Family Caregivers’ Perceptions regarding Stroke Prevention for Family Members at Risk

Main Article Content

Jatupong Panwilai
Warunee Fongkaew
Pratum Soiwong
Jindarat Chaiard


                 This paper reports on the qualitative descriptive first phase of a participatory action research study, which aimed to develop a stroke prevention model for people at risk of stroke in a tertiary hospital. The study’s purpose was to explore caregivers’ perceptions of preventative behaviors for family members at risk of stroke. The qualitative data collection was conducted through semi-structured interviews held with 36 primary caregivers living for at least one year with family members at risk of stroke risk people. All informants were recruited through purposive sampling. The interviews were recorded, transcribed, and analyzed using content analysis.

                The five emergent categories from the analysis were 1) struggle to modify behaviors, 2) lack of adequate knowledge about stroke prevention, 3) lack of awareness as being caregivers, 4) constraints of being caregivers, and 5) receiving unrealistic treatment regimens. These findings contribute to the need for interventions that enhance awareness and competency of the family caregiver, as well as promote the participation and collaboration of care among family caregivers and their family members, in addition, redesigning a stroke prevention service which appropriate with individual context.

Article Details

How to Cite
Panwilai J, Fongkaew W, Soiwong P, Chaiard J. Family Caregivers’ Perceptions regarding Stroke Prevention for Family Members at Risk. PRIJNR [Internet]. 2021 Dec. 9 [cited 2022 Aug. 10];26(1):90-104. Available from:
Original paper


1. Feigin VL, Norrving B, George MG, Foltz JL, Roth GA, Mensah GA. Prevention of stroke: a strategic global imperative. Nat Rev Neurol. 2016; 12(9): 501. doi: 10.1038/nrneurol. 2016.107.

2. Caprio FZ, Sorond FA. Cerebrovascular disease: primary and secondary stroke prevention. Med Clin North Am. 2019; 103(2): 295-308. doi: 10.1016/j.mcna.2018.10.001.

3. Belizan M, Alonso JP, Nejamis A, Caporale J, Copo MG, Sánchez M, et al. Barriers to hypertension and diabetes management in primary health care in Argentina: qualitative research based on a behavioral economics approach. Transl Behav Med. 2020; 10(3): 741-50. doi: 10.1093/tbm/ibz040.

4. Bekele H, Asefa A, Getachew B, Belete AM. Barriers and strategies to lifestyle and dietary pattern interventions for prevention and management of TYPE-2 diabetes in Africa, systematic review. J Diabetes Res. 2020 Jul 11;2020:7948712. doi: 10.1155/2020/7948712.

5. Bauer M, Fetherstonhaugh D, Winbolt M. Perceived barriers and enablers to conducting nursing assessments in residential aged care facilities in Victoria, Australia. Aust J Adv Nurs. 2018;36(2):14-22.

6. Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P. A systematic review: family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behav Sci. 2017; 7(62): 1-17. doi: 10.3390/bs7030062.

7. Bennich BB, Røder ME, Overgaard D, Egerod I, Munch L, Knop FK, et al. Supportive and non-supportive interactions in families with a type 2 diabetes patient: an integrative review. Diabetol Metab Syndr. 2017;9(1):1-9. doi: 10.1186/s13098-017-0256-7.

8. Noradechanunt C, Kunalasiri P, Sirirat N. Effects of selfmanagement program with family participation on perceived self efficacy, healthy lifestyle behaviors and blood pressure among adults with hypertension. J Nurs Health Sciences. 2020; 2020;14(2):138-51. Available from: https://he01. (in Thai)

9. Jannoo Z, Khan NM. Medication adherence and diabetes self-care activities among patients with type 2 diabetesmellitus. Value Health Reg Issues. 2019;18:30-5. doi:10.1016/j.vhri.2018.06.003.

10. Wannasiri T. Caregiving behaviors of family caregivers for diabetes mellitus patients. J Pub Health Nurs. 2019;33(2):76-95. Available from: 164465 (in Thai)

11. Pratama AY. Family involvement in the treatment of hypertensive patients using Dunn’s Health Grid: a multiple case study. Proceedings of the 5th International Conference on Health Sciences (ICHS 2018); Atlantis Press; 2019: 20-37.

12. Fort MP, Castro M, Peña L, Hernández SHL, Camacho GA, Ramírez-Zea M, et al. Opportunities for involving men and families in chronic disease management: a qualitative study from Chiapas, Mexico. BMC Public Health. 2015;15(1): 1-11. doi: 10.1186/s12889-015-2361-6.

13. Fort MP, Steiner JF, Santos C, Moore KR, Villaverde M, Nease DE, et al. Opportunities, challenges, and strategies for engaging family in diabetes and hypertension management: a qualitative study. J Health Care Poor Underserved. 2020;31(2):827-44. doi: 10.1353/hpu.2020.0063.

14. Rintala T-M, Paavilainen E, Åstedt-Kurki P. Everyday living with diabetes described by family members of adult people with type 1 diabetes. Int J Family Med. 2013;2013:967872. doi: 10.1155/2013/967872.

