Coping Skills of Iranian Family Caregivers’ in Caretaking of Patients Undergoing Haemodialysis: A Qualitative Study (original) (raw)
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Scandinavian Journal of Caring Sciences, 2017
Commitment to care: the most important coping strategies among family caregivers of patients undergoing haemodialysis Background: Caregivers of patients undergoing haemodialysis often experience an intensive burden of care; therefore, it is important to understand the type of strategies that are used by caregivers to adapt and to commit themselves to caring for another individual. Aim: The aim of this study was to explore the specific coping strategies used by family caregivers of patients undergoing haemodialysis. Methods: In this qualitative study, 16 family caregivers of patients undergoing haemodialysis were selected through purposive sampling in four dialysis centres in south of Iran. Semi-structured interviews were used to collect data. A content analysis of the interviews was performed to determine relevant themes. Results: Data analysis resulted in the emergence of four categories including 'cultural and religious constructs', 'sense of responsibility', 'self-restraint' and 'satisfactory caring', as whole of these categories are included in the main theme of 'commitment to care' which is experienced by the family caregivers during the care of patients undergoing haemodialysis. Conclusions: This study demonstrates that coping strategies stemming from the cultural beliefs of caregivers are very salient in their commitment to care; thus, the health-care team, especially nurses, should encourage family caregivers to use these strategies to maintain their physical and psychological health and to provide quality care for patients.
Jundishapur Journal of Chronic Disease Care, 2017
Background: The high dependence of hemodialysis patients on home caregivers is a great source of care burden for them; therefore, accountability with appropriate communication as well as appropriate behavior and attention to needs of caregiver by health care team is a serious impact on care burden. Methods: A content analysis approach was used for data collection and analysis. The participants included16 family caregivers selected through purposive sampling from 4 medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data. Results: Data analysis led to the emergence of 3 themes including "responsive treatment team" "negative influences of the treatment team," and "collaborative care," which were all incorporated into the main theme of "an effective treatment team". Conclusions: The treatment team can play an effective role in improving the caregivers' well-being by appropriate treatment, accountability, and responsiveness to the needs of patients and their caregivers; meanwhile, it provides a better position for better care, however, it will reduce the care burden.
Indian Journal of Palliative Care, 2018
Background: Although dialysis treatment is considered as a life-saving treatment for chronic renal failure patients, the caregivers face challenges in caretaking of these patients. Objectives: This study is aimed to explain the perspectives and experiences among caregivers of the patients undergoing hemodialysis in Iran. Methods: A qualitative design, based on a thematic analysis approach, was used to reach the study aim. In this study, 25 hemodialysis family caregivers were selected by purposeful sampling. The data were gathered through in-depth and unstructured interview and field observation and analyzed by the inductive thematic approach. Results: The three main themes were generated from the analysis of the data indicating that the caregivers face challenges such as heavy burden of care, tension in care, and emotional exhaustion. Conclusion: Caretaking of the hemodialysis patients is constantly accompanied with challenges and concerns regarding the effective care for patients. Health-care providers need to address these concerns based on both patient-and caregiver-focused approaches, rather than only patient focused, to the design and planning for helping the patients and their caregivers.
International Journal of Nursing Sciences
The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers. Methods: In this qualitative study, a content analysis approach was used for data collection and analysis. Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data. Results: Four categories were developed as follows: 'care challenges', 'psychological vulnerabilities', 'the chronic nature of care 'and "care in the shade". The categories led to the development of the main theme of 'progressive exhaustion' experienced by the family caregivers during the provision of care to patients undergoing hemodialysis. Conclusion: Family caregivers have a significant role in the process of patient care, and this role leads them to progressive exhaustion; therefore, the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life, social welfare, and satisfaction level.
BMC Psychology
Background Family caregivers of patients receiving hemodialysis experience physical and psychological disorders. They are unfortunately neglected. The aim of this study was to explain the psychological consequences for family caregivers of patients receiving hemodialysis. Methods This qualitative inductive conventional content analysis research approach was conducted in Tehran, Iran. Nineteen hemodialysis patient caregivers were enrolled via purposive sampling. Data collection was conducted through in-depth and semi-structured interviews until reaching data saturation. All interviews were recorded, transcribed, imported into the Open Code Software, and analyzed using the Graneheim and Lundman methods. Results The results included two main categories: (1) threats to the psychological integrity; (2) development of capabilities. The first main category comprised the sub-categories of “care-related negative feelings and emotions,” care-related stress and its behavioral impacts on care, ...
