E T H N I C E L D E R S ' N A R R A T I V E S A N D RESPONSES T O C U L T U R E T A L E S : A S T U D Y OF C U L T U R E A N D R E M I N I S C E N C E By Katherine Glenna Stewart B.Sc. (Hon), The University of British Columbia, 1984 M.Sc , McGil l Univeristy, 1987 Nursing Diploma, Cariboo College, 1991 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF M A S T E R OF SCIENCE IN NURSING in THE F A C U L T Y OF G R A D U A T E STUDIES (School of Nursing) .. . We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH C O L U M B I A May 2002 © Katherine Glenna Stewart, 2002 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of The University of British Columbia Vancouver, Canada Date fyril33,%%q DE-6 (2/88) A B S T R A C T This qualitative study of older adults of differing ethnocultural backgrounds explored the influence of culture on reminiscence. Specifically, the study examined the ways in which participants constructed their reminiscences by examining how culture is expressed in reminiscence and how each elder responds to a story specific to his or her culture. The research design of narrative analysis was chosen for its suitability to studying personal meaning in stories such as those told in reminiscence. The method of narrative analysis used was the construction of an Adequate Paraphrase (AP) because it allowed the analyst to extract the essence of a story from the structure of narrative text, and to see the connection between this essence and cultural meaning. Original interviews were obtained from four individuals and secondary analysis was performed on transcripts obtained from three pilot study participants. Several key findings were discovered. First, an elder can express the fluid and reciprocal relationship between culture and identity in reminiscing on his or her life. Second, AP interpretations offer only a partial understanding of an elder's reminiscence, possibly in relation to varying levels of representation of narrative. Third, the purpose of construction of a particular reminiscence appears to be to direct the use of structural devices in order to present the reminiscer as one who has acted reasonably and congruently with his or her values. Insights on cultural expression in reminiscence were discussed and used to propose a tentative outline of reminiscence construction involving content, structure, purpose and formulation. Each of these aspects appears to relate to particular theoretical perspectives on reminiscence. Thus, while no single perspective accounts for all of reminiscence construction, certain perspectives may be more applicable to certain aspects of construction. ii A key implication of this study is that by engaging diverse elders in reminiscence, one may promote identity integration, search for life meaning, understanding of meaning in context, accessing memory and communicating meaning. In turn, such engagement in reminiscence may promote quality health care in the face of diversity. ii i T A B L E OF C O N T E N T S Page A B S T R A C T ii T A B L E OF C O N T E N T S iv LIST OF T A B L E S viii A C K N O W L E D G E M E N T S ix C H A P T E R O N E : I N T R O D U C T I O N 1 Aging and Health 1 Cultural Context 2 Reminiscence 4 Problem and Purpose 5 Research Question 6 Significance 6 Reminiscence 6 Diversity 7 Consequences of Diversity 7 Summary 9 Definitions 9 Culture 10 Ethnicity 12 Other Related Terms 15 Terms as Defined for this Proposed Study 17 Narrative 17 Reminiscence 17 Ethnic Elder 17 Culture Tale 17 C H A P T E R T W O : L I T E R A T U R E R E V I E W 19 Reminiscence 19 Theory Development 19 Nature of Reminiscence 27 Reminiscence as Therapy-Therapeutic Uses 30 Reminiscence as Therapy-Influencing Factors 34 Summary of Review of Reminiscence 38 Culture and Aging Theories 39 Life Course Perspective 39 Continuity 39 Interpretive Paradigm on Aging 40 Integrated Pluralism 41 Double/Multiple Jeopardy 41 Ethnic Revival and Exchange Theory 42 Ethnic Compensation and Role Theory 42 iv Ways in Which Culture May Present in Reminiscence 43 Identity Development 43 Contextual Ways 52 Memory 57 Oral Performance 59 Spirituality 59 Conclusion 60 CHAPTER THREE: METHODS 62 Research Design 62 Assumptions 62 Rationale 64 Sampling 66 Data Collection 67 Data Analysis 69 Adequate Paraphrase 69 Rigour 71 Ethical Considerations 73 Limitations 74 Summary 74 CHAPTER FOUR: FINDINGS 75 Introduction 75 Interview Process 76 Data Sources 76 Data Inclusion for Analysis 76 Data Categorization 77 Language Influences on Interviews 77 Other Influences 78 Analysis Method 78 Meaning Emergence 78 Limiting Influences 79 Overall Findings 79 APs and Interpretations 81 Participant #1 (PI) 81 AP Examples for PI ....81 Participant #2 (P2) • 85 AP Examples for P2 86 Participant #3 (P3) 90 AP Examples for P3 91 Participant #4 (P4) 94 AP Examples for P4 94 Pilot Study Participant #1 (PS1) 100 AP Examples for PS 1 101 Pilot Study Participant #2 (PS2) 107 AP Examples for PS2 107 Pilot Study Participant #3 (PS3) 111 Responses to Culture Tales 112 v Response ofPS2 112 Response of PS3 113 Response of P3 114 Summary 114 Illustrations of Cultural Expression in Reminiscence 114 Cultural Expression and Identity Development 115 Ethnicity and Personal Identity 115 Ethnicity, Identity and the Life Course Perspective 118 Identity and Immigration 119 Summary 120 Cultural Expression Via Contextual Ways 120 Meaning Making 121 Relationship - Kin 122 Relationship - Reminiscer and Listener 124 Summary 125 Cultural Expression Via Memory 126 Cultural Expression Via Oral Performance 126 Cultural Expression Via Spirituality 127 Member Validation 129 Strong Agreement 130 Hesitant Agreement 130 Disagreement 131 Identity Development 131 Contextual Ways 133 Summary 134 Chapter Summary 135 C H A P T E R F I V E : DISCUSSION A N D I M P L I C A T I O N S 136 Introduction 136 Cultural Expression and Identity Development 136 Ethnicity and Personal Identity 137 Ethnicity, Identity and the Life Course Perspective 138 Identity and Immigration 138 Summary 138 Cultural Expression Via Contextual Perspective 139 Meaning Making 139 Relationship - Kin 140 Kin Relationship and Meaning Making 140 Relationship-Reminiscer and Listener 141 Summary 141 Cultural Expression Via Memory 141 Cultural Expression Via Oral Performance 142 Cultural Expression Via Spirituality 142 Member Validation and Levels of Representation 143 Construction of Reminiscence by Ethnic Elders 144 Content 144 Structure 145 Formulation 146 vi Purpose 148 Summary 149 Implications 149 AP Method 150 Use of Culture Tale 151 Contribution of this Study 151 Implications for Practice 152 Implications for Research 154 Implications for Education 156 Conclusion 157 R E F E R E N C E S 158 A P P E N D I X I: C O N S T R U C T I N G A N A D E Q U A T E P A R A P H R A S E 171 A P P E N D I X II: D E R I V A T I O N OF A P F O R PI 'S S E C T I O N " L I V I N G IN W A R T I M E " - P A R T 1 173 A P P E N D I X III: L E T T E R OF C O N T A C T 176 A P P E N D I X IV: I N F O R M E D CONSENT F O R M 178 vii LIST OF T A B L E S Page Table 1. Demographics for Participants 76 viii ACKNOWLEDGEMENTS My sincere thanks go to all my committee members, Dr. JoAnn Perry, Dr. Gloria Joachim and Dr. Roberta Hewat, for their thoughtful and substantive contributions to this thesis. I cannot express adequately my appreciation for the generous encouragement given to me by my chairperson, Dr. JoAnn Perry. Without her ideas, invitation to expand her pilot study, as well as invaluable guidance and support, this thesis would not exist. I extend true appreciation to the BC Medical Services Foundation for their financial support of this research. I also offer my sincere thanks to Shelley MacDonald who has gone beyond the call of duty in helping prepare the pages of this thesis. To those who contributed to the research through nominating study participants, I offer sincere thanks. This thesis has been built on the willingness of the participants to share their stories. My heartfelt gratitude is theirs. The encouragement of friends and relatives has been such a gift to me. I truly appreciate the support they have shown me throughout this time. I am most grateful to my mother and brother who gave up much for me to return to school and pursue this work. Their steadfast love and belief in me mean the world to me, and to them I dedicate this thesis. I also dedicate this thesis in loving memory of my Uncle Colin Stewart (1917-2002) who often encouraged me with his humour, poems and reminiscences of my late dad. ix 1 C H A P T E R O N E : I N T R O D U C T I O N In this qualitative thesis, I explore reminiscing in different cultural groups. Recent attention has been given to the therapeutic uses of reminiscence in the elderly. In Chapter one, I provide background to the study including information on aging and health, cultural context and reminiscence. After outlining the problem and purpose of the study, I identify the research question, discuss the significance of the study, and provide a brief summary. At the end of Chapter one, I offer definitions relevant to the study. Aging and Health In Canada, the population is expected to continue to age well into the next decade (Angus & Turbayne, 1995). From 1961 to 1996, the senior population increased at a faster rate than the nonsenior population (Northcott & Milliken, 1998). The impact of this trend on health care delivery is complex. This complexity may be related to the view that age is both biological and sociological in nature (Markides, 1989). For example, biological factors lead to a direct positive relationship between chronological age and health deterioration (Markides). In turn, contacts with doctors as well as use of care facilities tend to increase with age (Angus & Turbayne). Nevertheless, with improved health care, life expectancy of the very old is rising (Markides), and most of the hospital days used by the elderly are used by only a small proportion of the elderly (Angus & Turbayne). Perhaps as significant as biology are the sociological variables of power and life choices (Coutu-Wakulczyk & Beckingham, 1993). Advancing age may be a source of inequality and loss, leading to devaluation (Kropf & Tandy, 1998; Markides, 1989). Thus, even those elderly who gain in such aspects of life as financial situation (Angus & Turbayne, 1995) can face such health depressing life course transitions as widowhood, and such role strains as persistent marital problems (Markides). The combination of longer life expectancy, age-related physical deterioration and social losses presents 2 therapeutic challenges to health care professionals who work towards enhancing quality of life for elderly individuals. In addition to the biological and sociological variables associated with aging, ethnically related cultural factors may also present therapeutic challenges in caring for elderly individuals who possess an ethnic background distinct from the mainstream culture. Coutu-Wakulczyk and Beckingham (1993) state that ethnicity must be considered in quality of life studies in the elderly since cultural perspective can affect longevity as well as personal and relational meanings of aging. Ujimoto (1995) states that variation in the social and psychological behaviour of aged ethnic minority individuals demands new ways of addressing age related issues. Thus, not only do aging and health interact with each other, but they also interact with culture. For a discussion on the meaning of culture, ethnicity and related concepts, please see the section on definitions at the end of this introductory chapter. This section also includes the terms culture tale, ethnic elder, reminiscence and narrative as defined for this study. Cultural Context As with age, both biological and sociological variables are thought to be associated with culture. Lock (1993) addresses biological variables. She disagrees with the western medical view that culture consists of surface features which, once stripped away, leave a true, stable, transcultural, biological base. Lock argues that culture is related dynamically and interdependently with biology and must be seriously considered in delivering health care. Jackson, Antonucci and Gibson (1995) appear to agree with the idea that the relationship between culture and biology must be considered in the delivery of health care. They state that ethnicity is a self- and other- imposed group construction; and that culture relates to the patterning of artifacts, beliefs and values across generations. In an earlier work, Jackson, Antonucci and Gibson (1990 as cited in Jackson et al.) view ethnicity as a predisposing cultural and socioenvironmental orientation. They suggest that although values, motives and social and psychological domains vary widely among ethnic elders, certain attributes such as cultural expression, distribution of disorders and responsiveness to treatment relate to ethnic group background. The sociological aspects of culture involve how culture influences interactions among individuals. Coutu-Wakulczyk and Beckingham (1993) state that culture and society are inseparable concepts since culture arises from, and persists through, societal interaction. They add that societal organization is largely mediated through cultural meaning. Schultz and Lavenda (1995) state that in order to function successfully in society, an individual must proceed through socialization and enculturation. Whereas socialization involves learning to behave within socially established behavioural rules, enculturation involves learning the ways of thinking and feeling that are accepted within one's culture (Schultz & Lavenda). Lock (1993) suggests that enculturation results in the embedding of such characteristics as language use. The degree to which enculturation influences individuals varies, but the impact of this variation on health does not appear to be well understood. When individuals migrate, their previous enculturation is challenged. Holzberg (1982) argues that culture can be "turned on or o f f (p.251) by individuals as needed. For example, although their values may remain unchanged, people who have immigrated may let go of those traditional behaviours that they believe are not suitable in the new setting (Holzberg). Acculturation, the changes in original cultural patterns that occur when individuals from different cultural groups come into contact (Redfield, Linton & Herskovits, 1936 as cited in Aranda & Miranda, 1997), has been examined for effects on psychological health with mixed results. Most studies support a relationship, but some show it to be directly positive, others directly negative and yet others curvilinear (Aranda & Miranda). Anderson, Waxier-Morrison, Richardson, Herbert and Murphy (1990) suggest that 4 differing levels of acculturation can lead to conflict between ethnic elderly individuals and their children. The influence of acculturation on health brings into question the influence immigration may exert. Lock (1993) states that in Canada, the view of immigration as a kind of rebirth or fresh start has led to the assumption that multiculturalism, the notion that implies that immigrants are not expected to become assimilated, is something created within Canada, separate from life before migration. She calls for greater attention to such factors as the conditions that led to emigration from the homeland. Jackson et al's (1995) emphasis on life course transitions of ethnic elders appears to support Lock's view. They state that to more fully understand the mental health of ethnic elderly individuals, greater consideration must be given to adjustments made over the life course. Listening to an ethnic elder's life story offers one means of learning about the individual's life course. The story may provide information on the factors surrounding immigration and the influence of those factors, and the whole transition, on present perceptions. Anderson et al. (1990) suggest that ethnic influences affect people to varying degrees; and to avoid stereotyping, the details of individuals' life stories must be heard. Thus, the life story of an ethnic elder may lead to a balance in understanding both ethnic group influences and individual influences on that elder's health and expectations for health care delivery. One way of listening to an ethnic elder's life story is through the process of reminiscence. Reminiscence Reminiscing is a universal process (Cook, 1998; Lewis & Butler, 1974; McMahon & Rhudick, 1964). Bender, Baukham and Norris (1999) suggest that reminiscence can be of great value to those who have left their homeland by allowing them to see the past in a new way. A fresh view of the past can lead to a fresh view of the 5 present and future (Bender et al.). Furthermore, engaging in reminiscence may show immigrants that they, and their history are valued in their new home. Reminiscence involves several forms of reviewing a person's past, from structured and complete life review to unstructured talk of the past (Namazi & Haynes, 1994). The benefits of reminiscence range from providing a pleasurable past time (Bender et al., 1999), to decreasing depression (Haight, Michel & Hendrix, 1998), to resolving conflict and promoting identity resolution (Lewis & Butler, 1974). Coleman, Ivani-Chalian & Robinson (1998) suggest that with people living longer, opportunities to tell one's reminiscences to natural audiences of younger generations are decreasing. Thus, greater interest in supporting reminiscence professionally has developed (Coleman et al.). With this increased interest has come theoretical development and research. The impact of culture on reminiscence forms the basis for this study. Problem and Purpose Although recognized as a factor influencing the process and outcome of reminiscence sessions (Bender et al., 1999; Feinberg, 1996; Soltys & Coats, 1995; Wallace, 1992), cultural perspective has been addressed by relatively few studies (Soltys & Coats). Bender et al. state that reminiscence sessions designed for white elders in residential and day care centres were found to be unsuitable for black elders because the session leaders were white or young black staff and used language inappropriate to the age or culture of the black elders. Bender et al. add that for reminiscence in groups, membership of similar origin promoted the sharing of, and identifying with, reminiscences. Still, it is very important to recognize that differences in values, beliefs and social factors can exist among individuals within the same ethnic group (Anderson et al., 1990). Thus, sharing of the same ethnic background among participants may not guarantee enhancement of reminiscence sessions. 6 The purpose of this study is to explore the influence of culture on reminiscence. I will attempt to add to the knowledge on the therapeutic use of reminiscence in elders of diverse cultural backgrounds. This study is the extension of a pilot study begun in 1997 at the University of British Columbia by Dr. Jo Ann Perry. In this study I will continue with the pilot study's method of gathering personal narratives from a culturally diverse population to construct culture tales and explore how the tales influence reminiscence responses in ethnic elders. In addition to attempting to identify if and how reminiscence has been facilitated, I will analyze responses for possible ways in which culture has been expressed, and consider ways in which culture influences reminiscence. Research Question The research question guiding this study is: How does an ethnic elder respond to a culture tale specific to that elder's cultural background? Significance Reminiscence Reminiscence is relevant for nursing. For instance, Kovach (1991b) states that nurses can use reminiscence to gain an understanding of clients' self concepts and to identify clients' sources of "personal existential meaning" (p.203). Rentz (1995) sees reminiscence as a supportive intervention that nurses can use to help maintain integrity and enhance well-being in persons with dementing illness. Despite knowledge of the benefits of reminiscence, little is known about the relationship between reminiscence and culture. Attention to the cultural back ground of reminiscence participants is relevant in light of the changing ethnic composition that has occurred in Canada over the last 30 years (Baetz, 1997; Bhimani & Acorn, 1998). This change in composition can be attributed to immigration. Immigration levels, in turn, fluctuate with policy that reflects political and socioeconomic conditions (Angus & Turbayne, 1995). 7 Diversity Many of Canada's elderly are survivors of massive European migration that occurred in the early 1900's (Coutu-Wakulczyk & Beckingham, 1993). However, over the century, sources of immigration changed. Hiebert (1999) states that changes to Canadian immigration policy in the 1960's involved equalization of selection based on place of origin, resulting in reduced preference for Europeans and increased influx of Asians. Between 1967 and 1986, China, India and Hong Kong became sources of the three largest immigrant groups behind Britain to Greater Vancouver (Hiebert). Policy changes in the mid-1980's reflected economic and demographic concerns of the Canadian government (Hiebert, 1999). These changes perpetuated the trend toward decreased immigration from the United Kingdom, Europe and the United States, and increased immigration from Asia. In B.C., and in Greater Vancouver in particular, the national trends were echoed as the province recovered from a recession, the world exposition heightened international exposure, and Hong Kong prepared for repatriation to China (Hiebert). Between 1986 and 1996, changes to the national origin of Greater Vancouver's population included a drop from Europe and the United States, a doubling from South and Central America, and a dramatic rise from various parts of Asia (Hiebert). Immigrants now face a different Vancouver than did their predecessors, and the changes will likely continue with Vancouver expected to take a significant percentage of the anticipated annual national immigration target of 200,000 (Hiebert, 1999). Northcott and Milliken (1998) remind us that in time, the aging of these immigrants will add to the diverse ethnic composition of the senior population in Vancouver. Consequences of Diversity Hiebert (1999) states that with these changes to immigration patterns comes a need to better understand the dynamics of integration of populations and neighbourhoods. For instance, subgroups within ethnic groups vary in premigration characteristics and 8 more diverse social relations exist between and within ethnic groups (Hiebert). With the potential effects of acculturation on health (Aranda & Miranda, 1997), the need to understand the dynamics of integration may also be relevant for individuals. As argued by Baldonado et al. (1998): "...the rapid globalization of our society necessitates a growing recognition that it is not possible to provide high quality health and cost effective care in a cultural vacuum...." (p. 15). Harris (1999) supports greater understanding of the integration of individuals, stating that cultural variables contribute to low participation rates in community services by racial-ethnic minorities. Harris adds that culturally distinct psychosocial variables affect the help-seeking behaviours of older adults.. Furthermore, Disman and Disman.. (1995) show that cultural background can influence such attitudes as fear held by elderly individuals towards institutionalization. Kavanagh and Kennedy (1992) encourage nurses to examine their roles as models of belief, knowledge and ideologies in society, stating that nursing care is the factor exerting greatest impact on utilization of health care by ethnic minority individuals. As immigrants make their homes in Vancouver, meeting their diverse needs and expectations may require flexibility and more holistic modes of health care delivery. Harris (1999) states that changing demographic patterns necessitate the development of age-appropriate, culturally relevant therapeutic interventions to address the needs of growing numbers of ethnic elders. Ujimoto (1995) notes that in Canada, increased numbers of ethnic elderly individuals are entering intitutionalized care facilities. He states that these facilities have been organized for the dominant culture and provide little support or recognition for the cultural differences and life histories of elders of diverse ethnic backgrounds. In turn, this lack of support and recognition contributes to low self esteem and poor mental health in ethnic elders (Ujimoto). 