Experience of family caregivers of community-dwelling stroke survivors and risk of elder abuse: a qualitative study

Abstract

Purpose -The purpose of this paper is to explore the following questions. First, what are the experiences of family caregivers in caring for community-dwelling stroke survivors? Second, what services help or do not help the caregivers in managing their caregiving role? Design/methodology/approach -A qualitative study was conducted with a total of six focus group interviews with 29 stroke caregivers selected using convenience sampling in a local community centre. All interviews were recorded and transcribed for content analysis. Findings -The results pointed to three main themes working together to facilitate desirable outcomes in caregiving and prevent elder abuse: factors contributing to caregiver stress and factors that have a buffering effect on caregiver stress and unmet needs identified from caregivers' experiences.Research limitations/implications -The authors found that there were a number of factors contributing to caregiver stress. The findings matched with the concept that caregiver stress should not be considered as the primary cause of elder abuse. Findings provided information for further research to investigate positive coping and adjustment for stroke survivors, caregivers and their families. Practical implications -Policy makers and service providers may consider specific policies and tailor-made services to enhance the effectiveness of current practice. The themes emerging from the study could be further reviewed in a longitudinal way to explore the cost-effectiveness, the outcomes and trajectory of interventional programmes. Social implications -Education would be essential to let the public understand caregivers' difficulties and needs. Prevention of elder abuse may be approached with a range of risk factors for both perpetrating and being elder abuse victim. Originality/value -From the findings of the study, the authors found that there were service gaps within policy and interventions. Concrete suggestions for improving the public's attitude and public facilities/ transport for the disabled were captured in the study. In addition to personal resilience, caregivers had a strong wish for a supportive environment and services that would facilitate a better caregiving outcome.

Needs of Stroke Survivors as Perceived by Their Caregivers

“…Almost all studies reported the data collection process. Thirty studies provided the rationale for their research design, 9, 11, 23, 25–27, 29, 31–33, 35, 39, 41, 42, 44–50, 52–54, 58, 62, 65, 66, 70, 71 nine discussed the relationship between researcher and participants, 29, 42, 44, 46, 50, 54, 66, 70, 71 37 reported rigorous data analyses procedures, 4, 7, 9, 11, 24, 26–28, 30–37, 39, 41–46, 48–50, 52–54, 58, 60, 63, 65, 67–70 45 reported the ethical considerations, 4, 7, 9, 23–25, 27–29, 31, 32, 34, 36–50, 52–60, 62–66, 68–71 and 49 reported the recruitment strategy. 7, 9, 11, 23–25, 27–32, 34–63, 65–71 Of the 10 quantitative studies appraised using CEBMa, all clearly addressed the research question, methods, selection of participants, and had a sample representing the population.…”

“…anger and agitation 30, 59, 65, 69 , anxiety, 47, 81 and changes in behavior 23, 40, 70 – “He is more irritable because he realizes his limitations.” 65 …”

“…depression 28, 30, 31, 47, 51, 69, 81 – “ His depression … I just don’t know what to do to stop it.” 31 …”

Self-administered acupressure for symptom management among Chinese family caregivers with caregiver stress: a randomized, wait-list controlled trial

“…Furthermore, with 90 % of older Chinese living at home [11], much of the caregiving responsibilities are likely to fall on their family members. Although the Confucian value of filial piety may buffer the demands of caregiving, Chinese family caregivers are not exempt from caregiver stress [12]. Therefore, these caregivers, similar to their Western counterparts, are in need of effective, achievable, and acceptable interventions to help them manage caregiver stress.…”

“…In the present study protocol, we detail a self-administered acupressure intervention protocol for Chinese family caregivers with caregiver stress based on our previous study on: (i) a similar model of self-administered acupressure previously tested in women with osteoarthritic knee pain that was shown to be feasible and safe [14]; (ii) factors aggravating or buffering caregiver stress among Chinese family caregivers [12]; (iii) a case management approach to improve the health outcomes of Chinese family caregivers of dementia patients [24]; and (iv) the scientific basis of symptom management [25]. In light of the needs of these caregivers and the little evidence on the effectiveness of self-administered acupressure in symptom management, a specifically designed self-administered acupressure intervention for Chinese family caregivers will be implemented and evaluated in this study.…”