Managing caregiving at home: Thai caregivers living in the United States

Ethnography is the work of describing culture. It emphasizes the natural environment of the research participants and the relationship between research participants and culture (Fetterman, 1998). Ethnography focuses on the meanings people give to their culture. Therefore, this study also aims to explain the process of caregiving based on the perspective of Thai American caregivers of chronically ill patients, a specific cultural group. Thus, a qualitative descriptive design influenced by grounded theory and ethnography was considered appropriate for this study.

Study Setting and Participants

The researchers selected a purposive sample of seven caregivers to patients with chronic illness who lived in two large American cities--one in the western U.S. and one in the Midwest. The two cities were selected for large Thai populations and convenient researcher access. Thai friends and community leaders in each city were asked to locate potential participants. The criteria for recruitment included primarily Thai-speaking adult caregivers currently caring for chronically ill relatives for at least one month. All participants provided written informed consent, and the study was approved by the Colorado Multi-Institutional Review Board. The research was completed in mid-2002.

The participants included two men and five women, ranging from 48 to 65 years of age. Five participants were married and two were single. All the participants self-identified as Buddhist. Five participants were employed and two were unemployed. All participants were financially stable. Three participants lived in a midwestern city and four participants lived in a western city. They included three wives, two sons and two daughters of chronically ill individuals. The education level of most caregivers was a bachelor's degree or beyond. The length of time that the participants had taken care of the ill relatives ranged from one year to 10 years, with a mean of five years. The length of time that the participants resided in the United States ranged from eight to 28 years, with a mean of 15 years.

The duration of daily care provision ranged from eight to 18 hours per day, with a mean of 12 hours per day. The care recipients ranged in age from 60 to 82 years. Three subjects were diagnosed with cancer, one with Parkinson's disease, one with end-stage renal disease accompanied by hemodialysis treatment and two with stroke. All the care recipients were Buddhists. Two care recipients were dependent in all activities of daily living, and the remaining five patients required some assistance.

Data Generation and Data Management

Data for this study were obtained from semi-structured interviews, observations, field notes and memoranda. Each interview was tape-recorded with permission from the participants and lasted 30 to 60 minutes. In the absence of the care recipients, the researchers interviewed the caregivers in their homes. Second interviews were conducted with three participants to assure credibility of analysis and findings. These interviews were transcribed and analyzed together with the other data. All interview tapes were transcribed verbatim in Thai by the researcher. For confidentiality purposes, pseudonyms were used to identify participants.