9 Anderson et al. (1990) alert health professionals to the possibility that individuals who have left their homeland in order to leave behind suffering may now be facing disappointment with life in Canada, and should be treated with sensitivity and understanding. Reminiscence may provide a means to facilitate the filtering of culture and past experience. In this way, reminiscence may help an individual retain those aspects of culture and life history that are beneficial, and leave behind the harmful aspects (J. Perry, personal communication). Summary The relationship between health and the biology of aging is increasingly understood (Markides, 1989). We must now seek to understand aging in terms of social and cultural factors. Therapeutic aspects of reminiscence in the elderly are recognized. Still, some hospitalized elderly have expressed a desire to tell their life stories, but have found no one to listen, or have had difficulty constructing the stories (Coleman et al., 1998). Anderson et al. (1990) state that for ethnically diverse individuals, an important means of finding out each person's beliefs and expectations; and thereby providing culturally sensitive care, is to listen to the details of each person's life story. Thus, greater attention must be given to ways in which reminiscence may be used to help ethnically diverse elders tell their stories. Knowledge gained in this study on the use of reminiscence in elders of diverse backgrounds may be shown highly valuable in the face of Vancouver's increasingly changing ethnic composition. Definitions Exploring the meaning of culture and related terms can take one on a rather circuitous journey. The complexity of conceptualizing culture is amplified by considering its relationship to such terms as ethnicity. The meanings of these terms can vary with viewpoint, history and use. Thus, culture and such concepts as ethnicity, minority and 10 race are considered among the least stable in academic vocabulary (Berry & Laponce, 1994; Marks & Worboys, 1997). Nevertheless, exploring these concepts is necessary to determine meanings useful for the purpose of this study. Culture Culture is often broadly defined as the way of life of a group (Henderson et al., 1997; Jary & Jary as cited in Torres, 1999; Masi, Mensah & McLeod, 1993; McPherson, 1995). The group may be one of the several types. For instance, it may be a population or part of a population (Henderson et al.), a society (Henderson et al.; Jary & Jary as cited in Torres; McPherson), a nation or subgroup within a nation (Henderson et al.), or simply a group of people (Masi et al.). Some authors qualify, the descriptor, way of life in terms of such features as: language, beliefs and patterns of behaviour (Jary & Jary, as cited in Torres; Masi et al.). A few authors use the phrase, pattern of behaviour, as the broad descriptor under which fall such features as communication, beliefs, roles and relationships (Ost, 1989 as cited in Coutu-Wakulczyk & Beckingham, 1993; Taylor, 1997 as cited in Denboba, Bragdon, Epstein, Garthright, & Goldman, 1998). Ost (1989) adds that patterns of behaviour are learned, or acquired, and are needed for members to behave in ways that are acceptable to the group. Habayeb (1995) prefers definitions of culture that attempt to demonstrate the concept's complexity. For instance, she refers to Specter (1991) who suggests that culture involves the interrelationship of beliefs, values, language, modes of dress, social relationships, rules of behaviour, economics, politics, law and social control, artifacts, technology, dietary habits and health care. This definition indicates only indirectly any purpose related to the concept of culture. Yet, it reveals that the features of culture interrelate. Furthermore, this definition explicitly states that culture relates to health. Denboba et al. (1998) elaborate on this relationship, stating that culture influences how 11 health, illness and disability are perceived, how health care provision is perceived and sought, how health information is communicated, how the role of family in health care is perceived, and whether traditional or nontraditional approaches are preferred. A number of recent studies have demonstrated some of these influences. For example, the Quechua Indians of Peru view illness etiologies and therapies as closely connected to the landscape and cosmology (Greenway, 1998). Furthermore, an individual's health is seen as inseparable from that of the household and community (Greenway, 1998). Culture has also been thought to influence health through physical characteristics (Spector, 1996). For instance, Connelly-Kudzma (1999) states that drug polymorphism can relate to cultural group variation, in part through genetic variation in drug metabolism. However, Henderson et al. (1997) note that epidemiological^,, health risks previously associated with cultural group have been found less evident when socioeconomic status has been controlled. They caution against assumptions based on physical characteristics. As indicated, a widely accepted definition of culture with distinctive properties remains elusive (Berry & Laponce, 1994). Perhaps developing specific definitions for specific purposes is more useful than attempting to develop an all-encompassing definition. This direction seems to have been widely followed as demonstrated by Kroeber and Kluchhohn's (1952, as cited in Berry & Laponce, 1994) categorization of definitions of culture into six types: descriptive, historical, normative, psychological, structural, and genetic. To discern ways in which culture presents in reminiscence, it seems important to use a definition that will not limit possibilities and cause expressions of culture to be missed. At the same time, a definition is needed to recognize what is culture and what is not. One place to start may be recognizing, as stated earlier, that culture tends to refer to a group feature. Secondly, it may be helpful to develop, or draw on,, a definition that 12 incorporates elements amenable to expression in reminiscences (e.g. temporal, can be communicated, involve meaning of lived experience). Furthermore, seeing culture as having a purpose, rather than simply viewing it descriptively may make the conceptualization more operational. At this time, I propose to base the meaning of culture on the conceptualization by McPherson (1995) who states that culture is a way of life of a group (society or subgroup of society) that develops when that way of life is shared at the same time and place, that is composed of material elements (law, language, art, dress, folklore, technology) and nonmaterial elements (norms, customs, values, beliefs, knowledge, sanctions), and that provides symbolic order and a set of shared meanings to social life. This definition appears to satisfy, the criteria identified earlier as. important to the purpose of this study. Furthermore, the idea that culture provides symbolic order and shared meaning to social life appears to find support in Sokolovsky's (1997) suggestion that cultural systems create lenses of symbols through which specific versions of reality are developed. Finally, by incorporating such notions as sharing meanings and sharing a way of life at the same time and place, as well as by involving such elements as language, folklore, values, beliefs and knowledge, this definition seems to substantiate the idea that culture can find expression through reminiscence. Ethnicity Like culture, ethnicity has been defined in many ways. Again, no widely accepted definition appears to exist. Berry and Laponce (1994) state that sometimes ethnic means race, sometimes not; sometimes ethnic covers religion, sometimes not. Furthermore, the terms ethnicity and ethnic identity are not clearly delineated. For instance, Marks and Worboys (1997) state that ethnicity can relate to particular historical and cultural traits common to a group, or it can refer to an identity that is self-defined. At first, this self-defined identity seems to focus at the individual level. However, by adding that this 13 designation of identity may or may not be accepted by other social groups, Marks and Worsboys seem to be referring to a group identity. Trela and Sokolovsky (1979) state that ethnicity is a dimension of intergroup relations and ethnic identity is a dimension of ethnicity. In elaboration, they describe ethnic identity as feelings of solidarity with fellow ethnics, as well as personal subjective salience of ethnicity. Their elaboration receives support from Kalin and Berry (1994) who define ethnic identity as a personal attitude and attachment to a group with whom the individual believes, based on shared characteristics and sociocultural experiences, he or she has a common ancestry. On the other hand, Coutu-Wakulczyk and Beckingham (1993) seem to bypass any notion of the concept of ethnic identity, referring to ethnicity as an intimate dimension of one's mind, or inner identity. In the rest of this literature review, I will recognize this subjectivity by retaining each author's usage of the terms ethnicity and ethnic identity. Common to most definitions of ethnicity is the idea that ethnicity is a feature of groups of people, not of individuals. Furthermore, definitions centre on one or more of the ideas of origins, communities and social differentiation. DeVos and Romanucci-Ross (1975) emphasize that ethnicity is a concern of origins, or parentage. By explaining group origin through parentage, ethnicity provides knowledge as to why one has rights and obligations in a group, and why one behaves in accordance with group customs. In a study by Luborsky and Rubinstein (1987), interviewees regarded ethnicity as an inherent part of everyone, conceptualized, in part, in terms of family background. However, parentage as a key property of ethnicity has been challenged. For instance, lineage is seen as insufficient to explain ethnicity for those of mixed lineage (Kastenbaum, 1979). Kastenbaum considers varying degrees of ethnicity in which lineage acts as one of three criteria. He also considers self-definition and observed behaviour as criteria determining whether one is totally, partially or not ethnic. Jackson et al. (1995) offer a definition of 14 ethnicity that seems to deny any idea of parentage, stating that ethnicity is a "self- and other-imposed group construction" (p. 31). Several authors incorporate into their definitions of ethnicity the idea of commonalities. Such commonalities include a shared sense of peoplehood based on shared cultural meanings, heritage, common ties, elements and life patterns (Dowd, Newman Giger & Davidhizar, 1998; Padgett, 1995; Rosenthal, 1986). Although agreeing with the sense of commonality and sharing, several authors add the importance of social differentiation (Holzbert, 1982; Jackson et al., 1995; Masi et al., 1993). Masi et al. state that above all, members of an ethnic group feel they are one people different from all other people. Gelfand (1994) notes that a common assumption concerning ethnicity, in relation to aging, is that ethnic values are stable, urfchanging, ascribed characteristics. He challenges this assumption, stating that ethnic values are adopted or changed by individuals. He proposes an alternative assumption of emergent ethnicity in which recognition is given to the potential influence on ethnic values of coming into contact with other groups. Similarly, Sokolovsky (1997) points out that ethnic behaviour and identity are expressed in places other than where they originate. He suggests that ethnicity is a creative act, mixing patterns of ancestry with demands of the larger society and local environment. The dynamic nature of ethnicity will be explored more fully in a later section of this review. In summary, ethnicity, like culture, tends to refer to a group feature. Although origins has been considered a distinguishing feature by some, its appropriateness as a defining element has been questioned by others. Ethnicity can be understood as a shared sense of group commonality and/or as a sense of distinctiveness from other groups in society. The elements considered common to one group, and different from other groups, are generally cultural in nature (Coutu-Wakukzyk & Beckingham, 1993). 15 Holzberg (1982) offers a definition that may be useful for this study. Even though I question the inclusion of a common place of origin, I feel the way ethnicity and culture are related, and the way cultural criteria are specified are applicable. In this definition, Holzberg states that ethnicity is a social differentiation based on such cultural criteria as a sense of peoplehood, shared history, a common place of origin, language, dress and food preferences, and participation in associations that fosters a sense of exclusiveness, and self awareness that one is a member of a distinct and bounded social group. Challenging the inclusion of a common place of origin in Holzberg's (1982) definition does not necessarily contradict acceptance of McPherson's (1995) idea that culture develops when a way of life is shared at the same time and.place. Rather, the challenge is aimed at the idea that a common place of origin is an element whose influence is key and unchanging over time. So, although a culture may start from sharing a way of life in one place at one time, it will not remain static, but will develop from that start. Any distinction between culture and ethnicity is blurred. Nevertheless, in this study I will attempt to use these labels inline with McPherson's (1995) and Holzberg's (1982) definitions. The term culture will carry an emphasis on a way of life whereas ethnicity will tend to denote a sense of group identity. Other Related Terms In discussions related to culture and ethnicity, such terms as minority, race and immigrant are often used. Minority has been defined neutrally as any political, religious, occupational or racial group that makes up less than a numerical majority of the population (Dowd, et al., 1998). However, some authors suggest that minority carries the negative meaning of power disadvantage (Henderson et al., 1997; Padgett, 1995). In fact, the term "minority group" was first adopted in society in reference to ethnic groups who, regardless of their numerical status, lacked political and economic power, and 16 encountered prejudice and discrimination (Wagley & Harris, 1958 as cited in Padgett). Gelfand (1994) notes that another distinguishing feature of minorities is that group members recognize they are objects of discrimination as a result of their inferior social position. Marks and Worboys (1997) state that the term ethnic minority is often used to designate an immigrant group that develops and/or maintains a distinctive culture and identity in the host society. However, they note that the indefinite timing of this designation lends ambiguity to the term immigrant. For instance, they ask, how long does one remain an immigrant after settling? And what designation should be given to children born in the host society? The term, race has been used to imply a physical or biological categorization (Dowd et al., 1998; Henderson et al., 1997). Dowd et al. suggest that the terms race and ethnic group overlap since biological and cultural similarities can reinforce each other. McPherson (1995) considers race, along with ethnicity, as a main basis for subculture formation in society. McPherson acknowledges negativity, stating that racial subcultures are set apart by the dominant group on the basis of different physical characteristics. Padgett (1995) states that although the terms, minority group, and race fulfill certain needs in research (e.g. recording effects of discrimination), she agrees with others (e.g. Lock, 1993; Marks & Worboys, 1997) that race has no genetic basis and is more political than scientific. In summary, the term race will be avoided as much as possible in this study. Because immigration will be examined later in this literature review, the terms immigrant and minority will appear. They will be used in accordance with the meaning given in each reference. 17 Terms as Defined for this Proposed Study Narrative Prosaic discourse (text made up of complete sentences linked into a coherent statement and forming natural linguistic expressions) of the storied type in which events and actions are drawn together into a meaningful whole by a plot, or conceptual scheme (Polkinghorne, 1995). The events have occurred as a series in the past (Polanyi, 1985) and the storied narrative is the linguistic form that describes these events as biographies, autobiographies, histories, case studies and reports of remembrances (Polkinghorne). Reminiscence A form of narrative involving a telling of remembrance of personal past lived experience where the remembrance can range from earliest to recent memories. A reminiscence response is a reminiscence told in response to hearing a culture tale. Ethnic Elder An individual 65 years of age or older who demonstrates his or her ethnicity as a social differentiation based on such cultural criteria as a sense of peoplehood, shared history, common place of origin, language, dress and food preferences; and participation in associations that foster a sense of exclusiveness from the mainstream, English-speaking Canadian culture and an awareness of being a member of a distinct and bounded social group (after Holzberg, 1982). Culture Tale A narrative of past life experience as told by an ethnic elder, possibly supplemented by historical information from the literature and summarized by the researcher. This narrative expresses aspects of the ethnic elder's culture. This culture is the way of life of the elder's ethnic group that has developed from being shared by a group of people at the same time and place, and is composed of material elements (law, language, art, dress, folklore, technology) and nonmaterial elements (norms, customs, 18 values, beliefs, knowledge, sanctions), and that provides symbolic order and a set of shared meanings to social life (after McPherson, 1995). 19 C H A P T E R T W O : L I T E R A T U R E R E V I E W In this chapter, I set out to examine and critique the literature addressing reminiscence in the elderly, and the relationships between culture and aging. Reviewing this literature not only provides additional background for the study, but also evaluates the current knowledge base to identify gaps concerning the use of reminiscence with elderly individuals of diverse cultural backgrounds. Existing knowledge and identified gaps substantiate the need to understand how reminiscence can be suited to the needs of culturally diverse elders. The literature review will begin with an examination of the theoretical basis, functions and application of reminiscence. Next, I will discuss some of the theories relevant to culture and aging. These sections form the basis on which to review ways in which culture may present in reminiscence. Reminiscence Theory Development Perhaps the most widely recognized theory proposed as a foundation for reminiscence is the theory of life review (Butler, 1963 as cited in Lewis & Butler, 1974). This theory has been instrumental in changing the reputation of reminiscence from a sign of senility (Kovach, 1991b) to a meaningful, beneficial process (Wong & Watt, 1991). Butler based this theory on observations of older persons in psychotherapy. He suggested that life review is a mental process that occurs universally at all ages, but that intensifies at older ages, when death appears more imminent. Along with this increased intensity comes a renewal of the capacity to bring to surface deeply buried memories and their accompanying emotions (Lewis & Butler). The evocation of conflictual memories and emotions is natural and necessary for putting one's life in order (Lewis & Butler). Thus, outcomes of conflict resolution through life review include: finding meaning in life and identity resolution (Lewis & Butler). Other outcomes may include: decreased fear of 20 death, increased creativity, making amends and increased tolerance of conflict and uncertainty. Occasionally, the struggle to resolve old conflicts results in sadness and regret (Lewis & Butler). The person may become fixed in the past; or if regret is extreme, become panicky and even suicidal (Lewis & Butler). Although reminiscence does occur spontaneously, a facilitator can use techniques to trigger memories, guide the process and provide assistance in conflict resolution (Lewis & Butler). The theory of life review was largely influenced by Erikson's (1963) model of psychosocial development (Harris, 1999). According to Erikson, psychosocial development proceeds through a series of stages, each stage containing a specific crisis, or turning point between "progress and regression,.integration and.retardation" (p. 271).. Although each stage has its own crisis, it also exists, with all the other stages, in some form, throughout development. In late adulthood, the turning point centres on ego-integrity vs. despair, where ego integration is expressed as an acceptance of one's life as it has to be, and despair is expressed as a lack of this acceptance and a fear of death (Erikson). Although to achieve integrity, each individual needs to have developed the ego qualities of previous stages to a sufficient degree, the particular style of integrity can vary with the cultural history in which individuals developed (Erikson). Coleman (1999) states that ideas concerning identity maintenance and stimulation of social involvement, after observations by McMahon and Rhudick (1964), have provided the main theoretical foundations for reminiscence work over the last few decades despite the strength of the life review theory. According to identity maintenance, the gap between one's present life and one's desired life, as a result of loss, is decreased by examining and emphasizing the value of one's past life and achievements. A sense of self worth then receives justification (Coleman, 1995). However, the intensified review of life with increasing age may be as valid in promoting the examination of one's past, as is the discrepancy between actual and desired life created in the face of loss. 21 Indeed, loss may not always lead to such a perceived discrepancy and concomitant need for closure (O'Connor, 1994). In his study, O'Connor found that loss can become a natural expression of those whose lives it has pervaded. He questions the view that quality of life depends upon the resolution of crises, termed by Wright as the "requirement of cheerfulness" (as cited in O'Connor, 1994). Instead of aspiring to resolution, O'Connor argues that aspiring to the context where pain can be shared and present wishes be met may sometimes be more appropriate. Although resolving conflict is a main aspect of life review, the increased ability to tolerate conflict and uncertainty is acknowledged as a possible outcome (Lewis & Butler, 1974). -Reminiscence may-be thought of as a form of personal narrative leading to identity integration (Cohler,1993; Randall, 1999). Polkinghorne (1991; 1996) describes the self-narrative as the story that configures a person's life into a unified whole, providing the self identity. He states that temporality is the primary dimension of human existence and that our lives become meaningful and coherent through the cognitive temporal schematic configuration of narrative. This narrative configuration draws lived experiences together both temporally and in terms of their relevance to each other and to the whole life theme (Polkinghorne). Coleman et al. (1998) report that most of the survivors, all over 