Determinants of Continuing Home Care by Family Caregivers in Rural Community: Qualitative Study in Japan

Sunday, November 1, 2009

Imaiso Junko, MSN, BS, BA, RN, PHN
Nursing Department, Ishikawa Prefectural Nursing University, Kahoku-shi, Japan
Sasaki Utako, MSN, RN, PHN
Home Visit Nursing, Kuwanomi Home Visit Nursing Station, Ena-shi, Japan

Learning Objective 1: The learner will be able to achieve key elements that nurses should support family caregivers for dependent medical care patients at home in rural community.

Learning Objective 2: The learner will be able to achieve how nurses should support family caregivers of dependent medical care patients for continuing home care considering rural character.

Background:
In Japan, the transition of medical care from hospital to home has extended.  But, it is difficult that family caregivers continue to care the patients with the need of medical care at home because of family caregivers’ burden.
Objective:
To examine the related factors with continuing home-based care in a rural community perceived by primary family caregivers for the dependent medical care patients.
Methods:
Due to the exploratory nature of this study, qualitative methodology was employed.  The sample for this study consisted of primary family caregivers who reside in a rural community in Japan and who continue to care at home beyond three months.  The family caregivers were recruited through a home-visit nursing station.  Five primary caregivers were interviewed between September and November in 2008.  A semi-structured interview guide was used through the interview.  Each personal interview, lasting between 45 and 60 minutes, was tape-recorded and transcribed verbatim with the agreement of the participants.  Transcripts from the personal interviews were coded by content analysis.  The codes were grouped into themes. 
Results:
The sample included two men and three women.  The age range of the caregivers was 54 to 81 years.  Four were spouse caregivers and one was adult children caregiver.  The period range of caring at home was 3 months to 14 years.  Eight themes emerged as factors related with continuous of home-based care by family caregivers: (1)Self-reliance, (2)Caregiver’s health, (3)Stress coping, (4)Possible care contents, (5)Pace of providing care, (6)Maintain of night sleep, (7)Financial aspect, (8)Informal support by family members or neighbors.
Conclusions:
In a rural community, social support tends to be insufficient compared with an urban community.  The findings suggest a need for support the family caregivers by home-visit nurses in considering the family caregivers’ characters or their own daily life with cultural competencies in a rural community.