Abstract WP381: The Culture Influence on Coping and Adaptation to Stroke Caregiving: the Chinese Family Caregivers’ Experience

Introduction: In China, the estimated number of stroke survivors is 22.5 million, of which 78% need home care. It has been indicated that culture could play a major role on the stroke caregiving experiences. Understanding stroke caregivers’ coping and adaptation within Chinese culture is needed. Objective: To explore how Chinese culture influences the coping and adaptation to stroke caregiving among stroke caregivers. Methods: In this qualitative descriptive study, 25 stroke caregivers (age 52±15.6, 60% female, 58% children-caregivers, 40% spouse-caregivers) were recruited from an 1800-bed regional hospital in China. Data were collected through individual, semi-structured interviews. Qualitative content analysis was performed. Member checking, triangulation of the data and peer debriefing were used to achieve trustworthiness. Results: Three themes emerged from the interviews reflecting the influence of Chinese culture on stroke caregiving: (1) Caregiving role adaptation. Confucianism, which emphasizes duties and responsibilities profoundly influences Chinese world views. Chinese caregivers accepted caregiving for the sick family member as an expected part of life and caregiving is a culturally prescribed obligation. (2) Emotional coping strategies. The emotional coping strategies adopted by caregivers including relying on religion and discussing their feeling with families. Fatalistic appraisal has been described as an emotional coping strategy and Chinese caregivers reported cognitive appraisal of belief system involving ‘ Ming ’ (fate) to help them adapt the caregiving reality. (3) Passive help seeking attitude and behaviors. Chinese caregivers identified self-tolerance and traditional belief of ‘ Ren ’(tolerance)as a negative coping. Chinese caregivers did not actively seek professional/ community help and reluctant to turn to their families and friends for support even though they felt very helpless and isolated. Conclusions: An underlying coping and adaptation of undertaking stroke caregiving within Chinese culture is highlighted in our findings. Researchers and health care professionals who plan to develop a support intervention for Chinese stroke caregivers need to put culture in context.