A Grounded Theory Study of Thai Family Caregiving Process for Relatives with First Episode Psychosis

Authors

  • Wilai Napa RN, PhD Candidate, Lecturer, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
  • Patraporn Tungpunkom RN, PhD, Associate Professor, Faculty of Nursing,Chiang Mai University, Thailand
  • Hunsa Sethabouppha RN, PhD, Lecturer, Faculty of Nursing, Chiang Mai University, Thailand
  • Areewan Klunklin RN, PhD, Professor, Faculty of Nursing, Chiang Mai University, Thailand
  • Ritin Fernandez Fernandez RN, PhD, School of Nursing, Faculty of Science, Medicine and Health University of Wollongong, Australia

Keywords:

Family Caregiving, First-episode Psychosis, Grounded Theory, Schizophrenia, Schizophrenia Spectrum Disorders, Thailand

Abstract

                This grounded theory study explored the family caregiving process for relatives with first-episode psychosis related to schizophrenia spectrum disorders. The study was conducted during May 2013-March 2014 in lower northeastern region of Thailand using semi-structured interviews and observations, and involved 31 participants from 18 Thai families. The data were analyzed by using Strauss and Corbin’s constant comparative method until theoretical saturation was achieved.
                The core category emerging from the data was Balancing family life, which consisted of three phases: 1) Communicating to gain support and understanding, 2) Capturing solution, and 3) Engaging in the family caregiving role. To keep balance in their family life, family members needed to encourage and support each other and gain understanding toward the illness on Phase I. They also consulted one another; got suggestions from older or senior person; or depended on the primary caregiver’s decision for capturing solutions for care for their relatives in Phase 2. Finally, in Phase 3 they developed their sense of caring; shared care responsibility; provided essential care and controlling illness symptoms once they engage in the family caregiving role. These rich findings provide insight into caregiving in the Thai family context, especially in how they interacted and helped each other in order to provide care for relatives with first episode psychosis. Understanding of this process can assist with the development of interventions to enhance family members’ abilities to take on the caregiver role and to provide effective care for their relatives with first-episode psychosis.

Author Biography

Patraporn Tungpunkom, RN, PhD, Associate Professor, Faculty of Nursing,Chiang Mai University, Thailand

 

 

References

1. Lohacheewa S, Sitthimongkol Y, Sirapo-ngam Y, Viwatwongkasem C. Psychological distress of family members caring for a relative with first episode schizophrenia. Pacific Rim Int J Nurs Res. 2016 20(3): 183-195.

2. Sin J, Moone N, Harris P. Siblings of individuals with first-episode psychosis: understanding their experiences and needs. JPN. 2008 46(6):33-40.

3. Sadath A, Muralidhar D, Varambally D, Jose JP, Gangadhar BN. Caregiving and help seeking in first episode psychosis: a qualitative study. J Psychosoc Rehabil Ment Health. 2014 1(2):47–53.

4. Bergner E, Leiner SA, Carter T, Franz L, Thompson NJ, Compton, M.C. The period of untreated psychosis before treatment initiation: a qualitative study of family members’ perspectives. Compr Psychiatry. 2008 49:530-536.

5. McCann TV, Lubman DJ, Cleark E. First-time primary caregivers’ experience of caring for young adult with firstepisode psychosis. Schizophr Bull. 2011 37(2), 381-388.

6. Sin J, Moone N, Harris P, Scully E, Wellman N. Understanding the experiences and service needs of siblings of individuals with first-episode psychosis: a phenomenological study. Early Interv Psychiatry. 2012 6(1):53-9.

7. Popolo R, Vinci G, Balbi A. Cognitive function, social functioning and quality of life in first-episode psychosis: a 1-year longitudinal study. Int J Psychiatry Clin Pract. 2010 14:33-40.

8. Verhaegh MJM, Bongers IMB, Kroon H, Garretsen HFL. Model fidelity of assertive community treatment for client with first-episode psychosis: a target group-specific application. Community Ment Health J. 2009 45:12-18.

9. Gleeson J, Wade D, Castle D, Gee D, Crisp K, McGorry P, et al. The EPISODE II trail of cognitive and family therapy for relapse prevention in early psychosis: rationale and sample characteristics. JMH. 2008 17(1):19-32.

10. Bird V, Premkumar P, Kendall T, Whittington C, Mitchell J, Kuipers E. Early intervention services, cognitive-behavioral therapy and family intervention in early psychosis: systematic review. Br J Psychiatry. 2010 197:350-356.

11. Onwumere J, Bebbington P, Kuipers E. Family intervention in early psychosis: specificity and effectiveness. Epidemiol Psychiatr Sci. 2011 20:113-119.

12. Seeman MV. Bad, burdened or ill? characterizing the spouses of women with schizophrenia. Int J Soc Psychiatry. 2012 59(8):805-810.

13. Crowe A, Brinkley A. Distress in caregivers of a family member with serious mental illness. FJCTFCF. 2015 23(3):286-294.

