Determinants of Caregiver Well-Being in End-of-Life Care: A Systematic Review Protocol

End-of-life caregiving represents one of the most demanding experiences for informal caregivers who often sacrifice their own well-being while supporting dying loved ones. This systematic review protocol presents a comprehensive framework for synthesizing evidence on factors influencing caregiver well-being in end-of-life care settings. Using the SPIDER framework (Sample, Phenomenon of Interest, Design, Evaluation, Research type), we will investigate caregiver experiences across physical, psychological, social, and spiritual well-being dimensions. Eight electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, PsycINFO, Scopus) will be searched from inception to June 2025. Eligible studies include quantitative, qualitative, and mixed-methods research examining factors associated with caregiver well-being in hospice, palliative, and terminal care contexts. Covidence software will facilitate systematic screening, data extraction, and quality assessment by two independent reviewers using design-specific appraisal tools. Data synthesis will employ a convergent integrated approach combining narrative synthesis with meta-analysis where appropriate. Quality assessment will utilize JBI checklists, Newcastle-Ottawa Scale, and CASP tools, with evidence certainty evaluated using GRADE and GRADE-CERQual. This protocol follows PRISMA-P guidelines and will be registered with PROSPERO. Findings will inform evidence-based interventions and policies supporting the millions providing essential end-of-life care.