Abstract
BackgroundChronic disease poses a global health challenge and is a leading cause of death worldwide. Living with chronic disease impacts both those diagnosed and their carers, who are often immediate family members undertaking an informal caring role. As the prevalence of chronic diseases increases, so does the number of informal carers, including a subgroup known as ‘immigrant informal carers’. Individuals in this subgroup, immigrant informal carers play a vital role in their family members’ care of chronic illness. However, there is limited understanding about the experiences of Australian immigrant informal carers.
Purpose
The purpose of this research study was to explain the immigrant informal caring experiences of those caring for family members living with chronic conditions in Australia.
Methods
This research study conducted an holistic multiple-case study design, as recommended by Yin (2018). The researcher used Berry’s acculturation model and Bowen’s family system theory as conceptual frameworks to inform the research design. The ‘case’ of this research study was the relationship between the immigrant informal carers and their care recipients (partner/spouse, adult child, and parent). The overall research question aimed to understand how personal and social beliefs and values influence the caring experiences of immigrant informal carers with the objective to explain more about these cases. Conducted between August 2019 and May 2024, this research study unfolded in three phases. Phase One, document (archival) analysis, explored concepts about immigrant informal carers’ caring experiences and determined the units of analysis for subsequent phases through document analysis. Phase Two researched through individual interviews with 15 participants. Phase Three sought greater detail and explanation through additional five interviews, focusing on influential concepts about the experiences of immigrant informal carers. The researcher used purposive and snowball sampling techniques to recruit participants. The purposive sampling technique allowed the researcher to recruit participants who aligned to the inclusion criteria of this research study and who could provide details focused on the inquiry; that of Australian immigrants acting as informal carers for family members living with chronic conditions. The snowball sampling technique involved asking early participants to refer other potential participants from their social networks who appeared to meet the criteria of being Australian immigrants carers in Australia. Following ethical approval granted, Phase One data were collected and analysed using content analysis and then changed to thematic analysis to compare Phase One to Phase Two to see if secondary research questions had been answered. The transcribed verbatim of audio-recorded interviews, field notes and audit trails (Phases Two and Three) were thematically analysed. Advanced analysis to further compare phases and cases was implemented using Yin’s (2018) analytical strategies and techniques, specifically theoretical propositions and explanation building to synthesize the results.
Results
Phase One findings identified three groups of units of analysis related to immigrant informal carers, their caring experiences, and their care recipients’ caring needs. These findings were key to explaining immigrant informal carers’ caring experience in Australia. Phase One highlighted a lack of evidence and knowledge concerning immigrant informal carers’ caring experiences in Australia. Phase Two findings revealed both similarities and differences across cases. However, the researcher was yet to gain deeper understanding of how social influences shape immigrant informal caring. Phase Three findings further explained concepts that influenced immigrant informal carers’ caring experiences in Australia, adding depth to explaining this complex phenomenon. This research study determined the complexity of immigrant informal carers’ caring experiences in Australia, a complex social phenomenon. This research study confirmed some previously highlighted concepts from the literature and introduced new contributions to current knowledge. Previously highlighted concepts included the increased number of immigrant informal carers, complex caring experiences, caring influencing health and wellbeing of informal carers, need to balance life and caring, for carer’s health and wellbeing, gender-driven caring tasks, stigma and discrimination, residing in socially disadvantaged conditions, choice of cohabitation with their care recipient, and the impact of caring on the carer-care recipient relationship. New contributions arising from this research study that has expanded what is known about immigrant informal carers were the influence of concepts like immigrant informal carer’s level of education, length of stay in Australia, choice of cohabitation, choice of uptake in the informal carer’s role, English proficiency, navigating healthcare services, changes in family dynamics (but not carer care recipient relationship), and professionals not providing acculturation-sensitive care.
Recommendations
This research recommends systematic changes in healthcare and social services to accommodate needs of immigrant informal carers, promoting inclusivity, and support their caring role. One recommendation related to immigrant informal carers is to provide education in both their original and host languages. This aims to improve their understanding of chronic conditions and mainstream healthcare services and enhance their communication with healthcare and social professionals. A recommendation for healthcare professionals is to expand and adopt their engagement with immigrant informal carers through providing acculturation-sensitive care. This comprises acknowledging their cultural norms and caring practices, including evolving gender roles. Another recommendation related to healthcare and social services is to implement targeted education and training on acculturation-sensitive care with strategies to provide tailored support to immigrant informal carers. Policies need to address financial hardships faced by immigrant informal carers, which could support them in sustaining their caring role. Future research should explore the unique challenges faced by newly arrived (less than 10 years) immigrant informal carers, as well as the influences of changing dynamics within immigrant families on their caring experiences.
| Date of Award | 24 Jun 2024 |
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| Original language | English |
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| Supervisor | Margaret Yen (Supervisor), Jennieffer Barr (Supervisor) & Nicola Whiteing (Supervisor) |