The experience and meaning of caring for urban family caregivers of persons with strokes

This ethnographic study examined the experience and meaning of caring as it influences urban family caregivers\u27 (UFCs) capacity to care for persons with stroke within African American family systems. This study was executed within and supported the Framework of Systemic Organization (Friedemann, 1995), according to which families as open systems strive for congruence, a dynamic state of equilibrium, evidenced as health. In trying to achieve this state, each family\u27s style of function is different, depending on the family\u27s emphasis on Friedemann\u27s process dimensions: system maintenance, system change, coherence, and individuation. The major research questions were the following: (a) What is the experience of caring?—at are the perceived and observed caring actions related to Friedemann\u27s process dimensions? (b) What is the meaning of caring? —what are the perceived and observed personal and family congruence related to caring? and (c) What expressed caring actions and what expressions of congruence are universal or cultural bound? A purposive sample of 8 UFC key informants and 16 UFC general informants from a community in northwestern Ohio participated in interview and observation-participation field techniques. Domains of caring revealed that the experience of caring involved eight caring actions (i.e., caring is physical work, sacrifice, taught and shared, structured, communication, accommodation, mutuality, and learned) and four caring family functions (i.e., adaptation in families, in caregivers\u27 enforcement of old values, in caregivers\u27 watchfulness, and in differences in filial function). The meaning of caring concerned 13 affective caring expressions (i.e. emotional burden; evasion of conflicts; motivations concerned with love and a sense of duty, care recipients\u27 approval, and philosophical introspection; self-development; fairness; filial ethereal value; self-contemplation; filial and Christian piety; living in the moment and hoping for the future; and purpose). Cultural patterns were maintained and transformed within the domains of caring actions, family functions, and expressions for these UFCs in African American settings. The findings aid in understanding the concept of caring as an interpersonal process, place the concept of caring in a family system context and examine cultural patterns and diversity as well as common trends, and test the propositions underlying the Framework of Systemic Organization