Abstract
As the lead for International work within the Department of Nursing and Community Health at Glasgow Caledonian University I am acutely aware of how much of the evidence that underpins our understanding of health and healthcare originates from Europe, North America, Australia and New Zealand. Subsequently, I was very pleased to see that this study considered the coping strategies of family caregivers for people with dementia from a Chinese perspective. Whilst the Chinese government have enshrined the commitment of the extended family to help to care for elderly people in law, the expectation that this should be the case is evident from many other countries that I have visited. However, this is against the backdrop of many of these cultures undergoing a transition to a society where children do not always follow a more traditional model, as they seek full-time employment, often far away from their parental home.
The authors used interpretative phenomenological analysis to explore the experiences of caregivers. This approach facilitates a deep understanding of experiences as it allows the participants and the researchers to interpret the experiences that have been explored (Smith et al., 2009), thereby allowing the participant to think more deeply about their experiences and enabling the researchers to contextualise these experiences and interpretations in the wider landscape.
This study identified four main themes: Being filial, Changing self & self-care, Seeking help and Having hope & continuing life. I have to confess that I had to look up the meaning of ‘filial’. Those of you who have a wider vocabulary than me will know that it means a duty to one’s parents; this being extremely important in traditional Chinese culture. These four themes were explored using quotes from the participants and discussed referring to related literature. This process allowed exploration of the context in which this study was conducted, as well as the challenges and, importantly, the benefits that the caregivers experienced from the act of caring for their relative with dementia. These included exploration of the traditional cultural norm that children should look after their parents, the deviations from this as grown-up children are not always available, the adaptations that caregivers make to allow this new role to be undertaken, the help that is (or is not) available and how one strives to maintain independence whilst having significant caregiving responsibilities. The paper ends with important conclusions that are both thought-provoking and informative for clinicians and decision-makers alike. The findings from this research, whilst being grounded in one province in China, will resonate with many nurses and caregivers around the world.