Caregiving in rural African-American families for elderly stroke survivors.

Abstract

In recent years the literature on ethnic caregivers has grown, yet, it remains significantly small in comparison to the body of research on Caucasian caregivers. The overall purpose of this grounded theory study was to examine the process of caregiving from the perspective of African American families living in rural settings who were caring for a family member who had suffered a recent stroke. Another aim of the study was to generate a model to explain the impact caregiving had on the lives of rural African Americans. Semi-structured interviews and focused observation sessions were conducted with eight African American families consisting of eight stroke survivors, eight primary caregivers, and 18 secondary caregivers. Grounded theory method was used to collect and analyze the data. A multi-step data analysis technique that incorporated the constant comparative method was used to uncover basic social processes, core categories, and their dimensions. The collection and comparative analysis of the data occurred simultaneously over a period of 14 months. The findings revealed the basic social psychological problem of transitions, and a four stage basic social process of striking a balance. These four stages included: Stage I--Deciding to Care, Stage II--Dividing Care, Stage III--Protective Care, and Stage IV--Coming to Terms. Stage I strategies included: (a) being obligated, (b) giving back, and (c) attaching personal meaning. Stage II strategies included: (a) sharing care, (b) venting dissatisfaction with help, (c) recognizing need for more help, and (d) knocking down. Stage III strategies included: (a) covering up, (b) conferring, and (c) negotiating. Stage IV strategies include: (a) struggling for independence, (b) coping with changed roles, and (c) relinquishing care. This study has implications for both nursing practice and nursing research. First, the model of caregiving developed in this study provides a guide for nurses in determining appropriate interventions for rural African American families caring for a stroke survivor. This study provides a basis for future research and theory that may lead to a formal theory of caregiving in African Americans using the model of Caregiving in Rural African Americans, as a foundation.