additional responsibilities [111,114]. The challenge is particularly pronounced for overwhelmed caregivers, especially those caring for patients undergoing surgeries or coping with serious conditions, who find it daunting to enter information into the system [111].

The challenges in IT infrastructure, such as issues with internet accessibility and hardware, along with technical issues, were a factor hindering the use of IT applications [83,88,92,101,105]. One study highlighted the challenges posed by the lack of consistent internet access, impeding access to health information and engagement in video calls. In addition, hardware issues, particularly those associated with monitoring blood pressure at home using remote devices, were identified as obstacles to effective health monitoring [105]. The absence of reimbursement for IT applications and related infrastructure also posed a barrier for caregivers who could not afford them. Health care professionals cited the lack of reimbursement as a significant obstacle to program implementation due to the associated costs [92].

Several studies (5/39, 13%) highlighted the problems with user interfaces that affected caregivers’ ease of using the system [82,85,88,90,105]. Caregivers faced several challenges in comprehending the options within the interface, including difficulties understanding specific features such as accessing and using the physical activity function, navigating the notification menu flow, handling alarms, and managing message notifications [82]. They emphasized the need for the interface to provide clear instructions on accessing and using certain functions, underscoring the importance of clarity in using the interface effectively [82,105].

Many studies (5/39, 13%) emphasized that a lack of digital competence posed significant obstacles for users. These challenges included difficulties in using and navigating digital tools and technologies, struggles in accessing and using web-based information, limitations in effective communication through digital channels, and potential risks related to digital security [83,88,93,101,105]. Especially among older adults, challenges in using IT applications were observed, primarily attributed to insufficient digital competence [93].

The information provided in the IT applications was overwhelming, too generic, or irrelevant for caregivers, which was perceived as a significant barrier to using IT applications [96,111,112]. Caregivers noted that, especially at the time of diagnosis, they were overloaded with information yet paradoxically felt a need for a personalized search for information [112]. They acknowledged the positive impact of the support received but also underscored additional unmet support needs. Specifically, caregivers expressed receiving support not aligned with their specific requirements, encountering limitations in the availability of support, and feeling that the support provided was structured to meet the provider’s needs rather than addressing the caregivers’ unique needs [96].

Reluctance to adopt and use technology was evident in studies in which caregivers expressed hesitation toward incorporating new technological advancements into their daily routines. In addition, there was apprehension about using the chat forum stemming from previous negative experiences [108]. Concerns included the potential for the chat to focus excessively on individual issues or lead to cyberbullying based on caregivers’ past encounters with other social media platforms [108].

This theme explores the proposed improvements to and adaptations of IT applications aimed at addressing the specific needs and challenges faced by informal caregivers. These are improvements in the user interface, navigation, and language; personalization and customization; integration with existing IT services; additional functions in IT applications; and IT support and training. A total of 56% (22/39) of the articles reviewed were classified under in this theme.

In several studies (12/39, 31%), enhancements to the user interface, navigation, and language were suggested for system improvement [84,89,90,93,101,104,106,107,112,114,117,118]. This involved maintaining consistent and commonly used menu icons, ensuring uniform language across the system for effective communication with end users [85,118], and implementing plain icons with hover-over features to enhance system responsiveness [104]. These adjustments aimed to improve user experience and make the system more intuitive and accessible. The caregivers also suggested adding visual aids, warnings for potentially distressing content, and features such as frequently viewed buttons for easier navigation [116]. They also proposed rolling discussion topics and emoji reactions to enhance engagement with the forum [116]. Moreover, customization options were recommended for a more personalized user experience [106]. Caregivers recommended incorporating introductory text for created content, including videos and educational materials [108]. This serves to provide context and enhance the understanding of the content, offering users a more informed and engaging experience.

Caregivers expressed a strong desire for personalized and customized IT applications that aligned with their specific needs and use context [81,84,89,93,104,106,112,114,117]. For web-based family support systems to be truly effective, it is essential to introduce them promptly and tailor them to the individual preferences of working caregivers, accommodating each caregiver’s unique circumstances [93]. A persistent concern voiced by participants was the importance of maintaining a sense of ownership during caregiving, particularly when they felt that their caregiving role dominated other aspects of their lives, such as being a partner, parent, or sibling [117]. The suggestion was to shift the focus from designing solely for the caregiver as a user to exploring designs that consider caregivers with diverse roles and responsibilities, such as managing a career or caring for young children. The goal was to develop online support that enables caregivers to preserve their identity, emphasizing the broader spectrum of roles they fulfill rather than exclusively focusing on their caregiving responsibilities [117].

Caregivers and patients use various IT services, including health care journals, throughout the caregiving journey. The caregivers expressed a desire for seamless integration between existing services and the proposed ones [111,116]. Specifically, linking CareHeroes (a proposed IT application) with other telehealth technologies, such as monitoring blood pressure, blood sugar, and mobility, was recommended for better usability [111]. This integration was anticipated to substantially amplify the platform’s potential impact, creating a more comprehensive and interconnected health care ecosystem [111].

Several studies (3/39, 8%) suggested additional features for IT applications. Caregivers noted the need for multiple accounts to allow various family members and friends to participate in caregiving through the application, enabling a collaborative approach [90,105,106]. They also requested notifications and reminders for tasks but were concerned that automated reminders might feel “generic” and overwhelming. Customizable, personalized reminders were recommended to improve the user experience [106,107]. Caregivers suggested customizing messages in reminders, allowing for personalized and context-specific notifications [107]. Caregivers also struggled to find information within some applications, prompting the suggestion of a search function to enhance content accessibility and navigation [96,109,114].

Caregivers strongly desired easily accessible IT support and training as they encountered various issues while using IT applications [80,83,96,101,110,111,118]. To overcome these issues, caregivers recommended providing education and training on computer and internet use coupled with technical support for working caregivers [93]. The proposal included the addition of a “support” section in the main menu, enabling participants to request technical or emotional support directly from the application [118]. To enhance understanding of IT applications, instructional videos were recommended to educate caregivers about specific challenging tasks [111]. Furthermore, digital skill training was emphasized, particularly for caregivers with less experience with web services [110]. These comprehensive measures aimed to empower caregivers with the necessary support and knowledge to navigate and use IT applications effectively.