Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T21:23:01.863Z Has data issue: false hasContentIssue false
  • English
  • Français

The Role of Culture and Diversity in the Prevention of Falls among Older Chinese People*

Published online by Cambridge University Press:  15 March 2011

Khim Horton  and
Angela Dickinson
Khim Horton*
Affiliation:
Faculty of Health and Medical Sciences, University of Surrey
Angela Dickinson
Affiliation:
Centre for Research in Primary and Community Care, University of Hertfordshire
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Khim Horton, Ph.D., Division of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey GU2 7TE, United Kingdom (k.horton@surrey.ac.uk)
Get access Rights & Permissions [Opens in a new window]

Abstract

This grounded-theory study explored the perceptions of Chinese older people, living in England, on falls and fear of falling, and identified facilitators and barriers to fall prevention interventions. With a sample of 30 Chinese older people, we conducted two focus groups and 10 in-depth interviews in Mandarin or Cantonese. Interview transcripts, back translated, were analyzed using N6. Constant comparative analysis highlighted a range of health-seeking behaviors after a fall: Chinese older people were reluctant to use formal health services; talking about falls was avoided; older people hid falls from their adult children to avoid worrying them; and fatalistic views about falls and poor knowledge about availability and content of interventions were prevalent. Cost of interventions was important. Chinese older adults valued their independence, and cultural intergenerational relations had an impact on taking action to prevent falls. Cultural diversity affects older adults’ acceptance of fall prevention interventions.

Résumé

Cette étude, fondée sur la grounded théorie, a exploré les perceptions des personnes âgées chinoises, vivant en Angleterre, concernant les chutes et la peur de tomber, et les animateurs et les entraves à l’intervention pour prévenir les chutes. En utilisant un échantillon de 30 personnes âgées chinoises, nous avons mené deux groupes de discussion et 10 entretiens en profondeur, en mandarin ou en cantonais. Les transcriptions des entretiens ont été traduites en arrière et analysées à l’aide de N6. Une analyse comparative et constante mis en évidence une gamme de comportements sains après une chute : les personnes âgées chinoises manifestaient de la réticence à utiliser les services de santé formels ; on évite de parler des chutes ; les personnes âgées ont caché les chutes de leurs enfants pour éviter les inquiéter ; et des vues fatalistes sur les chutes et la méconnaissance de la disponibilité et le contenu des interventions ont été repandus. Le côut des inter-ventions était important. Les personnes âgées chinoises apprécient leur indépendence, et les relations entre les générations ont eu un impact sur leur prise de mesures pour prévenir les chutes. La diversité culturelle a un effet sur l’acceptation des personnes agées des interventions visant à prévenir les chutes.

Keywords

fondée sur la théoriepersonnes âgées chinoiseschutesculture et diversitéprévention des chutesgrounded theoryChinese older peoplefallsculture and diversityprevention of falls
Type
Special Section: Falls Prevention / Section spéciale: Prévention des chutes
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 30 , Issue 1 , March 2011 , pp. 57 - 66
Copyright
Copyright © Canadian Association on Gerontology 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Ethics approval was gained from the Eastern Multi-Centre Research Ethics Committee (MREC) (05/mre05/11), and Research Governance approval from the relevant acute National Health Service Trusts and Primary Care Trusts.

This work was undertaken by the University of Hertfordshire who received funding from the UK Department of Health [Grant Reference: 0010014]. This is an independent report commissioned and funded by Policy Research Programme in the Department of Health. The views expressed are not necessarily those of the Department.

