Table 1: Session description and materials.
|S No||Session One (S1). Opening up to caring for yourself|
This session was conducted to raise awareness of and normalize caregivers' oppressed feelings or demands within a culturally appropriate context.
The booklet (You're not alone: what I want you to know about your emotional health) contained quotes from working female caregivers regarding their oppressed feelings or demands, which were derived from the results of a previous qualitative study addressing the demands of the caregivers on emotional support and task-sharing from her spouse, and the caregivers' need for self-care. Booklet reading assisted caregivers in feeling that they were not alone by informing them that caregivers experienced those feelings or demands. The writing log (My notebook) was implemented to assist the caregivers in expressing and releasing distress.
The caregivers were encouraged to write about any sensitive and/or negative circumstances that they had experienced but did not feel like talking about with others for four days. Topics were suggested and changed as the project proceeded. A stopwatch and compact shredder were provided to destroy and dispose of the contents. In accordance with the value placed on protecting family privacy in Japan, the contents of the log were disposed of four days after its completion.
However, the caregivers were welcomed to submit the log contents to nurse educator (NE; the author) if they desired to do so. In light of this value, NE avoided discussing the contents with the caregiver.
Materials: Baseline measurements, a booklet, and a writing log.
|2||Session Two (S2). Being skilled at caring for yourself|
One week after S1, the caregivers learned how to become skilled at caring for themselves. A tip-sheet for self-care activities, which contained leisure activities related to self-care in women, was provided as an at-home assignment to encourage caregivers to stay motivated when undertaking with certain activities.
NE further asked each caregiver to jointly participate in the fourth session (session four: S4) with her spouse. If the couple agree to participate in S4, NE asked the caregiver to provide her spouse with the booklet and ask her husband to participate in booklet reading.
The booklet reading helped the spouse learn to be aware of his wife's oppressed feelings or demands.
Materials: Tip-sheet for self-care activities for caregivers, booklet (the same material provided to the caregiver for spouse).
|3.||Session Three (S3-i and S3-ii). Reflecting upon oneself as an organizer of self-care|
In S3-i, which was conducted two weeks after S2, NE evaluated the caregivers' use of the tip-sheet and encouraged its continued use during their three following weeks (S3-ii). This session added to the caregiver's recognition of herself as the organizer and creator of a healthy lifestyle when facing increased time or workload requirements due to worsening care-receiver health status. The caregivers learned skills for adjusting self-care activities when these issues occurred.
Material: Tip-sheet for self-care activities.
|4.||Session Four (S4). Being positive in expressing the feelings to husbands|
A joint session including the caregiver's spouse was conducted between S3-i and S3-ii. After obtaining signed informed consent, the spouse was encouraged to verbally express any thoughts regarding the caregiver's oppressed feelings or demands and provision of emotional support for and task-sharing with the caregiver. Spouses' current interpersonal support was re-examined by engaging with both spouses during this session, which helped the caregiver to feel free to express her feelings or demands regarding emotional support and task sharing to her spouse. By providing knowledge regarding what the spouse thought about the caregiver or caregiving for the aging-parent, it further strengths the caregiver's feeling of acceptance by spouse.
Material: A joint session was conducted with both spouses serves, which served as an educational resource for caregivers in terms of feeling of acceptance by spouse.
|5.||Session Five (S5). Defining yourself as capable of problem solving|
In the final session, which was conducted one week after S4, the caregivers participated in an exit interview and post-intervention test.
The interview helped the caregiver to internalize a new view of herself as a skilled woman who was confident in problem solving and had a spouse capable of providing interpersonal support rather than solely participating in task-sharing.
Material: Post-intervention test.
Contents of the booklet from Hashizume (2010) ; tip-sheet for self-care activities Colburn K (2003) The Women’s Book of Simple Delights: Running press: PA (2003); writing log from Pennebaker (2004) .