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Family caregivers’ experiences of providing care for older family members with a tracheostomy in Thailand

The doctoral dissertation of Watchara Tabootwong, Master of Nursing Science, sheds light on Thai family caregivers’ experiences of providing care for older family members with a tracheostomy during hospitalization. The public examination of the dissertation will be held online on 15 May 2020 at 12 noon.

The number of older people is increasing worldwide. Older people are often admitted to the hospital due to various health conditions, including age-related physiological changes and chronic illness, such as chronic obstructive pulmonary disease, heart failure, and chronic renal failure. These conditions cause respiratory failure and necessitate the use of mechanical ventilation in older people. Older people with prolonged mechanical ventilation will be assessed by doctors as to their need for a tracheostomy. Having a tracheostomy may affect older people in various ways, including their well-being and body image. Therefore, it is unavoidable that older people with a tracheostomy are supervised by doctors and nurses. Moreover, they need assistance from their family caregivers as well. 

In Thai society, family members always participate in providing care for older people, either at home or in the hospital. Approximately 60 percent of family caregivers are children and 30 percent are spouses. Thai people are instilled to respect and take care of older people or persons who have high status. Therefore, the role of providing care for older people is the responsibility of the family. The previous studies about family caregivers of older people with a tracheostomy were conducted at home and in hospitals, for example intensive care, coronary care, and respiratory care units, but few studies focused on family caregivers of older people with a tracheostomy in general wards. In this study, 40 family caregivers—adult-child and spousal caregivers—of older people who underwent tracheostomy during hospitalization were interviewed in medical-surgical wards in Thailand to examine the experiences of family caregivers.

The findings revealed that family caregivers learned to assist their older family members who underwent tracheostomy by observing and asking for advice from healthcare professionals as well as sharing experiences and information with caregivers of other patients. Family caregivers performed various caring activities to assist their loved ones. During the care for older family members, they experienced physical, psychological, social, and financial impacts of this caregiving. Meanwhile, they also needed to be supported by healthcare professionals and their own relatives. Adopting the family caregiver’s role made them feel proud, although caring for older people was difficult for them. Additionally, they mentioned that the qualities of being a good caregiver included love and caring with sincerity and confidence. Regarding the provision of care for older family members, they felt that providing care was a family responsibility that involved filial responsibility and spousal attachment, as well as learning new things and the end of life care for older people.

Based on the general experience obtained from adult-child and spousal caregivers, the results of this research will be useful information for developing a care plan to guide caring for family caregivers of older people with a tracheostomy. Moreover, this basic information can be utilized by researchers when conducting further research relevant to this topic.

The doctoral dissertation of Watchara Tabootwong, Master of Nursing Science, entitled Family caregivers’ experiences of providing care for hospitalized older family members with tracheostomy: a phenomenological study in Thailand, will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Päivi Åstedt-Kurki of Tampere University, and the Custos will be Professor Hannele Turunen of the University of Eastern Finland. The public examination will be held in English.

Photo available for download at https://mediabank.uef.fi/A/UEF+Media+Bank/36370?encoding=UTF-8

Tabootwong, Watchara. Family caregivers’ experiences of providing care for older family members with a tracheostomy during hospitalization - a phenomenological study in Thailand