Abstract
This study applied a Straussian grounded theory to explore the perspectives of caregivers on how they accomplished their long-term management in the process of caring for stroke survivors. Fifteen samples were recruited from the caregivers who had spent at least four hours per day on caring their patients for six months or more, and lived in Satengnok sub-district or Muang municipality, Muang district, Yala province. Data were gathered by using in-depth audio taped interviews, as well as observations, and field notes that enabled concurrent data validation with methodological triangulation. Following coded analysis of the data, the findings showed that the caregivers dealt with stroke and its negative consequences that influenced their patients, themselves, and their families in three stages that were represented by three categories. The first category related to the issue of dedicating care and cure where anticipating that the patient might make a full recovery/could be able to do some daily living activities was a significant condition that motivated the participants’ caring practices. They firstly assisted the patients who could not take/nearly could not take care of themselves to recover in order to limit undesirable effects that affected them and their families, and coupled this with managing their stress, leading to further developments in their caring. The second category, namely preventing deteriorating condition(s) where being concerned about developing complications was identified as the most powerful influence that reinforced the caregivers’care. They attempted to assist the survivors with fluctuating symptoms to continuously maintain their rehabilitation, in order to maintain some degree of recovery as long as possible. They also tried to cope with stresses and strains from the situations they encountered, including beginning to take care of themselves, to regain their power and effort to keep their care going. The final category, labelled as not seeking any treatments but keeping the survivors away from suffering where intending to provide care until the last minute came out as a challenging condition that encouraged the caregivers to sustain their care for their patients although their cure was hopeless. They attempted to make their patients as comfortable as they were able. Also, the participants tried to keep themselves healthier, and maintain their families without more difficulties. Nevertheless, throughout the care period, the caregivers and their families encountered a number of difficulties that challenged their own strength, endurance, and care intentions that they needed to care for their patients from the beginning of the illness to the end; however, they did not give up caring. This led them to reach the process of modifying care and cure based on the patients’ conditions, which emerged as the core category.The noteworthy findings are that the strength, endurance, and full care intention of caregivers encouraged them to develop more likely effective strategies to cope with their dramatically changed lives following the stroke and that would not return to a pre-stroke situation. This required establishing a balance in their “new lives” and in their families. They sought normality in a new way of living little by little, before making an advance to a certain degree that corresponded to the survivors’ conditions and the negative consequences they and their families encountered. Finally, they could still have normal lives of their own depending on their responsibility to sustain the long-term caregiving and probability of other support. The findings could be applied to guide nursing administrators and nursing practitioners about how to manage the provision of corresponding long-term care for stroke survivors, caregivers, and their families when their needs change over time throughout the stroke trajectory.
