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RISS 인기검색어
- 검색키워드
- 저자 : Almendarez, Bertha Longoria (검색결과 1 건)
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Mexican American elders and nursing home transition
Almendarez, Bertha Longoria The University of Texas Health Science Center at S 2007 해외박사(DDOD)
This study explores subjective perceptions of factors influencing Mexican American elders and their families during the process of transition from independent living to nursing homes. Specifically, it describes the processes and outcomes of nursing home transitions among Mexican Americans and the cultural beliefs, traditions and norms influencing them. The Mexican American population is now the largest minority ethnic group in the United States. If demographic trends proceed as projected, the number of athnic minorities entering nursing homes in the next 20 to 30 years will greatly increase as will the need for more culturally sensitive care. Little is known about Mexican Americans and factors preceding transition to nursing homes, how decision-making for admission takes place, what influences adjustment to being in a nursing home, or what perceptions family members have about nursing homes. The theoretical frame of reference orienting this study is a middle range theory on transitions (Meleis, et al., 2000). Among its precepts is that late life is a time of multiple transitions and that these multiple transitions form patterns that can be identified and described. It identifies personal, environmental and societal factors affecting the transition process and its outcomes. This study uses a naturalistic inquiry approach and ethnographic methods to learn from 10 Mexican-American dyads (eider and a family member) about the transition to life in a nursing home and how the decision for admission was made. Five questions provided a semi-structured format for interviews. These were followed as needed by structural or contrast questions to uncover more specifics and to discover the cultural meaning of living in a nursing home. Interview data are augmented by quantitative data obtained from instruments for measuring acculturation, acculturatioe stress, and familism, concepts that are relevant to the Mexican American experience in health care decisions, that were used to describe the sample characteristics. Using the transition theory typology as categories, interview data reveal only two types of transitions: situational and health/illness-related and most transition patterns were multiple and/or sequential. Elders reported declining function, and the inability of family members to provide care as preceding nursing home admission, while family members identified elders' changes in behavior and cognition as well. Minimal process indicators emerged to indicate that elders were making healthy transitions. One pattern of response that did emerge specific to this population was the concept of aguantando, a Spanish term for enduring or withstanding, which was used to describe their outcomes as withstanding or tolerating the situation but not necessarily accepting it. In this sample, children and/or extended family were the decision makers. All family participants agreed that they had no other option and would have rather been able to care for their elders at home. All elders felt they had to accept the admission decision as best for the family although not necessarily for them. The paucity of research with samples including Mexican-American elders supports the need for more studies in this area. Naturalistic inquiry elicits the perspective of the Mexican-American elder regarding factors affecting nursing home transition and adaptation to admission. These findings have implications for education, practice, and policy making. More studies based on the transition model will help to further validate the application of this theory to other ethnic groups. Future research should be considered with a focus on the Mexican American caregiver and the transition from caregiver to supporter of care in the nursing home setting.
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