Gaining Longitudinal Accounts of Carers' Experiences Using IPA and Photograph Elicitation

Abstract

Fluctuations in positive and negative caregiving experiences remain only partially explained as the significant variability over time of potential predictive factors themselves is understudied. The current study aims to gain considerable insight into caregiving experiences and perceptions over time by using photovoice methodology to support semi-structured interviews. A case study, longitudinal design is taken with three female caregivers who provide detailed insight into their caregivers' experiences over a 12 month period. The interview transcripts were analyzed using IPA- Interpretative Phenomenological Analysis. This innovative combination of methods resulted in the emergence of three related themes which included consuming the role, feeling consumed by the role, and letting go of the role. The idiographic approach taken allowed both within case differences to be examined over time, and also between carer differences to be highlighted. Implications of illness type and its characteristics, and of attachment and relationship quality with the care recipient were seen in terms of how and when the caregivers moved between the themes identified. The use of others' support or respite care is examined vis-a vis caregiver's own beliefs, emotions, relationship attachment and motivations to care. Caregivers self-efficacy beliefs also shifted over time and were influential in caregiver experience as the care recipient condition or needs changed. No previous studies have found that negative caregiving consequences are, in part, under volitional control and yet our data on the underlying reasons for consuming caregiving or allowing themselves to consume, would suggest this may in part be true. This is important because it suggests that interventions to support caregivers should address relational and motivational factors more fully.

Getting back or giving back: understanding caregiver motivations and willingness to provide informal care

“…We have attempted to highlight that motivations and willingness to provide care remain inappropriately and inconsistently conceptualised and defined as well as understudied in informal care research. As shown, motivations are multifaceted and multiply determined (Baker et al, 1988;Kanfer et al, 2008;Morrison & Williams, 2020;Wallroth, 2016) and contrary to early descriptions of intrinsic and extrinsic motivations as antagonistic we provide evidence of their coexistence (e.g. Morrison & Williams, 2020).…”

“…As shown, motivations are multifaceted and multiply determined (Baker et al, 1988;Kanfer et al, 2008;Morrison & Williams, 2020;Wallroth, 2016) and contrary to early descriptions of intrinsic and extrinsic motivations as antagonistic we provide evidence of their coexistence (e.g. Morrison & Williams, 2020). We suggest that the current model of extrinsic and intrinsic motivations is oversimplified and has omitted consideration of the diversity of caregiver motives, and indeed of other motivational models discerned in the context of the empirical research (Abell, 2001;Adams et al, 1976;Barber, 2010;Bateson, 1991;Blieszner & Shifflet, 1989;Clark & Mills, 2011;Frank, 2002;Greenberg, 1990;Homans, 1961;Humphrey, 1997;Johnson et al, 1999;Le et al, 2018;Lind & Tyler, 1988;Ryan & Deci, 2000;Vallerand, 1997).…”

“…In concluding this section we would note that in terms of studies of caregiving motivations, research has primarily been based on cross-sectional studies although several have noted that different types of motivations may be present at different times during the 'caregiving career' (Browne Sehy, 1998;Foster, 2012;Hsu & Shyu, 2003;Morrison & Williams, 2020;Parveen et al, 2011;Quinn et al, 2010;Schulz et al, 1989). Further longitudinal research is necessary to strengthen support for the points made herein.…”

“…Whilst it is evidenced that transitions can affect caregiver outcomes, especially in relation to the impact of cessation of caregiving on carer well-being, transitions in the role and time spent in the role may also impact motivations to care. This requires further empirical testing as suggested by qualitative literature (Browne Sehy, 1998 ; Foster, 2012 ; Hsu & Shyu, 2003 ; Morrison & Williams, 2020 ; Parveen et al, 2011 ). The suggested adaptation to the role, making it more habitual as well as unexpected rewards and reinforcers, especially with extrinsic motivators emerging over time (e.g.…”

“…Although we have limited knowledge of the influence of personal motivations and willingness to care on caregiver experience and outcomes, it has been shown that caregiving motivations and willingness play a vital role (Lyonette & Yardley, 2003 ; Morrison & Williams, 2020 ; Parveen, Morrison, & Robinson, 2013 ; Quinn, Clare, & Woods, 2010 ). We also have limited understanding of the factors that underly, promote and maintain motivations and willingness to provide informal care (Burridge, Winch, & Clavarino, 2007 ; Parveen et al, 2011 ; Parveen & Morrison, 2012 ) in the first place.…”