Qualitative Study on How Caregivers of Stroke Patients in Southern Thailand Manage their Own Self-Care and the Care for their Family in the Long-term

Abstract

This qualitative study applied the grounded theory method (Glaser and Strauss, 1965) to explore the perspectives of caregivers on how they manage their long-term self-care as well as the care for their family members, while caring for stroke patients. Fifteen participants, who had spent at least 4 hours a day on caring for stroke patients for a period of six months or more, were recruited in Southern border provinces of Thailand. Data were collected by using in-depth audio taped interviews, together with observations and field notes that enabled concurrent data validation with methodological triangulation. Coding analysis was also performed. The findings revealed as follows.

The participants handled their self-care and family care in a congruent way with their patients’ condition, which can be divided in 3 stages. The first stage corresponds to a strategy of care and cure to the patients who had recently developed symptoms. Strategy consisted in trying to adapt themselves so to be not too much suffering. By looking for someone to help their first-stage patient, by adjusting other missions in accordance with the appropriate care, caregivers attempted to limit undesirable effects that could affect them and their families so to restore family balance as soon as possible. They justified adopting this attitude and behaviour saying they had to be ready to care for other patients who could not take or nearly could not take care of themselves so they would recover first.

The second stage consists in preventing deterioration or stroke patients' condition. During this phase, caregivers made great and continuous efforts to support their patients who had already improved to some degree, so to maintain their condition as long as possible. They attempted to be patient and to accept the role they had, so to further being able to keep their care going, while taking care of themselves in the goal of not being sick, and adequately find and manage resources to support their efforts. These were the challenging approaches that made them cope with stresses and strains from the long-term situations they encountered. Along the way, their aim was to regain their power to continuously maintain the rehabilitation of their stroke patients with fluctuating symptoms. In the final stage, labelled as not seeking any treatments but keeping the survivors away from suffering, caregivers were resigning themselves to the situations they faced, and trying to keep themselves healthy, able to manage their families without more difficulties, along with sustaining their care for their patients until the end of their patients’ lives.

Findings could be applied to guide nursing administrators and nursing practitioners about how to manage long-term self-care among caregivers and their families throughout the stroke patients’ trajectory.