15. Wannasiri T. Families relationship in self-care promotion for uncontrolling blood sugar in type 2 diabetes. KJN. 2016;23(2):31-50. Available from: (in Thai)

16. Wulandari I, Kusnanto K, Wibisono S, Puspitasari T. Family experience of caring for a diabetes mellitus patient: a qualitative study. J Nurs. 2020; 15(2): 75-81. 20473/jn.v15i2.19010

17. National Stroke Association [Internet]. Stroke risk scorecard 2018. Available from:

18. Stringer ET. Action research. 4th edition. Thousand Oaks, CA: Sage; 2014.

19. Lincoln YG, Guba EG.Naturalistic inquiry. Newbury Park, CA: Sage Publications; 1985.

20. Kurnia V, Suza D, Ariani Y. Experience of barriers to hypertension management in Minangkabau Ethnic Group in Payakumbuh Indonesia: a phenomenological study. Belitung Nurs J. 2018;4(2):154-60.

21. Mogre V, Johnson NA, Tzelepis F, Paul C. Barriers to diabetic self‐care: a qualitative study of patients’ and healthcare providers’ perspectives. J Clin Nurs. 2019; 28(11-12):2296-308. doi: 10.1111/jocn.14835.

22. Sroisong S, Rueankon A, Apichantramethakul K, Nunta N, Sukkaseam J. Perceived self-care behavior among patients with type 2 diabetes mellitus with poor glycemic control. JPNC. 28(2):93-103. Available from: (in Thai)

23. Boonpok D. The role of family in transmission of food related folk wisdom : a case study of central Thai family.Parichart J. 2016;29(1):16-38. Available from: (in Thai)

24. Mathews A. Barriers to physical activity among Asian Indian women in the United States [doctoral dissertation]. [Walden (The USA)]: Walden University; 2020. 152 p.

25. Gowani A, Ahmed HI, Khalid W, Muqeet A, Abdullah S, Khoja S, et al. Facilitators and barriers to NCD prevention in Pakistanis–invincibility or inevitability: a qualitative research study. BMC Res Notes. 2016;9(1):1-9. doi:10.1186/s13104-016-2087-2.

26. Joseph PL, Bonsignore A, Kunkel GF, Grace SL, Sockalingam S, Oh P. Benefits and barriers to exercise among individuals with class III obesity. Am J Health Behav. 2019;43(6):1136-47. doi: 10.5993/AJHB.43.6.11.

27. Shamsi A, Nayeri ND, Esmaeili M. Living with hypertension: a qualitative research. Int J Community Based Nurs Mid. 2017;5(3):219-30. PMID: 28670584.

28. Ashoorkhani M, Majdzadeh R, Gholami J, Eftekhar H, Bozorgi A. Understanding non-adherence to treatment in hypertension: a qualitative study. Int J Comm Based Nurs Mid. 2018;6(4):314-24. PMID: 30465004.

29. Herrera Salinas P, Moncada L, Denise D. Understanding non-adherence from the inside: hypertensive patients’ motivations for adhering and not adhering. Qual Health Res. 2017;27(7):1023-34. doi: 10.1177/1049732316652529.

30. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Repo. 1985;100(2):126-31. PMID: 3920711.

31. Bukhsh A, Goh B-H, Zimbudzi E, Lo C, Zoungas S, Chan K-G, et al. Type 2 diabetes patients’ perspectives, experiences, and barriers toward diabetes-related self-care: a qualitative study From Pakistan. Front Endocrinol. 2020;11:534873. doi: 10.3389/fendo.2020.534873.

32. Jayanna K, Swaroop N, Kar A, Ramanaik S, Pati MK, Pujar A, et al. Designing a comprehensive Non-Communicable Diseases (NCD) programme for hypertension and diabetes at primary health care level: evidence and experience from urban Karnataka, South India. BMC public health. 2019;19:409.

33. The Lewin Group [Internet]. The value of diagnostics: innovation, adoption and diffusion into health care.. 2005. Available from:

34. Riegel B, Moser DK, Buck HG, Dickson VV, Dunbar S. B, Lee CS., ... & Webber DE. Self‐care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017; 6(9): e006997. doi: 10.1161/JAHA.117.006997.

35. Vongmany J, Luckett T, Lam L, Phillips J. Family behaviours that have an impact on the self‐management activities of adults living with type 2 diabetes: a systematic review and meta‐synthesis. Diabet Med. 2018; 35(2): 184-94. doi: 10.1111/dme.13547.

36. Kanjanakuntorna PC, S. Thai family relation models in the globalization era. J Soc Devel. 2019;21(2):164-75. Available from: (in Thai)

37. Manios Y, Lambrinou C-P, Mavrogianni C, Cardon G, Lindström J, Iotova V, et al. Lifestyle changes observed among adults participating in a family-and community-based intervention for diabetes prevention in Europe: the 1st year results of
the feel4diabetes-study. Nutrients. 2020;12(7):1-12. doi: 10.3390/nu12071949.

38. Kaewsaeng P, Isaramalai, S. Development and evaluation of a health assessment procedure for elderly patients in an out-patient department. Thai J Nursing Council. 2017; 32(3):91-103. Available from: index. php/TJONC/article/download/ 92502/84338/ (in Thai)

39. Kohori-Segawa H, Dorji C, Dorji K, Wangdi U, Dema C, Dorji Y, et al. A qualitative study on knowledge, perception, and practice related to non-communicable diseases in relation to happiness among rural and urban residents in Bhutan. PloS one. 2020;15(6):e0234257.

40. Karimi Moonaghi H, Emami Zeydi A, Mirhaghi A. Patient education among nurses: bringing evidence into clinical applicability in Iran. Invest Educ Enferm. 2016;34(1):137-51. doi: 10.17533/udea.iee.v34n1a16.

Most read articles by the same author(s)

1 2 3 4 > >>