Feedback Loop Reflecting Processes for Community Engagement in Elderly Care

Abstract

Introduction Recently our research team conducted a multi-village survey among volunteer elderly caregivers in the Non-Thon district of Khon Kaen province. To address community concerns, the information feedback is not only disseminating and informing people about the situation. Transforming information through community-led conversations is essential. Objectives This study aimed to describe how the community transforms the information related to elderly care using feedback loop reflecting processes, and to identify possible actions participated by the community to solve the problems. 

Design Community-based action research processes guided by Ernest Stringer action research framework. 

Methodology Community participants in this study were thirty community representatives and stakeholders purposively selected according to the inclusion criteria, consisting of 1) fourteen community leaders, 2) fourteen volunteer caregivers in the community, and 3) a nurse from primary care unit, 4) a community development worker. Data were collected using three focused group discussions with a semi-structured questions guide from May to June 2022. About ten informants were in each focused group. The researcher provided feedback information on elderly issues from the survey and community reflections were openly discussed on the information given including the problems and solving plans. The group discussions were community-led and facilitated by the researchers with taped recordings and field notes. The data were analyzed using the method of content analysis. Four criteria of credibility, transferability, dependability, and confirmability outlined by Lincoln and Guba were interwoven throughout the audit trail of the research methodology to reveal the transparency and the trustworthiness of the analysis. 

Findings The informants from 14 villages were 18 females and 12 males aged between 35 to 70 years. Most informants had completed primary school level, followed by low-secondary school level. The feedback reflection process confirmed its usefulness for better understanding and exploring the readiness and community participation towards the issues of elderly care in their community. Three major categories that emerged during the group meetings were reassessment of the issues, data transforming and prioritizing, and decision-making. The living conditions of the elders were reassessed and recognized in terms of living alone solely, living alone but having relatives nearby, and living with family which was the majority group. The family caregivers were elderly spouses and family members. Data transforming towards the issue and community needs to involve in direct elderly care. The community shelved the caring issue for reasons of low priority and not being ready to provide direct support for caregiving tasks. Separately, the community and health care team prioritized the issues and agreed to arrange caregiver training, ambulance services, and proactive support services for the elders at home. These strategies were beneficial to broader groups in the community. 

Recommendation Due to the action research process of this study, findings obtained from this reflection loop will be the beginning of the next step of “act” via the process of action planning, implementation, monitoring the actions, and evaluation of the outcomes. The future steps of action research required proper community involvement and research methodology