Over the Great Wall: A Qualitative Descriptive Study of the Experiences and Preferences of Chinese Immigrant Families when Receiving Hospice Services in New Zealand

<p>This thesis discusses the background, processes, findings and recommendations of a qualitative descriptive study to explore and describe the experiences and preferences of Chinese immigrant families when receiving hospice services in New Zealand (NZ). The study arose from clinical practice questions about how hospice services were providing end-of-life care to the growing number of Chinese immigrants in NZ. With the assistance of a Cultural Advisor and a team of professional interpreters, eight bereaved Chinese immigrants living in the greater Auckland area who had cared for a terminally ill close family member with hospice service involvement were interviewed using a semi-structured approach. Participants were asked to describe their family support in NZ as well as their experiences of referral to a hospice, the types of care and treatment provided, communication processes between staff and the patient/family, care in the patient's last days of life, comparisons with care provided in their country of origin and suggestions for NZ hospice service improvements. Four key themes emerged: 1) Unfamiliar territory - participants were unfamiliar with the role or services of hospice and staff's lack of awareness of Chinese customs had led to distressing situations; 2) Service experiences and expectations - while some services were deemed useful others were not; participants had expected more medical treatments to manage the patient's symptoms; deaths in in-patient settings were less concerning to families and were preferred to deaths at home; 3) Support to cope - participants wanted more psychological support from hospice and regarded the maintenance of hope as a key component of a good death; 4) Uncovering sensitive information - families wanted to be consulted before sensitive information was discussed with patients and they preferred information to be uncovered slowly and gently to avoid causing the patient psychological harm. Recommendations for hospice service development included: improved access to information for families; greater provision of support services, especially for patients and families at home; education for hospice staff about Chinese culture and customs; options for in-patient admission in the last days of life; and the involvement of families in disclosure decisions. It is hoped that by responding to the experiences and preferences shared by participants, hospice services will be better equipped to address the end-of-life care needs of Chinese immigrant families.</p>

Over the Great Wall: A Qualitative Descriptive Study of the Experiences and Preferences of Chinese Immigrant Families when Receiving Hospice Services in New Zealand

<p>This thesis discusses the background, processes, findings and recommendations of a qualitative descriptive study to explore and describe the experiences and preferences of Chinese immigrant families when receiving hospice services in New Zealand (NZ). The study arose from clinical practice questions about how hospice services were providing end-of-life care to the growing number of Chinese immigrants in NZ. With the assistance of a Cultural Advisor and a team of professional interpreters, eight bereaved Chinese immigrants living in the greater Auckland area who had cared for a terminally ill close family member with hospice service involvement were interviewed using a semi-structured approach. Participants were asked to describe their family support in NZ as well as their experiences of referral to a hospice, the types of care and treatment provided, communication processes between staff and the patient/family, care in the patient's last days of life, comparisons with care provided in their country of origin and suggestions for NZ hospice service improvements. Four key themes emerged: 1) Unfamiliar territory - participants were unfamiliar with the role or services of hospice and staff's lack of awareness of Chinese customs had led to distressing situations; 2) Service experiences and expectations - while some services were deemed useful others were not; participants had expected more medical treatments to manage the patient's symptoms; deaths in in-patient settings were less concerning to families and were preferred to deaths at home; 3) Support to cope - participants wanted more psychological support from hospice and regarded the maintenance of hope as a key component of a good death; 4) Uncovering sensitive information - families wanted to be consulted before sensitive information was discussed with patients and they preferred information to be uncovered slowly and gently to avoid causing the patient psychological harm. Recommendations for hospice service development included: improved access to information for families; greater provision of support services, especially for patients and families at home; education for hospice staff about Chinese culture and customs; options for in-patient admission in the last days of life; and the involvement of families in disclosure decisions. It is hoped that by responding to the experiences and preferences shared by participants, hospice services will be better equipped to address the end-of-life care needs of Chinese immigrant families.</p>

Sources of Intergenerational Conflict in Chinese Immigrant Families in the United States

Studies of family relations have not kept pace with the acceleration of international migration. To address this gap, this study relied on a survey of 545 Chinese immigrants in Chicago who reported information of 869 older parents to examine the sources of intergenerational conflict in five domains: norms/values, relationship itself, money, health, and parenting. The results of logistic regression showed that maintaining one’s traditional culture, in the form of endorsing a sense of filial obligation, was a significant protective factor against all types of conflict. Immigrants with a higher level of acculturation were more likely to report conflict regarding norms/values and relationship itself, but not more so regarding practical issues such as health, money, and parenting. Helping parents with ADLs, not IADLs, was associated with more conflict regarding monetary and health issues. Immigrants’ greater sense of mastery was associated with a lower chance of reporting norm/value-related intergenerational conflict.

Trembling strength: Migrating vulnerabilities in fiction by Sharon Bala, Yasmin Ladha, and Denise Chong

The Boat People by Sharon Bala, Blue Sunflower Startle by Yasmin Ladha, and Lives of the Family: Stories of Fate and Circumstance, by Denise Chong, are texts that engage with vulnerability as it relates to immigration, one of the most precarious of states or sites that Canadian literature chronicles. The abstract and concrete politics of adaptation are exemplified in these narratives of displacement, inspired by the Tamil refugee crisis of 2009–2010, the Indo-Tanzanian immigration wave of the 1970s, and the resourcefulness of Chinese immigrant families in the mid-twentieth century. These narratives effectively investigate vulnerability within spaces of interconnection, imprisonment, relation, visibility, and transformation. This paper works with their explorations of the Canadian trope of immigration as a process that moves from the vulnerability of strangeness to the vulnerability of adaptation to the vulnerability of commitment. Addressing the ways that these stages are subverted, the paper examines the extent to which migrancy and its resolution resist a “national” narrative in these texts, undercutting the prototype of success through adversity. How they model Hirsch’s “openness to unexpected outcomes” recites the complexity of their depictions of vulnerability.

Language transmission among multilingual Chinese immigrant families in the Northern Netherlands

Maintaining heritage languages is of vital significance for multicultural families. We present a study of Mandarin transmission among ten Dutch Chinese families in Groningen (Netherlands) associated to a local Saturday school. Data from semi-structured interviews and a questionnaire reveal that personal, integrative, and instrumental values, all play a role in language choices. Remarkably, with general positive attitudes towards multilingualism in Dutch society, families too feel encouraged to maintain Mandarin. Nevertheless, they report lack of school and institutional support, and criticisms about their ability to belong in Dutch society. Parents wish that teachers attached more importance to their heritage languages, rather than solely focusing on children’s learning of Dutch (and English), and that their own multiculturality (not only that of their children) be embraced. Likewise, parents are critical of the Chinese school, and wish teachers better accommodated to the sensitivities and practices their children are used to from their Dutch school experience.