Client-Centred Concepts in a Personalized E-Mail Support Intervention Designed for Chinese Caregivers of Family Members with Dementia: A Qualitative Study:

Objective A new personalized e-mail supported intervention was designed based on client-centred occupational therapy concepts. Research showed that the new intervention benefit Chinese caregivers. This study aimed to analyze the content and process of the new intervention and explore how the client-centred concepts can be applied to Internet-mediated intervention. Methods Twenty-eight Chinese Canadian family caregivers exchanged e-mails with Chinese clinicians for 6 months. E-mail was the sole form of communication between the caregivers and clinicians who provided conventional one-to-one support intervention via the e-mail medium. All e-mail exchanges were analyzed using an open coding system. Results The communication process through e-mail exchanges paralleled those presented in face-to-face support interventions. The caregivers' approach to caregiving was guided by Chinese beliefs in (a) honouring and respecting parents and grandparents; (b) sharing the care among family members, thereby insuring a harmonious family life; and (c) shaping emotional responses to avoid disruption to the harmonious family life. Core client-centred concepts were reflected in the intervention strategies, and the caregivers were responsive to the strategies. Therapists used special questions and responses to compensate for a lack of nonverbal cues in the communication process but had difficulty in assessing what prevented some caregivers from participating in the intervention process. Conclusion Client-centred occupational therapy can be successfully applied in the context of e-mail intervention and benefited Chinese caregivers. As the Internet has become a daily activity among many clients and occupational therapists, more studies are needed to advance the theory and practice of Internet-mediated occupational therapy.