Please do not remove this page The influences of Thai Buddhist culture on cultivating compassionate relationships with equanimity between nurses, patients and relatives : a grounded theory approach Chinnawong, Tippamas https://researchportal.scu.edu.au/discovery/delivery/61SCU_INST:ResearchRepository/1267148400002368?l#1367375620002368 Chinnawong, T. (2007). The influences of Thai Buddhist culture on cultivating compassionate relationships with equanimity between nurses, patients and relatives: a grounded theory approach [Southern Cross University]. https://researchportal.scu.edu.au/discovery/fulldisplay/alma991012821675802368/61SCU_INST:Research Repository Southern Cross University Research Portal: https://researchportal.scu.edu.au/discovery/search?vid=61SCU_INST:ResearchRepository [email protected] Open Downloaded On 2021/09/24 22:56:14 +1000 Please do not remove this page The Influences of Thai Buddhist Culture on Cultivating Compassionate Relationships with Equanimity between Nurses, Patients and Relatives: A Grounded Theory Approach Tippamas Chinnawong RN., B.N.S., M.N.S. (Adult Nursing) A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy May, 2007 Department of Nursing and Health Care Practices School of Health and Human Sciences Southern Cross University Lismore, New South Wales, 2480 STATEMENT OF SOURCES I, Tippamas Chinnawong, declare that the work presented in this thesis is, to the best of my knowledge and belief, original, aspect as acknowledged in the text, and that the material has not been submitted, either in whole or in part, for a degree at this or any other university. Signed ………………………………………………………Date………………………… ii Dedication This study is dedicated to nurses, patients, and patients’ relatives who are sharing the truth of life, facing both suffering and happiness in the process of caring for illness, death and dying, who are cultivating compassionate acts with equanimity and supporting each other in alleviating suffering, promoting comfort and preparing for a peaceful death. iii ACKNOWLEDGEMENTS I am deeply honoured to have the chance to do grounded theory research in spirituality and holistic nursing care, exploring the influences of the Thai Buddhist culture on nurses’, patients’ and relatives’ relationships in Thailand. This thesis could not be completely finished without direct and indirect support from people and sacred power from all directions of my life. I believe that other people, the universe, and I always relate to and support each other by the gentle flow of breathing in and breathing out. Thank you very much to Thai Government, the Ministry of Education (previously the Ministry of University), and related staff who offered a scholarship, provided a chance to study in Australia, and for their wonderful support. I give my thanks to the Office of the Civil Service Commission, Office of Educational Affairs in Canberra, Australia, for their assistance while I studied in Australia. Thanks to my supportive colleagues at the Faculty of Nursing, Prince of Songkla University, Thailand, expecially Associate Professor Arphorn Churprapaisilp, who introduced me to my supervisor. You all gave me the best chance in my life to study overseas, to learn and absorb the best from the Australian people, the university and a multicultural setting. I pay homage to the Buddha, the Dhamma, and the Sangha for cultivating my compassion and guiding me to gain deep understanding about working and living with mindfulness, compassion and equaminity while dealing with multiple suffering in my personal, work, and study life especially in the four years of hard work during this PhD. I am grateful to Barney G. Glaser, Anselm Strauss, Juliet Corbin, and the qualitative and grounded theory researchers who opened new ways of thinking, provided methods and processes for social and nursing research, and provided me with flexible guidelines to do grounded theory research. A respectful acknowledgement is for my participants: nurses, patients and relatives, my great teachers, who shared their stories about compassionate and spiritual caring relationships. iv The greatest acknowledgement is to my superb supervisor, Professor Bev Taylor, who is my teacher, sister, and spiritual supporter. She has become my spiritual friend who always understands, helps, and supports. Thank to all caring staff and PhD friends at the Department of Nursing and Health Care Practices, especially Ms. Chris Game, Associate Professor Dr Nel Glass, Dr Kierrynn Davis, Jill Barwick, Carmen Zammit, Susan Westwood, Linda, and Jane. Thanks to my critical friends: Dr Neville Jennings, Dr Leonie Jennings, Dr Arphorn, Pe Sukulya, Pe Sawangpong and Pe Steven, who shared the idea of doing qualitative research about Buddhist