80 years old, of a longitudinal study, stated that they saw their lives as whole stories rather than as "series of disconnected events" (p. 401). Benner (1993) lends support to this idea stating that despite previously reflecting on his past lived experiences, it is only through the exercise of writing his whole autobiography that he sees the coherence and direction of his life and his authorship of it. Cohler (1993) agrees that the personal narrative composes the currently remembered personal past, rendering order and sense to lived experience. He emphasizes the role of "followability" (p.l 13) of the personal narrative in providing integrity. He states that followability involves both a personal accountability as well as an appreciation 22 of societal dimensions over time. Cohler proposes that the need for a coherent and followable life story appears to increase in importance with advancing age. He suggests that increased awareness of mortality in the face of loss, and the need for settling accounts through life review provide the context in which reminiscence becomes characteristic. In fact, he suggests that memory becomes the key means of attaining solace and morale. With more frequent losses of loved ones, relationships and interactions, the elderly may see reminiscence as their main source of comfort in older age (Cohler). Parker (1995) has criticized the theory of life review for relying heavily on disengagement and ego-integrity .theories.. She criticizes certain assumptions of these . theories and offers continuity as an alternative theoretical foundation. Although the • theory of life review may incorporate aspects of disengagement and ego-integrity, it does not share all of their assumptions. For example, by acknowledging that reminiscence can result in "elementality", life review theory seems to withstand criticism of the assumption of withdrawal. Furthermore, the way in which continuity contests ego-integrity is unclear. Both ideas incorporate a linking of the past to the present and are identity-oriented. The assumption of continuity theory that older individuals tend to seek familiarity and comfort over the unknown and discomfort (Parker) is perhaps no more valid than the assumption that older individuals tend to seek meaning and significance in their lives. Woodward (1986) critiques Butler's (1963, as cited in Woodward, 1986) interpretation of reminiscence. She questions the accomplishment of integration in life, particularly through reminiscence, asking whether memory is always available. She also asks why integration should be valued. She bases this critique on ideas from several works of fiction used by Butler to demonstrate his views. In one work, the character listens to tape recordings he made on his past birthdays. Woodward states that despite these recordings, the character does not try to rebuild his life from the losses he has 23 endured, and his characterization demonstrates the impossibility of reintegration from fragments of stories. Nevertheless, within the critique, Woodward states that the lack of continuity is perplexing to the character. Furthermore, he lacks someone to listen to his story. Thus, although the character does not come to a point of integration, he possibly could i f a listener were present to help him connect the fragments of his stories. Finally, Woodward's description of the character's end as dismal, in which the past is not part of his present, and absence is all there is, seems to indicate that indeed integration is something to be valued. Webster (1999) considers the theory of life review to fall under an organismic metamodel. He states that in this metamodel, organisms are.believed to possess internal genetic blueprints that dictate the order, direction and end state of development,"and in . which environmental conditions play a passive role. In terms of reminiscence research, Webster criticizes the organismic perspective for such shortcomings as: (a) an emphasis on universal development that downplays any need for cross-cultural research; (b) an emphasis on the final stage of life that downplays any inquiry into reminiscence in younger adults; (c) an emphasis on facilitating ego-integrity that downplays any need to search for a wider set of functions; (d) an emphasis on thoughts of own mortality as the trigger, downplaying any need to search for alternative initiators; and (e) a de-emphasis on context, and assumption of stable sociohistorical background that downplays any inquiry into cohort effects. Alternatively, according to the contextual metamodel, the organism and context are considered interdependent, dynamic aspects of an ongoing drama or historic event (Webster, 1999). Humans and the environment interact dialectically, change is multidirectional, and development is seen as a process of "best fit" (Webster, p. 33). Humans try to make sense of lived experiences through intrapersonal reflection and 24 interpersonal comparison. Meaning is derived and negotiated within the perceived sociohistorical conditions (Webster). Webster's (1999) critique of the organismic perspective appears to rest on assumptions that he feels have limited research on reminiscence due to their gerocentric and universally directed nature. The nature of these assumptions is perhaps more subjective than noted by Webster. For example, Lewis and Butler (1974) suggest that a revival of one's ethnic identity may have personal and social value. In this case, they not only recognize the possibility of variation with diverse ethnic background, but they also appear to recognize the possibility of life review in a slightly younger age group as they talk about first generation Americans who have not yet transmitted ethnic heritage of their immigrant parents to their own children. Guided by the organismic perspective; Harris (1999), and Liton and Olstein (1969) have recognized the variation that diverse cultural background may introduce to reminiscence. Furthermore, based on the theory of life review, some have sought wider applications beyond achievement of ego-integrity. For example, Goldwasser, Auerbach, and Harkins (1987) studied cognitive, affective and behavioural effects of reminiscence on demented elderly. Clinically, Borden (as cited in Bender et al., 1999) has used life review in attempting to help young adults cope with AIDS. Webster (1999) acknowledges that the organismic metamodel is not wrong. He adds that the contextual metamodel incorporates positive aspects of the organismic view. He agrees that internal psychological forces do contribute to the unique qualitative experiences of emergent meanings in reminiscence. Despite the criticisms by Parker (1995), Woodward (1986) and Webster (1999), reminiscence continues to be linked with ego-integrity as in the theory of life review. Harris (1999) describes reminiscence as an "adult-onset developmental language behaviour". Still, Woodward's (1986) critique brings into question the assumption that 25 the primary dimension of human existence is temporal. For example, when memory is not available, can identity integration continue? In a grounded theory study on the experience of family caregivers of members with Alzheimer's Disease, Orona (1997) poignantly describes the effects of identity loss for both members. As memory fades with progress of the disease, the individual becomes less aware of temporal aspects of existence and less able to make biographical connections for identity integration (Orona). At the same time, the caregiver loses aspects of his or her identity when no longer receiving reciprocation of the relationship from the impaired member (Orona). For awhile, the caregiver may use approaches other than life review to maintain identity. These include recalling and reenacting memories of everyday living to symbolically maintain social interactions as they once took place (Orona).-Thus, personal narrative, through reminiscence may not comprise the whole process of identity integration. Wallace (1992) appears to support the contextual metamodel, seeing the personal narrative of reminiscence as a social construction. He suggests that reminiscence occurs only in response to narrative challenges from others, and that increased reminiscence with age may result from more frequent challenges posed to the elderly who are viewed culturally as "keepers of tradition" (p. 123). Wallace calls for heightened awareness of reminiscence as a social construction, and not necessarily beneficial to an individual's well-being. Even if, as Wallace (1992) says, "talk of the past" (p. 121) is a social activity constructed through interaction with others, it retains its past nature. Although that past may be shaped by present interaction (Wallace), it involves to some extent memory of a lived experience. Some researchers feel that reminiscence is a component of remote, or episodic memory, stating that this type of memory is resistant to deterioration and forms the repository for the autobiography (Harris, 1999; Parker, 1995). However, Bender et al. (1999) caution against viewing increased use of reminiscence with age as a simple 26 consequence of short term memory loss, with an adaptational (Parker) increased use in remote memory (Parker). They emphasize the function of reminiscence in providing meaning for older adults. Nevertheless, development of knowledge in the area of remote memory may add to the knowledge of the nature of reminiscence (Orten, Allen & Cook, 1989; Parker, 1995). Coleman (1999) outlines such characteristics essential to a good life story as coherence and truth. He suggests that further attention to the characteristics of telling a good story of one's life is needed in order to advance knowledge on reminiscence. Recognizing that knowledge concerning the specific nature of a good reminiscence story may be limited, I address knowledge concerning the general nature of reminiscence in the next section. In summary, theory development in reminiscence involves both conflict and agreement. Two overall competing perspectives, organismic and contextual, appear to contest the main purpose driving reminiscence. Whereas the contextual perspective places more emphasis on derivation of meaning from historical, sociocultural and relational contexts, the organismic perspective highlights individual, internally driver sources. Within the organismic perspective, disagreement exists on the exact nature of these sources. According to the life review theory, reminiscence is driven by the developmentally related process of resolving conflict that intensifies with older age in an attempt to achieve ego-integrity. Identity maintenance theory focuses on the effects of losses on one's perspective of his or her life, and continuity theory focuses on a tendency to seek familiarity throughout life. Yet, these three theories appear to agree that reminiscence relates to identity development. Moreover, both the contextual and organismic perspectives attend to the importance of linking one's past with one's present on development over the lifespan. 27 Nature of Reminiscence Although a complete picture has yet to emerge, results from a number of studies have begun to support the idea that several categories of reminiscence content, process and function exist. Kovach (1991b) applied a content analysis to a convenience sample of 21 cognitively intact elderly women to derive themes related to the content and process of reminiscence. The content themes were divided into meaning and event categories. Meaning themes included validating reminiscences (positive self appraisals, positive choices, positive social connections, positive images of the past) and lamenting reminiscences (regrets, lack of choice, difficulties) (Kovach, 1991b). Kovach (1991a) suggests that the way in which a person interprets own past experience provides a representation of that person's concept of self and sources of personal existential meaning. Some of the meaning themes appeared to vary with age, and to predominate in certain individuals. Kovach (1991c) goes on to suggest that diversity in lamenting and validating themes may reflect stage of ego development, or the usefulness of reminiscence as an intervention. Event categories included activity-centred, person-centred and possession-centred (Kovach, 1991b). Activity-centred events involved work, school, religion and travel themes. Person-centred themes included family, friends and own personal qualities. Possession-centred themes focussed on material goods. Kovach (1991b) suggests that the depth and intimacy of event themes revealed the relevance of a person's past to her present existence. A study of process revealed the degree to which people engage in reminiscence (Kovach, 1991c). Engagers tended to express more feeling, depth and detail, as well as access memories more easily. They also tended to remain focused on the reminiscence topic and request feedback. Non-engagers were less focused, tending to switch topics to the present, future, or more recent past and tending to respond neutrally (Kovach). Kovach feels that understanding the reasons for such non-engagement may be valuable 28 for implementation purposes. For example, studying avoidance exhibited by some non-engagers may help determine i f avoidance is selected as a useful coping strategy or as a harmful defence (Kovach). Kovach advocates further study into the avoidance of feelings, evaluations and painful memories, stating that the neutral probes in her study elicited only avoidance of content. This statement implies that the nature of the stimulus may influence a person's reminiscence response. In summary, the results of Kovach's (1991) studies do not clearly support one theoretical base of reminiscence over another. For example, the suggestions that engagement in reminiscence is developmental, and that reminiscence reflects events of personal significance appear to support the life review theory. The idea that reminiscence-may provide an important source of continuity supports continuity theory. Finally, the idea of the importance of a person's past to her present existence appears to most strongly support the contextual perspective's focus on lifespan development. Wong and Watt (1991) also used content analysis of reminiscence data obtained by interview of elderly individuals living in either the community or in nursing homes. They developed a taxonomy of six categories: integrative, instrumental, transrhissive, escapist, obsessive and narrative. Integrative consists of reconciliation of the past and achievement of self worth. Instrumental involves memories of goal attainment and contributed to a sense of self worth. Transmissive refers to aspects of cultural heritage and personal legacy. Escapist includes reminiscences which glorify the past and may be either beneficial (protecting self esteem from decline), or harmful (decreasing satisfaction in the present). Obsessive relates to the inability to resolve past conflicts and is characterized by ruminating and despair. Narrative pertains to factual, autobiographical statements and may reveal either cognitive soundness (e.g. retention of detail) or decline (Wong & Watt). This taxonomy was based on a much larger sample than Kovach's and appears to have encompassed Kovach's meaning and event themes. 29 Wong and Watt (1991) have expanded the knowledge concerning the process of engaging by testing which types of reminiscence are associated with success in aging and with living conditions. After distinguishing successful and unsuccessful agers by a two-step screening procedure, they found that successful agers engage in more integrative and instrumental, and less obsessive reminiscence than unsuccessful agers. Results for community-dwelling elders were similar to those for successful agers; and results for elders living in institutions were similar to those identified as unsuccessful agers (Wong & Watt). These results appear to support the view that reminiscence can influence the outcome of the developmental crisis of ego-integrity vs. despair and offers support of the adaptive function of life review suggested by-Butler (1963, as cited in Wong & Watt). However, they do not reveal whether the types of reminiscence are causes, or consequences, of successful aging (Wong & Watt). Furthermore, their suggestion that the interview setting hindered the ability to obtain any significant difference in transmissive reminiscence between successful and unsuccessful agers lends support to the contextual model. Webster (1993) has expanded on previous taxonomies (including that by Wong & Watt, 1991) to create a Reminiscence Functions Scale. This scale consists of seven main factors including: boredom reduction, death preparation, identity/problem solving, conversation, intimacy maintenance, bitterness revival and teach/inform. Certain factors correlated with personality domain (e.g. bitterness revival and neuroticism). Webster (1999) states that for certain factors, age trends are apparent. For instance, a linear increase with age exists in intimacy maintenance, while a decrease exists in bitterness revival. He states that these results fit well with the contextual lifespan perspective in which, over time, gradual shifts in such factors can occur with shifts in attention and energy allocation. Webster feels this scale is an improvement over Wong and Watt's (1991) taxonomy for research purposes because unlike the taxonomy, it does not 30 confound "type" and "function". Webster provides a range of alpha coefficients and matrix of factor intercorrelation for his scale. He states that the range of alpha levels (from .79 for conversation to .89 for identity/problem solving) shows good internal consistency. In addition, Webster supports the predictive validity of his scale. He identifies positive correlations between three personality traits and the scale's reminiscence functions expected to correlate with those traits. He also identifies expected differences in use of reminiscence functions over the life span (Webster). Wong and Watt claim difficulty in measuring reliability on narrative data, providing only a kappa statistic (.88) to demonstrate interjudge reliability. Nevertheless, Webster argues that the strong parallels between his scale and Wong and Watt's.taxonomy support the idea.that reminiscence is composed of several elements with potentially, adaptive functions. The results of the studies by Kovach (1991), Wong and Watt (1991) and Webster (1993) all suggest that reminiscence may promote adaptation. Other studies have gone further to try to establish causal relationships between reminiscence and adaptation; and thereby to establish a foundation for applying reminiscence as therapy. Reminiscence as Therapy-Therapeutic Uses (1) Depression Depression is a predominant health problem in older adults (Fry, 1983; Haight, Michel & Hendrix, 1998). As such, it has prompted much of the research into reminiscence as an intervention. Overall, results have indicated that reminiscence is effective. In his study, Fry found that both structured (explicit questions in a step-by-step procedure) and unstructured (choice of subject and procedure determined by reminiscer) approaches decreased depression. McDougall, Blixen and Suen (1997) conducted one-to-one evaluative life review sessions with clinically depressed, homebound individuals. Through content analysis, they found a significant decrease in disempowerment themes with life review therapy, 31 supporting the theory of life review. They suggest that changes found in themes of anxiety, denial and despair indicate that outlook may improve despite physical problems. Furthermore, they feel that such a positive impact by psychosocial treatments specific for the elderly may promote independent living for these older individuals. Haight et al. (1998) also performed one-to-one evaluative life review sessions. However, their sample consisted of individuals experiencing minor reactive depression related to relocation to nursing homes. Significant short and long-term decreases in depression resulted. Haight et al. suggest that life review may be used not only to help people adjust during the transition to a nursing home, but also as a means of preventing the worsening of subsyndromal depression into clinical, depression Studies obtaining insignificant results examined individuals who presented free of depression prior to treatment (Haight, 1988; Stevens-Ratchford, 1993). Furthermore, the Zung Depression Scale used by Haight with insignificant results is not specific to age (Haight). On the other hand, the scale used in studies obtaining significant results, the Beck Depression Inventory, is both valid and reliable for use in the elderly (Haight et al., 1998). The above studies examining effects of reminiscence on depression have tended to use life review as their theoretical base. (Although Fry [1983] does not explicitly refer to life review theory, his suggestion that reminiscence is a cognitive activity originating from a participant's memory appears congruent with the organismic perspective.) Because overall, the results of these studies have shown reminiscence to be effective in decreasing depression, they appear to support life review theory. (2) Life Satisfaction In addition to being therapeutic for depression, reminiscence is thought to enhance quality of life. The relationship between reminiscence and life satisfaction has been studied fairly extensively. Haight (1988; 1992) examined the influence of one-to-32 one structured life review in a sample of homebound elderly individuals. After an eight week treatment, she found significantly increased life satisfaction. After one year, an insignificant but upward trend in life satisfaction was measured in the survivors of the initial group (Haight, 1992). Interestingly, in a sample of newly relocated nursing home residents, using the same structured life review and same measurement index for life satisfaction, Haight et al. (1998) found no significant change at eight weeks, but did find significantly increased life satisfaction after one year. Haight et al. feel the early insignificant results in the nursing home study may have been a consequence of the research design allowing only half of the sample to be pretested. Nevertheless, in both groups, life review appeared to confer a lasting influence,, perhaps by helping individuals learn how to reframe memories constructively (Haight, 1992;. Haight et al., 1998). Instead of using one-to-one sessions, Cook (1998) used a group format to examine the effects of structured reminiscence on life satisfaction in elderly women in nursing homes. Using the LSI-A, with a Cronbach's alpha reliability for internal consistency of 0.71, she found a significant increase in life satisfaction, even after removing a possible confounding effect of education level. Haight (1988; 1992), Haight et al. (1998) and Cook (1998) used life review theory as the theoretical framework for their studies. Since reminiscence was shown to increase life satisfaction, life review was supported by these studies. (3) Self Esteem A third possible therapeutic use of reminiscence relates to self esteem. The effects of reminiscence on self esteem remain uncertain, but appear insignificant overall. Lappe (1987) conducted unstructured reminiscence sessions in groups and found a significantly greater increase in self esteem in reminiscence groups than in control groups. Lappe suggested that this increase was related to interest and approval demonstrated by peers in individuals' past experiences and accomplishments. However, using the same self esteem scale and similar format, Stevens-Ratchford (1993) found no significant effect. In both studies, the group facilitators may have influenced the outcomes (Lappe; Stevens-Ratchford). Using a more structured, one-to-one format, Haight et al. (1998) still found no effect on self esteem. Haight et al. suggest that outcome measures used to examine self esteem may lose sensitivity in old age, producing flat scores. In any case, all of these studies used life review theory as their framework. Since according to life review reminiscence can enhance self esteem, the results of these studies question life review theory. (4) Behaviour Modification Although research on therapeutic uses of reminiscence has concentrated on the potential benefits for enhancing quality of life in the elderly, a number of studies have begun to address its potential for modifying cognitive and behavioural functioning. Intrigued by discrepancies between nursing home reports of substantial behavioural improvements and statistically nonsignificant evidence, Berghorn and Schafer (1987) decided to study the characteristics of individuals most affected by reminiscence. They hoped to learn how to predict which individuals would benefit most. Only trends in behavioural changes were found. For instance, individuals were more likely to perceive others as more friendly than to obtain a confidente. However, their findings did indicate that those individuals who were unable to align their values with nursing home life were the ones most likely to elicit reminiscence in response to prompts. Berghorn and Schafer propose that reminiscence acts as a compensation, allowing individuals to live, indirectly, those situations more in line with their values. Thus, for cognitively intact individuals, changes in attitudes and behaviour may not occur without an adjustment in personal values (Berghorn & Schafer). The finding that reminiscence is compensatory, tending to reinforce personal values, appears to support reminiscence as adaptive for ego-integrity and thus appears to support life review theory. 