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- Ehrlich, Kethy Forssell
(författare)
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Family caregivers caring for a relative with dementia : a comparison of urban and rural areas
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Family caregivers´ efforts for a family member with dementia are considerable and constitute a major societal resource. Most studies in family members’ caregiving have been carried out in major cities and there are lack of knowledge in how rural families experience their situation. The overall aim of this thesis was to develop and deepen the knowledge of the relationship between the settlement, here urban and rural areas, and family caregivers' experiences of providing care for a relative with dementia. The two sub-studies of the thesis are based on a social constructionist perspective in which the human being is considered to construct their lives both in interaction with others and with the place they live in. The place is not only a geographical area, but also a place consisting of social relations. Relatives of urban and rural areas were assumed to construct their lives in different ways that could affect the situation as family caregivers. The aim of study I was to describe and compare urban and rural family caregivers' reactions to caring for a relative with dementia and to examine the associations between caregiving and socio-demographic factors. It was conducted as a prospective cross-sectional study with a total of 102 (57 urban + 45 rural) participants. The Swedish version of The Caregiver Reaction Assessment Scale (CRA) was used and consisted of 27 positive and negative items divided into five subscales (caregiver esteem; lack of family support; impact on finances, health and schedule). Data were analyzed using descriptive statistics. Student's t-test was used to examine differences, Chi-2 test for proportions and linear regression analysis was used to examine the associations between the five sub-areas and socio-demographic variables. The aim of study II was to explore and better understand how the approach of family members to their caregiving situations differs in rural and urban areas. Narrative interviews were conducted with 23 family caregivers (11 urban + 12 rural). The questions involved daily life and work both now, with a relative with dementia, and earlier, and the meaning of the settlement and the social life. The interviews were analyzed based on a hermeneutical approach. The results of the regression analysis showed that neither the settlement nor the level of education had any association with how family members assessed their situation (I). However, most families in both urban and rural areas were satisfied being able to take care of their relatives even though the situation had a major impact on everyday life (I-II). The adult children experienced a conflict between their own and the family's needs and the sick parent's need of care (II). Everyday life was affected to a greater extent than for the spouses (I). The women assessed a greater impact on the economy, and more impact on daily life than the men. But family caregivers in the rural area seemed to get more help from family and others than those in the urban area (I). The interview study (II) showed a more collective view of the family and partner relationship of the family caregivers in the rural area, which seemed to be manifested in a greater acceptance of life and to preserve normal life. The family caregivers in the urban area showed a more individual view expressed in more frustration and seemed to be characterized of fulfilment of duty. In conclusion being a family caregiver to a relative with dementia is probably as stressful whether one lives in urban or rural areas. At the same time there were a variation of approaches to the situation affected of how people view themselves, the family, and the couple, which imply different formal support.
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- Ehrlich, Kethy, et al.
(författare)
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Family caregivers’ assessments of caring for a relative with dementia : A comparison of urban and rural areas
- 2015
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 10:1, s. 27-37
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study aimed to describe and compare urban and rural family caregivers' reactions to caring for a relative with dementia and to examine the associations between caregiving and socio-demographic factors. Background: Most studies on family caregivers' experiences caring for older people with dementia have been conducted in urban areas, and little is known about the experiences of family caregivers living in rural areas. Design: A cross-sectional study design was used. Methods: A total of 102 caregivers (response rate 85%) from urban (n = 57) and rural (n = 46) areas completed the Caregiver Reaction Assessment (CRA) Scale and demographic information. Data were analysed using descriptive and inferential statistics and linear regression models. Results: Overall, family caregivers reported high satisfaction even if they also reported high impact on finances and daily living. Rural caregivers experienced a higher negative impact on finances but reported more support from family members than urban caregivers. Age, gender and relationship were significantly associated with four of the five CRA subscales. Educational level and geographical setting were not associated with any of the CRA subscales. Conclusions: The results of the study raise questions about the financial situation of older female caregivers and on the expectations of built-in family structures in urban and rural areas. Further studies focusing on the meaning and constitution of a family would help us to understand how these factors influence family caregiving both in rural and urban areas. Implications for practice: To provide person-centred care and to avoid stereotyped caregiving, a better picture of traditions in family caregiving can improve a more differentiated and appropriate professional caregiving pliable with the cultural context in which it is carried out.
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- Ehrlich, Kethy, et al.
(författare)
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The relationship between geographical and social space and approaches to care among rural and urban caregivers caring for a family member with Dementia : a qualitative study
- 2017
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 12:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge about family caregivers in rural areas remains sparse. No studies to date have addressed the sociocultural aspects in caregiving, thus neglecting potentially significant data. This study aimed to explore and better understand family caregivers’ experiences in rural and urban areas and the sociocultural spheres that these two areas represent. How do family caregivers approach their caregiving situation? A hermeneutical approach was chosen to uncover the underlying meanings of experiences. Open-ended in-depth interviews were conducted. The ontological and epistemological roots are based on hermeneutic philosophy, where a human being’s existence is viewed as socially constructed. The study followed a purposeful sampling. Semi-structured in-depth interviews were conducted with 12 rural and 11 urban family caregivers to persons with dementia. These were then analyzed in accordance with the hermeneutical process. The findings provide insight into the variations of family caregiver approaches to caregiving in rural and urban areas of Sweden. There seemed to be a prevalence of a more accepting and maintaining approach in the rural areas as compared to the urban areas, where caregiving was more often viewed as an obligation and something that limited one’s space. Differences in the construction of family identity seemed to influence the participants approach to family caregiving. Therefore, community-based caregiving for the elderly needs to become aware of how living within a family differs and how this affects their views on being a caregiver. Thus, support systems must be individually adjusted to each family’s lifestyles so that this is more in tune with their everyday lives.
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