School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam.
Ethn Health. 2022 Oct;27(7):1630-1651. doi: 10.1080/13557858.2021.1922612. Epub 2021 May 5.
This study aims to examine the help-seeking process of family caregivers for persons with dementia (PWD) in Vietnam, and how health and cultural beliefs shape this process.
Twenty family caregivers of PWD at a geriatric hospital in Northern Vietnam were recruited. A total of 30 face-to-face, semi-structured interviews, including 10 follow-up interviews, were conducted. Structural coding was used first to guide data analysis through four structural codes consistent with the four stages of the help-seeking model: (1) disease and symptom experience; (2) explanatory models for symptom appraisal; (3) decision to seek help; and (4) contact with the sources of help. Then thematic coding was used for more detailed and data-driven initial codes to emerge from the data.
Cultural and health beliefs, particularly collectivist values, such as familism and filial piety, shaped each stage of Vietnamese family caregivers' help-seeking process. Caregivers experienced different PWD's symptoms and adopted a mixed explanatory model combining biomedical and folk beliefs to explain the causes of dementia. They highly valued independence, autonomy, devotion to their family, and self-sacrifice, making these values the driving force underlying their self-reliance regime in caregiving. Help-seeking was often delayed until caregivers considered the situation to be beyond their own capacity to manage independently. The family was always the primary informal source of support for caregivers, with additional help sought from friends, neighbors, and religious facilities. Health professionals, if available, were also an important formal source for medical advice.
The results highlight the importance of culture and health beliefs in shaping caregivers' help-seeking process, and advocate the needs of service development targeting not only Vietnamese family caregivers for PWD, but also caregivers sharing similar collectivist culture in different areas. Interventions and services that are consistent with their values of self-sacrifice, devotion to family, autonomy, and self-reliance are much needed.
本研究旨在探讨越南痴呆症患者（PWD）家庭照顾者的求助过程，以及健康和文化信念如何影响这一过程。
在越南北部的一家老年医院招募了 20 名 PWD 的家庭照顾者。共进行了 30 次面对面的半结构化访谈，其中包括 10 次随访访谈。首先使用结构编码通过与求助模型的四个阶段一致的四个结构编码来指导数据分析：（1）疾病和症状体验；（2）症状评估的解释模型；（3）寻求帮助的决定；和（4）与帮助来源的接触。然后使用主题编码为数据中出现的更详细和数据驱动的初始代码。
文化和健康信念，特别是集体主义价值观，如家庭主义和孝道，塑造了越南家庭照顾者求助过程的各个阶段。照顾者经历了不同的 PWD 症状，并采用了结合生物医学和民间信仰的混合解释模型来解释痴呆症的原因。他们非常重视独立、自主、对家庭的奉献和自我牺牲，使这些价值观成为他们在照顾中自力更生的动力。求助往往会延迟到照顾者认为情况超出了自己独立管理的能力。家庭始终是照顾者的主要非正式支持来源，还会从朋友、邻居和宗教场所寻求额外的帮助。如果有医疗专业人员，他们也是提供医疗建议的重要正式来源。
研究结果强调了文化和健康信念在塑造照顾者求助过程中的重要性，并提倡不仅针对越南 PWD 的家庭照顾者，而且针对在不同地区具有相似集体主义文化的照顾者，需要制定服务发展计划。需要提供与他们的自我牺牲、对家庭的奉献、自主和自力更生的价值观相一致的干预措施和服务。
