A Phenomenological Study of Javanese Family Caregivers’ Perspectives on Caring for Stroke Survivors

Authors

DOI:

https://doi.org/10.60099/prijnr.2025.275670

Keywords:

caregiver, Family caregivers, Interpretative phenomenology, Java, Non-communicable disease, Resilience, Stroke rehabilitation

Abstract

Stroke is a major cause of long-term disability in Indonesia, where family members often become primary caregivers with minimal formal support. In culturally rooted communities like East Java, caregiving is deeply influenced by local values, yet limited research has examined how these values shape caregiver resilience. This study aimed to explore how Javanese cultural beliefs influence the experiences and resilience of family caregivers providing home-based care for stroke survivors. Using a qualitative design, in-depth interviews were conducted with ten caregivers in East Java, employing interpretative phenomenological analysis.

Thematic analysis identif ied four key themes: caregiving as a devotion and cultural duty; the family’s understanding of illness as a foundation for meaning; home-based continued care with love, hope, and spirituality; and emotional dynamics in the early stages of caregiving. Caregiving was seen not only as a responsibility, but as a moral and spiritual calling rooted in values such as Ngabekti (devotion), Nrimo (acceptance), and Pasrah (surrender). Participants employed both biomedical and traditional practices, showing creativity in overcoming limited resources. These f indings highlight the importance of culturally responsive nursing care that addresses the emotional, spiritual, and informational needs of caregivers. Supporting caregiver resilience through culturally informed nursing and medical interventions may enhance stroke rehabilitation outcomes and promote caregiver well-being in similar community settings.

References

World Health Organization (WHO). World Stroke Day 2022 [Internet]. 2022 Oct 29 [cited 2024 June 23]. Available from: https://www.who.int/srilanka/news/detail/29-10-2022-world-stroke-day-2022

Feigin Valery L, Brainin Michael, Norrving Bo, Martins Sheila, Sacco Ralph L, Hacke Werner, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. Int J Stroke [Internet]. 2022 Jan 1;17(1):18–29. doi: 10.1177/17474930211065917. Erratum in: Int J Stroke. 2022;17(4):478. doi: 10.1177/17474930221080343.

McCurley JL, Funes CJ, Zale EL, Lin A, Jacobo M, Jacobs JM, et al. Preventing chronic emotional distress in stroke survivors and their informal caregivers. Neurocrit Care. 2019;30(3):581–9. doi: 10.1007/s12028-018-0641-6.

Indonesian Ministry of Health. National basic health research report 2018 [Internet]. Indonesian Ministry of Health. Jakarta; 2018. Available from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf (in Bahasa Indonesia).

Septianingrum Y, Yusuf A, Widyawati IY, Sari RY, Wardani EM, Musfirah NR, et al. Factors associated with family caregiver readiness to care for post-stroke patients after hospital discharge. Discov Soc Sci Health. 2024;4(1). doi: 10.1007/s44155-024-00064-6.

Tarigan R, Harris S, Dahlia D, Mansyur M. Family caregiver perspectives in caring of stroke patients: a qualitative study. Rawal Med J. 2024;49(4):960-3. doi: 10.5455/rmj.20240805042128.

Jacobs-Nzuzi Khuabi L-A, Bester J, Kloppers M, Crous B, Crous K, Petersen R, et al. The well-being of family members as informal caregivers of persons with stroke in an African context: understanding their lived experience. In: Louw Q, editor. Collaborative capacity development to complement stroke rehabilitation in Africa. Cape Town (ZA): AOSIS; 2020.

Purwati NH, Rustina Y, Supriyatno B. Knowledge and healthcare-seeking behavior of family caregivers of children with pneumonia: a qualitative study in an urban community in Indonesia. Belitung Nurs J. 2021;7(2):107–12. doi: 10.33546/bnj.1268.

Heltty H, Zahalim Z. Resilience after stroke and its correlation with functional independence. J Ners. 2023;18(1): 47–53. doi: 10.20473/jn.v18i1.41229.

Chayati N, Mikami A, Setyopranoto I, Effendy C. Unveiling the patient-centered approach: exploring the needs of Javanese stroke patients in home health services. Int J Public Heal Sci. 2024;13(2):820-8. doi: 10.11591/ijphs.v13i2.23564.

Gawulayo S, Erasmus CJ, Rhoda AJ. Family functioning and stroke: family members’ perspectives. Afr J Disabil. 2021;10:801. doi: 10.4102/ajod.v10i0.801.

