Family-oriented self-care : an ethnographic study of stroke patients in Thailand.

Abstract

The aim of this ethnographic study was to explore and describe the lay care (self-care) phenomenon in Thai culture. Spradley's (1979) ethnographic method was utilised to investigate the meaning of lay care, the lived experiences of 10 individuals who had suffered a stroke and their family caregivers in caring for the sick person at home.The meanings and perceptions of self-care from the individuals' and their families' perspectives, were explored, including the practices and cultural issues relating to care at home. The data collection was undertaken over a 10 month period in Songkla Province, southern Thailand. The major sources of data were the transcripts of semi-structured informal interviews, focus group discussions, field notes of participant observations and interviews with other individuals who were knowledgeable of health services and cultural issues relating to care and treatment in the community.Data analysis revealed a number of themes related to family relationships, and home and community care. These themes included the lived experience at both home and healing centres, experiences with change and loss after the stroke and coping with these, perceptions of care-receiving and caregiving, scope of the family's responsibilities in the caregiving role, caregiving burden, factors influencing the quality of care and the recipient's satisfaction with care. Other themes related to support and health services: Western and traditional medicine, social networks and religion. These themes were discussed from three perspectives: the individual, the family and community resources.The results of the study support the concept of interdependence of family members, and to a lesser extent their wider social network, in health and illness. Consequently the model of care developed from this study focuses on the family, with the family as a whole contributing to the well-being of its members through both the promotion of family members' health and the restoration of the health of the family with a sick member(s). Implications of this model of care were identified for nursing practice, education and research.