Family caregiving process for a person with schizophrenia

Abstract

Schizophrenia is the most important of mental health problems in Thailand. Approximately 343,680 Thais suffer from this illness which makes them unable to control perceptions, thoughts, emotions, and behaviors. A person with schizophrenia (a PWS) was often dependent on the family for daily living, personal care, and medical administration. According to health care policy, the responsibility for care of the PSW was shifted from the hospital care system to the family system. However, family caregivers have still a little knowledge of the disease and care. Therefore, they develop their own strategies of care which might not be appropriate to control symptoms of the PWS. To help the family caregivers to provide good care for the PWS, health care professional required understanding that how the family took care of the PWS first. Thus, the purpose of this study was to explore the caregiving process of the PWS as perspectives of Thai family caregivers. To meet the purpose of this study, grounded theory was used as the research methodology. Data were collected by the observation and in-depth interviews of 17 family caregivers were recruited from Outpatient Department of selected hospital and were willing to participate in this study. Data were analyzed by using the constant comparative method. Major findings were found that process of family caregiving. It began with family caregivers had 2 groups: a family caregiver who was willing and unwilling to care. However, both types of the family caregivers needed information about schizophrenia and how to care the PWS in order to appropriate care for a PWS. According to caregiving for a PWS, a family caregiver would help a PWS in 4 categories: providing routine care, finding alternative treatments, avoiding psychotic episodes, and preparing for future. The linkage of these four categories was indicated that a family caregiver used these 4 categories back and forth in order to promote the well-being of a PWS. The findings in this study provide a basis for an understanding of the caregiving process of Thai family caregivers. In addition, it can be used as the basis for information to psychiatric nurses and health care providers to assist the family caregiver. Examples were providing health education for family caregivers including the disease and care for both the PWS and the family caregiver themselves and establishing caregivers’ support group for family caregivers to learn lived of experience of each another in order to deal with the PWS appropriately.