Mentally ill; Thailand; Buddhist; Family caregiving; Caregiving
摘要
Family caregiving has been extensively investigated in the literature. However, the lived experiences from Thai Buddhist family caregivers’ perspectives has not been as thoroughly documented. The purpose of this phenomenological study was to elicit information about Thai Buddhist caregiving from caregivers’ perspectives in order to explore the meaning of the lived experiences of Thai Buddhist caregivers through posing the question: How do Thai Buddhist caregivers experience their daily lives when a family member is seriously mentally ill? Following the phenomenological method described by Cohen, Kahn, and Steeves (2000), fifteen Thai Buddhist family caregivers to seriously mentally ill relatives living in northern Thailand provided in-depth descriptions of the typical, the worst, and the best days in their caregiving. Results showed the presence of five major themes: caregiving is suffering, caregiving is Buddhist belief, caregiving is compassion, caregiving is management, and caregiving is acceptance. The caregiving is suffering theme emerged from the categories of physical burden, emotional distress, social problems, economic problems, and knowledge deficit. The theme of caregiving is Buddhist belief connected an understanding of caregiving with the beliefs in Karma, Boon (merit) and Babb (demerit), and Dharma (Buddhist teaching). Within the caregiving is compassion theme, Thai caregivers' descriptions of compassion were interpreted as caring and support. The categories of stress management, symptom management, and treatment management were represented by the theme of caregiving is management. The caregiving is acceptance theme emerged from the caregivers' perspectives that their relatives’ illness was incurable and sickness is a natural part of Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. living. Finally, Thai caregivers practiced their Buddhist beliefs when caregiving, particularly (1) practicing Metta (caring) and Karuna (support) to generate compassion in caregiving, (2) practicing the Noble Eight Fold Path (the middle way) to create management in caregiving, and (3) practicing Ubekkha (equanimity) to promote acceptance in caregiving. Even though suffering from the problems posed by mental illness permeated their lives, Thai Buddhist caregivers were able to continue to maintain compassion, management, and acceptance in caregiving to their seriously mentally ill relatives. This study makes a unique contribution in that it presents the actual lived experience of Thai Buddhist caregivers and explicates the connection of Buddhist principles to sustaining caregiving to the seriously mentally ill. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. PREVIEW
目次
ABSTRACT i TABLE OF CONTENTS iv ACKNOWLEDGEMENT viii
CHAPTER I: INTRODUCTION 1-6 Introduction 1 Significance of Study 2 Family Caregiving Studies 2 Buddhism and Thai People 3 Implications for Nursing 4 Theoretical Framework 4
CHAPTER II: LITERATURE REVIEW 7-20 Perspectives on Caregiving 7 Western Family caregiving Studies 7 Asian Family Caregiving Studies 10 Perspectives on Religion 14 Thai Religion: Buddhism 14 Studies of Religious Practice 17 Summary 19
CHAPTER III: METHODS 21-36 Design Phenomenological Study 21 Setting 22 Sample 23 Selection Criteria 23 Procedure for Data Collection 24 Subject Recruitment 24 Human Subjects Protection 24 Data Collection 26 Demographic Descriptions 27 Demographics Profile 27 Data Analysis 28 Multi-Step Analysis 30 Themes and Categories Development 31 Bias Control 34
CHAPTER IV: FAMILY CAREGIVERS' STORIES 37-154 Understanding Narrative: Background and Rationale 37 Family Caregivers' Stories 38 Case 1 Aek's Story 39 Case 2 Nu's Story 48 Case 3 Ome's Story 58 Case 4 Boon's Story 66 Case 5 Kong's Story 73 Case 6 Jintra's Story 81 Case 7 Buan's Story 88 Case 8 Sureeya's Story 95 Case 9 Pang's Story 101 Case 10 Tipa's Story 108 Case 11 Tham's Story 115 Case 12 Peng's Story 121 Case 13 Gem’s Story 130 Case 14 Sang's Story 137 Case 15 Lee’s Story 145
CHAPTER V: ESSENTIAL STRUCTURE: THEMES 155-214 Caregiving is Suffering 155 Physical Burden 156 Emotional Distress 159 Economic Problems 163 Social Problems 165 Knowledge Deficit 166 Caregiving is Buddhist Belief 169 Karma 170 Boon and Babb Concept 173 Dharma 175 Caregiving is Compassion 177 Caring 178 Support 184 Caregiving is Management 189 Stress Management 189 Symptom Management 197 Treatment Management 204 Caregiving is Acceptance 209 Incurable Illness 210 Sickness is Natural 212
CHAPTER VI: DISCUSSION 215-259 Caregiving is Suffering 215 Physical Burden 216 Emotional Distress 217 Economic Problems 219 Social Problems 220 Knowledge Deficit 222 Caregiving is Buddhist Belief 224 Caregiving is Compassion 229 Caring 229 Support 232 Caregiving is Management 236 Stress Management 236 Symptom Management 240 Treatment Management 243 Caregiving is Acceptance 249 Incurable Illness 249 Sickness is Natural 250 A Conceptualized Connection between Family Caregiving and Buddhist Philosophy 253
CHAPTER VII: CONCLUSION 258-269 Strengths and Limitations 258 Implications for Nursing Practice 260 Recommendations for future research 266 Summary 268
