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Older people and decision-making following acute stroke in China: ‘hiding’ as a barrier to active involvement

Published online by Cambridge University Press:  19 June 2015

YUE WANG  and
MIKE NOLAN
YUE WANG
Affiliation:
School of Nursing, Tianjin Medical University, People's Republic of China
MIKE NOLAN*
Affiliation:
The School of Nursing & Midwifery, University of Sheffield, UK
*
Address for correspondence: Mike Nolan, The School of Nursing & Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield S10 2LA, UK E-mail: [email protected]
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Abstract

Decision-making among older patients with stroke, their families and professionals has been extensively studied in a Western context, but there has been little prior work in China. The study reported here explored how decision-making took place between older people with stroke, their family carers and professionals in an acute care context in mainland China using a constructivist grounded theory approach. Data were collected through semi-structured interviews, participant observation and documentary analysis. Constant comparative analysis of the data was carried out. This paper focuses on the key social process of ‘hiding’ and its dynamic relationship with the core category ‘keeping the peace’. In order to meet the traditional Chinese cultural value of ‘maintaining harmony’, both family carers and professionals hid essential information from older stroke survivors who, as a consequence, were effectively precluded from playing an active role in major decisions. In understanding ‘hiding’, the paper draws upon both Chinese cultural values and ‘awareness context theory’ and in so doing questions the relevance to the Chinese context of key Western notions such as involvement in health-care decision-making. A better understanding of the experiences of decision-making processes between older people with stroke, their family carers and professionals in China will help professionals to provide the best possible support and care whilst promoting informed decision-making amongst all concerned.

Keywords

decision-makingacute strokeChinaconstructivist grounded theory
Type
Articles
Information
Ageing & Society , Volume 36 , Issue 7 , August 2016 , pp. 1526 - 1554
Copyright
Copyright © Cambridge University Press 2015 

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