Factors That Influence the Care of Chinese Nursing Home Residents: The Person-Environment Interaction
Elderly Chinese residents in nursing homes in the United States experience cultural and language barriers, encounter Western health care practices, and have difficulty adjusting to a new environment. The purpose of this ethnographic study is to identify, describe, and analyze the factors: clinical, environmental, social, and cultural, that influence the care of elderly Chinese residents in nursing homes. Data were collected through participant observation and interviews on Chinese residents, their families, and nursing home staff at a 100-bed nursing home facility. The mission of this facility is to provide compassionate and quality care that recognizes the ethnic diversity of its residents. Kayser-Jones' Conceptual Model of Person-Environment Interaction was used to illustrate the effects that the interactions of multiple factors in the physical, organizational, personal-suprapersonal, and cultural and psychosocial environment have on elderly Chinese nursing home residents. It was found that the teamwork between the nursing home operator, Asian community, and the nursing home leadership team was important in helping this facility reach its goals in providing quality care. They have implemented and maintained an organizational structure with the goal of meeting the needs of the Chinese elders and the other residents in the facility (organizational environment). This affects the physical and cultural-psychosocial environment, as this team works together to provide a home-like environment sensitive to the needs of the Chinese residents (physical and cultural-psychosocial environment). Chinese elders seeking long-term care are thus drawn to this facility, one which supports an environment sensitive to the social, psychological, and cultural needs of this population (personal supra-personal environment). The outcome for the resident is that there is a good person-environment fit, resulting in high resident morale and self-esteem and thus, a high level of resident satisfaction. This research has shown that positive outcomes occur for Chinese elders in a nursing home providing culturally-specific care. These findings offer valuable information in helping to develop and implement interventions to improve the care of Chinese elders in nursing homes.