spirituality. To my wonderful editors, Jude Belcher, Sue Cronen, Kim Luckman and Pe Pratin, my English has gradually improved because of you. Thanks to Tricia Freely and Chris Garlick, for being the best English teacher and moral supporter. Chris Tricia and English teachers from English Language Centre thank you also. Thanks to the friendly staff at the International Office, computer room, and library, at Southern Cross University, especially at the document supply section, and the learning assistance unit. Thanks to my wonderful homestay families, Peggy and Mark Predebon, their warm family and friends: Cecily, Michel and Susie. Mark tried to teach me to drink wine, but I always failed this subject. Peggy will always be with me whenever I am happy or sad. She is my beloved sister. Bede, my brother, and Fabia, my dear sister, played with me and taught me to play with Barbie. She also tried to teach me to speak English with her dolls. Lexie and Peter, and Uncle Ken are my best friends in my homestay family, who took care of me as one of their daughters. To my Thai friends and families, especially Pe Nee, Pa Su, Pe Rin, Pe Pa, Pe Tuk, Pe Wan. Thank you for very yummy hot and spicy Papaya Salad, Thai Curry, chilli paste and fresh spring rolls. You made my life comfortable and it felt like home. Also Pe Tin who always gave me some herbs, cheered me up and encouraged me to improve my writing skills. Thank you Pe Pok, P Boon, P Ta, Tony, Nong Jib, Leky, Noi, Goi, and nong Nan, who shared their happiness and support with each other. I’d also like to thank all my good friends at Sirius College and at SCU, expecially Aethea, David, Judy, Alana, Nick, Belinda, Kim, Julia, Ankie, Vanessa, Diep, Vi, Bao, Sunny, Ephraim, Phosai, Gloria, and Atsushi. Thanks to many Thai sisters and friends, especially Pe Sa, Pe Nai, Pe Nom, P Taew, Pe Su, Pe Ying, Pe Hong, Pe Aree, Nong O, Pe Peak, Pe Luay, Pe Ra, Ly, Tas, Jang, Maew, Lak, Cake, Pui, Pure, Pla, Yui, and Nok, who were always ready to listen to my sad stories and be with me when I needed help and suport. Thank you my spiritual friends for taking care of my sick parents while I studied overseas. I am also remember with gratitude the very supportive environment, the bus drivers and friendly people from the very peaceful town of Lismore, a herd of cows in the farm near the Sirius residence, chilli trees and herb gardens at the Sirius college, and all the sacred power and sources of healing energy around us: the Australian blue sky, the sun, the moon, the rain, wonderful weather, beautiful birds, flowers, trees, parks, beaches, and the peaceful field in front of my unit which helped me calm my mind and get ready to keep writing my thesis. Finally, I’d like to thank my parents, sisters, and brothers in Thailand for all their support. I am deeply grateful to Pe Sukanda Chinnawong who, since I was born, has taken care of me as the second mother and always nurtured my freedom and creativity with her kindness and compassion, Pe Wanpimol Chinnawong who devotes herself to help me take care of our sick parents while I am staying so far away from home. Thank you, everybody and everything, for providing learning power and moral support so I could complete my thesis. May good health, peace and happiness be with you all. Thank you very much. ABSTRACT The Influences of Thai Buddhist Culture on Cultivating Compassionate Relationships with Equanimity between Nurses, Patients and Relatives: A Grounded Theory Approach Thai Buddhist people, especially elderly patients, usually apply Buddhist teachings to deal with illness and death. This grounded theory research was developed to explore the influences of Buddhist culture on nurse-patient-relative relationships in Thailand. The purposes were to highlight the importance of the spiritual dimension in nursing care and examine ways in which nurses can use Buddhist principles to improve nursing care. Seventeen registered nurses, 14 patients and 16 relatives were purposely selected. The semi-structured interviews and audio tape recording took place in Thailand from October 2003 to March 2004. Three steps of analysis: open, axial and selective coding (Strauss & Corbin, 1998) were conducted. “The Cultivation of Compassionate Relationships with Equanimity between Nurses, Patients and Relatives” emerged as the basic social process, which were composed of the three co-processes including: 1) facing suffering/understanding the nature of suffering, 2) applying Dhamma (Buddhist beliefs and practices), personal/local wisdom, and traditional healing, and 3) embodying compassion with equanimity. Such relationships showed influences of Buddhism and Thai culture, and highlighted patient- relative centred care. Personal, professional and organisational