Document Type : Original Article


Department of Community Health Nursing, Boromarajonani College of Nursing Nakhon Phanom, Nakhon Phanom University, Nakhon Phanom, Thailand


BACKGROUND: Informal and formal caregivers of older adults with noncommunicable 
diseases (NCDs) are important in every aspect of current caregiving for older adults by understanding 
reality specific to direct experiences perceived by each person in caring for older adults in order to 
develop nursing knowledge and using knowledge to plan care for older adults with NCDs to have a 
good quality of life. The current study aimed to investigate the points of view on factors concerning 
the care provided by informal and formal caregivers providing care for older adults with chronic 
diseases in the community.
MATERIALS AND METHODS: This study was conducted with a qualitative design. The sample 
was 5 informal and 20 formal caregivers providing care for patients with chronic diseases, namely 
hypertension and diabetes mellitus. Furthermore, a qualitative approach was used with four focus 
groups (FGs) with 25 informants. Data were collected during March–August 2021 in rural communities 
of Nakhon Phanom Province, Thailand. Finally, the qualitative analysis used content analysis; FG 
data were analyzed using content analysis in which a preliminary set of codes was determined 
according to other documented experiences of patients.
RESULTS: The findings revealed three main themes emerging in the data obtained on the perceived 
factors contributing to the care provided by informal and formal caregivers: “caregivers’ knowledge,” 
“factors related to caregivers” and “community factors.”
CONCLUSION: Points of view on the factors correlated with the care provided by informal and formal 
caregivers of older adults with chronic diseases that explain and confirm the findings can be used to 
plan care with effects on quality of life among older adults with chronic diseases.


1. GBD 2015 Risk Factors Collaborators. Global, regional, and 
national comparative risk assessment of 79 behavioural, 
environmental and occupational, and metabolic risks or clusters 
of risks, 1990–2015: A systematic analysis for the Global Burden 
of Disease Study 2015. Lancet, 2016; 388(10053):1659‑1724.
2. Bureau of Non‑Communicable Disease, Department of Disease 
Control, Ministry of Public Health; 2010. Available from: 
http://e‑ [Last cited 
on 2020 Jan 10].
3. Yang SO, Jeong GH, Kim SJ, Lee SH. Correlates of self‑care 
behaviors among low‑income elderly women with hypertension 
in South Korea. J Obstet Gynecol Neonatal Nurs 2014;43:97‑106.
4. Machado BM, Dahdah DF, Kebbe LM. Caregivers of family 
members with chronic diseases: Coping strategies used in 
everyday life. Cad Bras Ter Ocup 2018;26:299‑313.
5. Shakibazadeh E, Sabouri M, Mohebbi B, Tol A, Yaseri M. Validity 
and reliability properties of the Persian version of perceived health 
competence scale among patients with cardiovascular diseases. 
J Educ Health Promot 2021;10:19.
6. Kitzinger J. The methodology of Focus Groups: The importance 
of interaction between research participants. Sociol Health Illn 
7. Elo S, Kaarianinen M, Kanste O, Polkki R, Utriainen K, Kyngas H. 
Qualitative content analysis: A focus on trustworthiness. Sage 
Open 2014;4:1‑10.
8. Martins G, Corrêa L, Caparrol AJ, Santos PTA, Brugnera LM, 
Gratão ACM Sociodemographic and health characteristics of 
formal and informal caregivers of elderly people with Alzheimer’s 
Disease. Anna Nery 2019;23:1‑10.
9. Almeida LP, Meneses TM, Freitas AV, Pedreira LC. Social and 
demographic characteristics of elderly caregivers and reasons to 
care for elderly people at home. Rev Min Enferm 2018;22:E‑1074.
10. Santos‑Orlandi AA, Brito TRP, Ottaviani AC, Rossetti ES, 
Zazzetta MS, Gratão ACM, et al. Profile of older adults caring 
for other older adults in contexts of high social vulnerability. Esc 
Anna Nery 2017;21:E1‑8.
11. Shiba K, Kondo N, Kondo K. Informal and formal social support 
and caregiver burden: The AGES caregiver survey. J Epidemiol 
12. Liu J, Liu Q, Huang Y, Wang W, He G, Zeng Y. Effects of personal 
characteristics, disease uncertainty and knowledge on family 
caregivers’ preparedness of stroke survivors: A cross‑sectional 
study. Nurs Health Sci 2020;22:892‑902.
13. Daniel WL. Effect of financial costs on caregiving burden of 
family caregivers of older adults. SAGE Open 2012;2: 1‑14. [doi: 
14. Diameta E, Adandom I, Jumbo SU, Nwankwo HC, Obi PC, 
Kalu ME. The burden experience of formal and informal 
caregivers of older adults with hip fracture in Nigeria. SAGE 
Open Nurs 2018;4:1‑10
15. Larkin M, Henwood M, Milne A. Carer‑related research and 
knowledge: Findings from a scoping review. Health Soc Care 
Community 2019;27:55‑67.
16. Sareeso P, Praison P, Thohinung U, Umsrewaing W, Fongrat N.
The situation, health problems and care needs of older persons 
with chronic illness: Chiangrai municipality. J Nurs Sci Health 
17. Diniz MA, Melo BR, Neri KH, Casemiro FG, Figueiredo LC, 
Gaioli CC, et al. Comparative study between formal and informal 
caregivers of older adults. Cien Saude Colet 2018;23:3789‑98.
18. Greenwood N, Pound C, Brearley S, Smith R. A qualitative study 
of older informal carers’ experiences and perceptions of their 
caring role. Maturitas 2019;124:1‑7.
19. Levasseur M, Routhier S, Clapperton I, Doré C, Gallagher F. 
Social participation needs of older adults living in a rural regional 
county municipality: Toward reducing situations of isolation and 
vulnerability. BMC Geriatr 2020;20:456.
20. Durch JS, Bailey LA, Stoto MA, editors. Improving Health 
in the Community: A Role for Performance Monitoring. 
Washington (DC): National Academies Press (US); 1997. [doi; 
21. Smith M, Saunders R, Stuckhardt L, McGinnis M, editors. Best 
Care at Lower Cost: The Path to Continuously Learning Health 
care in America, Committee on the Learning Health Care System 
in America; Institute of Medicine; Washington (DC): National 
Academies Press (US); 2013.
22. Ploeg J, GarnettA, Fraser KD, BairdLG, Kaasalainen S, McAiney C,
et al. The complexity of caregiving for community‑living older 
adults with multiple chronic conditions: A qualitative study. 
J Comorb 2020;10:1‑12
23. Mohebbi B, Sabouri M, Tol A. Application of health education 
and promotion theory‑based interventions on patients with 
cardiovascular disease: A systematic review. J Educ Health 
Promot 2021;10:236.