Developing support for Thai family caregivers of adults with a physical disability: a community-based action research study

Submission note: A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Nursing and Midwifery, Faculty of Nursing, La Trobe University, Bundoora.

There is an increase in adults with a physical disability in developing countries like Thailand. Their care is solely dependent on family caregivers whose substantial commitment to long-term care can impact significantly on their health. This study aimed to develop caregiver support to prevent and manage health problems for caregivers of adults with a physical disability using Bronfenbrenner’s ecological model as a theoretical lens. A community-based action research (C-BAR) approach with mixed methods was used. The study conducted in a rural area of eastern Thailand followed a traditional action research structure with two phases. Phase 1, a reconnaissance, was undertaken to ascertain caregiver health and existing caregiver supports. Quantitative and qualitative data were collected concurrently involving a face-to-face structured interview with 150 caregivers and 150 controls as well as interviews with six key informants involved in disability services. In Phase 2 a C-BAR group was established with 16 caregivers, eight non-professionals, and eight professionals in disability services. Findings from Phase 1 presented to C-BAR group showed caregivers had poorer health status and their needs were overlooked by support services and caregivers themselves. The C-BAR group set a goal to improve their health, and instill happiness into their lives. Support strategies addressed caregivers physical, mental, social and spiritual health needs. Caregivers reported satisfaction as newly established social networks empowered them to seek support as required and thereby fostered well-being for caregivers and care recipients. This study identified an urgent need for caregiver support to promote their health to enable them to maintain their vital role. It is suggested that long-term care support services should emphasize an inclusive approach to program delivery and consider community services available for adults with a physical disability and caregivers.