References

Aminzadeh, F., & Edwards, N. (2000). Factors associated with cane use among community dwelling older adults. Public Health Nursing, 17(6), 474–483.CrossRefGoogle ScholarPubMed
Ballinger, C., & Payne, S. (2002). The construction of risk of falling among and by older people. Ageing and Society, 22, 305–324.CrossRefGoogle Scholar
Bunn, F., Barnet-Page, E., McInnes, E., Dickinson, A., & Horton, K. (2008). A systematic review of older people’s perceptions of facilitators and barriers to participation in falls-prevention interventions. Ageing and Society, 28, 449–472.CrossRefGoogle Scholar
Butt, J., & O’Neil, A. (2004). ‘Let’s move on’ Black and minority ethnic older people’s views on research findings. York, UK: Joseph Rowntree Foundation.Google Scholar
Chau, R., & Yu, S. (2000). From double attachment to double detachment: Chinese older people in Britain. In Maltby, T., Warnes, A., & Warren, L. (Eds.), Care services for later life: Transformations and critique. London, UK: Jessica Kingsley.Google Scholar
Chen, Y. (2001). Chinese values, health and nursing. Journal of Advanced Nursing, 36(2), 270–273.CrossRefGoogle ScholarPubMed
Cryer, C. (2001). What works to prevent accidental injury among older people? Report to the Health Development Agency, London. Centre for Health Services Studies, University of Kent, UK.Google Scholar
Davison, C., Davey Smith, G., & Frankel, S. (1991). Lay epidemiology and the prevention paradox: The implications of coronary candidacy for health education. Sociology of Health and Illness, 12, 1–19.CrossRefGoogle Scholar
Day, L., Fildes, B., & Gordon, I. (2002). Randomised Factorial trial of falls prevention among older people living in their own homes. British Medical Journal, 325, 128–131.CrossRefGoogle ScholarPubMed
Department of Health (DH). (2001). National Service Framework for older people. London, UK: Department of Health.Google Scholar
Department of Health (DH). (2009a). Falls and fractures: Developing a local joint strategic needs assessment. London, UK: Department of Health.Google Scholar
Department of Health (DH). (2009b). Falls and fractures: Effective interventions in health and social care. London, UK: Department of Health.Google Scholar
Dickinson, A., Machen, I., Cove, J., Horton, K., Jain, D., & Maddox, T. (2009). Phase 2: Facilitators and barriers to older people accepting and adhering to interventions to reduce falling and fractures: A qualitative exploration. Final Report to the Department of Health, London, UK.Google Scholar
Douglas, M., & Wildavsky, A. (1982). Risk and culture: An essay on the selection of technical and environmental dangers. Berkeley, CA: University of California Press.Google Scholar
Edwards, N., Lockett, D., Aminzadeh, F., & Nair, R. (2003). Predictors of bath grab-bar use among community-living older adults. Canadian Journal on Aging, 22(2), 217–227.CrossRefGoogle Scholar
Gervais, M.C., & Jovchelovitch, S. (1998). The health beliefs of the Chinese community in England: A qualitative research study. London, UK: Health Education Authority.Google Scholar
Green, J. & Thorogood, N. (2009) Qualitative methods for health research. London, UK: Sage.Google Scholar
Hakim, C. (2000). Research Design successful designs for social and economic research. London, UK: Routledge.Google Scholar
Health Education Board for Scotland. (2003). The construction of the risks of falling in older people: Lay and professional perspectives. Edinburgh, UK: Health Education Board for Scotland.Google Scholar
Helman, C.G. (2001). Culture, health and illness. London, UK: Arnold.Google Scholar
Horne, M., Speed, S., Skelton, D., & Todd, C. (2009). What do community-dwelling Caucasian and South Asian 60–70 year olds think about exercise for fall prevention? Age and Ageing, 38, 68–73.CrossRefGoogle ScholarPubMed
Horton, K. (2002). Gender and falls: Older people and key family members’ perspectives. Unpublished PhD thesis, Department of Sociology, University of Surrey, Guildford, Surrey, UK.Google Scholar
Jones, R.S., Chow, T.W., & Gatz, M. (2006). Asian American’s and Alzheimer’s disease: Assimilation, culture and beliefs. Journal of Aging Studies, 20, 11–25.CrossRefGoogle Scholar
Kavanagh, A.M., & Broom, D.H. (1998). Embodied risk: My body, myself? Social Sciences and Medicine, 46(3), 437–444: 438.CrossRefGoogle ScholarPubMed
Kingston, P. (2000). Falls in later life: Status passage and preferred identities as a new orientation. Health, 4(2), 216–233.CrossRefGoogle Scholar
