Wu Shu-Chen, White Alan, Cash Keith, Foster Sally
Department of Nursing, Tzu-Chi College of Technology, Hualien, Taiwan.
J Clin Nurs. 2009 Jul;18(14):1986-93. doi: 10.1111/j.1365-2702.2008.02697.x.
To generate a substantive theory for understanding the phenomenon of nursing home care for older people in Taiwan.
Taiwanese culture shows great respect for older people and older people are traditionally cared for at home by their families. However, the older population in Taiwan is rapidly increasing and this demographic shift, together with various socio-economic changes, has resulted in nursing homes becoming a new and significant care option.
A grounded theory approach was used to study the residents and relatives from three nursing homes in Taiwan.
Formal and informal interviews and participant observation data were collected over two months in each nursing home. Forty nursing home residents and 20 of their relatives were recruited. The data were analysed using the constant comparative method and involved the use of theoretical memos and theoretical sampling procedures.
The study found that nursing home care for older people in Taiwan is understood to be a process of forced choice, involving three stages; namely, 'becoming a problem', 'making a forced choice' and 'coping with the forced choice'.
Taiwan is in a state of conflict with regard to providing care for older people, a situation in which the influence of traditional cultural and that of industrialization exist side by side. The consequence of having to relocate older people into nursing homes means that both parties are the victims of this choice.
This conceptual explanation helps us to understand how the Taiwanese respond to the issue of care for older people and how they resolve their main concerns related to it. Subsequently, it is hoped that this will help health care practitioners to provide care more effectively to meet the needs of the Taiwanese with the aim of enhancing the standards of care for older people.
构建一个实质性理论，以理解台湾地区老年人养老院护理现象。
台湾文化高度尊重老年人，传统上老年人由家人在家照顾。然而，台湾老年人口迅速增加，这种人口结构转变以及各种社会经济变化，导致养老院成为一种新的重要护理选择。
采用扎根理论方法研究台湾三家养老院的居民和亲属。
在每家养老院的两个月时间里收集正式和非正式访谈以及参与观察数据。招募了40名养老院居民及其20名亲属。使用持续比较法分析数据，包括使用理论备忘录和理论抽样程序。
研究发现，台湾地区老年人的养老院护理被理解为一个被迫选择的过程，包括三个阶段；即“成为问题”“做出被迫选择”和“应对被迫选择”。
台湾在为老年人提供护理方面处于冲突状态，传统文化和工业化的影响并存。将老年人安置到养老院的结果意味着双方都是这一选择的受害者。
这一概念性解释有助于我们理解台湾人如何应对老年人护理问题以及他们如何解决与之相关的主要担忧。随后，希望这将有助于医护人员更有效地提供护理，以满足台湾人的需求，从而提高老年人的护理标准。
