Native-born Chinese Women’s Experiences in Medical Encounters in the U.S.

Abstract

Native-born Chinese women's experiences with medical help seeking in the U.S. is poorly understood, including how life phase affects it. Focus groups with middleaged and older immigrant Chinese women explored: a) behaving assertively with doctors, b) strategies for assertiveness, c) characteristics of "ideal" doctors. Assertiveness was described as a reciprocal behavioral process between patient and doctor. Responsibility for initiating the process was seen as resting with doctors. Patient assertiveness goals included obtaining information and referrals. Strategies for achieving goals included not mentioning low-priority medical concerns in order to increase odds of obtaining referrals, and switching doctors when dissatisfied with communication. Older women reported refusing medical treatment due to language barriers. Cultural values, reported to be rooted in Confucianism, were identified by participants as shaping their help seeking. "Ideal" doctors were described as unhurried, and fully responsive to patient symptoms. Older women viewed "direct speaking" by doctors as always desirable around general information, and sometimes desirable around serious diagnoses. Older women perceived cultural differences with American-born Chinese providers. Findings are discussed in relation to continuity of care issues.

Negotiating Vulnerabilities: How Older Adults with Multiple Chronic Conditions Interact with Physicians

“…However, many of our participants perceived that they were not receiving thorough and comprehensive medical care, including referrals to specialists and full examinations, as a result of the personal failings of their physicians, the constraints of typical medical consultations, and perceived ageism. Our fi ndings build on the existing research which has identifi ed health care system constraints such as lack of time during appointments to be a source of discontent among older patients (Adelman et al, 2000;Evans & Robertson, 2009;Lee & Kasper, 1998;Ogden et al, 2004;Rost & Frankel, 1993;Vieder et al, 2002;Weitzman et al, 2008). Our fi ndings further reveal that the presence of multiple morbidities exacerbates concerns about the amount and usage of time during medical appointments.…”

“…Older adults consistently cite lack of time during medical appointments as a source of dissatisfaction, as they perceive that overly short appointments preclude adequate discussion of concerns and receipt of information and explanations about their treatment options (Adelman, Greene, & Ory, 2000;Evans & Robertson, 2009;Lee & Kasper, 1998;Ogden et al, 2004;Rost & Frankel, 1993;Vieder, Krafchick, Kovach, & Galluzzi, 2002;Weitzman et al, 2008). Some studies suggest that rather than time being the underlying problem, it is the tendency of physicians to utilize a closed, one-way communication style that heightens older adults' displeasure with their experiences during medical consultations (Adelman et al, 2000;Evans & Robertson;Ogden et al).…”

“…Statistics Canada (2006) has reported that 77 per cent of men and 85 per cent of women aged 65 and over have at least one chronic condition, and that the average number of chronic conditions increases with age. Despite the central role that physicians play in chronic illness management, with a few exceptions (Coles et al, 2010;Mutran & Ferraro, 1988;Seale & Charteris-Black, 2008), the research has primarily focused on patient-physician interactions and the experiences of women of varying ages having one chronic condition (Asbring & Narvanen, 2002;Skuladottir & Halldorsdottir, 2008;Werner, Isaksen, & Malterud, 2004;Werner & Malterud, 2003) or with an unspecifi ed health status (Evans & Robertson, 2009;Tannenbaum, Nasmith, & Mayo, 2003;Weitzman, Ballah, & Levkoff, 2008;Weitzman, Chang, & Reynoso, 2004). To date, there has been little investigation of how older individuals with multiple morbidities perceive and interact with their physicians around the management of their chronic health issues.…”

Optimising social conditions to improve autonomy in communication and care for ethnic minority residents in nursing homes: A meta‐synthesis of qualitative research

“…Residents' experiences of racism towards them in the past affected their trust in staff: ‘Some don't want white people to take care of them… Some of them may be hurting so bad but you go in there [their room] to do something, [they say] “I don't want you”’ (Dobbs et al, 2014, p. 91). Refusing medical treatment was also attributed to residents' discomfort talking with, and their lack of trust, in health professionals (Weitzman et al, 2008). Both situations required staff to demonstrate cultural desire to overcome difficulties in meeting residents' care needs.…”