Sidek NN, Kamalakannan S, Tengku Ismail TA, Musa KI, Ibrahim KA, Abdul Aziz Z, et al. Experiences and needs of the caregivers of stroke survivors in Malaysia-a phenomenological exploration. Front Neurol. 2022;13: 996620. doi: 10.3389/fneur.2022.996620.

Na’imah S, Effendy C, Supriyati S. Burden of Family Caregiver in Caring for Stroke Patients: A Mixed Method Research. J Keperawatan Respati Yogyakarta. 2023;10(1): 17-23. doi: 10.35842/jkry.v10i01.721.

Wang M, Wang K, Xie B, Liu D, Song L, Cao X, et al. Understanding the needs of family caregivers of stroke patients with disabilities: a phenomenological study using the timing it right theory. PLoS One. 2025;20(6):e0325671. doi: 10.1371/journal.pone.0325671.

Panwilai J, Fongkaew W, Soiwong P, Chaiard J. Family caregivers’ perceptions regarding stroke prevention for family members at risk. Pacific Rim Int J Nurs Res. 2022;26(1):90–104. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/255278

Kristanti MS, Effendy C, Utarini A, Vernooij-Dassen M, Engels Y. The experience of family caregivers of patients with cancer in an Asian country: a grounded theory approach. Palliat Med. 2019;33(6):676–84. doi: 10.1177/0269216319833260.

Comer A, Roeder H, Jones A, Jawed A, Kramer N. The impact of sex and gender on burden for caregivers of stroke patients: a narrative review. J Stroke Cerebrovasc Dis. 2024;33(11): 107854. doi: 10.1016/j.jstrokecerebrovasdis.2024.107854.

Veronese M, Simeone S, Virgolesi M, Rago C, Vellone E, Alvaro R, et al. The lived experience of caregivers in the older stroke survivors’ care pathway during the transitional home program—a qualitative study. Int J Environ Res Public Health. 2024;21(10):1276. doi: 10.3390/ijerph21101276.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. doi: 10.1191/1478088706qp063oa.

Guba EG, Lincoln YS. Effective evaluation: improving the usefulness of evaluation results through responsive and naturalistic approaches. 1st ed. San Fransisco: Jossey-Bass Publishers; 1981. 423 p.

Rahmawati D, Umaedi M, Lusiani M, Silfiah S. Phenomenological study: family experience as caregiver in caring for post-stroke patients at home. Edu Masda J. 2023;7(2):89-99. doi: 10.52118/edumasda.v7i2.199 (in Bahasa Indonesia).

Utaisang A, Pearkao C, Junsevg K, Sangsaikaew A, Boonkong D, Korcharoenyos C. Experiences of family members in caring of stroke patients: a case study in the border provinces of the upper Northeast of Thailand. Open Access Maced J Med Sci. 2021;9(G):172–9. doi: 10.3889/oamjms.2021.7125.

Chance EA, Sardi Abdoul I. The roles and contributions of women to the health of their families and household economics in rural areas in the district of Mbe, Cameroon. Soc Sci Humanit Open. 2025;11:101456. doi: 10.1016/j.ssaho.2025.101456.

Boehme AK, Esenwa C, Elkind MS. Stroke risk factors, genetics, and prevention. Circ Res. 2017;120(3):472-95. doi: 10.1161/CIRCRESAHA.116.308398.

Nugroho S, Fikri M. Positive thinking of Javanese people in Serat Durcara Arja by Ki Padmasoesastra: study of anthropology of literature. Alayasastra. 2020;16(2):153–67. doi: 10.36567/aly.v16i2.569 (in Bahasa Indonesia).

Rosenstock IM. The health belief model and personal health behavior. Health Educ Behav. 1974;2(4)354–86. doi: 10.1177/109019817400200405.

Sunarno I. The Concept of health from a Javanese cultural perspective (study of Javanese community behavior in maintaining and improving health in Blitar, East Java) [dissertation]. [Surabaya, East Java]: Universitas Airlangga; 2012. Available from: https://repository.unair.ac.id/32854/8/32854.pdf (in Bahasa Indonesia).

Widayanti AW, Green JA, Heydon S, Norris P. Health-seeking behavior of people in Indonesia: a narrative review. J Epidemiol Glob Health. 2020;10(1):6-15. doi: 10.2991/jegh.k.200102.001.

