RELATING, REALIZING, REPEATING AND REINVENTING: EXPERIENCES OF PSYCHIATRIC PATIENTS AND FAMILY CAREGIVERS IN A THAI RURAL COMMUNITY

Abstract

Patients with psychiatric illnesses require a long-term management; however, disruptions in care and resultant relapse are often expected. Family caregivers of psychiatric patients often experience anxiety and stress related to caregiving and lack of appropriate understanding and skills to care for the patient. This qualitative research aimed to explore experiences of psychiatric patients and their caregivers. The participants included 8 patients and 9 family caregivers who were purposively recruited into the study. The authors conducted in-depth interviews and thematic analysis. Four themes reflected the experiences of the participants: 1) surviving family and social relationships, 2) never again slip away, 3) repeated daily routines, and 4) searching for a new me. Based on these themes, the authors formulated a model of culturally sensitive care for psychiatric patients represented in a 4 R’s model, that is, Relating, Realizing, Repeating and Reinventing. Relating deals with the relationships between patients and significant others which change over the course of illness and care management. Realizing reflects the patients’ awareness of their own illness as incurable and thus requiring continuous medical treatment. Repeating describes day-to-day routines including self-care and household chores. As a result of the changing self and landscape, some patients attempt to reinvent different aspects of their lives. This model guides culturally sensitive humanistic care of psychiatric patients and their family.