Psychology Research and Behavior Management
The purpose of this study was to investigate the relationship between care burden and coping strategies in caregivers of hemodialysis patients. Methods: This cross-sectional survey was conducted from September to December 2018 in Kermanshah, Iran. A total of 130 caregivers of patients admitted to the hemodialysis wards of Imam Reza and Imam Khomeini hospitals of Kermanshah, Iran were selected via convenience sampling. Data-collection tools included a demographic information form, caregiver-burden inventory, and coping inventory for stressful situations. Data were analyzed using descriptive and analytical tests. Results: The mean age of the caregivers was 35.8±13.7 years, and 71 (54.6%) were patients' children. The mean caregiver-burden score was 58.5±20.5 out of 96. Mean scores of timedependent, evolutionary, physical, social, and emotion-dependent care burdens were 17.5 ±5.3, 12.2±6.3, 9.1±4.7, 8.2±4.0, and 11.4±5.1, respectively. Mean scores of problemfocused, emotion-focused, and avoidance-oriented coping strategies were 46.0±80.8, 43.1 ±9.0, and 48.9±9.5, respectively. Among the strategies, only the avoidance-oriented one had a significant positive relationship with total care burden and all its subscales. Conclusion: Caregivers of hemodialysis patients experienced a relatively high care burden. However, they did not use appropriate coping strategies; therefore, they should be trained to select an effective coping strategy.
Acta Facultatis Medicae Naissensis
The present study tries to design and evaluate the psychometric properties of coping strategies scale for family caregivers of hemodialysis patients. This study consisted of two phases: phase one was a qualitative study to analyze the experiences of coping strategies of hemodialysis patients' family caregivers' (N = 14). Then, the items were extracted from the interviews and the literature. Phase two was a psychometric assessment including face validity, content validity, construct validity (N = 245) and reliability. In phase one, 89 items were extracted and after face and content validity, 56 items remained. Construct validity of the scale, based on exploratory factor analysis, removed another 22 items. The remaining 34 items contained nine subscales (active coping, positive thinking, appeal to spirituality, help-seeking, altruism, acting out, self-blaming, seeking isolation, and intentional forgetting). The reliability of the scale with Cronbach's Alpha was 0.91 and it...
Nursing and Midwifery Studies, 2016
Background: Studies have shown that family caregivers of hemodialysis patients experience high levels of burden. However, these caregivers are often neglected, and no studies are available on the effectiveness of coping strategies on the burden of care among these caregivers. Objectives: This study aimed to examine the effectiveness of problem-focused coping strategies (communication skills, anger management, and deep breathing) on the burden on caregivers of hemodialysis patients. Patients and Methods: A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad hemodialysis center in Tehran, Iran. The subjects were equally allocated into two groups of 38. Through a coin-tossing method, caregivers of patients who referred on even or odd days of the week were randomly assigned into the intervention group or the control group, respectively. The intervention group received four training sessions on problem-focused coping strategies, but the control group did not receive any intervention. Both groups answered the caregiver's burnout inventory at the start and six weeks after the last educational session. Descriptive statistics, chi-square, Fisher's exact test, independent-samples t-test, and Mann-Whitney U test were used to analyze the data. Results: The majority of caregivers (54%) were in the age range of 35-55 years, female (68.4%), and married (70%). No significant difference was found between the baseline mean caregivers' burden scores of the intervention and control groups (88.56 ± 11.74 vs. 84.97 ± 15.13, P = 0.308). However, the mean caregivers' burden in the intervention group decreased, and the two groups were significantly different at the end of the study (58.77 ± 6.64 vs. 87.84 ± 11.74, P < 0.001). Conclusions: The current study showed the effectiveness of problem-focused coping strategies on reducing the burden on caregivers of hemodialysis patients. Authorities and policymakers in the healthcare system are responsible for developing strategies to integrate educational programs, such as the program implemented in the current study, into the country's healthcare system.