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"Chi lo, mai lo" : the experience of aging and chronic illness in older women of Chinese ethnicity : a phenomenological, feminist study Anthony, Carol Ann

Abstract

Conceptualization for the study was formulated from the researcher's professional practice experience in nursing and from theoretical perspectives of personhood, aging, chronic illness, ethnicity, feminist sociology, black feminism and nursing. The subjective, personal experience of aging and chronic illness in older, migrant women is a poorly understood phenomenon within nursing. When such knowledge is lacking, the delivery of culturally relevant care to elderly, ethnic minority populations is compromised. The study sought an understanding of older migrant women's personal experience of aging and chronic illness. The study explored two themes of knowledge: what meaning ethnicity brings to the older, migrant woman's experience of aging and chronic illness and how personhood is manifested within the aging and chronic illness experience. All six study participants lived independently in the community and their ages ranged from 60 to 78 years. Data collection and analysis occurred concurrently. Data were collected through nine unstructured interviews. Each interview was audio recorded and transcribed. The transcripts were individually then collectively analyzed for emergent themes. Themes were validated and clarified with the participants. A final framework titled the Dialectic of Control was constructed from synthesis of the participants' narratives. Control was characterized as the process of balancing adversity (loss) and prosperity (gain) associated with the experience of aging and chronic illness. Adversity referred to lowered Activities of Daily Living (ADL) and Role performance accompanied by discomfort or pain. Prosperity referred to the freedom from responsibilities, optimizing independence in and accepting limitations of ADL and role performance, and remaining pain free. Three phases informed the participants' experience of aging and chronic illness: Noticing the Changes, Reflecting on the Meaning and Optimizing Control. Noticing the Changes described alterations in the participants' ADL and role performance, the notion of usefulness and fears regarding anticipated ADL and role performance changes in the future. Reflecting on the Meaning followed the participants' exploration of relationships, culture, significant life events and self-perception as sources of insight into their experiences of aging. Finally, Optimizing Control revealed strategies for balancing the changes associated with aging and chronic illness. Wisdom, the culmination of life long knowledge, formed the central referent point through which the experiences of aging and chronic illness were understood. Findings were discussed in relation to the current literature and the organizing framework. Although the notion of personhood was not explicitly defined in the data, several themes and subconcepts relevant to the literature and to the study's orienting definition were identified. Conclusions on the experience of aging were drawn from the participants' stories of their experiences. Assertions regarding the relationship of the data to Feminist thought were presented. Finally, the implications for nursing education, research and practice arising from the data were identified.

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