Gujarati Hindu carers : their experiences with primary health care nursing services
A pragmatic qualitative approach located within the research tradition of retrospective accounts was adopted and the perspectives of different types of carers, caring at home were obtained. The views of primary health care nurses were sought to examine their perspectives of caring for minority ethnic carers and the views of health service managers sought to examine their views about how primary health care nurses provide support for carers. A total of 43 in-depth interviews were conducted. A fieldwork diary was kept throughout the study and the data were analysed using a framework approach. The findings identified that despite policy intentions that health services should meet carers' needs and emphasis on the need for partnership, there was little evidence of this. Rather, Gujarati Hindu carers were not supported because primary health care nurses adopted a restricted model of the `patient-centred' approach to caring and failed to fully involve carers in holistic assessment. This subsequently affected their ability to access information, overcome communication difficulties and their need for emotional support. The interviews with primary health care nurses confirmed carers' claims of being unsupported. Primary health care nurses focused their attention on patients and viewed carers' needs as secondary. Health service managers also endorsed this view. An explanatory model is developed. It shows that socio-economic factors, carers' general material disadvantage, lack of awareness about service provision, coupled with primary health care nurses' lack of recognition of the need for support, compounded further by institutional racism and structural issues in the health services all served to disadvantage carers.