Experiences and Meanings of Buddhist Beliefs and Lower Lanna Cultural Values in Family Members' Decision-Making for Critically Ill Patients: A Hermeneutic Phenomenological Study
Keywords:
Buddhist Beliefs, Lower Lanna Culture, Decision-Making, Family Members of Critically Ill Patients, Hermeneutic PhenomenologyAbstract
This qualitative study aimed to understand and interpret the meanings of Buddhist beliefs and Lower Lanna cultural practices within the decision-making experiences of family members of critically ill patients in Uttaradit, Phrae, and Nan provinces. A hermeneutic phenomenological qualitative approach was employed. Sixteen key informants were selected using purposive and snowball sampling. Data were collected through individual in-depth interviews and analyzed using van Manen's thematic analysis.
The finding revealed four major themes: 1) illness interpretation through a karmic and merit-based lens that motivated active caregiving rather than passive acceptance; 2) the use of Lower Lanna cultural rituals including life-extension ceremonies, votive offerings, and merit dedication as mechanisms for managing uncertainty in crisis situations; 3) seniority-based family authority structures and the role of Buddhist monks as ethical consultants who share collective moral responsibility in decision-making; and 4) the application of Buddhist teachings on intention and letting go to derive meaning and adapt to outcomes. The essence of the experience revealed that Buddhist beliefs and Lower Lanna cultural practices function as a "meaning space" enabling family members to sustain dignity amid uncertainty, operating alongside biomedical care as complementary systems rather than barriers to treatment. The contribution of this study lies in uncovering the meaning dimensions of decision-making within the Lower Lanna cultural context, an area that has not been systematically examined. Nurses should assess family belief systems as part of initial admission, provide space and time for families to perform cultural rituals alongside medical treatment, and communicate medical information in ways that reasonably accommodate family consultation with elders and Buddhist monks.
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