| Summary: | This study was designed to explore how Chinese families managed the care of an adult member with advanced cancer both in home and hospital settings, to identify factors that affected care management, to examine the influence of cultural beliefs and practices on caregiving, and to examine the preference for location of care, from the perspective of one family member. The method used in conducting this study was the grounded theory approach of qualitative research.
Data were collected through a series of interviews with six Chinese informants (five adult children and one spouse). The initial interviews were guided by the research questions. Constant comparative analysis was employed throughout data collection to permit analytic material to guide and focus the process of constructing the core social process. The informants' degree of ethnic identity was measured using the Ethnic Identity Questionnaire to further validate the researcher's observations pertaining to cultural orientation.
The results indicated that Chinese families managed the care of an adult member with advanced cancer through the balancing process. This process, used when patients were in hospital and home, characterized the struggle the families experienced in managing everchanging caregiving demands and everyday family demands. Balancing was comprised of four interrelated management strategies: gauging, anticipating, sharing the load, and resourcing. It was concluded that the process is not culturally-bound although activities of trying out and patterns of help-seeking were thought to be
culturally based. Factors which were found to influence the balancing process were past experiences and the patients' and family members' style or previous patterns of coping. Cultural beliefs influenced family members' actions and the reasons given for their actions.
The results also indicated that Chinese families preferred care at home to care in the hospital. However, care at home was contingent on four factors: availability and ability of caregivers, family support, information from physician, and patients' physical condition and symptom management. The hospital setting was identified as the place where the ill family would die.
In terms of nursing practice, the results support the need for nurses to be family-focused and support the actions of family members as the families manage the care. The results also suggest nurses to explore their own beliefs as well as beliefs of patients and families to ensure sensitivity is shown to differences. The findings reinforce the importance of educating families, as well as other health care professionals, about nursing's role in providing care, especially in the community. With regard to nursing research, the results reinforce the need to conduct family unit research and further explore the validity of the balancing process with more Chinese families and other ethnic groups. === Applied Science, Faculty of === Nursing, School of === Graduate
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