Date of Award

2007-05-01

Degree Name

PhD Nursing

Dissertation Committee

Patricia A. Roth, EdD, RN, Chair; Eunice E. Lee, DNSc, RN; Mary-Rose Mueller, PhD, RN

Keywords

culture, elders, Grounded theory, Korean-Americans, nursing, nursing home

Abstract

The purpose of this study was to explore factors affecting Korean-American (KA) elders during the transition to nursing homes in the first month following admission. The three aims of this proposed study were (1) to explore culture specific factors that affect KA elders' perspectives during the transitional period to a nursing home, (2) to identify thoughts and feelings of KA elders about their admission into a nursing home, (3) to describe the adjustment process associated with admission to a nursing home. A grounded theory design was utilized to explore KA elders' perceptions/experiences associated with adjustment to a nursing home. Open-ended, semi-structured in-depth interviews of 15 newly admitted elders were conducted in Korean within one week of admission and again after one month of admission to the nursing home. Data were transcribed verbatim from the audio-recorded interviews, translated into English, and analyzed using a constant comparative method of analytic induction. In the process of Finding My Last Home, four subcategories of Fearing the Future, Deciding to Leave, Struggling to Adjust, and Finding “Pyung-Aan” (Peace of Mind) reflected KA elders' thoughts and feelings, while culture specific factors influenced adjustment, and consequences of the adjustment process. Fearing the Future, the context for this study, reflected reasons causing fear which included loss of familiar surroundings, unknown nursing home life, deteriorating physical condition, and new relationship with their children. Deciding to Leave reflected the conditions to leave their homes and the moving process. Although many other reasons made KA elders decide to admit to a nursing home, most elders stated that they wanted to avoid being a burden to their family. In the process of Struggling to Adjust, internal determinant factors were particularly critical and included personal characteristics, physical condition, and cultural background. External facilitators were identified as maintaining relationships, living environment, culture specific care, rules and regulations, and supportive care. Finding “Pyung-Aan” (Peace of Mind) was identified as a consequence of an elder's experience in the nursing home. KA elders who felt that the nursing homes were their home had increased sense of relief and security. However, elders who did not adjust to a nursing home increased discontent and expressed feelings of insecurity and suffering. Although this study focused on KA elders' perspectives about nursing home admission, future longitudinal research including other geographic areas and family members should refine the nursing home adjustment process and the concurrent family members' perspectives. The results of the research can be applied to nursing practice in order to help make the transitional process smoother.

Document Type

Dissertation: Open Access

Department

Nursing

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Nursing Commons

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