| Summary: | Background and Rationale: Falls are among the most common problems faced by elderly persons. While the physical risk factors for falls are well established, the psychosocial aspects have been largely neglected. Moreover, studies exploring the responses to falls from the individuals’ perspectives in an immigrant population are virtually non-existent. The older Chinese immigrant population is substantial and growing in the Greater Toronto Area. The cultural and immigrant-related factors that influence their responses to and recovery after a fall are important considerations as health and social care professionals develop falls prevention strategies, and provide services and care. This dissertation explored the nature of immediate and subsequent responses of community-dwelling older Chinese immigrants after falling.
Method: Focussed Ethnography, as guided by elements from Critical Social Theory, was used as the research methodology. Eighteen informants over 70 years of age, living in the community who had experienced a recent fall were interviewed using a semi-structured guide developed after a detailed literature review. Thematic analysis of transcribed interviews was conducted.
Results: Four major themes related to responses to falling were drawn forth from the interview data: 1) Help-seeking decisions immediately after the fall, 2) Psychological impact of the fall, 3) Care and support networks, and 4) Learning from the fall.
Discussion: The psychosocial responses supported a “blended” explanatory model of illness. Respondents appeared to adhere to both Western medical models and traditional Chinese explanatory model depending on the severity of the fall injuries. Also, the roots of Chinese culture in the blended traditions and philosophies of Confucianism, Taoism, and Buddhism appear to be the foundation for many of the beliefs and attitudes expressed in this study, and these beliefs and attitudes in turn influence how Chinese fallers experience falling. The wide range of psychosocial responses also illustrated the complexity of the Andersen’s Behavioural model for health services use and its potential to explain the different types of services an older Chinese immigrant may need post-fall.
Conclusions: Findings from this study provided key, previously unexplored insights into the cultural and immigrant-related factors that influence the psychosocial experience, vulnerability and care-seeking behaviours of older Chinese immigrants following a fall.
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