An unbreakable family bond: A focused ethnographical study of perceptions of bedridden patient caregivers in Isan context

Abstract

It is recognized that the world, including Thailand, has entered the aging society, which brings with it an increasing number of chronically disabled and bedridden patients. This situation significantly impacts the families responsible for caring for these patients, placing on them the burden of providing dedicated, unpaid care. Despite the efforts of health service organizations to develop the capabilities of caregivers to some extent, the input data still needs to be adjusted periodically and be specific to each group. Additionally, society still lacks in-depth information on caregivers’ perception and value of caring for patients in the family within the context of beliefs in Isan society, which is crucial input data for developing policy proposals and designing care strategies that align with the service recipients.

This research aimed to explain the thoughts and beliefs in caring for bedridden patients within the context of Isan society to fill the knowledge gap, using a focused ethnographic research method. The study examined the contexts and experiences of 39 informants related to patients in a community in Khon Kaen Province, including 7 stroke survivors, 10 family caregivers, 14 sub-district health service personnel, and 8 community leaders. Data were collected through participant observation, field notes, in-depth interviews, and analysis of emergent themes. Data trustworthiness had been ensured through triangulation technique. The data collection took place between July and December 2023.

The research findings identified three main themes: defining the meaning of care, coping with caregiving challenges, and finding resources to address the challenges. As follows: Defining the meaning of care: Care was understood in four ways: 1.1) As a role and duty of the family, 1.2) As an unbreakable relationship or unbreakable bond within the family that cannot be abandoned, 1.3) As compassion (Luea Ton), and 1.4) As a form of making merit. 2. Coping with caregiving challenges: Caregivers addressed challenges in three ways by: 2.1) "Tam Jai", which was accepting their situation and not overthinking it, 2.2) “maintaining hope”, and 2.3) “creating balance”. 3. Finding resources to address the challenges, which relied on two aspects: 3.1) Self-reliance, and 3.2) Seeking resources for help.

The research results indicated that the caregivers’ perception in the Isan social context is positive and valuing. The findings also highlighted the strong and harmonious relationship of Isan families. These insights can inform the design of practices to promote care with positive perception of caregivers in other social contexts, contributing to create balance and psychological well-being for family caregivers.