Invisible Bodily Burden in Unpaid Family Caregiving and Domestic Work: A Qualitative Meta-Synthesis

PURPOSE: To synthesize qualitative evidence on how unpaid family caregivers and individuals engaged in unpaid domestic work experience, interpret, and manage musculoskeletal pain, physical strain, fatigue, and bodily burden related to home-based caregiving tasks and domestic work. DESIGN: A qualitative meta-synthesis. METHODS: A systematic search was conducted in PubMed/MEDLINE, CINAHL/EBSCO, Scopus, and Web of Science for qualitative studies published between 2016 and 2026. Eligible studies involved unpaid family caregivers, informal caregivers, unpaid domestic workers, or individuals engaged in unpaid domestic work, and reported qualitative findings related to musculoskeletal pain, physical strain, fatigue, bodily burden, caregiving tasks, or domestic work. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Qualitative Research. Data were synthesized using thematic synthesis. FINDINGS: Ten qualitative studies were included. Five analytical themes were generated: the caregiver's body as an invisible site of unpaid work; ordinary routines as hidden ergonomic exposure; pain and fatigue normalized through family duty, gendered expectations, and moral obligation; coping through endurance, improvisation, spirituality, and self-neglect; and the need for community health nursing assessment, ergonomic education, and family-based support for caregiver bodily burden. CONCLUSIONS: Unpaid family caregiving and domestic work produce an invisible bodily burden that is physical, gendered, morally shaped, and structurally reinforced. CLINICAL RELEVANCE: Community health nurses should assess caregiver physical strain, provide ergonomic education, support safe care practices, and promote family-based redistribution of care responsibilities.