Hamdana, Amin AN, Karim SS. The relationship between the use of anti-decubitus mattresses and skin integrity in stroke patients at RSUD Sultan Daeng Radja Bulukumba District. J Rumpun Ilmu Kesehat [J Health Sci]. 2021;1(3):66-72. doi: 10.55606/jrik.v1i3.95 (in Bahasa Indonesia).

Rochmah TN, Rahmawati IT, Dahlui M, Budiarto W, Bilqis N. Economic burden of stroke disease: a systematic review. Int J Environ Res Public Health. 2021;18(14):7552. doi: 10.3390/ijerph18147552.

Hu M, Li X, Zhu Y, Chen Z, Lai C, Liu R, et al. The role of family caregiving in the management of individuals with mental illnesses and the outcome of family-based interventions for mental illnesses in China: a scoping review. Lancet Reg Heal West Pac. 2024;56: 101184. doi: 10.1016/j.lanwpc.2024.101184.

Endraswara S. Javanese life philosophy [Internet]. 6th ed. Endraswara S, editor. Yogyakarta: Media Pressindo; 2018. Available from: https://books.google.co.id/books?id=wEm-EAAAQBAJ (in Bahasa Indonesia).

Jeong H, Han SJ, Jang SJ, Lee JE. Factors affecting activities of daily living in severely disabled stroke patients. Brain Neurorehabil. 2018;11(2):e11. doi: 10.12786/bn.2018.11.e11.

Muhrodji P, Wicaksono HDA, Satiti S, Trisnantoro L, Setyopranoto I, Vidyanti AN. Roles and problems of stroke caregivers: a qualitative study in Yogyakarta, Indonesia. F1000Res. 2021;10:380. doi: 10.12688/f1000research.52135.2.

Pratama FASR, Stanislaus S, Antono YS. Appreciation of Tepo Seliro in Javanese culture in Indonesia as a contribution to the present world to build universal brotherhood. Logos. 2024;21(1):102–13. doi: 10.54367/logos.v21i1.3421 (in Bahasa Indonesia).

Abdullah VI, Wahidin W, Wibowo DP, Mariani R. Cross-cultural analysis of the role of traditional medicine in health access in Indonesia. West Sci Interdiscip Stud. 2023;1(10):940-7. doi: 10.58812/wsis.v1i10.279.

Farmawati C, Wiroko EP. Javanese indigenous healing for physical and mental health. JOUSIP J Sufism Psychother. 2022;2(1):17–32. doi: 10.28918/jousip.v2i1.5658.

Triratnawati A, Wulandari A, Marthias T. The power of Sugesti in traditional Javanese healing treatment. Komunitas [Community J]. 2014;6(2):280–92. doi: 10.15294/komunitas.v6i2.3307.

Zhao X, Lin W, Li J, Chen Y, Patel A, Zhao H, et al. Dose correlation of Danggui and Chuanxiong drug pairs in the Chinese medicine prescription based on the copula function. Evid Based Complement Alternat Med. 2020;2020:2372746. doi: 10.1155/2020/2372746.

Agianto A, Kamilah A, Agustina R. Stroke traditional therapy in the community in Indonesia. KnE Life Sci. 2022;2022:240–53. doi: 10.18502/kls.v7i2.10319.

Agianto A, Kamilah A, Agustina R. Exploring the key aspects shaping traditional therapy adoption for stroke treatment: an ethnographic inquiry. J Healthc Adm. 2023;2(2):92–102. doi: 10.33546/joha.2743.

Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing; 1984.

Liu HY, Liu QH, Li ZR, Deng CS, Zhang XP, Wan LH. The cognitive appraisal path of stroke knowledge, coping traits, family functioning and stigma among stroke patients: a moderated parallel mediation model. J Clin Nurs. 2024;33(3):1048–61. doi: 10.1111/jocn.16909.

Rahmawati P. Reading Javanese ethnohealing: an introduction to understanding culture-based self-healing. 1st ed. Firdaus MZ, editor. Mataram: Genius; 2021 (in Bahasa Indonesia).

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Published

2025-12-08

How to Cite

1.
Cahya Ramadhan S, Septianingrum Y, Rusdianingseh, Mawarda Hatmanti N, Fitriasari A, Yuswanto A. A Phenomenological Study of Javanese Family Caregivers’ Perspectives on Caring for Stroke Survivors. PRIJNR [internet]. 2025 Dec. 8 [cited 2025 Dec. 26];30(1):58-74. available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/275670