O cuidador familiar de idosos com demencias : um estudo qualitativo em familias de origem nipo-brasileira e brasileira

AUTOR(ES)
DATA DE PUBLICAÇÃO

2003

RESUMO

Transcultural studies are useful opportunities to improve knowledge on the meanings that human groups attribute to the great issues of life course, like dependence and family caregiving to the oldest. They can contribute to establish what is culturally particular and what is general, as well as to a better understanding of patterns of cultural continuity and change. In Brazil, the presence of relatively closed Japanese communities where old immigrants and their descendents still strive to maintain their cultural identity gives chance to the development of comparative studies with groups that seems not hold the same values, beliefs and practices. We carried out an qualitative study aimed at knowing how the caregiving role is built among members of two different cultural groups and what are the meanings attributed to the caregiving experience into their families. Founded on Geertz´s ethnographic approach, our procedure includes participant observation and semi-structured interview that were applied to six Japanese-Brazilian and to six Brazilian families. They constituted a convenience sample whose participants were matched by educational and economic criteria. They were recruited in hospitals, clubs and community. All they held at least one highly dependent cognitive impaired old member, that could be the spouse, the parents or the parents-in-law of the primary caregiver. In all families the member that assumed the majority of responsibilities in caregiving was elected as the chief source of data and the link with other family or community members. Data collection was mostly done at participants home, but also at public places and events, like churches, clubs, parties and rituals to which the researcher was invited. These different situations produced field records, representations of the families kin relationships (heredograms), as well as a corpus initially constituted by the verbatim transcription of the interviews´ content. This corpus was submitted to content analysis with aid of the software QSR NUD*IST (Non-Numeric Unstructured Data, Index, Searching and Theorizing). The first output was a pool of native categories which were constantly compared to the researcher´s field records and heredograms. A in-deep analysis of these material produced a hierarchy (or tree) of categories of meanings, from which we abstracted five great themes: 1) Building the concept of cognitive impairment by dementia as a disease and shaping the notion that the demented old relative is a diseased person; 2) The caregiver and his/her plurality; 3) The complexity of the caregiving process; 4) The family group and the dynamic of interactions among its members and the primary caregiver; 5) Strains, challenges and conflicts experienced by family caregivers. Interpretation of data allows to say that to both groups, family is the chief locus of caregiving. However, instead of caregiving be exclusively focused on the primary caregiver, as suggested by literature, in both group caregiving tasks are primary shared by the closest family group and also by other people that maintain some kind of affective commitment with the family nucleus. We called these enlarged group as domestic group. The domestic group can be better described as a network of caregiving, where tasks and roles suffer successive reconfigurations, in depending on caregiving demands, caregivers´ personality and personal resourcefulness, caregiving dials made by the members of the network, actual and past relationships between the impaired elderly and the caregivers, status of the elderly´s illness, contextual conditions and cultural beliefs and practices. The best metaphor to make reference to the complex dynamic established by the domestic network of caregiving is ballet of caregiving. The main difference observed between the Japanese-Brazilian and the Brazilian families did not consist in patterns of caregiving tasks and roles, but in the meanings attributed to family support, to caregiving by itself, and to caregiving and aging in the context of social and individual life course. Japanese- Brazilian mentioned more their cultural references as explanations to the meanings and experiences they had reported than Brazilian participants did, what suggests that their beliefs on something like Japanese ancient culture is an important element of their identity and continuity as a group.

ASSUNTO(S)

demencia familia idosos

ACESSO AO ARTIGO

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