2.50
Hdl Handle:
http://hdl.handle.net/10755/158078
Type:
Presentation
Title:
Basic Social Processes: Mexican American Elders’ Use of Home Care Services
Abstract:
Basic Social Processes: Mexican American Elders’ Use of Home Care Services
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Crist, J., PhD, RN
P.I. Institution Name:University of Arizona, College of Nursing
Contact Address:University of Arizona, CON, PO Box 2, Tucson, AR, 85721-0203, USA
Co-Authors:Garcia-Smith, D, MS, RN
AIMS: Health disparities in Mexican American (MA) elders include higher levels of functional impairment associated with arthritis, cancer, diabetes, stroke, heart attack, and hip fracture, and lower rates of use of home care services (HCS) than Anglo elders. Functional impairment would decrease if client and caregiver (CG) instruction in self-management of diet, exercise, stress, and symptoms; advocacy with medical and other services; rehabilitation; and other personal supportive services benefiting the elder and CG were provided in the home. Lower use of HCS by MA elders, with their higher levels of need, is inequitable. The specific aim was to gain insight into the decision-making process by family caregivers and elders about their decisions to use HCS. The research questions were: 1) What factors (people, events, beliefs) influence elders’ decisions to use HCS? 2) What factors influence CGs’ decisions to accept HCS? 3) What interactions between elders and CGs influence decisions whether to use HCS? 4) How are the decisions made and who makes them? BACKGROUND: A predictive model of MA elders’ use of HCS has been hypothesized in an ongoing study by the principal investigator, based on previous studies about elders’ barriers to using HCS. However, decisions are not made by elders alone. CGs also contribute to the MA families’ decisions whether to use HCS—the focus of this study. METHODS: Interviews were conducted with MA elders (N=12: 8 women and 4 men) and CGs (N=10: 5 women and 5 men) about their process of deciding whether to use HCS, using theoretical sampling. Grounded theory’s constant comparison analysis was used. FINDINGS: Data bits, initially openly coded, later selectively coded, were sorted into categories including Context (Expectations of Familism), Conditions-Qualifiers (Health Event Trajectory, Functional Ability, Service Awareness, Financial Access), Causes-Antecedents (Impression Management, Acculturation, Perceptions of Experiences of Discrimination, Confidence in HCS), Consequences (positive and negative; for elders, CGs and both), and Covariance-Contingencies (Caregiving Burden, availability of family CG and of HCS). Some of these basic social processes (BSP) have been described in previous research. Others (Health Event Trajectory and Impression Management) are new to theories explaining use and non-use of HCS. Further abstraction included referring to existing theory (e.g., satisfying; blending cosmopolitan and local knowledge). IMPLICATIONS: Increased understanding of BSPs influencing MA elders’ and CGs’ decisions to use HCS can inform interventions to reduce health disparities, thus improving or sustaining MA elders’ functional ability, decreasing CG burden, and reducing government spending. Acknowledgements: Funded by the University of Arizona Faculty Small Grants, 2002-2003.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBasic Social Processes: Mexican American Elders’ Use of Home Care Servicesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158078-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Basic Social Processes: Mexican American Elders&rsquo; Use of Home Care Services</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Crist, J., PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Arizona, College of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">University of Arizona, CON, PO Box 2, Tucson, AR, 85721-0203, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Garcia-Smith, D, MS, RN</td></tr><tr><td colspan="2" class="item-abstract">AIMS: Health disparities in Mexican American (MA) elders include higher levels of functional impairment associated with arthritis, cancer, diabetes, stroke, heart attack, and hip fracture, and lower rates of use of home care services (HCS) than Anglo elders. Functional impairment would decrease if client and caregiver (CG) instruction in self-management of diet, exercise, stress, and symptoms; advocacy with medical and other services; rehabilitation; and other personal supportive services benefiting the elder and CG were provided in the home. Lower use of HCS by MA elders, with their higher levels of need, is inequitable. The specific aim was to gain insight into the decision-making process by family caregivers and elders about their decisions to use HCS. The research questions were: 1) What factors (people, events, beliefs) influence elders&rsquo; decisions to use HCS? 2) What factors influence CGs&rsquo; decisions to accept HCS? 3) What interactions between elders and CGs influence decisions whether to use HCS? 4) How are the decisions made and who makes them? BACKGROUND: A predictive model of MA elders&rsquo; use of HCS has been hypothesized in an ongoing study by the principal investigator, based on previous studies about elders&rsquo; barriers to using HCS. However, decisions are not made by elders alone. CGs also contribute to the MA families&rsquo; decisions whether to use HCS&mdash;the focus of this study. METHODS: Interviews were conducted with MA elders (N=12: 8 women and 4 men) and CGs (N=10: 5 women and 5 men) about their process of deciding whether to use HCS, using theoretical sampling. Grounded theory&rsquo;s constant comparison analysis was used. FINDINGS: Data bits, initially openly coded, later selectively coded, were sorted into categories including Context (Expectations of Familism), Conditions-Qualifiers (Health Event Trajectory, Functional Ability, Service Awareness, Financial Access), Causes-Antecedents (Impression Management, Acculturation, Perceptions of Experiences of Discrimination, Confidence in HCS), Consequences (positive and negative; for elders, CGs and both), and Covariance-Contingencies (Caregiving Burden, availability of family CG and of HCS). Some of these basic social processes (BSP) have been described in previous research. Others (Health Event Trajectory and Impression Management) are new to theories explaining use and non-use of HCS. Further abstraction included referring to existing theory (e.g., satisfying; blending cosmopolitan and local knowledge). IMPLICATIONS: Increased understanding of BSPs influencing MA elders&rsquo; and CGs&rsquo; decisions to use HCS can inform interventions to reduce health disparities, thus improving or sustaining MA elders&rsquo; functional ability, decreasing CG burden, and reducing government spending. Acknowledgements: Funded by the University of Arizona Faculty Small Grants, 2002-2003.</td></tr></table>en_GB
dc.date.available2011-10-26T20:29:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:29:13Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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