34 Namazi and Haynes (1994) examined the effects of reminiscence therapy on clients with Alzheimer's Disease. They incorporated sensory stimuli, assuming these would enhance participation. A slight increase in mental status and number of behaviours was found in individuals receiving reminiscence with sensory stimuli. Certain adverse behaviours such as combativeness increased (Namazi & Haynes). Namazi and Haynes suggest that the increased number of aberrant behaviours may have related to increased stress and anxiety stimulated by pressure to participate or respond to a picture or conversation topic with which the individual was unfamiliar. Those individuals with increased cognitive impairment responded less to stimuli than those who were more lucid. Furthermore, sessions incorporating.topics relevant to participants' histories . produced greater responses not only by allowing participants to draw on past experiences, but also by facilitating contribution to the group discussion (Namazi & Haynes). These . results appear to emphasize the importance of the severity of cognitive impairment, as well as client's premorbid past (Namazi & Haynes). Namazi and Haynes do not clearly favour one theory over another. Rather, they emphasize the diversity of possible foundations. Their results appear to lend more support to the contextual perspective, emphasizing the importance of perceived sociohistorical conditions on meaning derivation. Reminiscence as Therapy-Influencing Factors (1) Format The research on therapeutic effects of reminiscence indicates that format and participant characteristics are significant to the implementation and outcomes of reminiscence sessions. Fry (1983) compared structured vs. unstructured formats of reminiscence for effectiveness in treating depression. The structured format consisted of a set of explicit questions concerning negative life events, followed by a step-by-step interaction between participant and facilitator. The unstructured format also involved 35 recalling a negative life event, but the participant was encouraged to choose and talk about anything associated with the event. Both formats reduced depression, but the structured format's effect was more significant. Fry attributes the structured format's greater effectiveness to its incorporation of encouragement for verbalization of upsetting events and associated feelings. He suggests that the structured format is both informative (by organizing and eliciting memories), and supportive (by providing a social context). The procedure used in Fry's study was adapted in part from Butler's (1963, as cited in Fry) structured reminiscence modality. Thus, the findings of increased effectiveness of the structured format seem to lend at least indirect support to Butler's life review theory. The importance of group format remains unclear. Results of quantitative studies. . have been contradictory. For example, studies finding significant differences between control and treatment groups, such as those by Cook (1998), would suggest that reminiscence therapy is more important than the group process. On the other hand, Rattenbury and Stones (1989) found no significant difference between reminiscence and current topics groups on their influence on psychological well-being. Each of these studies involved limitations including small samples, questionable inter-rater reliability, and questionable instrument reliability. Feinberg (1996) used a grounded interpretive approach to study the effectiveness of group meeting on life story discussion. Like Cook (1998), Feinberg based this study on the life review theory. In his sample of elderly Jewish Russian immigrants, he found that the group model did promote reminiscence. Within the group, reminiscences stimulated associations and memories, and provided themes for others to borrow for their own stories. Feinberg suggests that the group model is effective in providing a context in which all individuals can integrate their lives. However, he admits that such factors as translator difficulties, prevented validation of content themes with the participants. 36 The effectiveness of the group model would seem to support more readily the contextual perspective. However, Lewis and Butler (1974) discuss a number of ways in which participating in a group format of reminiscence can benefit an elderly individual in terms of ego-integrity. One benefit they suggest is a decreased sense of isolation and uselessness. Thus, effects of group format could be explained by both greater meaning derived in relational context, as well as greater drive towards achieving integrity of identity. And thus, the results of studies on group format do not seem to support one theory over another. (2) Participant Characteristics Blankenship, Molinari and Kunik (1996) demonstrated the importance of .. participant characteristics in their study on geropsychiatric clients. Using the Reminiscence Functions Scale (Webster, 1993), they found that reminiscence functions were unexpectedly high on admission but tended to decrease over time despite attendance at life review groups and improvement in psychiatric symptomatology. Furthermore, their participants reminisced no more frequently on negative functions. Because these results differed greatly from studies on community dwellers, who were more likely to reminisce on positive functions, and from chronically institutionalized elderly, who tended to reminisce on negative functions (Wong & Watt, 1991), Blankenship et al. feel that cognitive and psychiatric characteristics of participants may differentially affect the process of reminiscence. Although Blankenship et al. use Webster's scale, and Webster promotes the contextual perspective, Blankenship et al. base their study on life review theory. Their results bring into question that reminiscence increases in intensity universally. The idea that reminiscence intensity varies among populations seems more supportive of the contextual perspective. Bender et al. (1999) agree that participant characteristics are significant to reminiscence therapy. They categorize these characteristics as: physical and sensory well-37 being, cognitive abilities, individual background/life history, personality characteristics, emotional state, motivation, and life adjustment. They highlight the importance of assessing the participant's background, including development of coping strategies, over the lifespan. They state that difficulties in reminiscence sessions may arise if current expectations placed on the individual are incongruent with that person's history and perspective. The theoretical basis underlying the importance of participant characteristics is unclear. Bender et al. (1999) suggest that content themes that consider the history and perspective of the participant will act as catalysts for reminiscence by holding relevance for that individual. This suggestion appears, congruent with the contextual perspective's view that development is lifelong and influences by evolving sociohistorical and cultural conditions (Webster, 1999). Nevertheless, the organismic perspective is supported by the statement that personal past memorabilia and events (e.g. reunions) may stimulate reminiscence by allowing the person to see his own place and significance in the life course (Lewis & Butler, 1974; Pickrel, 1989; Romaniuk, 1983). Furthermore, the use of materials and content that are relevant to the person's history and perspective tends to help establish rapport between participant and facilitator (Lewis & Butler; Romaniuk). This observation seems to emphasize the perspective that meaning is brought to the relationship by the participant rather than the contextual idea that meaning is created within the relationship. (3) Stimuli Soltys and Coats (1995) call for clinicians to be familiar with the possible uses of reminiscence stimuli in order to acquire a wider array of benefits. Yet, knowledge on the action of stimuli appears to have come mainly from clinical observations rather than from systematic research. Questions remain as to the differential effectiveness of certain features of content themes, as well as to the relative influence of stimuli vs. barriers. 38 What is considered acceptable as a life story may be culture specific (Cohler, 1993). Furthermore, concern with linear time and individuality appears to be distinctively western (Cohler). Thus, the use and effectiveness of reminiscence, and reminiscence stimuli may vary cross-culturally. In turn, cultural differences appear to hold implications for research on reminiscence stimuli. For instance, are the stimulating effects of certain content theme features stable cross-culturally? Can factors affecting ethnic identity influence the effectiveness of certain stimuli? Do relevant stimuli always lead to the establishment of rapport in the face of language, or other cultural, barriers? Do relevance and rapport always enhance reminiscence? The group format in Feinberg's (1996) study appeared to enhance reminiscence by bringing together members of the same ethnic group who could relate to themes of each others' stories. However, if other members of the same ethnic group are not available, can one member relate to, and be stimulated by a simulated, culturally specific reminiscence tale? Summary of Review of Reminiscence In summary, the theoretical basis of reminiscence appears complex. The life review theory has received support from studies examining therapeutic uses of reminiscence on depression and life satisfaction, as well as from studies examining structure and group formats on effectiveness of reminiscence. Life review theory has been brought into question by nonsupportive results from studies looking at effects of reminiscence on self esteem. Results of studies on behaviour modification and participant characteristics have not clearly supported one theory or overall perspective over another. Furthermore, questions remain unanswered in relation to the influence culture exerts on reminiscing activity and effectiveness. Examining culture's influence on reminiscence may lend insight to the theoretical understanding. For example, if it is possible to discern from an individual's reminiscence, how she views and values culture in this latter stage of her life, as well as how she has viewed and valued culture over her lifespan, a 39 researcher may discover not only the degree to which organismic and contextual perspectives fit, but perhaps also more knowledge on the extent of intertwining of individual and cultural identity. In the next sections, I will examine how factors related to culture and aging may interact and influence reminiscence. First, I will briefly discuss theories related to culture and aging. This discussion, along with the definitions found at the end of Chapter One provide background for the last main section of this chapter reviewing ways in which culture may find expression in reminiscence. Culture and Aging Theories Life Course Perspective According to the life course perspective, individuals progress through age-related' statuses, each requiring specific role behaviours (Barresi, 1987). Clausen (1972 as cited in Barresi) states that the experience of one role transition can influence the next one so that perception of past events influences present perceptions. Furthermore, four main life course determinants - personal resources, sources of support, availability of opportunities and investment of individual effort - contribute to the shaping and timing of role transitions. These determinants are influenced by social context, particularly culture (Clausen). Thus, ethnic group membership is seen as a main force shaping a person's life course, acting through norms and values as well as through group monitoring of passage from one life stage to the next. These ethnic group influences continue into an individual's later years (Barresi), ultimately affecting adjustment to major life changes in old age (Jackson, et al., 1995). Continuity Atchley (1989) states that continuity theory explains and describes the ways adults apply ideas and experiences of their past to define their future, and make decisions in response to changes produced by normal aging. Atchley defines normal aging as 40 commonly encountered patterns of aging. He suggests that because socio-cultural context interacts with physical and mental aging, normal aging can vary with culture. Continuity is thought to be a primary adaptive strategy for dealing with changes brought on by aging. Furthermore, since continuity assumes evolution rather than homeostasis, change according to continuity, leads to integration rather than disequilibrium (Atchley). Gelfand (1994) states that continuity theory examines an older person's behaviours as they relate to the whole life course. In this way, continuity seems similar to the life course perspective. However, continuity theory downplays any idea of separate age stages. Gelfand states that in continuity theory, advanced age is seen as a continuation of earlier stages, and not as a separate period. Furthermore, instead of distinguishing life course determinants, continuity examines,the dynamics of internal (identity and self-concept) and external (e.g. skills, relationships) structures (Atchley, 1989). Gelfand (1994) and Disman (1987) apply continuity theory to issues related to ethnicity and aging. They both suggest that ethnicity may be considered a resource by older people. Gelfand explains that the repertoire of values and behaviours developed in younger years will be used to deal with changes of aging, and if the repertoire includes ethnic values, the older person will likely turn to them. Interpretive Paradigm on Aging Neugebauer-Visano (1995) states that the interpretive paradigm challenges normative approaches that view aging as a social reality, an adaptive response to external forces, and as defined by fixed sets of norms and values. The interpretive approach views the elderly as creators of their environments, constructing meaning in relation to their social realities. Meanings are negotiated and reconstituted, and experiences collectively defined, through reflection and interaction with others (Neugebauer-Visano). 41 Neugebauer-Visano (1995) argues that the interpretive approach invokes empathic understanding of the subjective meanings individuals assign to social action. In a study on barriers of age and ethnicity to access to various societal institutions and interpersonal relations, Neugebauer-Visano concluded that normative roles, rules and ideologies tend to oppress and devalue older women of diverse ethnic backgrounds. She urges greater understanding and sensitivity by both minority and non-minority practitioners to the needs and culture of disadvantaged seniors, in order to facilitate communication with these seniors. Integrated Pluralism In this model, persistence of ethnic diversity is recognized (Trela & Sokolovsky, 1979). Ethnic groups maintain distinctive cultures while simultaneously participating in the dominant culture. Trela and Sokolovsky state that implications of this model for the aged include a focus on ethnic values and norms governing treatment of the aged, and the role of the aged in transmitting cultural heritage. Bender et al. (1999) describe how political legislation in Britain in the 1970's and 1980's contributed to equal opportunities, and to provision of nursing home care that would recognize culturally specific needs of residents. Eventual results included young nursing home staff members learning old cultural ways, and the establishment of cultural legacy groups (Bender et al.). Double/Multiple Jeopardy According to this view, occupying more than one stigmatized status (e.g. ethnic, aged, female) leads to greater negative consequences than occupying only one (Driedger & Chappell, 1988). Since difficulties arise in defining minority status characteristics, this perspective has received criticism for qualifying women and elderly as minorities (Ujimoto, 1995). Furthermore, empirical support has been mixed (Driedger & Chapell). Driedger and Chappell (1988) state that this view has stemmed from an age stratification model (Riley, 1971 as cited in Driedger & Chappell) in which societies are 42 thought to be ordered hierarchies of age strata with norms, obligations and social roles appropriate for each stratum. On the other hand, Trela and Sokolovsky (1979) state that this view derives from the invidious pluralist model of ethnicity in which groups are included or excluded from full participation in society on the basis of ethnicity and class. Ethnic Revival and Exchange Theory These two models seem to hold similar implications for the elderly. Ethnic revival is an increased ethnic consciousness in society in which the ethnic characteristics of the elderly become a source of pride for adult children (Trela & Sokolovsky, 1979). According to exchange theory, the experience of an older person holds greater value in the ethnic culture than in larger society (Driedger & Chappell, 1988). Thus, because his or her knowledge and experience is valued, the older person may exchange this knowledge for respect within the ethnic culture (Driedger & Chappell). Ethnic Compensation and Role Theory According to ethnic compensation, an older person may take hold of his or her ethnic identity and its associated patterns in order to compensate for losses of occupational and other social roles (Trela & Sokolovsky,! 979). Ethnicity may be seen as a resource for coping (Disman, 1987) or for personal identity and social connection (Jackson et al., 1995) for ethnic elders. Similarly, according to role theory, the elderly find roles to occupy within his or her ethnic groups. As these roles do not exist in larger society, the elderly are encouraged to participate more in their ethnic groups (Driedger & Chappell, 1988). In summary, several theories have been developed to try to understand processes related to aging, and to culture. Aspects of separate theories are sometimes combined. For instance, Holzberg (1982) suggests that ethnicity offers elders the opportunity to sustain continuity in their repertoire of familiar lifestyles to buffer exclusion via role loss from the wider society. 43 Several theories offer suggestions as to ways in which culture and aging interact to influence the individual. In the next section, I will attempt to draw together knowledge from the definitions and theories, and from reminiscence, and suggest ways in which culture may present in reminiscences of culturally diverse elderly individuals. Ways in Which Culture May Present in Reminiscence I have outlined this discussion of ways in which culture may present in reminiscence on the basis of two perspectives related to reminiscence, namely identity development (organismic) and contextual (Webster, 1999). I have also included sections that do not easily fit into the two perspectives. These separate sections include memory and spirituality. Identity Development As a brief review, reminiscence theory has been influenced by perspectives that address human development over the lifespan. Related to Erikson's (1963) theory of psychosocial development, reminiscence is thought to intensify in older age as part of the struggle between ego-integrity and despair. This view acknowledges a number of possible reminiscence functions, but seems to centre on identity resolution (Harris, 1999). On the other hand, according to the contextual life course perspective (Webster, 1999) greater emphasis is placed on reminiscence occurring throughout life with identity resolution constituting just one of several reminiscence functions. (I include this perspective here because of its recognition of identity integration, and also because it has been seen as closely related to Erikson's theory of life stage development (Barresi, 1979). Later, I address the life course perspective in terms of its contextual features.) Finally, continuity theory has been offered as a basis for reminiscence (Parker, 1995). Atchley (1989) states that internal continuity relating to the identity and self concept, is essential to a sense of ego-integrity in older age. 44 Building upon Erikson's (1963) theory of psychosocial development and Butler's (1963 as cited in Lewis & Butler, 1974) theory of life review, reminiscence may be thought of as a form of personal narrative contributing to an individual's identity development (Cohler, 1993; Harris, 1999; Randall, 1999). The idea that our lives and identities are narrative in nature (Bruner, 1987; McAdams, 1988; Polkinghorne, 1991) has received much support (Coleman et al., 1998; Randall, 1999). The ways in which narratives are shaped, formed and told are influenced by cultural understanding (Coffey & Atkinson, 1996). Randall proposes that narrative intelligence (the capacity to formulate and follow the story of one's own life) is significantly shaped by the sociocultural context in which one lives. Polkinghorne states that the plot lines of one's self narrative are often adaptations of plots honored in one's culture. Furthermore, culture provides sets of narratives that give meaning to major life events, thereby facilitating continuity to self identity during disruptions, and drawing together individual and community purpose. This suggestion by Polkinghorne seems congruent with ideas on ways in which culture is thought to play a role in the life course perspective and continuity theory. Bruner (1999) seems to draw a link between narrative and theories of culture and aging. He suggests that cultures provide aging narratives that lead to culturally distinct aging patterns. Although he proposes this as an untested hypothesis, his suggestion is not unfounded, given current thought on narrative, aging, and culture's influence on both. So far, I have tried to sketch out possible connections between reminiscence, identity, culture and aging. Briefly, reminiscence is a form of narrative. Narrative shapes our self identities, and in turn is shaped by our culture. Reminiscence is connected to lifespan development. Culture and aging can be linked to each other and to lifespan development according to the contextual life course perspective. Culture may influence aging patterns by providing aging narratives. I will now attempt to shade in these 45 sketches with details to illustrate more fully how culture may be expressed in reminiscence. (1) Ethnicity and Personal Identity Several authors relate ethnicity to personal identity (Disman, 1987; Kastenbaum, 1979; Luborsky & Rubinstein, 1987; Trela & Sokolovsky, 1979). Luborsky and Rubinstein state that ethnicity is a key component of personal identity, and that if the present-day sense of self identity is constructed from a lifetime of experiences, then the ethnic identity should be so constructed. They explain that past experiences of ethnic concerns serve as salient complements, contrasts or settings to the present day ethnic identity. From their study on life reorganization by ethnically identified older widowers after initial bereavement, Luborsky and Rubinstein have discovered four main life course concerns affecting the meaning of ethnicity in late life. They interviewed Jewish, Irish and Italian men, aged 65 and older, and widowed two to eight years after long marriages. The first life course concern that Luborsky and Rubinstein have discovered focuses on family history. A theme of this concern is that an individual's subjective sense of identity and attitudes toward his or her ethnicity are enmeshed with those of parental figures. Weinfeld (1994) agrees, suggesting that ethnic self identification increases with increased parental commitment. Also, ethnic intermarriage and mixed parentage are highly associated with decreased levels of ethnic identity (Weinfeld). Thus, family background may be the most relevant variable explaining adult ethnic identity (Weinfeld). Nevertheless, Luborsky and Rubinstein state that ethnicity has also been found to provide a language for the expression of conflict and need for redefinition of cultural values and identities between family generations. The second life course concern involves historical settings and circumstances (Luborsky & Rubinstein, 1987). Luborsky and Rubinstein state that historicity of ethnic experiences provides the backdrop for ethnic identity. Such co-experienced events as international wars can change the meaning of belonging to a certain ethnic group across 46 the lifespan. Lock (1993) appears to agree, stating that ethnicity is reinvented and reinterpreted by individuals with each new generation as a result of migration, wars and intermarriage. According to the third life course concern, current day ethnic identity is situationally evoked (Luborsky & Rubinstein, 1987). Thus, significant situations such as the need to reorganize one's life after the death of a spouse, can lead to a reconsideration of ethnicity. This concern of situation appears to play a role in the degree of cultural identity expressed by an ethnic elder following immigration (Henderson et al., 1997). The fourth life course concern focuses on how past ethnic experiences can become the ingredients for present day ethnic meaning (Luborsky & Rubinstein, 1987). In their sample, Luborsky & Rubinstein found that sets of meanings led to either a re-embracing, or rejecting of dimensions of ethnic identity. For instance, one gentleman who cherished memories of participating in Jewish traditions as a child and young father, became more involved in the Jewish community once again after his wife died. He re-embraced his Jewish identity and his role as a religious teacher, as had his father and grandfather before him (Luborsky & Rubinstein, 1987). Kastenbaum (1979) suggests that in later years, an individual can exercise choice over how much influence on thought and identity to give ethnic characterization. Thus, he states ethnic identity can vary among people of the same lineage, as well as over the lifespan. Overall, Luborsky and Rubinstein, (1987) suggest that personal meanings and social experiences of ethnic identity continue to be relevant, but mutable in late life. Furthermore, the degree to which ethnicity influences one's personal identity may vary with family history, cohort history, significant life events and personal past ethnic experiences. If reminiscence is related to personal identity, and therefore, ethnic identity, reminiscences may reflect the variations of ethnic influence described by Luborsky and Rubinstein. For example, an elderly man of German ethnicity may or may not express memories of past experiences in Germany depending on how relevant to his present-day 47 ethnic identity are the events of World War II in comparison to the events of family traditions and parental influence. Disman (1987) connects ethnicity to identity from a continuity perspective. In order to address ethnic identity as it is experienced and manifested in the lives of elderly individuals, Disman interviewed Canadian-born elderly as well as individuals born abroad. These individuals varied in age, gender, education, length of residence in Canada, marital status and living arrangements. Disman examined external manifestations of ethnicity rather than internal aspects, stating external expressions (e.g. language, food, artifacts) are easily identifiable by both an outsider and ethnic individual. Internal aspects such as values and attitudes are difficult to separate from other aspects of the self (Disman). From the interviews, Disman (1987) discerned a hierarchy of selves in which the dominant self is clearly identifiable and is the central organizing feature of a person's identity. According to a continuity perspective, Disman found that such changes as becoming old pose a threat to one's sense of continuity only when they affect the continuity of the dominant self. Furthermore, an ethnic self is not always dominant in the hierarchy. Therefore, ethnicity becomes an important issue (e.g. in decision-making regarding long-term placement) if there is a threat to the ethnic self, and that ethnic self has been consistently high in the hierarchy throughout life. In other words, ethnicity matters in older age only to the extent it has mattered throughout life (Disman). From this perspective, reminiscence of an older person may be expected to contain increased or decreased numbers of references to features of external ethnicity, depending on the extent to which ethnicity has been significant throughout the person's life. (2) Ethnicity, Identity and Life Course Perspective Whereas Luborsky & Rubinstein (1987) and Disman (1987) focus on how ethnicity relates to personal identity, Barresi (1987) focuses on how ethnicity influences 48 the life course of a person. Barresi describes a model of three parts based on the life course perspective. At the centre of the model is the individual, surrounded by social factors of the ethnic group. In turn, the ethnic group is surrounded by cultural factors of the host society. At the individual level, Barresi (1987) states that ethnicity influences biological and psychological life course aspects including personality development. Personality may be thought of as a feature of the person of which identity is a part (McAdams, 1988). Cohler and Lieberman (1979) studied the influence of ethnicity on the course of personality change in the second half of life. Their sample included middle-aged as well as elderly adults, of either first or second generation Irish, Italian or Polish ethnicity. They measured a number of personality variables including dominance, mastery style and interpersonal assertiveness using such measures as the self-sort, thematic apperception, and speech samples. While Italian and Polish men showed increased dependence on passive mastery indicating increased introversion and self-preoccupation with age, Irish men showed greater concern with active mastery and achievement with age. Cohler and Lieberman explained their findings in terms of ethnic differences in patterns of land tenure in the homeland and patterns of migration to the new society. From these results, they suggested that personality change over the second half of life is not independent of cultural context. Barresi (1987) states that at the ethnic group level of the model, ethnicity influences role transitions by determining the timing of transitions and by placing ethnically unique norms and values on social aging. Finally, according to the model, ethnicity influences the degree of fit (or conversely, distinctiveness) between the ethnic group and host cultural group. Ethnicity's influence on fit is most significant in relation to language, values and beliefs, and relationships (Barresi). For instance, ability to use the host language influences motivation for increased fit since language incorporates the 49 values, beliefs and imagery of a culture (Barresi). Complete abandonment of ethnic language then may not only reflect economic adaptation, but also lack of interest or value in ethnic culture (Gelfand, 1994; Weinfeld, 1994). Thus, i f ethnicity influences the life course and development of personal identity, and identity relates to reminiscence, then we may expect varying degrees of introspection and self-preoccupation in reminiscences of ethnically diverse elders. Furthermore, we may find reflection on ethnically specific aspects of role transitions (e.g. suitable mourning period for widows), as well as on factors influencing fittedness within the host society (e.g. reasons for giving up, or retaining, ethnic language). Certainly, the language used by the reminiscer may reflect culture. (3) Immigration and Identity Barresi's (1987) model brings to the forefront the effects of different cultural groups coming into contact. Kalin and Berry (1994) discuss effects of immigration, stating that immigration not only provides a chief source of ethnic diversity in a host society, but also that it serves to supply ethnic communities with new members who may help sustain and reinforce cultural traditions. For immigrant groups, the degree to which cultural and identity maintenance are desired, and the degree to which contact with people of other cultures is sought determines the degree of acculturation (Kalin & Berry). Kalin and Berry describe four types of acculturation. Assimilation results when the desire for cultural maintenance is low, and preference for contact with others is high. Separation is the opposite of assimilation. Integration results when immigrants desire both cultural maintenance and contact with others. Marginalization refers to minimal interest in maintenance or contact. The ethnicity models of the melting pot, and of pluralism incorporate these types of acculturation. Together, they indicate that processes resulting from contact are not only a function of the immigrant, but also of the host society. One idea that seems key is that all types of acculturation are dynamic, not one-time events. 50 One factor that influences type of acculturation is reason for immigration (Gelfand, 1994). Shapiro et al. (1999) describe push or pull forces. Pull forces include positive draws of the host society such as better employment opportunities, whereas push forces include negative conditions in the home country such as fear of persecution. Migration patterns also result from a combination of push and pull forces (Shapiro et al.). Gelfand states that reasons for immigration, acculturation type, attitude of immigrants to the new country, and mental health are related. For instance, increased integration can help reduce depression associated with losses of leaving the homeland and feelings of isolation (Gelfand). Baker, Arseneault & Gallant (1994) interviewed twenty immigrants of varied background in a phenomenological study to examine.the experience of being a culturally isolated immigrant (i.e. moving to an area lacking an ethnocultural community). Overall, the immigrants tended to suffer mental health problems. They felt pushed to leave their home country, and experienced a sense of discontinuity. However, memories of why they left, and the sense of a better future and quality of life in the new country were helpful. The immigrants expressed a strong commitment to adjust, willingness to learn English, and willingness to receive support (Baker, et al.). On the other hand, Shapiro et al. (1999) interviewed 184 immigrants of varying age groups from Vietnam to study generational differences in psychosocial adaptation to immigration. Shapiro et al. did not specify type of acculturation, but stated that youngest members of the sample were most acculturated in language and social proficiency. Self reports indicated that youngest members perceived themselves as healthier and less depressed than older members perceived themselves. Nevertheless, younger members reported poorer mental health than young Vietnamese immigrants in other studies. For example, the mean score on the Vietnamese Depression Scale (VDS) for this sample was twice the score found in a similar sample in a study by McKelvey and Webb (1996, as cited in Shapiro et al.). Furthermore, this sample scored higher in depression and anxiety 51 on the Hopkins Symptom Checklist (though not on the VDS) than in a study on young Vietnamese by Felsman, Leong, Johnson and Felsman (1990, as cited in Shapiro et al.). . Shapiro et al. stated that the main contributors to mental distress appeared to be current dissatisfaction with life in the U.S., and family conflict. Language acquisition was not an effective buffer to mental distress (Shapiro et al.). For the elderly, immigration may be more difficult than for younger generations (Gelfand, 1994). Shapiro et al. (1999) state that the only explanation they could suggest for the better mental health of the younger Vietnamese over older Vietnamese in their study was youth. Furthermore, if acquisition of the host language is helpful (Gelfand), the elderly may be at a disadvantage. Baker (1994)-states that in herstudy, older immigrants expressed more doubt than others of their ability to learn, and perceived old age to be a hindrance to learning English. Another factor influencing attitude of acculturation may be length of time since immigrating. Ujimoto, Nishio, Wong and Lam (1995) state that in their study on cultural factors affecting self assessment of health satisfaction of Asian Canadian elderly, the Korean immigrants they interviewed showed a strong pride in their cultural heritage. These Koreans were the most recent immigrants among the Asian elderly in their study. Ujimoto et al. suggest that because most socialization occurred in Korea, these individuals showed a stronger attachment to traditional values. In summary, i f acculturation reflects the degree of cultural identity maintenance desired by an immigrant, and i f reminiscence helps configure the identity of an elderly individual, then factors influencing, and effects of, acculturation may be reflected in reminiscence. For example, an immigrant who left the homeland a long time ago, was drawn to the new country by its higher quality of life, and desired to contact others more than to retain own culture (i.e. to assimilate), may express few aspects of the original culture during reminiscence. This individual's identity might be based more on plot lines 52 taken from the host culture, as well as from experiences lived according to the host culture's norms and values. On the other hand, someone who has grown old in their homeland and then been pushed to leave; and who desires to maintain the cultural identity, and finds the new language difficult to learn, may continue to use the language and plot lines of the home culture as well as memories from homeland experiences in his or her reminiscences. According to ideas related to identity development, the ways in which culture may present in reminiscence are widely varied. In the next section, I will consider contextually-related means of cultural expression in reminiscence. Contextual Ways Webster (1999) states that seven main propositions of lifespan theories outlined by Baltes (1987) exemplify the contextual perspective. Some of these propositions include: (a) lifelong development with both cumulative and innovative processes; (b) multi-directional behavioural development; (c) co-occurring losses and gains; (d) individual plasticity in functioning; and (e) development influenced by sociocultural conditions existing in a given historic period and evolving over time. Although the perspectives related to the contextual metamodel (Webster, 1999) do not necessarily negate the ideas concerning identity development, they add important insight that allows for a wider variety of possible means of cultural presentation in reminiscence. Furthermore, although immigration and acculturation have been reviewed under identity development, such factors could also be included under the contextual view since they carry potential for meaning-making through interaction between hosts and immigrants. In this way, degree of fit between ethnic and host cultures in Barresi's (1987) life course perspective model emerges as a contextual concept. 53 (1) Meaning-Making Carnavale (1999) offers an alternative perspective on the self to Disman's (1987) hierarchy of selves. Through clinical and empirical observations made over a number of years, on families of varied ethnic backgrounds with critically i l l children, Carnavale became dissatisfied with the Western psychological notion of the self as inward and autonomous. Instead, Carnavale sees the human experience as shaped by what matters to the person. Those things that matter are usually what matters to the person's community. Things that matter in the person's community create a local ideal of the self. In other words, a "local se l f (p. 30) is shaped by what matters in the community. This idea seems to support the idea in Barresi's (1987) model that ethnic group membership shapes a person's life through its norms and values, as well as through its monitoring of passage through life stages. Carnavale calls this notion of local self a cultural meaning of self, and bases it on the idea that human experience is constituted through interpreting, encountering and deriving meanings. His argument for moving toward an interpretive cultural framework for mental health seems to support the interpretive paradigm of aging described by Neugebauer-Visano (1995). Carnavale (1999) derives support for his critique on the Western self from constructivism. According to cultural constructivism, human realities are simultaneously cultural and historical phenomena, social realities are constructed by particular cultures, and social interactions , over historical time, determine what is locally meaningful (Gaines, 1992 as cited in Carnavale). A number of authors see narrative as socially constructed through interactions with others, and as giving meaning to lived experience through its presentation from a particular viewpoint (Abma, 1998; White & Epston, 1990). If narrative, and in particular, reminiscence, is socially constructed, its meaning will derive in part from what is culturally and historically important, as well as how it is expressed in interaction with others. Indeed, from his observations, Wallace (1992) states 54 reminiscence is a social construction told only in response to narrative challenges from others. Thus, i f the self is constituted by meanings that matter to the community, and reminiscence is expressed only in response to requests from the community, then reminiscence will likely reflect matters of cultural and historical relevance to that community. This idea may form a basis for reminiscence functioning in transmission of cultural heritage (Bender et al., 1999). In turn, this idea may find a basis in ethnic revival and exchange theories. (2) Relationship - Kin and Not Kin If meanings are derived through interactions with others, thenthe way in which culture influences relationships may be reflected in reminiscences. Trela and Sokolovsky (1979) note that the level of ethnic distinctiveness (degree of distinctiveness from dominant culture norms) of a group can affect the status of the aged in that group. This idea appears to support Barresi's (1987) model in terms of connecting degree of fit between ethnic and host cultures, with ethnic group influence over individual role transition. According to Trela and Sokolovsky, high level groups such as the Amish, have maintained sociocultural systems distinct from American norms, and hold the aged in prestigious roles. Low level groups such as some European groups have retained little cultural distinctiveness that would influence the status of the aged (Trela & Sokolovsky). Moderate level groups include Asian groups (Trela & Sokolovsky, 1979). Ujimoto et al. (1995) state that filial piety in Chinese, Japanese and Korean families involves a number of obligations including obeying parents, supporting them in old age, and succeeding in a career to bring honor to parents. If children do not live up to these expectations, intergenerational conflict may occur, or parents may internalize their feelings (Ujimoto et al.). Among Japanese Americans, Kiefer (1974 as cited in Trela & Sokolovsky) notes that although traditional filial devotion and loving indulgence of the 55 elderly have been impossible to maintain, the Japanese elderly have continued to retain nonstigmatized family roles. He credits maintenance of core values of group cohesiveness and intimate relationships with the elderly's ability to maintain their status. He also suggests that non-kin social networks of age-peers who share the same values and a sense of mutuality may be highly influential on the status of Japanese elderly. These observations appear to support ideas proposed by the ethnic compensation and role theories. Kim (1999) studied the relationship between ethnic attachment and loneliness in elderly Korean immigrants. In this study, 174 individuals living in a metropolitan area were interviewed. These immigrants varied in their length of residency in the U.S., so factors related to acculturation could have varied among them. Kim defined ethnic attachment as a function of degree of subjective identification with ethnic group and maintenance of intimate sociocultural ties with members of the same ethnic group. Overall, K im found that strong ethnic attachment decreased loneliness. Ethnic attachment was mediated through social network size and satisfaction. Social networks consisted mainly of kin, but any non-kin were Korean. Kim suggests that with stronger ethnic attachment, more intimate relationships are developed and maintained, and greater emotional and tangible support is received. Kim admits a possible confounding influence of housing circumstances, since many participants cited neighbours as supporters. Nevertheless, the results of this study appear to agree with Barresi's (1987) model in that the degree of fit between cultures is influenced by ethnicity's influence on relationships. In this case, ethnicity appeared to help maintain intraethnic group relationships and intercultural group distinctiveness. Lubben and Becerra (1987) point out that economic need can confound results regarding the influence of cultural values on intergenerational relationships. Such confounding may offer an avenue for testing the double/multiple jeopardy hypothesis. In 56 their study on ethnic dimensions of aging support among Black, Mexican and Chinese elderly, Mexican and Chinese elderly were most likely to share housing and receive help from an adult child. Although their results indicated that stronger ties of traditional culture were related to increased parent-child supportive behaviour, Lubben and Becerra suggested that limited English ability of the elderly also inhibited use of formal services and may have increased their need for assistance from children. Reminiscences of culturally diverse elders may be influenced by a wide variety of perspectives on relationships. For instance, change in status and importance of age-peer relationships with age may be reflected. Relationships with children may be expressed in terms of traditional filial devotion or socioeconomic assistance or a combination of both. Reminiscences may contain references to past relationships with own parents compared to current relationships with children and how immigration has been an influence. Still, in Asian families, if children are not fulfilling filial obligations, internalization by the elderly may inhibit expression of reminiscence altogether. (3) Relationship - Reminiscer and Listener If meaning is constructed through negotiation