14. Chompikul J, Suthisukon P, Sueluerm K, Dammee D. Relationships in Thai families. Bangkok: N&N Copy and Printing; 2009.


15. Podhisita C. Thai family and household changes: what we don’t know. 2011 24-4. Available from: https://www2. ipsr.mahidol.ac.th/Conference VII/Download/2011Article-02-pdf.

16. Neilssen O, Large M. Rates of homicide during the first episode of psychosis and after treatment: a systematic review and meta-analysis. Schizophr Bull. 2010 36(4):702-712.

17. Machielsen M, Sluis S, Haan L. Cannabis use in patient with a first psychotic episode and subjects at ultra-high risk of psychosis: impact on psychotic- and pre-psychotic symptoms. Aust N.Z. J Psychiatry. 2010 44:721-728.

18. Bowman S, Alvarez-Jimenez M, Wade D, Howie L, McGorry P. The impact of first episode psychosis on sibling quality of life. Soc Psych Psych Epid. 2014 49:1071–1081.

19. Chan SWC. Global perspective of burden of family caregivers for persons with schizophrenia. Arch Psychiatr Nurs. 2011 25(5):339-349.

20. Mo FYM, Chung WS, Wong SW, Chun DYY, Wong KS, Chan SSM. Experience of caregiving in caregivers of patients with first-episode psychosis. Hong Kong J Psychiatry. 2008 18:1001-6.

21. Corcoran C, Gerson R, Sills-Shahar R, Nickou C, McGlashan T, Malaspina D, et al. Trajectory to first episode of psychosis: a qualitative research study with families. Early Interv Psychiatry. 2007 1:308-315.

22. Gerson R, Wong C, Davidson L, Malaspina D, McGlashan T, Corcoran C. Self-reported coping strategies in families of patients in early stages of psychotic disorder: An exploratory study. Early Interv Psychiatry. 2011 5(1): 76–80.

23. Piercy KW. Theorizing about family caregiving: the role of responsibility. J Marriage Fam. 1998 60(1):109-118.

24. Stajduhar KI, Funk L, Outcalt L. Family caregiver learning-how family caregivers learn to provide care at the end of life: a qualitative secondary analysis of four datasets. Palliat Med. 2013 27(7):657-664.

25. Eggenberger SK, Nelm TP. Being family: the family experience when an adult member is hospitalized with a critical illness. J Clin Nurs. 2006 16:1618-1628.

26. Wongsawang N, Lagampan S, Lapvongwattana P, Bowers BJ. Family caregiving for dependent older adults in Thai families. J Nurs Scholarsh. 2013 45(4):336-343.

27. Sherman CW, Webster NJ, Antonucci TC. Dementia caregiving in the context of late-life remarriage: support networks, relationship quality, and well-being. J Marriage Fam. 2013 75:1149-1163.

28. Burnard P, Naiyapatana W, Lloyd D. Views of mental illness and mental health care in Thailand: a report of an ethnographic study. J Psychiatr Ment Health Nurs. 2006 13:742-749.

29. Sanseeha L, Chontawan R, Sethabouppha H, Disayavanish C, Turale S. Illness perspectives of Thais diagnosed with schizophrenia. Nurs Health Sci. 2009 11:306-311.

30. Dangdomyouth P, Stern PN, Oumtanee A, Yunibhan J. Tactful monitoring: how Thai caregivers manage their relative with schizophrenia at home. Issue Ment Health Nurs. 2008 29:37-50.

31. Kertchok R, Yunibhand J, Chaiyawat W. Creating a new whole: helping families of people with schizophrenia. Int J Ment Health Nurs. 2011 20: 38-46.

32. World Health Organization. Primary health care-now more than ever: introduction and overview (pp. 5-14). Available from https://www.who.int/whr/2008/en/.


33. Kuipers E, Onwumere J, Bebbington P. Cognitive model of caregiving in psychosis. Br J Psychiatry. 2010 196: 259-265.

34. White JM, Kline DM. The symbolic interaction framework. In White JM, Kline DM. Family Theories. California: Sage Publication Inc; 2002, pp. 58-87.

35. Strauss A, Corbin J. Basic of qualitative research: grounded theory procedures and techniques. California: Sage Publications Inc; 1998.

36. Tangchonlatip K, Vapattanawong P, Chamchan C, Kanungsukkasem U, Vong-Ek P, Punpuing P. Value of Thai elderly: perspectives from two generations. In Thaveesit S, Boonyamanon S. Value of the elderly from the eyes of Thai society. Nakornpathom: Dauntoola Publisher; 2010, pp. 29-64.

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Published

2017-05-05

How to Cite

1.
Napa W, Tungpunkom P, Sethabouppha H, Klunklin A, Fernandez RF. A Grounded Theory Study of Thai Family Caregiving Process for Relatives with First Episode Psychosis. PRIJNR [Internet]. 2017 May 5 [cited 2024 Dec. 26];21(2):158-70. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/74254

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