Population aging is a great challenge globally due to increasing life expectancy and decreased fertility rate, especially in mainland China with a vast population (1, 2). A trend similarly is observed in many developed countries, including the USA, UK, France, and Germany (3). On this basis, home-based informal caregiving, community-based residential care, and institutionalized care have been advocated and become increasingly significant modes of care provision. According to Article 49 of the Constitution of the People’s Republic of China, “Parents have the duty to rear and educate their minor children, and children who have come of age have the duty to support and assist their parents” (4). This constitutional provision reflects the traditional Confucian value of filial piety, which remains deeply embedded in Chinese culture and social norms. On this basis, most of the older adults care is given by their family members.

Informal caregiving refers to the unpaid care and assistance provided primarily by family members, relatives, or close friends to older adults with functional limitations. As a type of care usually provided by family members, it assists the older adults with functional limitations in their daily lives with no paid compensation (5). Informal caregiving for the older adults is often a long-term commitment, involving not only basic daily support but also more complex tasks such as rehabilitation training and the management of chronic diseases (6). The scope and intensity of caregiving tasks vary widely, depending on the number of caregiving hours, specific care needs, and the level of support available. Compared with the nursing caregivers, informal caregivers, typically family members without formal training, are more likely to experience significant physical and psychological stress (7). The lack of professional knowledge and caregiving skills often contributes to a gradual decline in care quality, negatively affecting the health and well-being of older adults over time.

Studies in the USA and the UK have demonstrated that untrained informal caregivers are at increased risk of caregiver burden, depression, and reduced care quality (8). Evidence from randomized controlled trials and systematic reviews shows that targeted caregiver training programs can significantly reduce caregiving burden, enhance coping skills, and improve outcomes for both caregivers and care recipients (9). Despite a vast population in China, limited attention has been paid to the status and training needs of informal caregiving in the Chinese population. Previous research found that greater caregiving load was significantly associated with higher caregiver burden, with social support intensity playing a key moderating role (10). However, while the impact of caregiving burden has been acknowledged, relatively little is known about the specific skills and support informal caregivers require to improve care quality and reduce stress. Accordingly, this study sought to identify the training needs of informal caregivers in Jiangmen City, China, with a focus on the types of caregiving skills required, preferred training formats, and factors associated with those needs.

Caring the older adults presents a significant challenge for families, particularly in China, where population aging is accelerating. In some developed countries, family caregiving has been incorporated into the long-term care insurance system (11, 12), however, in most of Asian countries, adult children are expected to assume primary responsibility for supporting and caring for their aging parents, due to cultural norms of filial piety and legislative requirements (13). This reliance on informal caregiving has led to considerable burdens for family members. Thus, attention should be paid to these individuals in order to alleviate their stress and improve the quality of life (QoL) for both caregivers and care recipients. This study was designed to investigate the current landscape of informal caregiving in Jiangmen City and to identify the factors associated with caregiving needs, based on findings from a cross-sectional survey.

Informal caregiving has been associated with reduced quality of life, poorer overall well-being, increased risk of severe depression, and substantial financial strain (14). Despite these challenges, most informal caregivers have limited access to professional training and receive no financial compensation for their efforts (15, 16). In the present study, 47.2% of informal caregivers have provided care for more than 6 months, and 56.1% offered care for more than 2 h per day, and 18.2% reported caregiving durations exceeding 6 h daily. Additionally, over half of the respondents were not engaged in full-time employment while providing care, reflecting the significant time commitment and economic burden associated with informal caregiving. These results were consistent with the previous studies (14). Notably, 78.5% of informal caregivers had not received any form of professional training, and over 90% expressed a need for such training. These results implied the urgent and unmet demand for structured training programs to support informal caregivers in delivering safe and effective care. In our survey, some caregivers had received only basic life-support training, with a lack of professional guidance. Informal caregivers primarily acquired caregiving knowledge through informal channels, such as advice from friends or relatives with caregiving experience, online resources and television programs (17). Very few participants had access to structured training delivered by formal institutions or professional caregivers. Consistent with the previous studies (18, 19), our data showed that the caregiving responsibilities were predominantly undertaken by middle-aged, unemployed women. These findings underscore the critical need for accessible, standardized, and professionally led training programs to better equip informal caregivers in China.