and collective definition in interactions with others (Neugebauer-Visano), then reminiscence may be influenced by the interaction, and hence, relationship between the reminiscer and listener. One aspect of this influence may be authorship of meaning. Diverse views on authorship in narrative exist. Meaning may be seen as the creation and possession of the teller (Cotterell & Turner, 1989). For instance, Feinberg (1996) states that members of his reminiscence groups borrowed themes from each other's stories. On the other hand, meaning may also be considered the creation and possession of both teller and receiver (Cotterell & Turner, 1989). Baker and Diekelmann (1994) state that narrative is a place where both teller and receiver are participants, and the boundaries of each person disappear. Ayres and Poirier (1996) suggest that meaning takes place at 57 the intersection of narratives of both teller and receiver, and this meaning must fit into a larger meaning. The idea that authorship is shared between teller and receiver seems to be reflected by Liton and Olstein (1969) who state that once understanding of an elder's culture is demonstrated, then the interviewer may take part in the elder's life story. Harris (1999) points out that culture influences all interpersonal relationships, including that of client-clinician. If so, culture likely influences the relationship between reminiscer and listener. If authorship rests with the reminiscer, then expression of reminiscences may depend little on any perception by the reminiscer that his or her culture is understood by the listener. However, i f authorship is shared, stimulation and depth of reminiscence may be significantly influenced by the reminiscer's perception of how well his or her culture is understood by the listener. The ways in which factors concerning identity development and context influence the relationship between culture and reminiscence seem multidimensional. Thus, the ways in which culture presents in reminiscence are likely to vary among individuals, and over lifetimes. Two further potential sources of variation include memory, oral performance and spirituality. These factors will be discussed next. Memory Harris (1999) states that through reminiscence, the complex interaction of memory and language is revealed. For example, when preferred topics are evoked, older individuals tend to use qualitatively better language (Harris). Harris explains that reminiscence activates several memory processes, especially those of semantic and episodic memory. Semantic memory is considered the processing unit of concepts, world knowledge and linguistic usage. Episodic memory acts as a storehouse of autobiographical and temporally linked information, and is considered to comprise the essence of reminiscence (Harris). Parker (1995) appears to agree, stating that remote memory, a specialized component of long-term memory including memories for events 58 long past, episodic in nature and significant to the individual, is where reminiscence occurs. Park, Nisbett and Hedden (1999) review ways in which cognitive processes including memory are thought to vary with age and culture. In particular, they review results of studies comparing young adults and elderly of Chinese and American cultures. These studies have involved individuals who have not migrated and who have received little exposure to individuals of the other culture (Park et al.). According to the studies reviewed, Park et al. note that Chinese tend to process information more holistically, with an increased responsiveness to contextual cues; whereas Americans tend to process information more conceptually. Park et al. stress that no evidence exists to suggest that these cultural differences in cognitive processes are genetically based. Rather, they state that differences appear to derive from fundamental differences between cultural environments. Exposure to culture activates culture-specific biases and world knowledge (Park et al., 1999). These cognitive processes are automatic and with increased age likely show cultural divergence in performance. On the other hand, effortful, nonautomatic cognitive tasks are approached by adults of different cultures similarly, and with increased age likely show cultural convergence as a result of cohort or of levelling effects of neurobiological decline (Park et al.). Park et al. (1995) state that little cross-cultural data exists with respect to memory processes. Nevertheless, they suggest that memory facilitated by world knowledge and automatic activations would show magnified cultural differences in effectiveness of recall cues across the lifespan. For example, old Chinese would show most facilitation for cues consisting of contextual, physically interacting figures, while old Americans would show most facilitation for more conceptually related figures (Park et al.). 59 Thus, reminiscence that activates semantic memory processes related to world knowledge may be facilitated by cues that complement the individual's cultural bias, as evidenced by qualitatively better language. Furthermore, performance of this type of reminiscence may vary widely among elderly of diverse backgrounds, particularly among those who have received little exposure to other cultures. Any reminiscences concerning more effortful cognitive processes may show little difference with culture in performance. Oral Performance Coffey and Atkinson (1996) also address performance, but not at the cognitive processing level. Rather, they look at oral performance, and suggest that "how things are said" (p. 77) is as important as what is said. They add that storytelling success depends on culturally shared conventions about language and listening to stories. Thus, culture may present in reminiscence via particular culturally-based norms for performing stories. Spirituality Spirituality is thought to be integral to reminiscence (Bender et al., 1999). Such espoused values of reminiscence as showing respect for others and sharing with others are believed to have a spiritual, or religious component (Bender et al.). Complexities of defining spirituality include distinguishing it from religion, and from the psychosocial dimension (Farran, et al.; Fitchett, Quiring-Emblen & Burck, 1989; Walter, 1997). From content analysis of definitions found in the nursing literature between 1963 and 1989, Emblen (1992) suggests that spirituality is a broader term under which religion falls. Walter describes spirituality as a search for meaning that goes beyond the psychosocial to include forgiveness, hope and love. He sees spirituality not so much as a dimension of the individual, but as a way of relating between two individuals. Culture appears to have a strong connection with religion. Torres (1999) notes that many sociological studies support the existence of a religious foundation to cultural 60 values. For example, Torres states that according to Tilak (1989) and Vatuk (1980), because Hindu scriptures dictate withdrawal form worldly activities and interest in order to age successfully, disengagement is considered normative in cultures with roots of Hinduism. Indeed, to fully understand a culture's value orientations, an understanding of the culture's fundamental religious roots is necessary (Kimble, McFadden, Ellor & Seeber, 1995 as cited in Torres). Spirituality can be viewed broadly as a dimension that gives meaning and purpose to life (Bender et al., 1999). Within this perspective, culture, as the way of life of a group, seems to find a place. Through spirituality, members of a culture may find meaning and purpose to their cultural ways of life. Reminiscence is thought to help bring people in touch with the spiritual dimension by extracting the essence of experiences and relationships; thereby going beyond the immediacy of facts and historical events to an overall, meaningful picture of life (Brady, 1999; Bender et al., 1999). By providing a comprehensible way of communicating, reminiscence can reveal to people how God has been working in their lives. Reminiscence functions to validate one's life (Brady), bringing affirmation to one's values and uniqueness (Bender et al.). Thus, through reminiscence, an individual may present his or her culture by reflecting on the meaning religion has held in his or her life. Furthermore, reminiscences may contain references to ways in which, or extent to which, cultural values and elements have provided uniqueness and a sense of worth to an individual, as well as meaning and purpose to his or her life. Conclusion Whether through providing a stock of plotlines from which one draws to begin writing a personal narrative, through influencing the social construction of narratives, through creating bias in memory processes, through influencing oral performance, or 61 through interacting with religion and the spiritual dimension, there are many possible means of expression of culture in reminiscence. By considering thoughts on culture, aging and reminiscence, I have attempted to indicate the variety of means by which culture may present in reminiscence. Throughout the illustration, one dye that appears to infuse color is that of values. For example, parental values of ethnicity affect ethnic identity of children. The values of family honor and obligation affects intimacy of family relations, living arrangements of the elderly and such emotions as loneliness. The value of cultural identity influences the pace and type of acculturation. The value of an ethnic elder's cultural knowledge influences transmission of that knowledge, as well as esteem of the elder. Religious roots influence the value orientations of a culture. Spirituality involves understanding the values of an individual and his or her life. By allowing individuals to talk about their past lived experiences through reminiscence, and examining how they respond to brief narratives from another person of the same cultural background, we may be able to discover the roles cultural and individual values have played in their lives. In so doing, we may enlarge our understanding of the connection between the individual, and the individual in culture. In the next chapter, I set out to describe the method by which I will attempt to explore how culture presents in reminiscence. 62 CHAPTER THREE: METHODS In order to discover ways in which an ethnic elder constructs his or her reminiscence and ways in which culture is expressed through reminiscence, I employed narrative analysis. While "there is no single method of narrative analysis, but a spectrum of approaches to texts that take narrative form" (p.25), narrative analysis generally takes story as the object of study and provides a systematic way of studying personal experience and meaning (Riessman, 1993). Thus, narrative analysis lends itself to studying the stories of personal experiences as told in the reminiscence responses in this study. I open this chapter with a discussion of assumptions underlying the approach. Upon this background, Twill attempt to build my rationale for choosing this approach as the basis of the study's research design. Later in the chapter, I will describe the specific type of narrative analysis that was particularly suited to the study. I will describe procedures of sampling, data collection and data analysis in the context of the research design and the specific narrative method. Finally, I will address issues of rigour, ethics and limitations. Research Design Assumptions Narrative consists of multiple and diverse forms (Mishler, 1995), but several of these forms appear to have shared assumptions. First, narrative cognition, or storied knowing (Bruner, 1985, as cited in Polkinghorne, 1995), contributes to the ways in which humans make sense of encounters with the self, others and the material world (Polkinghorne). Narrative knowledge focuses on human action - its diversity, temporal context and the complexity of interactions characterizing experiences. Storied memories retain the complexity as well as emotional and motivational meanings associated with these experiences (Polkinghorne). Stories that maintain narrative knowledge contain a plot that delimits a temporal range, provides criteria for selecting events to be included in 63 the story, temporally orders events towards an outcome and clarifies the meaning events hold in relation to the story's theme (Polkinghorne). Thus, storied knowing appears to incorporate assumptions that temporality is a primary human dimension, and that events, motives and interpretations can affect the action and consequences of human behaviour (Polkinghorne). Second, as suggested in the previous chapter, culture can influence and be expressed in narratives. Lieblich, Tuval-Mashiach and Zilber (1998) state that through self-narratives, not only can the individual's identity and system of meaning be identified, but so can the individual's culture and social world. Similarly, Coffey and Atkinson (1996) suggest that narratives are shaped, formed and told in part through cultural understanding. Third, researchers cannot directly access an informant's experience, but can only work with representations of the experience (Riessman, 1993). Riessman illustrates various possible levels of representation, ranging from the informant's own awareness of the experience to others' readings of the experience. Between these two levels are three levels of representation that are influenced by the researcher (Riessman). At the level of telling about the experience, while the informant structures his or her telling for a strategic purpose (to communicate his or her awareness of the experience effectively) (Riessman, 1990), the researcher contributes to representation through listening, questioning and encouraging the telling of particular aspects. Through transcribing, the researcher adds to representation by choosing particular aspects of verbal expression to transform into written text, and then by fixing the action of the experience in that written form. In analyzing, the researcher makes decisions about form, order and significance that contribute to the representation of the experience (Riessman). Connelly and Clandinin (1990) appear to agree with the idea of multiple levels of representation, stating that narratives are constructed on the levels of the personal narrative, the shared 64 and jointly constructed narrative expressed in research writing and the research narrative. Lieblich et al. (1998) provide a view of narrative representation that seems useful for studying individuals' reminiscence responses to culture tales. In this view, Lieblich et al. acknowledge the potential influence of both objective reality as well as individual subjective perspective. They suggest that narrative is neither a completely constructed fictional account of lived experience, nor an accurately realistic account of experience. Rather, they view narrative as a story developed from a core of factual life events. Through individual creativity, changing identity over the life course and contextual influences, these "remembered facts" (p. 8) become modified. This view allows for the potential existence and influence of some commonly shared objective background embedded in both a culture tale and an ethnic elder's own life. So, while humans are considered to be storytelling organisms (Connelly & Clandinin, 1990), narrative is considered the organizing principle on which human action is based (Riessman, 1993). Not only is narrative a known, everyday form of discourse (Coffey & Atkinson, 1996), but telling stories of past lived experiences is a widespread activity used throughout the life course (Riessman). Each story is one instance of many possible versions that people use to present their selves and lives to others (Lieblich et al., 1998). Rationale Narrative analysis provides a useful design for the proposed study. Riessman (1993) states that narrative analysis is used to examine how respondents in interviews impose order on the flow of lived experience, to determine the linguistic and cultural resources utilized in responding and to identify the means by which respondents persuade listeners of authenticity. Through narrative analysis a researcher can study why a story has been told in a particular way (Riessman). Furthermore, Coffey and Atkinson (1996) state that narrative analysis can be used to critically examine cultural conventions and 65 social norms, as well as address an individual's perspective in relation to the wider cultural setting to which he or she belongs. I suggest then that through narrative analysis, a researcher can study why a response to a culture tale has been given in a particular way, perhaps revealing information on the cultural influences affecting that reminiscence response. In addition to providing a means for studying why a story has been told in a particular way, narrative analysis provides a way for a researcher to interpret meaning from both the structure and content of a story. Mishler (1986) argues that because interpretation of stories requires attention to what respondents and interviewers say to each other as well as how they say it, the actual talk itself cannot be ignored. Sandelowski (1991) states that in narrative analyses, investigators do focus on the tellings themselves and on the discourse devices used to make meaning in stories. Riessman (1993) adds that unlike in some traditional methods of qualitative analysis, in narrative analysis, the sequential and structural elements of narratives are preserved. By preserving, rather than fracturing for the sake of interpretation and generalization, narrative analysts show respect for the respondents' ways of making meaning (Riessman). Not only did narrative analysis appear to be an appropriate design for the proposed study, but it also held promise for expanding horizons in nursing research. Sandelowski (1991) suggests that not only do qualitative nursing studies tend to create conditions in which stories are told, but also by involving participants in storytelling, researchers engage participants in an activity in which they are already engaged simply by being human. Furthermore, narrative analysis can offer new ways to address the "temporality and liminality" (p. 161) of humans' interpretations of their lives, and the historical and sociocultural influences on humans' abilities to tell about their lives and to listen to others (Sandelowski). Narrative approaches encourage nursing researchers to listen not only to the tales, but also to the human impulse to tell tales, and thereby 66 discover access to the human experience of time, order and change (Sandelowski). By employing narrative analysis, this study could then contribute to that discovery process. Sampling In narrative analysis, the aim is not to generalize, but rather to achieve a new or better understanding of a particular phenomenon (Koch, 1998). Narrative reasoning involves seeking understanding through the cumulative effect of individual cases, using analogy among cases, not analogy to a general type (Polkinghorne, 1995). Indeed, the uniqueness and complexity of each case is sought, and to do so, narrative analysts must deal with issues of form, content and interactional context (Mishler, 1986). In order to pursue an in-depth understanding of what people say and how they say it, sampling is not representative, but is purposeful, seeking individuals who will contribute data relevant to the research question (Morse, 1991). Lieblich et al. (1998) state that typically, studies using the narrative approach recruit fewer participants than studies using traditional research methods. Nevertheless, the data gathered in each narrative may be copious and rich. Just as narrative analysis is not aimed at generalization or representativeness, neither is it aimed at saturation (Moffatt, 1990). In this study, I looked for the unique instances within an individual's response. I was not necessarily seeking categories of themes across stories, nor saturation of categories. Still, to gain insight into the potential variety of responses and influences of culture, I examined a number of responses and attempted to seek analogies among them. Any analogies discovered were interpreted in terms of possible meanings relevant to the responses in which they were found. Analogies were not intended for constant comparisons. To balance the goals of seeking uniqueness and variety, I selected a small sample of seven individuals (including three transcripts of pilot study participants). 67 To facilitate sampling, I asked professional contacts who have access to elderly individuals to nominate individuals for the study. These professionals made first contact with the study participants. I gave each professional a brief letter that explained the study and asked him or her to share the letter with potential participants. I also asked the professional to seek the potential participants' permission to be contacted by me. I then contacted those potential participants who gave permission and invited them to participate. At that time, I explained issues of confidentiality, as well as rights regarding agreeing or refusing to participate. With those nominees who consented, I discussed a mutually convenient time and location to conduct the interview. The source of the pilot study participants was an adult day, centre.. These participants were located by word of mouth. To be eligible for selection in this study, individuals were to be cognitively intact, to live in the Lower Mainland or Fraser Valley, to fit this study's definition of an ethnic elder and were to be willing to share his or her reminiscences. If an interested, nominated individual could not communicate in English, I may have sought translation services. However, i f such translation service was unavailable, I would have simply thanked the individual for his or her interest. However, all nominated individuals were able to communicate in English. Data Collection Data collection involved two aspects of an interview: (a) construction of the culture tale, and (b) obtaining response to the culture tale. In both aspects, the interview format was unstructured, using a broad, open-ended question to begin and then probes as needed to encourage elaboration. Although respondents may tell stories in response to direct, specific questions, unstructured, open-ended interviews may be more conducive to examining how individuals connect responses into a narrative account (Mishler, 1986), and perhaps to discovering a variety of types of responses. Examples of introductory 68 questions included: "I am interested in hearing about your life. What are some (past) experiences you would like to share?" "What was your life like in ?" "What experiences do you remember from when you lived in ?" "What has your life been like since coming to Canada?" To construct culture tales, I interviewed four ethnic elders to obtain their personal narratives. Three of these narratives were embedded into relevant historical and cultural context by first asking each ethnic elder to identify historical and cultural issues significant to his or her past lived experience. Unclear issues were explored by consulting historical texts and later in a second visit reviewed again with the participant. The purpose of such clarification was to obtain contextual accuracy for a culture tale, not to obtain one unique truth. To obtain a culture tale response, one of these four participants was asked in the interview in the initial visit to respond to a tale of an elder of the same ethnic background. Interviews ranged from approximately forty minutes to an hour. The time varied with such factors as a participant's desire to talk. Interviews were tape recorded and subsequently transcribed by me in conjunction with a professional transcriber. Demographic data from each participant, as well as field notes of context and participant nonverbal behaviour were taken to supplement interview data for interpreting responses. Data from the pilot study, consisting of two Chinese culture tales and two responses were also included. These pilot study interviews were conducted by a member of the pilot project team headed by Dr. Jo-Ann Perry. Along with pilot study data, total data collected included seven narratives. Five of these were used to construct culture tales (two Chinese, one German, one Japanese and one French). Three responses to culture tales were obtained. A l l culture tale data represented Chinese culture. Although two more Japanese elders and one more German elder were nominated, these elders refused to participate. No further French elders were nominated. 