Caring for Terminally Ill Persons with Cancer: Experiences of Thai Buddhist Family Caregivers

Authors

  • Wipa Wiseso RN, PhD Candidate, Faculty of Nursing, Chiang Mai University, Thailand
  • Warunee Fongkaew RN, PhD, Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • Nitaya Pinyokham RN, PhD, Assistant Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • Jude Spiers RN, PhD, Associate Professor, Faculty of Nursing, University of Alberta, Canada

Keywords:

Caregiving, Focused Ethnography, Terminally Ill Persons with Cancer, Thai Family

Abstract

Previous studies about family caregivers of terminally ill persons with cancer in Thailand focused on primary caregivers individually. In order to promote family well-being, it is essential to explore how individuals’ construct the perspective of the family as a unit in caregiving. This study aimed to gain an understanding of the experiences of family members in caring for terminally ill persons with cancer in the Thai cultural context. The design was a qualitative focused ethnography. Purposive sampling was used to recruit 30 individuals from 13 families. Data were generated through participant observation and in-depth interviews and were analyzed using thematic analysis.
                  Participants discussed how family values and shared expectations were reflected in their caregiving practices as a family. Experiences of Thai families in caring were reflected in two major themes: 1) promoting comfort and preparing for a peaceful death by respecting the patient’s wishes, valuing patients as dearly loved, understanding death is a natural law in life, performing religious activities to compensate bad karma, and arranging a calm environment, and 2) mutually managing care by providing care wholeheartedly, reprioritizing life plans, sharing responsibilities for caring, and managing family finances. These findings provide essential information to understand how individual family members work as a unit in caregiving practices. Understanding the experiences of family members in caring for terminally ill persons with cancer can contribute to the further development of health care services for promoting family well-being. 

 

References

1. Given, B. A., Given, C. & Sherwood, P. R. Family and caregiver needs over the course of the cancer trajectory. J Support Oncol. 2012; 10(2): 57-64.doi:10.1016/j.suponc.2011.10.003.

2. Glajchen, M. Physical well-being of oncology caregivers: An important quality-of-life domain. Semin Oncol Nurs. 2012; 28(4): 226-235.

3. Mehta, A., Cohen, R. & Chan, L.S. Palliative care: A need for a family systems approach. Palliat Support Care. 2009; 7: 235–243.

4. Corà, A., Partinico, M., Munafò, M. & Palomba, D. Health risk factors in caregivers of terminal cancer patients: A pilot study. Cancer Nurs. 2012; 35: 38-47.

5. Kang, J., Shin, D. W., Choi, J. E., Sanjo, M., Yoon, S. J., Kim, H. K., et al. Factors associated with positive consequences of serving as a family caregiver for a terminal cancer patient. Psychooncology. 2013; 22(3): 564-571.

6. Ling, S.F., Chen, M.L., Li, C.Y., Chang, W.C., Shen, W.C., & Tang, S.T. Trajectory and influencing factors of depressive symptoms in family caregivers before and after the death of terminally ill patients with cancer. Oncol Nurs Forum. 2013; 40: 32-40.

7. Tang, S.T., Chang, W.C., Chen, J.S. Wang, H.M., Shen, W.C., Li, C.Y., et al. Course and predictors of depressive symptoms among family caregivers of terminally ill cancer patients until their death. Psychooncology. 2013; 22:1312-1318.

8. Delgado-Guay, M.O., Parsons, H.A., Hui, D., Cruz, M.G., Thorney, S., Bruera, E. Spirituality, religiosity, and spiritual pain among caregivers of patients with advanced cancer. Am J Hosp Palliat Care. 2013; 30(5): 455-461.

9. Otis-Green, S. & Juarez, G. Enhancing the social well-being of family caregivers. Semin Oncol Nurs. 2012; 28(4): 246-255.

10. Son, K.Y., Lee, C.H., Park, S.M., Lee, C.H., Oh, S.I., Oh, B., et al. The factors associated with the quality of life of the spouse caregivers of patients with cancer: a cross-sectional study. J Palliat Med. 2012; 15(1):216-224.

11. LeSeure, P. & Chongkham-ang, S. The experience of caregivers living with cancer patients: A systematic review and meta-synthesis. J Pers Med. 2015; 5: 406-439.

12. Reczek, C. Conducting a multi family member interview study. Fam Process. 2014; 53(2): 3178-335.

13. Matchim, Y. Hospice care: A cross-cultural comparison between the United States and Thailand. J Hosp Palliat Nurs. 2009; 11(5): 262 – 268.

14. Chan , C.L.W., Ho, A.H.Y., Leung, P.P.Y., Chochinov, H.M., Neimeyer, Pang, S.M.C. & Tse, D.M.W. The blessings and the curses of filial piety on dignity at the end of life: Lived experience of Hong Kong Chinese adult children caregivers. J Ethn Cult Divers Soc Work. 2012; 21(4): 277-296.