Our study showed a substantial demand for caregiving training among informal caregivers, with an overall score of 4.17 ± 0.88. Among the four dimensions, knowledge related to older adults care received the highest score, encompassing psychological and physiological guidance, information on common chronic diseases, and dietary and nutritional advice. This elevated need may reflect the high prevalence of chronic conditions among older adults (20), for which caregivers require more specialized knowledge, including medication management and disease-specific dietary recommendations. The score for rehabilitation caring was the lowest among these items. This may be attributed to the perception that rehabilitation should be conducted by trained professionals, such as physicians or institutional nurses, rather than informal caregivers. Among the 18 items assessed across the four dimensions, the top three priorities identified were: guidance on managing common chronic diseases in older adults (e.g., hypertension, DM, and COPD); first aid procedures (e.g., for falling, choking, injury and fracture); and diet and nutrition guidance. These findings are in line with previous studies, which have consistently shown that informal caregivers express the most urgent need for knowledge regarding chronic disease management (21), first aid (22), and older adults nutrition (23).

Caregivers of different age groups showed different needs for the informal caregiving training (19). Our findings indicate that older caregivers, particularly those aged 40–50 years and above, reported higher training needs, which may reflect their more intensive caregiving roles, longer daily care hours, and potentially lower adaptability to new caregiving knowledge acquisition channels compared with younger caregivers. In contrast, younger caregivers may rely more on self-learning via digital resources, reducing their perceived need for formal training. This may be attributed to their younger age and generally higher educational attainment, which enables them to access caregiving knowledge independently through the internet, books, and other self-directed channels (24). Education level was also a key determinant, with lower educational attainment linked to higher demand for training. This aligns with the notion that caregivers with limited educational backgrounds may face greater challenges in understanding disease management, medication use, and rehabilitation techniques without structured guidance. This finding aligns with previous studies showing that lower educational attainment is associated with a higher perceived caregiving burden (25, 26). These findings suggest the importance of adopting stratified and tailored training strategies. For older caregivers with lower levels of education, easily accessible formats such as popular science videos, animated content, and other visually engaging materials may facilitate understanding and knowledge retention. In contrast, for more educated caregivers, expert-led seminars or in-depth lectures on geriatric conditions may offer a more appropriate and effective training modality.

Significant differences were reported in the training needs of informal caregivers with different working conditions (27). Employment status further influenced training demand: unemployed and retired caregivers expressed stronger needs in this study, likely due to their greater availability for caregiving and reliance on it as a primary daily activity. Balancing employment responsibilities with caregiving duties can constrain their involvement in direct care, thereby reducing their perceived need for formal training (28). This finding was consistent with the study by Rachiel, which showed that full-time employment was associated with reduced hours spent on informal caregiving as early as the 1980s (29). Therefore, for informal caregivers with full-time employment, training program should offer greater flexibility in terms of timing, delivery methods, and formats. This approach would enable them to access essential caregiving knowledge efficiently, without imposing additional time and energy burdens, thereby improving the quality of care they provide. In our study, significant differences were observed in the training needs and dimensions among informal caregivers with varying relationships to the older adults. Among them, compared with sons or daughters-in-law, and daughters or sons-in-law, those shared a social relationship or other relations with the older adults reported significantly lower training needs. This may reflect the closer familial or blood ties between these caregivers and the care recipients, which could foster a stronger intrinsic motivation to enhance their caregiving skills and provide higher-quality care.

There are inevitably some limitations in this study. First, this is a retrospective study, which could not eliminate the possibility of selection bias. Second, the sample size is not large, and in the future, we will carry out a study with a large sample size. Third, the study did not capture detailed information regarding the specific training content desired by respondents, nor did it account for the potential use of alternative or supplementary caregiving arrangements. Forth, training dimensions were not grouped as logically and systematically as might be ideal, which may affect the clarity and readability of the framework. Last, the generalizability of these findings may be limited due to the unique social, cultural, and economic characteristics of Jiangmen. Differences in caregiving practices, family structures, and available resources across regions could influence the applicability of the results to other settings. Due to many direct relatives living abroad, most caregivers were other relatives or friends, potentially affecting generalizability. Therefore, caution should be exercised when extrapolating these findings beyond Jiangmen, as training needs and caregiving dynamics may vary in different contexts.

In summary, there is a great need for informal caregiver training in Jiangmen city, Guangdong, China. More than half of the informal caregivers had not received formal training in older adults care and demonstrated a strong demand for such training. Multi-stepwise regression analysis indicated that training needs were significantly associated with caregivers’ age, education level, employment status, and relationship to the care recipient.