Cultural Care among Homebound Older people to Maintain Holistic Health: A Focused Ethnographic Study

Abstract

This focused ethnographic study aims to explore ways of life to maintain holistic health of homebound older people and describe socio-cultural factors that could promote their holistic health. Sixteen homebound adults were purposive selected to be key informants and twenty-three associated informants (family caregivers, health professionals, caregivers, folk doctor, health village volunteer, and community leader) were participated. Data were collected through participant observation, semi-structure interview, and focus group discussion. The content analysis was used to analyze the data following four steps of Leininger. The results showed that all informants perceived holistic health as interrelated with their lifestyles surrounding Thai folk culture. The meaning of holistic health was reflected as “I am alive with good health in my age” which included three sub-themes; 1) “I assume a self-support function, so I am healthy”, 2) “I am in good health because I am able to control my conditions”, 3) I can adapt my living to the changes around me and then I enjoy in my life”. Two main practices to maintain holistic health were; 1) “always taking care of myself to stay healthy”, 2) “keeping contact with family and friends as usual”. Existing health, social care services, and folk care for promoting holistic health were described. Factors that facilitated holistic health maintenance of the homebound older people included 1) “strong family network”, 2) “supportive family network”, and 3) “local wisdom of older people care”. The findings suggested that nurses who work in the community should consider program development for homebound older by integrating meanings of holistic health, beliefs, values, socio-cultural context of care. In addition, some community resource and family support should be encouraged to maintain older people holistic health. Therefore, it is necessary to design and accommodate culturally appropriate care system to improve holistic health of homebound older in southern Thai community.