Caregiving process of Thai caregivers to elderly stroke relatives : a grounded theory approach

A grounded theory approach was used in this study to generate a substantive theory that explains the process of caregiving based on the perspectives of Thai caregivers of elderly stroke relatives. The study sample consisted of 20 primary caregivers living in five districts of Chachoengsao Province, Thailand. The participants were interviewed in their homes. Observations were made during the interviews and the researcher's memos were maintained. All interviews were tape-recorded and transcribed verbatim. All data accumulated from the interviews, observations, and notes were analyzed. The substantive theory that emerged from the data was called "maintaining caregiving at home." This theory described how and why Thai caregivers cared for their elderly stroke relatives. The process of maintaining caregiving encompassed the following seven aspects which helped caregivers provide care for their relatives: (a) caregiving as an integral part of life; (b) caregiving: an unavoidable task; (c) caregiving with love, sympathy, and attachment; (d) family and kinship support; (e) community support; (f) managing treatment; (g) managing problems and difficulties. This theory can help nurses and other health care providers gain a better understanding of the caregiving process of Thai caregivers. Major factors identified in this theory can be related to concepts or variables indicated in previous studies and existing models. Problems and difficulties experienced by participants suggest the need for caregiver support services. Personal beliefs due to religion and culture played major roles throughout the caregiving process. Also, important religious and cultural concepts such as karma, bunkhun, merit, sin, and heaven are needed to understand the theory. Health care providers should integrate scientific, religious, and cultural knowledge into their clinical practice for promoting quality of life of family caregivers and their elderly stroke relatives. Further research is needed to test the theory with larger samples and its value in developing appropriate interventions for Thai caregivers and stroke patients.