69 Data Analysis Polkinghorne (1995) distinguishes two general classes of narrative analysis. In the class he calls a paradigmatic analysis of narrative, methods are used to seek common themes across stories in a database. In the other class, which he calls narrative analysis, methods are used to discover a plot that links data elements into a temporal account. In this study, I employed a method that appears to fall into this second class of narrative analysis. I sought a reminiscence response and attempted to locate such features as linguistic devices and plot that could reveal both a story of lived experience, and the impact of culture on reminiscing about that experience. Riessman (1993) encourages the analyst to begin analyzing from the inside, interpreting meaning encoded in form, and then to expand outward, interpreting meaning from propositions underlying the talk. To examine form, or structure, I scrutinized whole interview transcripts to become more familiar with narrative and non-narrative forms, and with the general organization of talk in each one. Labov's (1972; 1982 as cited in Riessman, 1993) Evaluation Model is considered useful for beginning to examine organization and structure of narratives in interviews (Riessman), but it can be limited in terms of seeking cultural variation (Cortazzi, 1993). Cortazzi states that Polanyi (1985) has extended Labov's framework to account for cultural aspects. The method developed by Polanyi highlights the connection between the main point of a narrative text and cultural salience. Thus, I applied Polanyi's method of constructing an Adequate Paraphrase. Adequate Paraphrase Polanyi (1985) states that through the method of constructing an Adequate Paraphrase (AP), analysts can extract the essence of the told story from the surface structure of the text. According to Polanyi, a story narrative is told with the purpose of making a point. With this idea in mind, Polanyi defines features germane to this method 70 of analysis. For example, a key event is an event that leads to change(s) in state(s) in the storyworld that is relevant to the point of the story. Tellers, not hearers, evaluate events as key ones or less important ones. Tellers need to give enough detail for hearers to understand the nature of change brought about, and must make clear which events and states should be used to infer the point being made (Polanyi). When tellers and hearers share a world view, tellers can rely on shared understandings of people, objects, occurrences, values and beliefs shared with hearers to direct hearers to infer both the main point and plot of the story. Tellers convey their own inferences by means of linguistic and paralinguistic evaluation devices, and thus the linguistic structure of the text can signal what the teller evaluates as relevant (Polanyi). By using the most highly evaluated key events and states, an AP of the storytelling can be constructed (Polanyi, 1985). The steps of this construction can be summarized as follows: (a) attend closely to encoding details of the event and state clauses of the text; (b) assemble a list of event and state propositions relevant to the main story line; and (c) assess each proposition using evaluative meta-structure to designate key events and states. The AP appears to approximate a reasonable representation of the particular telling of the story (Polanyi). Hall, Stevens and Meleis (1992) used this method to compare how stories of role integration experiences differed among individuals as well as among a number of ethnic groups. Stevens (1993) used this method to analyze the content and context of stories of marginalized women's experiences of accessing healthcare. I followed the steps of this method of analysis as outlined in Appendix I. My ability to detect cultural influences may have been constrained by my limited understanding of the teller's cultural world view. Nevertheless, by using the AP method, I hoped to discover ways in which narrative structure and content relate in the reminiscence responses. Lieblich et al. (1998) suggest that structural elements of a story 71 reflect the personality of the teller, while content indicates the culture containing the unfolding story. In addition, by using this method, I hoped to detect ways in which structural and content-related responses related to prompting by a culture tale. Rigour Establishing rigour in narrative studies tends to defy a straight forward application of standard procedures (Riessman, 1993). The material is made up of talk and text that represents reality only partially, selectively and imperfectly (Riessman). The recognition of various levels of representation (e.g. telling, transcribing, reading) encourages an attitude of reflection and caution in making interpretive claims (Riessman). An example demonstrating this need for caution is the "illusion of causality" (Crites,T986 as cited in Connelly and Clandinin, 1990, p. 7). Connelly and Clandinin state that this illusion refers to the deterministic appearance of events when examined temporally either backward or forward. To avoid this illusion, they suggest researchers make a clear distinction between events-as-lived and events-as-told. Another example that encourages caution in interpretation is given by Poirier and Ayres (1997) as they discuss such aspects of storytelling as silence, repetition and endings. They suggest that carefully and respectfully attending to these aspects may give a more complete interpretation than attending to the words alone. Recognition of various levels of representation promotes the idea that seeking trustworthiness in narrative interpretation is more appropriate than seeking the real, true story (Polkinghorne, 1995; Riessman). Towards the goal of seeking trustworthiness, a narrative analyst can use a number of approaches. One approach involves the criterion of persuasiveness, evaluating an interpretation for how reasonable or convincing it is (Riessman, 1993). In this study, I attempted to establish persuasiveness by documenting not only those interpretations seen as most reasonable, but also alternative interpretations. 72 Another approach called correspondence, involves taking work back to study participants to check if the researcher's interpretations are considered adequate by those participants (Riessman, 1993). Although I recognize that such member checking is considered questionable since meanings in stories can shift over time (Lieblich et al., 1998; Riessman), I used this approach for its potential validation value. I returned to each of 3 participants (PI, P2 and P4) with copies of his or her transcript and the culture tale I had constructed from the transcript. This visit was to seek clarification of words and phrases that were difficult to hear on the tape recording and to try to ensure that the culture tale corresponded to the narrative. After having analyzed and interpreted their interviews using the AP method (Polanyi, 1985), I interviewed PI, P2 and P4 once again. Each validating interview was brief, lasting less than thirty minutes. In these interviews, I explained that I had analyzed the transcripts, that several ideas had emerged and I wanted to know their thoughts and feelings regarding these ideas. My questions tended to begin with "Would you say that ?" I decided against returning to P3 due to his verbalization during his interview of worrying too much. Coherence, a third criterion, is demonstrated by connections linking the teller's overall goals of narrating with the means (e.g. linguistic devices) of expressing her main point and her focus on particular themes (Riessman, 1993). Researchers must adjust interpretations of a teller's goals in light of the form and content of the narrative (Riessman). Interpretive decisions are not made with complete freedom. Rather, decisions rest in the justification sought through self-awareness and self-discipline while examining data (Lieblich et al., 1998). To this end, I kept a personal journal to attempt to bring to my attention any personal biases influencing my interpretations. I did so not necessarily to remove subjectivity, but to raise my awareness of as many possible sources of variation in interpretation as possible. To the same end of achieving coherence in 73 interpretation, I discussed my interpretations with my chairperson and sought her perspective. Furthermore, I will attempt to make my research process visible to others by making available for scrutiny the tapes and transcripts, as well as the methods and decision-making processes used (Mishler, 1990 as cited in Hil l Bailey, 1996). I have used these criteria for rigour to lend authenticity to the work. I have also tried to learn more about subjectivity in experience, and the experience of working with subjectivity. Ethical Considerations Ethical approval has been obtained for this study from the University of British Columbia Clinical and Behavioural Sciences Research Ethics Board. Informed consent will be requested from potential participants following an explanation of the study and the offer of reassurance against any negative consequences associated with refusing to participate in any way at any time. Interviewing began only after obtaining both participant consent and agreement of a mutually convenient location and time. Participants received a copy of the consent form that explains their rights as participants and includes the name and phone number of the researcher. Participants' identities remain confidential. Identifying information was seen only by the researcher. Care was taken so that names would not be connected with responses. The only places names appeared was on the consent form and on a code list that will be on file in a computer that has a security system. The consent forms were filed separately from the data and kept in a locked drawer. Codes were used on tapes and transcripts instead of names. Names did not appear in any part of the written report. The code list will be destroyed when the research is completed. Tapes and transcripts were stored securely by the researcher. Although no risk was anticipated with this study, feelings of sadness could have accompanied remembrances of past times. The researcher paid attention to signs of 74 emotional upset or fatigue and reminded participants that they could terminate the interview at any time. The researcher would have ended the interview if she felt such action was warranted. However, each interview lasted until each participant expressed the idea that he or she had nothing further to say. No benefits are known to be associated with participating in this study. Nevertheless, sharing personal past experiences appears to have been pleasant for each participant (e.g. with expressions of thanks and/or interest in hearing about the results of the study). Upon completion of the study, copies of the written report will be sent to participants. In this way, the participants may realize more fully the impact they, and their participation, have had in this research endeavor. Limitations Limitations may have occurred at a number of stages in the study. As mentioned earlier, the findings from the AP method may have been limited by my incomplete understanding of the teller's cultural perspective. Summary In this chapter, I have described assumptions and features of narrative analysis in an attempt to provide a rationale for employing it as the research design. Because this approach encompasses a variety of specific methods, I have also described one specific narrative analysis method (AP). This method was appropriate for this study because it allows an examination of both reminiscence and culture. Finally, I have considered issues of rigour, ethics and limitations related to the study. 75 C H A P T E R F O U R : FINDINGS Introduction The primary question guiding this study addressed ways in which ethnic elders construct their reminiscences. This question concerned ways in which culture is expressed in reminiscences and how ethnic elders respond to culture tales. (Definitions of the terms, ethnic elder and culture tale are given in Chapter One.) To explore the research question, I examined interview transcripts using the AP method (Polanyi, 1985) of narrative analysis. Through this method, I derived APs from ethnic elders' stories of past lived experiences. These APs serve to retain information essential to convey story meaning (Polanyi). I found that the APs preserved story information that could be interpreted in terms of meaning and structure in the construction of reminiscences. In addition to using the AP method, I examined three interview transcripts for specific responses to culture tales. I found that these responses could be interpreted in terms of the process of reminiscence construction. In this chapter, I will present the APs and the meanings I interpreted from them. I will also present findings related to the use of culture tales as prompts for reminiscence. The chapter is organized as follows. First, I will discuss findings related to the interview process and analysis method. Then, for each participant, I will give a brief introductory description followed by a summary of the AP findings for his or her transcript. Support for this summary will be subsequently illustrated by AP examples. I am organizing the AP information with summaries first because the AP approach can be more fully appreciated by examining specific text sets in light of interpreted meanings to which each text set has contributed. Following the AP findings for each participant, I will discuss the responses to culture tales. Then, I will present relationships among the findings to illustrate ways, as proposed in Chapter Two, in which culture can be expressed in 76 reminiscence. I will close this chapter with a discussion on findings of member validation. Interview Process Data Sources The individuals (PI, P2, P3 and P4) I interviewed were of diverse ethnic backgrounds including two European and two Asian elders. The individuals (PS1, PS2 and PS3) whose pilot study interviews I analyzed were of Chinese ethnicity. Please see Table 1 for demographic information on these participants. Table 1. Demographics for Participants Participant Religion Age (at interview) Ethnicity Gender Marital Status P1 not reported 68 German1 M Divorced P2 Christian 65 Japanese F Married P3 not reported 87 Chinese M Widowed P4 Catholic 88 French F Widowed (previously divorced) PS1 not reported 79 Chinese F Single PS2 not reported not reported Chinese F Single PS3 not reported 76 Chinese M Widowed Data Inclusion for Analysis Each participant shared stories of past experiences ranging along his or her lifespan. At times these stories diverged from chronological order as a result of such interviewer questions as those seeking clarification on earlier topics. Participants tended to digress from their stories in such ways as voicing opinions on current events or discussing potential future plans. I omitted such digressions from analysis. I also ' Please see text for Pi's description concerning his ethnic background. 77 omitted sections of opinions on past world events, or talk of "the way things were for everybody" i f such sections were long and did not include any apparent personal story. However, i f such sections were short and appeared to evaluate clauses within a story, I included them in analysis. The omissions of the large sections of opinions on past world events, or talk of "the way things were for everybody" may have affected results by negating some of the impact of context. Such opinions could indicate the individual's current perspective on life at the time on which he or she was reminiscing. However, such opinions contained no story clauses of experience and did not directly evaluate any of the story world clauses. The analysis method did not readily allow for the incorporation of general contextual evaluation on life that could perhaps indirectly evaluate story world clauses. Data Categorization Each interview could be divided into sections according to such categories as life stage (e.g. Childhood), world event (e.g. Second World War), or general theme (e.g. Coming to Canada). Certain categories emerged as unique to one participant's interview (e.g. "Writing" for P4). Other categories appeared appropriate for more than one participant's interview (e.g. "Living in Wartime" for PI and P2). Moreover, some categories appeared in parts with subheadings such as when the participant digressed from the category and returned to it later in the interview. Language Influences on Interviews Among the participants I interviewed, proficiency with English varied. Proficiency not only influenced participant verbalization, but also ease and accuracy of transcription and interpretation. PI and P2 understood and spoke English with ease. Only minor clarification on words and phrases were required for transcription. P3 and P4 understood and spoke English, but with greater difficulty than PI and P2. They appeared to spend more time searching for words and tended to shift tenses, 78 using the present and past interchangeably. Context of surrounding clauses seemed helpful in identifying the time frame to which P3 or P4 was referring. In addition, P4 occasionally substituted French words and expressions for English ones. A l l participants I interviewed used such expressions as "you know" and "I think" frequently. Where these expressions seemed more habitual than meaningful, I omitted them from analysis. Other Influences Because I was absent from the pilot study interviews and unable to access the tapes, or validate findings with participants, my analysis of pilot study interviews may have been more limited in scope than that of the interviews I conducted. For instance, the pilot study participants seemed to shift tenses. Occasionally PS2 shifted gender pronouns (he/she) in reference to the same person. Furthermore, breaks in clauses were sometimes ambiguous and gaps in transcriptions difficult to fill. Such ambiguities seemed difficult to clarify from context. Thus, I give my interpretation of APs from the pilot study interviews with considerable caution and acknowledgement of limited insight. P3 stated that sometimes he had difficulty remembering the past because of his tendency to worry excessively. Such worrying and subsequent forgetting may have influenced both his reminiscing and my analysis. I chose to forego seeking validation from P3 so as not to risk intensifying any such worrying. Therefore, as with the pilot study interviews, I guardedly offer my interpretations of P3's interview. Analysis Method Meaning Emergence Polanyi (1985) states that the AP method of narrative analysis preserves the information given in a person's story needed to demonstrate understanding of that story. Upon deriving and studying APs from stories in each interview, I interpreted content meanings related to each participant's expressions of character, values and life meaning. 79 I also interpreted structural aspects related to ways in which each participant conveyed his or her stories. Limiting Influences Because I had never before used the AP method (Polanyi, 1985), I was learning as I was going. For example, when I first began, I was examining clauses word-by-word. Later, I realized the method called for a proposition level of examination. Consequently, my findings changed from extensive summaries of sections to more precise paraphrases. Although with time and practice I did gain a sense of greater proficiency with the method, I also felt that more time and practice would be needed to reach a real sense of competence with it. My limited proficiency and sense of competence may be viewed as hindrances to the analysis. Nevertheless, the learning process in which I engaged may be evidence that this approach offers a structure that facilitates exploration for a neophyte researcher. Next, I will present the overall findings followed by the APs derived from each participant's interview that support these findings. I will also discuss my interpretations of these APs. Overall Findings The exploration of cultural expression in reminiscence has led to discoveries concerning the nature of relationship between culture and identity, a potential connection between levels of representation of narrative material (Reissman, 1993), and adequacy of AP interpretation and reminiscence construction by ethnic elders. The following is a summary of these findings. AP interpretations indicate that through reminiscence, an ethnic elder can express the fluid and reciprocal relationship between culture and identity in the story of his or her life. Among ethnic elders, the reminiscence expressions of ethnic features like cohort history events and immigration factors vary in such ways as emphasis and frequency. 80 Within a single elders' reminiscences, such expressions also vary in emphasis and frequency. These variations may be associated with varying degrees to which culture and personal identity influence each other at different times in an elder's life and to the extent that the elder perceives and chooses to express these degrees of influence. The complex relationship between culture and identity is one indicator that the true meaning of a reminiscence is elusive. Results from seeking member validity indicate that AP interpretations offer only a partial understanding of an ethnic elder's reminiscence. Varying degrees of adequacy of AP interpretations may be linked to the extent of reminiscence information present at varying levels of representation. In turn, this extent may relate to aspects of the identity development and contextual perspectives. Perhaps even a partial understanding of a reminiscence can provide clues as to the construction of that reminiscence. AP interpretations indicate that in constructing a reminiscence, an ethnic elder not only produces the content of the narrative, but also its structure. Moreover, the elder constructs the reminiscence according to a particular purpose and by using a formulation process. An elder draws material for each aspect of construction (content, structure, purpose and formulation) from one or more of the following theoretical perspectives: identity development, contextual perspective, memory, oral performance and spirituality. Thus, this proposed construction outline indicates that diverse theoretical perspectives can contribute to reminiscing. A key idea within the construction process is that the purpose of a particular reminiscence is to direct the use of structural devices in order to present the reminiscer as one who has acted reasonably and in ways congruent with his or her values. The bases of these overall findings are the APs. I will now direct attention to the APs and their interpretations. 