15. McCleary, L. & Blain, J. Cultural values and family caregiving for persons with dementia. J Gerontol. 2013; 27(1): 178-201.

16. Lin, J. & Yi, C. A comparative analysis of intergenerational relations in East Asia. International Sociology. 2013; 28(3): 297-315.

17. Funk, L., Chappell, N.L. & Liu, G. Associations between filial responsibility and caregiver well-being: Are there differences by cultural group?. ROA. 2013; 35(1):78-95.

18. Kongsuwan, W., Chaipetch, O., & Matchim, Y. Thai Buddhist families’ perspective of a peaceful death in ICUs. Nurs Crit Care. 2012; 17(3): 151-159.

19. Cruz, E.V., & Higginbottom, G. The use of focused ethnography in nursing research. Nurse Res. 2013;20(4): 36-43.

20. Wall, S. Focused ethnography: A methodological adaptation for social research in emerging contexts. Forum Qual Soc Res. 2015; 16(1). https://nbn-resolving.de/urn:nbn:de: 0114-fqs150111

21. Eggenberger, S.K. & Nelms, T.P. Family interviews as a method for family research. J Adv Nurs. 2007; 58(3): 282-92.

22. Braun, V. & Clarke, V. Using thematic analysis in psychology. Qual Res Psychol. 2006; 3: 77-101.23. Lincoln, Y.S. & Guba, E.G. Naturalistic inquiry. Newbury Park, CA: Sage Publications; 1985.

24. Morse, J., Barrett, M., Mayan, M., Olson, K. & Spiers, J. Verification strategies for establishing reliability and validity in qualitative research. Int J Qual Methods. 2002; 1(2): 1–19.

25. Crawford, C.F. Duty, obligation and prostitution: How family matters in entry into and exit from prostitution in Thailand. In P.H. De Neui (Eds.), Family and faith in Asia: The missional impact of social networks. Pasadena: William Carey Library; 2010, pp.77-99.

26. Meyer, O.L., Nguyen, K.H., Dao, T.N., Vu, P., Arean, P. & Hinton, L. The sociocultural context of caregiving experiences for vietnamese dementia family caregivers. Asian Am J Psychol. 2015; 6(3): 263–272.

27. Rukchart, N., Chaowalit, A., Suttharangsee, W. & Parker, M.E. End-of-life decisions among Thai Buddhist adults with chronic illness. Songklanagarind Journal of Nursing. 2014; 34: 44-544.

28. Kunsongkeit, W. Good death as perceived by the patients’ family members. The Journal of Faculty of Nursing Burapha University. 2015; 23(3): 41-55.

29. Somanusorn, S., Hatthakit, U. & Nilmanat, K. Caring for a relative at the end of life to die peacefully in the Thai Buddhist culture. The Journal of Faculty of Nursing Burapha University. 2011; 19(2): 28-41.

30. Stajduhar, K.I. Burdens of family caregiving at the end of life. Clin Invest Med. 2013; 36(3): E121-E126.

31. Kinoshita, H., Maeda, I., Morita, T., Miyashita, M., Yamagishi, A., Shirahige, Y., et al. Place of death and the differences in patient quality of death and dying and caregiver burden. J Clin Oncol. 2015; 33(4): 357-363.

32. Bekkema, N., de Veer, A.J., Hertogh, C.M. & Francke, A.L. Perspectives of people with mild intellectual disabilities on care relationships at the end of life: A group interview study. J Palliat Med. 2016; 30(7): 625-33.

33. Nilmanat, K., Chailungka, P., Phungrassami, T., Promnoi, C., Tulathamkit, K., Noo-urai, P., et al. Living with suffering as voiced by Thai patients with terminal advanced cancer. Int J Palliat Nurs. 2010; 16(8): 393-399.

34. Senden, C., Vandecasteele, T., Vandenberghe, E., Versluys, K., Piers, R., Grypdonck, M., et al. The interaction between lived experiences of older patients and their family caregivers confronted with a cancer diagnosis and treatment: A qualitative study. Int J Nurs Stud. 2015; 52: 197–206.

35. Fletcher, B.S., Miaskowski, C., Given, B. & Schumacher, K. The cancer family caregiving experience: An updated and expanded conceptual model. Eur J Oncol Nurs. 2012; 16(4): 387-98.

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Published

2017-08-07

How to Cite

1.
Wiseso W, Fongkaew W, Pinyokham N, Spiers J. Caring for Terminally Ill Persons with Cancer: Experiences of Thai Buddhist Family Caregivers. PRIJNR [Internet]. 2017 Aug. 7 [cited 2024 Apr. 18];21(4):317-30. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/78750