Caring for the Seriously Mentally Ill in Thailand: Buddhist Family Caregiving

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The purpose of this study was to explore the lived experiences from Thai Buddhist family caregivers of seriously mentally ill relatives to understand their perspectives about Buddhist caregiving. A phenomenological study of 15 Thai Buddhist family caregivers was conducted following Cohen et al.'s process for analysis. Analysis of the interviews revealed five major themes: caregiving is Buddhist belief, caregiving is compassion, caregiving is management, caregiving is acceptance, and caregiving is suffering. Although suffering from the problems posed by mental illness permeated their lives, Thai Buddhist caregivers were able to continue to maintain compassion, management, and acceptance in caregiving to their seriously mentally ill relatives. A model of Thai Buddhist caregiving, constructed from the five major themes, is presented.

Section snippets

Family Caregiving Studies

Western research studies published during the last three decades (i.e., Guarnaccia & Parra, 1996, Gubman & Tessler, 1987, Hoenig & Hamilton, 1965, Hoenig & Hamilton, 1967, Noh & Turner, 1987, Poulshock & Deimling, 1984, Tuck et al., 1997) make it clear that families living with the seriously mentally ill at home face complex problems. These studies showed that families were affected by the illness in a variety of ways: family life becomes disorganized, household routines are upset, and family

Design

This study employed a phenomenological approach that focused on understanding the experience of the phenomenon of Buddhist family caregiving. Cohen, Kahn, and Steeves (2000) described phenomenological research as the study of the meaning of experience. Further details on the methods for this study are available elsewhere (Sethabouppha, 2001).

Essential Structure: Themes

Five themes were revealed in the data analysis process and are presented in the context of scientific evidence from Western and Eastern literature. The themes were caregiving is Buddhist belief, caregiving is compassion, caregiving is acceptance, caregiving is management, and caregiving is suffering.

Discussion

This phenomenological study revealed the connection between Buddhist philosophy and caregiving. Karma, boon and babb, and dharma appeared to influence caregivers directly. Results showed the presence of five major themes: caregiving is suffering, caregiving is Buddhist belief, caregiving is compassion, caregiving is management, and caregiving is acceptance. The caregiving is suffering theme emerged from the categories of physical burden, emotional distress, social problems, economic problems,

Connecting Family Caregiving and Buddhist Philosophy

This section describes the connection between Buddhist philosophy and the five themes of caregiving found in this study. They include caregiving is suffering, caregiving is Buddhist belief, caregiving is acceptance, caregiving is management, and caregiving is compassion. A Buddhism and caregiving model is presented to illustrate the connection between Thai Buddhist family caregiving and Buddhist philosophy (see Figure 1).

Buddhist beliefs including Karma, boon/babb, and dharma strongly

Strengths and Limitations

A major strength of this research study was the utilization of the phenomenological approach to gain an in-depth understanding of the Thai Buddhist caregiving world. The findings can be generalized to Thai populations living outside Thailand because the population and setting represent an in depth formulation of Thai Buddhist caregiving. They may also apply to Buddhist caregiving in other populations. Qualitative data analysis is guided by an epistemology that reveals multiple interpretations

Implications for Practice and Research

The findings of this study provided insights for consideration in improving nursing interventions for Asian Buddhist family caregivers. First, the results of this study indicated that caregivers exhibited experiences of suffering in caring for their seriously mentally ill relatives at home, which affected them physically, emotionally, socially, economically. Because of the emergence of suffering as a major theme in this study, nurses or other health-care providers should be sensitive to the

Acknowledgments

The Royal Thai Government and Sigma Theta Tau International provided financial support to the first author. The authors thank Drs. Richard Steeves, H. Seneviratne, Sarah Farell, Monthana Hemchayat, Prof. Manee Payomyong, and the study participants for their contributions.

References (48)

  • K. Chau et al.

    Burden experienced by caregivers of relatives with dementia in Taiwan

    Nursing Research

    (1999)
  • M.Z. Cohen et al.

    Hermeneutic phenomenological research

    (2000)
  • C.J. Farran et al.

    Race, finding meaning and caregiver distress

    Journal of Aging and Health

    (1997)
  • P. Guarnaccia et al.

    Ethnicity, social status, and families' experiences of caring for a mentally ill family member

    Community Mental Health Journal

    (1996)
  • G.D. Gubman et al.

    The impact of mental illness: Concepts and priorities

    Journal of Family Issues

    (1987, June)
  • W. Hatthapanom et al.

    Pajjaiteetamhaipoopuayjitpate klubmaraksaumniarongpayabaljitwetch KhonKaen

    (1986)
  • A. Haworth et al.

    Measuring religiousness of parents of children with developmental disabilities

    Mental Retardation

    (1996)
  • M. Hayden et al.

    Support, problem-solving/coping ability, and personal burden of younger and older caregivers of adults with mental retardation

    Exceptional Children

    (1997)
  • J. Hoenig et al.

    The schizophrenic patient in the community and his effect on the household

    International Journal of Social Psychiatry

    (1965)
  • J. Hoenig et al.

    The burden on the household in an extramural psychiatric services

    (1967)
  • M. Jacob et al.

    Recurrent depression: An assessment of family burden and family attitudes

    Journal of Clinical Psychiatry

    (1987)
  • P. Jantrasak et al.

    Karnsuksawijaipeopattanroopbabkarndoolaepoopuayjitwetchteeban

    (1996)
  • P. Jones

    Paying respect: Care of elderly parents by Chinese and Filipino American women

    Health Care for Women International

    (1995)
  • D.L. Kahn et al.

    The experience of suffering conceptual clarification and theoretical definition

    Journal of Advanced Nursing

    (1986)
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