Chung Jane, Seo Jin Young, Lee Jongwon
University of New Mexico College of Nursing, Albuquerque, NM, USA.
Hunter-Bellevue School of Nursing, Hunter College, CUNY, New York, NY, USA.
Int J Older People Nurs. 2018 Jun;13(2):e12179. doi: 10.1111/opn.12179. Epub 2017 Oct 30.
The purpose of this study was to explore multilevel factors affecting older Korean immigrants' health-seeking behaviours.
Although studies have documented significant issues related to healthcare access and utilisation issues among older immigrants, a noted limitation of current research is its failure to explore multiple factors related to their health-seeking behaviours.
A qualitative study using interview data from two previous studies.
We performed a qualitative analysis of focus groups and individual interviews using inductive coding methods. The socioecological model provided a useful framework to guide this study. The sample included 17 community-dwelling older Korean immigrants aged ≥65 years living in the metropolitan area of Seattle, WA, USA.
Findings revealed various factors at the individual (e.g., perception of health and illness, mistrust, cultural values and norms, length of residency in the United States, language barriers and ageing experiences), interpersonal (e.g., peers, family and primary care physicians), community (e.g., ethnic community centres and organisations, home care helpers and interpretation services) and policy (e.g., lack of affordability and health benefits coverage) levels. Each of these factors played a role as either a barrier to or facilitator of older Korean immigrants' health-seeking behaviours. Several factors, such as language barriers and lack of available information, were intertwined.
Findings indicate the importance of considering four major areas when designing culturally appropriate, community-based interventions for older immigrants. Also, utilising peers or trusted human resources in the community is critical to the design and implementation of health promotion interventions for older immigrants.
Examining intrapersonal, interpersonal, community, and policy level factors that affect older immigrants' health-seeking behaviours informs the design of community-based health promotion interventions for older immigrants.
本研究旨在探讨影响韩国老年移民求医行为的多层次因素。
尽管已有研究记录了老年移民在医疗保健获取和利用方面的重大问题，但当前研究的一个显著局限性是未能探讨与其求医行为相关的多个因素。
一项定性研究，使用来自之前两项研究的访谈数据。
我们采用归纳编码方法对焦点小组和个人访谈进行了定性分析。社会生态模型为指导本研究提供了一个有用的框架。样本包括居住在美国华盛顿州西雅图市大都市区的17名年龄≥65岁的韩国社区老年移民。
研究结果揭示了个体层面（如对健康和疾病的认知、不信任、文化价值观和规范、在美国的居住时间、语言障碍和衰老经历）、人际层面（如同伴、家庭和初级保健医生）、社区层面（如族裔社区中心和组织、家庭护理助手和口译服务）和政策层面（如缺乏可承受性和健康福利覆盖范围）的各种因素。这些因素中的每一个都对韩国老年移民的求医行为起到了阻碍或促进作用。几个因素，如语言障碍和信息匮乏，相互交织。
研究结果表明，在为老年移民设计适合其文化背景的社区干预措施时，考虑四个主要领域非常重要。此外，利用社区中的同伴或可信赖的人力资源对于为老年移民设计和实施健康促进干预措施至关重要。
审视影响老年移民求医行为的个人、人际、社区和政策层面因素，有助于为老年移民设计基于社区的健康促进干预措施。
