Role of the Lebanese family caregivers in cardiac self‐care: a collective approach

Abstract

Aims and objectives The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. Background The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. Design The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. Method Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. Results One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). Conclusion In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. Relevance to clinical practice Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive patient/family intervention.

Awareness and attitudes towards advance care planning in primary care: role of demographic, socioeconomic and religiosity factors in a cross-sectional Lebanese study

“…The Lebanese society is known to have a family-oriented culture where decisions, including healthcare, are made in conjunction with other family members which potentially lessens the value of autonomy. 41 42 However, most of the participants in our study favoured truth-telling, healthcare autonomy and making their own healthcare decisions, suggesting an attitude that favours active participation in care management; this is in line with findings from another study that showed that Lebanese patients prefer taking part in the management of their own treatments. 43 These findings that Lebanese adults show preference towards a more engaged and independent decision-making process can be explained by the increased accessibility and advancement in education and technology.…”

Determinants of Self-Care in Patients With Heart Failure: Observations From a Developing Country in the Middle East

“…Social support was expectedly high in this sample given the cultural context of this study being conducted in Lebanon, a country that thrives on a large repertoire of family relations. Family caregiver role was grounded in the sense of obligation and duty toward the sick family member whereby caregivers collectively provided care (Dumit, Abboud, et al, 2015). The importance of social support as a facilitator of self-care was previously demonstrated in the international literature (Gallagher, Luttik, & Jaarsma, 2011;Sayers, Riegel, Pawlowski, Coyne, & Samaha, 2008).…”

“…Arabs thrive on a large repertoire of family relations where the extended family is the most powerful social institution of the Middle East (Lipson & Meleis, 1983). The Lebanese family, in particular, is classically over protective of the patient and family members exchange turns in providing care (Dumit, Abboud, Massouh, & Magilvy, 2015). The effect of this family structure on self-care has not yet been addressed.…”

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

“…Generally, studies have shown that intrinsic motives lead to more positive caregiver outcomes than extrinsic motives, with differences noted in coping strategies, emotional distress, feelings of burden, quality of care, caregiver satisfaction and stress (e.g. Burridge et al, 2007 ; Carruth, 1996 ; Donorfio & Kellett, 2006 ; Dumit, Abboud, Massouh, & Magilvy, 2015 ; Knight & Sayegh, 2010 ; Lyonette & Yardley, 2003 ; Parveen et al, 2011 ; Romero-Moreno, Gallego-Alberto, Márquez-González, & Losada, 2017 ). However, we should not easily conclude an advantage of one or other type of motivation as research addressing extrinsic motivation, based on, as described previously, incentives and outcome expectancies has also found these motives to be associated with positive caregiver outcomes (Burridge et al, 2007 ; Qiu, Sit, & Koo, 2018 ; Rohr & Lang, 2016 ; Tang, Li, & Liao, 2007 ; Vroman & Morency, 2011 ; Youn, Knight, Jeong, & Benton, 1999 ).…”