Family Strength in Caring for a Stroke Survivor at Home

This hermeneutic phenomenological study explored the meaning of family strength when caring for a stroke member at home. Family strength is considered to be the competency of a family when faced with a stressful life event that can be viewed through a continuous man-environmental interaction process. Six family units were purposively recruited and screened using the Family Hardiness Index (four with high-level of hardiness, and two with moderate-level of hardiness). Data were collected through in-depth interviews, field observations and field notes, and analyzed using Braun and Clarke’s thematic analysis method. Findings revealed families with high-hardiness continuously strove to overcome caregiving hardships and had hope for the stroke member’s long existence, while families with moderate-hardiness demonstrated less effort to overcome caregiving hardships and held no hope for the stroke member’s long existence. Primary caregivers among families with high-hardiness revealed more self-development incarer role than did those of families with moderate-hardiness. Families with high-hardiness shared caregiving and family task responsibilities, while families with moderate-hardiness lacked collaboration regarding caregiving and family tasks. In addition, family strength emerged from families overcoming caregiving hardships through: hope for the stroke member’s long existence; development, accumulated experiences of “can do” family members; and, establishment of shared caregiving and family task responsibilities. Consideration of views and abilities of the family unit to provide homecare for a stroke member can enhance nurses’ understanding of different developmental experiences of home caregiving families. In addition, such knowledge can facilitate adoption of meaningful nursing interventions to support the families.

Experiences of Caregivers of Spouses With Head and Neck Cancer Undergoing Radiation Therapy

Spousal caregiving is an important aspect of traditional Thai caregiving ideology. Evidence suggests that such continuous caregiving may affect the caregivers’ well-being. Presently, the knowledge of experiences of Thai spouses who are caregivers of persons with head and neck cancer undergoing radiation therapy is limited. The purpose of this study was to describe the experiences of spouses who care for persons with head and neck cancer undergoing radiation therapy. Fifteen spousal caregivers, consisting of 12 wife caregivers and 3 husband caregivers, were recruited from the Radiation Therapy Unit at the University Hospital in Songkhla province from May 2005 to December 2005. In-depth interviews were conducted, and data were analyzed using the hermeneutic phenomenological research approach described by Cohen, Kahn and Steeves. Six major themes emerged: (1) “Being committed for life to spouses” was rooted in the powers of love, intimacy, and trust, and led to repayment with gratitude, (2) “Enhancing the spouses’ comfort” was accomplished by strengthening their physical health and relieving symptoms and by giving them encouragement, intimacy and compassionate love , (3) “Being a co-sufferer” was due to the uncertainty of their future lives, the caregiving strain, and the difficulties with new living arrangements, (4) “Readjusting themselves” was through rearranging the caregivers’ life and holding onto hope for a cure and a longer life for their ill spouse, (5) “Appreciating peoples’ support”, and (6) “Being gratified with self-development and marital life growth” was derived from being successful caregivers, gaining a better marital relationship and developing insight into the truth of life. These findings can both help health professionals recognize spousal caregivers as a vulnerable group and care for them, and also pave the way for future Thai spousal caregiving research.

Effect of Educative-Supportive Program on Quality of Life in Breast Cancer Survivors

Breast cancer survivors experience long-term problems related to their disease and treatment, and this can decrease their quality of life. This quasi-experimental research aimed to study the effect of an Educative-Supportive Program on quality of life among 61 breast cancer survivors diagnosed for at least 5 years, at Maharaj Nakorn Chiang Mai hospital, Thailand. Eligible participants were obtained by using purposive sampling and matching of age, education, and year of survival was conducted before group assignment. Participants were assigned into the control and the experimental group, 31 in the control and 30 in the experimental. Implementation of the Educative-Supportive Program was separated into 4-hour sessions, conducted 4 times continuously with 2 weeks interval. Participants’ self-report instruments included, Demographic Data Form, Quality of Life: Breast Cancer Version Questionnaire and Self-management Questionnaire. Data were collected 3 times: before the program began (time 1), after the program (time 2) and 3 months after the program ended (time 3). The results showed that mean score of quality of life in the experimental group for all 3 times were 6.43 (SD=1.21), 6.30 (SD=1.18) and 5.86 (SD=1.39), respectively while those in control group were 5.82 (SD=1.22), 5.51 (SD=1.09) and 5.41 (SD=1.14), respectively. By using repeated measure ANOVA, the results indicated no interaction between treatment effect and time effect (F Wilk’s Lamba = .763, p=.471). Moreover, a significance differences in quality of life mean score between groups (F=5.313, p=.025) and within groups (F=6.682, p=.002) were shown. Using Bonferroni criterions, the results revealed a significance difference of quality of life score between time 1 and time 3 in the experimental group (mean difference = .491, p=.001). Although the results were not as expected, the evidence of intermediate outcome-self care activities in the experimental group was shown. Further development of Educative-Supportive Programs among Thai breast cancer survivors is still needed, as it is an essential strategy to increase quality of life.