Understanding friends and family members' experiences of going abroad with medical tourists

89 Pages·2013·5.83 MB·English

by  Vicky Casey

Understanding friends and family members’
experiences of going abroad with medical tourists
by
Victoria Casey
B.A.Sc., University of Lethbridge, 2010
Thesis Submitted In Partial Fulfillment of the
Requirements for the Degree of
Master of Arts
in the
Department of Geography
Faculty of Environment
© Victoria Casey 2013
SIMON FRASER UNIVERSITY
Summer 2013
Approval
Name: Victoria Casey
Degree: Master of Arts
Title of Thesis: Understanding friends and family members’ experiences
of going abroad with medical tourists
Examining Committee: Chair: Anders Knudby
Assistant Professor
Valorie Crooks
Senior Supervisor
Associate Professor
Nadine Schuurman
Internal Examiner
Professor
Paul Kingsbury
External Examiner
Associate Professor
Date Defended/Approved: July 25, 2013

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Partial Copyright Licence

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Ethics Statement

The author, whose name appears on the title page of this work, has obtained, for the
research described in this work, either:
a. human research ethics approval from the Simon Fraser University Office of
Research Ethics,
or
b. advance approval of the animal care protocol from the University Animal Care
Committee of Simon Fraser University;
or has conducted the research
c. as a co-investigator, collaborator or research assistant in a research project
approved in advance,
or
d. as a member of a course approved in advance for minimal risk human research,
by the Office of Research Ethics.
A copy of the approval letter has been filed at the Theses Office of the University Library
at the time of submission of this thesis or project.
The original application for approval and letter of approval are filed with the relevant
offices. Inquiries may be directed to those authorities.
Simon Fraser University Library
Burnaby, British Columbia, Canada
update Spring 2010
Abstract
When patients privately obtain a medical procedure abroad they are engaging in medical
tourism. Friends and family members often accompany medical tourists abroad to
provide care, and are herein referred to as caregiver-companions. This thesis provides a
broad understanding of caregiver-companions from an industry perspective. Interviews
were conducted with medical tourism facility staff members who interact closely with
caregiver-companions: International Patient Coordinators (IPCs). Twenty-one IPCs who
work in nine countries were interviewed. Thematic analysis of these interviews resulted
two analyses. The first examines the care roles taken on by caregiver-companions. The
second examines the challenges that informal caregiving in medical tourism can present
to medical tourists, facility staff, and caregiver-companions themselves. This thesis
concludes that while caregiver-companions provide valuable care to medical tourists,
with assistance from IPCs, they are not fully incorporated as caregivers in the medical
tourism industry.
Keywords: Medical tourism, informal caregiving, international patient coordinators,
qualitative analysis, international health care, family caregiver
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Dedication
This thesis is dedicated to my family for their
lifelong love, support and encouragement, and
to my fiancé who has been an ongoing source of
motivation and inspiration.
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Acknowledgements
I would like to express my gratitude to my supervisor, Valorie Crooks, for being my
tireless cheerleader. Her guidance and enthusiasm kept my standards high and reminded
me of the payoff that comes from persistence. To the research collaborators who co-
wrote the articles herein, Jeremy Snyder and Leigh Turner, I would like to give my
thanks for sharing their thoughts, expertise and time with me. I would also like to thank
my lab-mates: Rory Johnston, Krystyna Adams, and Melissa Giesbrecht who gave me
their advice and support from the beginning. Furthermore, this thesis could not have
been possible without the willingness of the research participants who volunteered their
time and shared their experiences, for which I am grateful. Finally I would like to thank
my loved ones who have bolstered my spirits and offered me a fresh perspective on the
project.

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Table of Contents
Approval.............................................................................................................................ii

Partial Copyright Licence..................................................................................................iii

Abstract..............................................................................................................................iv

Dedication............................................................................................................................v

Acknowledgements............................................................................................................vi

Table of Contents..............................................................................................................vii

List of Tables.....................................................................................................................ix

List of Figures....................................................................................................................ix

List of Acronyms.................................................................................................................x

Glossary.............................................................................................................................xi

1.
  Introduction.................................................................................................................1

1.1.
  Background on Medical Tourism...............................................................................3

1.2.
  Informal Caregiving in Medical Tourism...................................................................6

1.3.
  Study Overview..........................................................................................................7

1.4.
  Thesis Outline.............................................................................................................9

2.
  Knowledge Brokers, Companions, and Navigators: Informal Caregivers’
Roles in Medical Tourism......................................................................................11

2.1.
  Background...............................................................................................................11

2.2.
  Methods....................................................................................................................14

2.2.1.
  Participants....................................................................................................14

2.2.2.
  Data collection..............................................................................................15

2.2.3.
  Analysis.........................................................................................................16

2.3.
  Findings....................................................................................................................16

2.3.1.
  Knowledge Broker........................................................................................19

2.3.2.
  Companion....................................................................................................21

2.3.3.
  Navigator.......................................................................................................22

2.4.
  Discussion.................................................................................................................24

2.4.1.
  Future Research Directions...........................................................................28

2.4.2.
  Limitations....................................................................................................29

2.5.
  Conclusions...............................................................................................................30

3.
  “You’re dealing with an emotionally charged individual…”: An industry
perspective on the challenges posed by medical tourists’ informal
caregiver-companions.............................................................................................32

3.1.
  Background...............................................................................................................32

3.2.
  Methods....................................................................................................................35

3.2.1.
  Recruitment...................................................................................................36

3.2.2.
  Data collection..............................................................................................37

3.2.3.
  Analysis.........................................................................................................38

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3.3.
  Findings....................................................................................................................38

3.3.1.
  Caregiver-companions can require time, attention, and resources...............39

3.3.2.
  Caregiver-companions can disrupt the provision of quality care.................41

3.3.3.
  Caregiver-companions can be exposed to risks............................................43

3.4.
  Discussion.................................................................................................................46

3.4.1.
  Directions for future research.......................................................................50

3.4.2.
  Limitations....................................................................................................51

3.5.
  Conclusions...............................................................................................................52

4.
  Conclusion.................................................................................................................54

4.1.
  Introduction...............................................................................................................54

4.2.
  Summary...................................................................................................................55

4.3.
  Revisiting the Objectives..........................................................................................58

4.4.
  Research Contributions.............................................................................................59

4.5.
  Future Research Directions.......................................................................................60

4.6.
  Importance................................................................................................................62

4.7.
  Conclusion................................................................................................................63

References.........................................................................................................................65

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List of Tables
Table 1: Selected interview questions................................................................................37

List of Figures
Figure 1.
  Shared space between the medical tourist and informal caregiver.................18

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