Kwan, S.Y.L., & Holmes, M.A.M. (1999). An exploration of oral health beliefs and attitudes of Chinese in West Yorkshire: A qualitative investigation. Health Education Research, 14(4), 453–460.CrossRefGoogle Scholar
Kwok, C., Cant, R., & Sullivan, G. (2005). Factors associated with mammographic decisions of Chinese-Australian women. Health Education Research, 20(6), 739–747.CrossRefGoogle ScholarPubMed
Kwok, C., & Sullivan, G. (2007). Health seeking behaviours among Chinese-Australian women: Implications for health promotion programmes. Health, 11(3), 401–415.CrossRefGoogle ScholarPubMed
Lehoux, P., Poland, B., & Daudelin, G. (2006). Focus group research and ‘the patient’s view’. Social Science and Medicine, 63(8), 2091–2104.CrossRefGoogle ScholarPubMed
Lilley, J.M., Arie, T., & Chilvers, C.E.D. (1995). Accidents involving older people: A review of the literature. Age and Ageing, 24, 346–365.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence (NICE). (2004). Falls: The assessment and prevention of falls in older people. Clinical Guideline 21 November 2004. London, UK: NICE.Google Scholar
Office for National Statistics (ONS). (2001). Focus on older people & ethnic minorities. Retrieved October, 2010, fromhttp://www.statistics.gov.uk/focuson/ethnicityGoogle Scholar
Office for National Statistics (ONS). (2004). Health expectancies at birth and age 65 in the UK. London, UK: ONS.Google Scholar
Parker, M.J., Twemlow, T., & Pryor, G. (1996). Environmental hazards and hip fractures. Age and Ageing, 25, 322–325.CrossRefGoogle ScholarPubMed
Robertson, M.C., Devlin, N., & Gardner, M.M. (2001). Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls: A randomised controlled trial. British Medical Journal, 322, 697–701.CrossRefGoogle Scholar
Roe, B., Howell, F., Riniotis, K., Beech, R., Crome, P., & Ong, B.N. (2009). Older people and falls: Health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall. Journal of Clinical Nursing, 18, 2261–2272.CrossRefGoogle ScholarPubMed
Rotter, J.B. (1966). Generalized expectancies for internal versus external control of reinforcement, Psychological Monographs, 80, (1, Whole No. 609).CrossRefGoogle ScholarPubMed
Shearer, R., & Davidhizar, R. (2000). Luck, what the nurse should know about it and how it affects nursing situations. International Journal of Nursing Practice, 6(1), 2–6.CrossRefGoogle ScholarPubMed
Skelton, D.A., & Dinan, S.M. (2009). Falls and factures: Exercise training to prevent falls. London, UK: Department of Health. Tinetti, M.E., Richman, D., & Powell, L. (1990) Falls efficacy as a measure of fear of falling. Journal of Gerontology, 45, P239–P243.Google Scholar
Tinetti, M.E., Mendes de Leon, C.F., Doucette, J.T., & Baker, D.I. (1994). Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. Journal of Gerontology, 49, M140–M147.CrossRefGoogle ScholarPubMed
Todd, C., Ballinger, C., & Whitehead, S. (2007). Reviews of socio-demographic factors related to falls and environmental interventions to prevent falls amongst older people living in the community. Copenhagen, Denmark: World Health Organization. Regional Office for Europe.Google Scholar
Wight, D. (1999). Cultural factors in young heterosexual men’s perception of HIV risk. Sociology of Health and Illness, 21(6), 735–758.CrossRefGoogle Scholar
Xia, Q.H., Jiang, J., Niu, J., Tang, C.X., & Xia, Z.L. (2009). Effectiveness of a community-based multifaceted fall-prevention intervention in active and independent older Chinese adults. Injury Prevention, 15, 248–251.CrossRefGoogle ScholarPubMed
Yang, X.J., Haralambous, B., Angus, J., & Hill, K. (2008). Older Chinese Australians’ understanding of falls and fall prevention: Exploring their needs for information. Australian Journal of Primary Health, 14(1), 36–42.CrossRefGoogle Scholar
Yardley, L., Beyer, N., Hauer, K., Kempen, G., Piot-Ziegler, C., & Todd, C. (2005). Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age and Ageing, 34(6), 614–619.CrossRefGoogle ScholarPubMed
Yardley, L., Donovan-Hall, M., Francis, K., & Todd, C. (2006). Older people’s views of advice about falls prevention: A qualitative study. Health Education Research, 21(4), 508–517.CrossRefGoogle ScholarPubMed
Yu, W.K. (2000). Chinese older people: A need for social inclusion in two communities. Bristol, UK: The Policy Press and the Joseph Rowntree Foundation.Google Scholar