Developing a family-based caring model for stroke survivors to enhance healthy family

Caring for stroke survivors is a heavy burden for caregivers, especially during the rehabilitation period at home. This is because family members have to provide a long-term care. Therefore, it is important to encourage family members for adjustment of their lifestyles towards an effective care for stroke survivors.This research study aimed to develop a care model of healthy families in those with members having a stroke. The study was conducted during January 2020-February 2021, which divided into two phases. Phase 1 was a study of family life situations in caring for stroke survivors and factors that enabled families to take care and make themselves healthy. In this phase, forty primary caregivers were included. All of them were interviewed individually, with two groups of discussions (seven persons in each group). Phase 2 was a participatory action research with four cycles during a period of sixteen weeks. In this phase, there were fourteen primary caregivers who represented their families. All of them were divided into two groups with seven persons in each for group discussions and activities. Important factors from the results of Phase1 were brought to set goals, with strategies for caring of stroke survivors and ways to promote healthy family as appropriate to the context of each family. Then, participants applied those goals and strategies into their practice and observed for problems and obstacles as feedbacks for discussions and adjustments in the groups each week towards their goals. The researcher only acted as a helper and encouraged group members to express their opinions. Data were collected by the researcher in semi-urban community areas under responsibility of the Sub-district Health Promotion Hospital, Nonthaburi Province through individual interviews, group discussions, participant/non-participant observations, and note-taking. A triangular review was conducted with data confirmed by research participants, experts, and related theories. Data were analyzed by content and theme analysis using Atlas ti.8 software package for analysis and extraction of necessary data to be presented as tables and figures. In Phase 1, the results showed that factors influencing families in caring for stroke survivors consisted of three main concepts: 1) Caregiver characteristic: Virtue love and gratitude, Experience in caring, Good health and self-care ability, Good management of emotions, and Freedom to manage problem and obstacles; 2) Family functions and relationship: Family structure, roles and duties, relationship, and management of family problems; 3) Assisting support: Financial, health service, and environment support. In Phase 2, the results of four-cycle group activities yielded various paradigms for changes, including Cycle 1: Strategic design and collaborating, Cycle 2: Supporting and fulfilling care potential, Cycle 3: Balance body and mind for creating positive energy, and Cycle 4: Self-improvement to happiness. Then, the researcher analyzed information from all cycles toward a caring strategy, Caring achievement, that can enhance a healthy family. A family-based caring model was synthesized from the results of phases 1 and 2. This model shows that caregivers work together with Community Care Commanders to develop Caring Achievement for stroke survivors. Community Care Commanders promote knowledge, advice how to solve the problems, and build care capacity for caregivers. In addition, the community resourcefulness is importance for caring support to achieve the goal. Caregivers made their caring achieved towards a healthy family, including Happiness, Physical health, Financial Balancing, and Family Bonding. Ultimately, the evaluation of the aforementioned components will be feedback to the caregivers for future improvement. If the existing performance was unsuccessful, it would be led to improving goals and changing the care suitable for the family context. The findings of this research study could be applied as a care model to achieve a healthy family for stroke survivors. Knowledge gained from this study could be further applied towards a better family care system in the community.