Background: Family caregivers (FCGs) of heart failure (HF) patients in rural areas in Thailand tend to experience role strain because they complete difficult and time consuming HF caregiving tasks for long periods of time. Framework: This study was guided by the Role Strain Theory (Goode, 1960). Specific Aims: The study aims were to: (1) Determine the relationship of FCG and HF patient characteristics, difficult and time consuming HF caregiving tasks, belief in the Buddhist Karma Rule, and social support to caregiver role conflict and role strain; (2) Examine the impact of difficult and time consuming HF caregiving tasks on caregiver role conflict; and (3) Test the belief in the belief in Buddhist Karma Rule and social support as possible moderating factors on the relationship between caregiver role conflict and role strain, controlling for difficult and time consuming HF caregiving tasks. Methods: This study had a cross-sectional descriptive design. The relationships among HF patient and FCG characteristics, difficult and time consuming caregiving tasks, belief in the Buddhist Karma Rule, participation in Buddhist activities, and social support on levels of caregiver role conflict and role strain were explored by conducting multiple regression procedures. The moderating effects of belief in the Buddhist Karma Rule, participation in Buddhist activities, and social support on the relationship between caregiver role conflict and role strain were tested using a general linear model. Sample: A convenience sample of 144 rural Thai FCGs of HF patients were recruited from an outpatient clinic in the Buddhasothorn Hospital of rural eastern Thailand. Results: Specific Aim 1: Caregiver gender and difficult caregiving tasks were positively correlated with caregiver role conflict (r= .267 to .664), while social support was negatively correlated with caregiver role conflict (r = -.579). Caregiver gender, difficult caregiving tasks, and social support were significant predictors of caregiver role conflict (p < .05). Caregiver gender, difficult caregiving tasks, caregiver physical function, and HF functional class had positive correlations with caregiver role strain (r = .237 to .577). Participation in Buddhist activities, and social support were negatively correlated with caregiver role strain (r = -.631 to -.710). Caregiver gender, difficult caregiving tasks, physical function, HF functional class, participation in Buddhist activities, and social support were found to be significant predictors of caregiver role strain (p < .05). Specific Aim 2: Difficult and time consuming caregiving tasks were positively correlated with role conflict (r = .577 to .664). Difficult caregiving tasks was a significant influence on role conflict (p < .000) but time consuming caregiving tasks was not significantly correlated with role conflict (p = .291). Specific Aim 3: Caregiver social support, belief in the Buddhist Karma Rule and participation in Buddhist activities were negatively correlated with caregiver role conflict and role strain (r = -.579 to -.710). Caregiver social support, belief in the Buddhist Karma Rule and participation in Buddhist activities were significant moderating factors on the relationship between caregiver role conflict and role strain (p < .05). Implications: The study results can be used to develop of evidence-based caregiver screening and support programs to evaluate, or relieve, role conflict and role strain in FCGs in order to enhance physical and psychological health. Explicit guidelines, standards, and protocols should be developed to deliver care for FCGs of HF patients and other chronically ill patients in rural Thailand. Future research should examine specific types of caregiving tasks and Buddhist activities that influence caregiver role conflict and role strain in a larger sample.
Read