81 APs and Interpretations Participant #1 (PI) PI was born July 15, 1932 in Bugrin Karczemka, a region of Ukraine that was under Polish administration. PI identified himself as a Polish citizen, but a German in nationality. He explained that his father was German, and his first language was German. In his interview, PI reminisced from his childhood onward. He shared stories on his experiences in the Second World War, immigrating to Canada, settling in Canada and developing a career. PI tended to tell his stories with rich detail. When examined together, the APs convey ideas that thread throughout P i ' s reminiscences, revealing meaningful themes of his life story plotlines. One theme is overcoming difficult obstacles and surviving amidst dire conditions, with or without the ability to control those conditions. In turn, overcoming and surviving (as well as achieving), relates largely to P i ' s resourcefulness, acceptance of responsibility and hard work. In addition to informing the reader of the content themes of P i ' s reminiscences, the APs also seem to give clues as to the structure of those reminiscences. Despite the powerful nature of his surrounding circumstances, PI presented them as contextual backdrops to the more prominent actions of his characters. Thus, his reminiscences seemed to build chiefly upon action and characterization. AP Examples for PI In the section, "Living in Wartime", PI reminisced on his experiences of living in Eastern Europe during the Second World War. PI spoke on this topic on three separate occasions in the interview. Thus, I divided this section into three parts, with Part 1 corresponding to the first occasion, and so on. Please see Appendix II for the derivation of the AP for Part 1. The AP for Part 1 reads as follows: 82 They got bombed. They could tell by the direction the bombs were falling when they had to duck and find a place to hide. This AP lacks such rich story descriptions as the countless numbers of American planes, and the tumbling down of the bombs. But, it appears to retain information needed to understand the story's plot. From this AP, P i ' s reminiscence seems to present a story of adaptation and survival. PI and his family were living under dangerous conditions. They learned how to overcome the almost insurmountable odds of being bombed (telling the direction of fall), and did what they had to do in order to survive (hide). The AP for Part 2 reads: P i ' s dad was arrested as a subversive,.and put in a concentration camp. But after he was released, he found the family and joined them. Although such details as: (a) P i ' s father being arrested because he was a minister and schoolteacher; (b) the family being shipped out to Germany and not knowing where the father was; and (c) PI's father finding them through the Red Cross would provide interesting context, the AP conveys meaningful information. Again the reader can sense the story is about survival. The AP also seems to present a story of strong family ties. Although circumstances beyond their control separated them, the family survived and were reunited. P i ' s father appeared resourceful, and faithful in his role as father. The AP for Part 3 reads: They took everything by wagon. They were shipped by train on a very long trip -a whole night, a whole day, and another night. This AP leaves the reader unaware of such details as PI's uncle providing assistance, and the horrible conditions on the train. But such details seem unnecessary for the AP to convey the sense that Part 3 is also a story of survival. The reader can infer the arduous nature of the trip from P i ' s emphasis on its long duration. Furthermore, although they 83 tried to retain control of their situation (taking their belongings), circumstances were beyond their control (being "shipped"). Still, the family survived. Taken together, the APs of "Living in Wartime" seem to convey the sense that PI and his family lived in a time in which they were swept up into circumstances beyond their control and which threatened their very survival. Yet, in P i ' s perspective he and his family valued their lives and family ties. They adapted and survived. In the section "Escaping to Canada," PI reminisced about a time at the end of the Second World War when his family were trying to get out of the Eastern, or Russian, zone of Germany in order to receive help to immigrate from relatives who were living in Canada. The AP reads as follows: The family had to cross the border illegally. The Russians changed border guards. They shot at PI until he and his little brother were across the creek. The English had a guard on their tower who saw the whole thing. PI was hungry and bought a herring. He and his brother ate. P i ' s parents had managed to get down to the station. This AP preserves story information to indicate that in "Escaping to Canada," PI again reminisced on surviving difficult, uncontrolled circumstances. The family did what they had to do - separate and cross "illegally." Plans had to change - border guards unexpectedly "changed." Things worked out - parents "managed" to get to the station. But in addition to survival in general, this AP seems to convey P i ' s perspective on his character as a survivor. The information in this AP seems to show PI as resourceful and responsible. He defied bullets to lead he and his brother to safety. He overcame hunger by finding and providing food. The inclusion of enemy and ally figures seems to add emphasis to the serious conditions in which PI performed these actions. In turn, PI appears not just as a survivor, but as an overcomer. 84 In "Adjusting to Canada," PI told abut his family's arrival in Halifax in winter, their train trip to Winnipeg to meet their relatives, and adjustment to life there. The AP for this section is: Nobody could see anything from the train and P i ' s mother was very sad. But they had relatives in Winnipeg, who got clothes for them right away. PI worked at what was very hard work in winter. He was like a cowboy finding cows that had calves. He would pick up the calves. He became rundown and had to work like that. From this AP, PI seemed to again tell of surviving and overcoming. The information in the AP conveys that PI viewed Canada as a cold and lonely, place at first. But by accepting help from relatives, using his own resourcefulness, and working hard, PI survived and overcame new obstacles. No longer threatened by war, PI had to face the unknown, hard labor and harsh winter conditions. His emphasis on working in poor physical health added emphasis to his theme of overcoming. Furthermore, similar to the information on helping his brother in the previous AP, the information on rescuing calves in this AP seems to emphasize P i ' s responsible and hardworking, nature. In both cases, PI perhaps viewed himself nearly as vulnerable as those he helped (he too was young and cold). Yet he did accept the responsibility and succeeded in looking after them. Thus, in reminiscing on adjusting to Canada, PI viewed the theme of overcoming as part of his character. In the section, "Career Development," PI spoke about his efforts to seek and establish a career. The AP reads: PI started working in a printing shop. He got full fledged tuberculosis. He survived. He learned English through a physical worker at the sanatorium. He started working for the provincial government and was given chartered accountant 85 status. He worked until the time that he shouldn't be working anymore was decided by him. Explanatory details missing from this AP include P i ' s acquisition of tuberculosis after working day and night when a flood hit Winnipeg, not being able to return to work at the printing shop because of the chemicals there, and suffering two heart attacks near the end of his career. Nevertheless, the AP preserves key plot information that once again focuses on surviving and overcoming. In this story, PI recounted facing the dreadful obstacle of a life threatening illness, as well as a difficult language barrier. But he emphasized that he survived, overcame and went on to succeed in an accounting career. Finally, this AP also conveys a message concerning agency. PI appeared to view his retirement as having been ultimately his own decision. Participant #2 (P2) P2 was born in Osaka, Japan in 1935. In her interview, P2 reminisced on her experiences in the Second World War, traveling to America and going to university, getting married and creating a family. Like PI, P2 told her stories with rich descriptions. Together, the APs of P2's reminiscences reveal two or three main themes. First, P2 seemed to see herself as having faced change and uncertainty throughout her life. She seemed to look back with a sense of humility, recognizing her weaknesses, but also of her growth and maturity in meeting, accepting and dealing with change. She seemed to demonstrate in her reminiscences times of varying degrees of agency - for example, in her ability to make, own and let go of decisions. P2's stories indicated that she has come to value characteristics of integrity, and showing appreciation for others. Overall, the APs indicate a process of learning and gaining insight - on relationship and on the self. The APs indicate that a key aspect to the way P2 structures her reminiscences is emotion. Story events seemed to provide a backdrop or framework that only took on meaning when P2 recounted her feelings associated with those events. 86 AP Examples for P2 In the section, "Living in Wartime," P2 described her experiences of being moved around as a young girl during the war. The AP reads as follows: P2 and her younger sister went to live with their grandparents in the village. P2 was bullied a lot. But, P2's father moved his factory to another prefecture, and P2 and her sister moved back with him after a year. One night, the city of Fukui, which was not too far from them, was bombed. It was very scary but they were safe. According to this AP, P2's reminiscence on the experience seems to be one of fear and lack of control. Although not stated explicitly in this AP, the reader may sense that P2 and her sister were moved around for safety purposes. But what is emphasized in this AP are the injuries imposed by bullies (in a place where safety would be expected -grandparents' home in a village), and threats imposed by bombs. Even though P2 now acknowledges that they were safe from the bombs, she views herself during the time in her story as being scared. In "Going to America," P2 told how, as a teenager, she learned about America and gained permission to go there. The AP reads: Next, they met another missionary. And the two families ate together. That's how they learned English. So P2 developed a dream of going to America. But P2's father was against her going. But her mother was very progressively minded, and her father said she could go. He decided to support her. So she went. From this AP , the reader can sense that for P2, this time in her life was one of inspiration. She appears to view her time with the foreign missionary's family as meaningful. The AP indicates that time shared at meals and language lessons was instrumental in P2's development of a dream. She also seemed to view her mother's progressive nature as positive and encouraging in the pursuit of that dream. This AP also contains information that this time in P2's life may have been one of a growing awareness of her parents' 87 characters and how to relate to them. She showed in her story that she continued to obey them, not traveling until she had their full support. Yet she also showed that she felt her mother could understand her dreams, and that her father's attitude toward her dreams could be influenced and changed. In "Adjusting to Life in America," P2 reminisced on her time in university in the United States. P2 spoke on this topic on two separate occasions in her interview. In Part 1, she focused on what it was like to be a student. The AP is: She was spoiled. But after three years, P2 became dissatisfied with a small college and transferred to UCLA-Berkeley. She was challenged there because she was no longer treated as a special student. She found it difficult to compete against other students. But she made good friends. The information in this AP indicates that P2 viewed this time in her life as one of personal character growth and insight. For instance, P2 emphasized that over a period of three years, she went from being spoiled to transferring herself for the sake of her studies. Not only did she see herself as becoming dissatisfied with what a small college offered, but also that she was taking greater control of her situation, and recognizing the effects (competition and challenge) of her decisions and actions. Furthermore, P2 recounted coming to realize that she was not in actuality a special student, but had only been treated as one at the small college. Finally, this AP indicates that P2's priorities may have expanded. She appears to view herself as coming to value friendship at least as highly as her own academic achievement. For Part 2, P2 focused on the experience of being a foreigner. The AP is: There was a particular family. The wife would cook rice and bring it to P2. P2 would go to different churches speaking about the college. P2 was like a movie star. The students were very friendly. She was so impressed and touched. But at the same time she became proud. She didn't really show appreciation for a 88 certain elderly lady. Overall, her experience there was very pleasant. When P2 moved to Berkeley she was warned that in California, people would be prejudiced against the Japanese because of their history during the war. It was different. There was no open racism. Then afterwards, P2 went to Washington DC for six months to graduate school. From this AP, P2's reminiscence seems to be a story of learning the meaning of relating to others effectively. First, this AP includes her rich descriptions of her own responses to new people in a new land, and their responses to her as a foreigner. Second, the reader can sense that P2 values showing kindness to others. The strength of her conviction is demonstrated by her emphasis on her weakness in showing appreciation. Finally, the AP shows that P2 highlighted her perspective on her experience of prejudicial relationships. She indicated that she did not receive direct effects of prejudice. But in using the qualifier "no open" in referring to her perception of racism in California, P2 may have been indicating that racism did exist and affect her in subtle ways. This AP conveys a sense of irony in terms of prejudice. P2 indicated that those who warned her against prejudice saw her as different (needing warning). In the section, "Getting Married," P2 reminisced on the process of finding the man who would become her husband. The AP reads: P2's father didn't like that she was dating a boy from Taiwan. P2 did not really feel that the boyfriend was the right one. Her father's opposition was a good excuse to break up. P2's father arranged through his best friend for her to meet somebody from Japan. But that didn't work out. P2's husband to be was teaching her how to drive. At that time, she was immature and that he would be the one for her was never what she thought. She matured. She could really appreciate him as a caring man of integrity. So her eyes were opened after five years. 89 This AP reflects the story's plotline that seems to weave beautifully to its conclusion. From the AP, the story seems to be primarily one of discovery. In her perspective, P2 was searching to find the man who was her "right one." She tried dating and searching through her father's arrangements. P2 indicated that the final search took place within her own heart. Once she discovered what the "right one" meant ("caring man of integrity"), her "eyes were opened." She found the man who exemplified that meaning for her. Thus, through this process of discovery of the "right one," P2 appeared to view her own character as one that was maturing and discovering more about the self. In the section, "Family Development," P2 reminisced on her life as a wife and mother. The AP reads: A few months later P2 had a miscarriage. But soon she became pregnant again and gave birth to her first child, her daughter, in January, 1964. Their family moved to England. P2 became pregnant. Suddenly they went from three to five children. So they considered coming to Canada as immigrants and came in 1974. P2's husband got a job with a major radio station. In 1988 they moved to one of Canada's largest cities. They hated to sell the house they had there but were praying and moved back three years ago. This AP seems incongruous by omitting such connecting details as P2's other pregnancies, her family's arrival in British Columbia, her husband's retirement, and their son's request that P2 and her husband live in Vancouver with him. Yet, the AP seems to reflect the way in which P2's story unfolds as a series of significant events. It also seems to preserve a theme of change and acceptance of change - whether loss or gain; whether controlled or uncontrolled. Through this AP, the reader can see P2's commitment to her husband and children, as well as her faith. In "Relationship with Elderly Parents," P2 told of a relatively recent interaction between herself, her sister and her parents. The AP is as follows: 90 It was a miracle. P2's father was a lonely man so P2 and her sister invited him to a religious crusade. He talked to a counselor and prayed the prayer. He went other nights because he wanted to make sure. There was a small church with a Godly pastor. P2's dad was baptized at Easter. He tried to be a good father even though P2 and her sister resented him for his marital unfaithfulness. Towards the end of his years, P2's sister acted like a peacemaker, so their parents lived in the same house but on different levels. P2's mother couldn't really forget. Although the details of P2's father's bankruptcy, and renewal of her parents' friendship would add clarity, this AP seems to retain significant story information on reconciliation. From the AP, P2's story seems to highlight the efforts made by herself and her sister in facilitating reconciliation - between their father and God; and between their father and mother and themselves. At the same time, P2's story seems to allow for her parents' perspectives and efforts to be voiced. P2 appeared to view all of their efforts as only partially complete or fruitful. Her father needed reassurance of his conversion; P2 and her sister continued to resent him; and their mother could not completely forget his unfaithfulness. Participant #3 (P3) P3 was born in August, 1913 in Canton, China. In his interview, P3 reminisced on his experiences in childhood, working life, and retirement. Although he elaborated less richly than PI or P2, he did give precise details on such aspects as locations and material items. Together, the APs from P3's reminiscences seem to present two main themes. P3 appeared to value the ability to make a living and to develop that ability through hard work and perseverance. This value appears evident in the way P3 reminisced with pride in his father's work life as well as in his own bookkeeping training. Another theme appears to be P3's value for family. Together, the APs convey the sense that P3 viewed 91 his own, and his father's efforts at making a living highly important for providing for family. The APs also convey information on the way P3 structured his reminiscences. For instance, in this interview, P3 tended to reminisce on loved ones and their life experiences as much as on his own experiences. Furthermore, he tended to explicate the influences of external factors on his decisions and actions. He expressed the influences of emotions and character more subtly. Examples of such expressions might be the repetition of his wife's inability to eat, and the outcome of being able to do his own bookkeeping. Thus, P3 seemed to build his reminiscences chiefly on the details of events and the external causes and effects surrounding them. Another structural aspect to P3's reminiscences can be seen in the AP for "Retirement and Family." P3 tended to give a general statement about an idea, then the story details leading up to and supporting that statement, and then repeated the general statement in summary fashion (e.g. "That was why she could not eat." "She didn't want to eat.") AP Examples for P3 In the section, "Childhood/Parents", P3 told about his father's immigration and life in Canada. The AP reads as follows: When P3 was three to four years old, his father wanted him to come over with his mother. But she, like many other people didn't want to come. P3's father was about 17 years old. He was a manager of a store, so stayed there forever. He knew lots of people in Nanaimo, even important people downtown. This AP indicates that P3's reminiscence on his childhood is a story of his father's life more than of his own. Because P3 was not with his father during that time, his reminiscence may have derived from his father's (or perhaps others') stories. The influences of these indirect sources may be significant. For example these influences 92 may have determined on what aspects of the story emphasis was placed. What this AP does appear to show about P3 is that he viewed both parents with respect. His father in particular is portrayed with pride for desiring his family to be together, immigrating and managing a store at a young age, and knowing important people. Even though P3's mother is shown as the agent keeping the family apart, her desire is portrayed as being shared by many others and so is presented as being reasonable. In "Education," P3 recounted his educational pursuits as an adult. The AP reads: P3 received a bookkeeping certificate. Before, he worked in the market and earned only nine dollars per week. He learned some English. At night he went to school with a friend and got 100% in bookkeeping. He could do his bookkeeping himself. From this AP, P3 appears to have reminisced on his bookkeeping training with certain pride. Not only does the AP include P3's achievement of 100%, but it also retains the details of his extra efforts of learning English and going to night school. Furthermore, this AP conveys the idea that P3 viewed his bookkeeping education as having been instrumental in improving his career status and self-sufficiency. This AP may also indicate that P3 viewed himself as hard-working and determined. In "Business Career," P3 spoke about his many jobs and businesses. The AP reads as follows: P3 worked for a certain market. After, he went to Nanaimo. Later, he operated a store in Ladysmith. It was very hard to make a living. Everything went for low prices, even lettuce and carrots. Then he operated a grocery store in a three-way partnership. It was wartime. After that, he sold the store and worked at the market again across from Woodward's. Then he put a store on Main Street and operated it there. He sold that business and rented out the store. After, he tried to 93 buy a restaurant on Granville. Then he operated a store on Granville and business was very good downtown. Finally, he sold that business. This AP does not include every job, move, wage and cost that P3 gave in his story. But it does convey the significance with which P3 viewed the factors of money, location and the "times" in influencing his past career decisions. The AP also conveys a story of hard work, and persevering behaviour. Although P3 recounted mixed success for his efforts, he appeared to reminisce on his business career as one in which he did all he could do to make a living. In "Retirement and Family," P3 reminisced on times spent with his wife and children after he retired. The AP reads: P3 came back here with his wife but his three sons stayed in San Francisco. The second son was going to school. P3 stayed here for over twenty years and let his daughter stay with him for a few years. She bought a house in North Vancouver. P3 and his wife moved there, but then moved back. After, they traveled all over. P3's wife ate too much fish. That was why she could not eat. Their son was able to work at Vancouver General Hospital and St. Paul's. He liked it at St. Paul's as it wasn't too crazy. He got more and more tired. It was too late. He passed away. That was why his wife worried. After one year she passed away too. She didn't want to eat. This AP preserves information that seems to reveal a story of devotion. For example P3 recounted devotedly helping his children become established before he and his wife went traveling. He also recounted experiences of great loss. In these times of loss P3 appeared to view himself as having been helpless. His phrases "it was too late" and "she didn't want to eat" may indicate thatP3 felt he would have (devotedly) tried to stop what was happening to his son and wife, but was helpless to do so. The information preserved in r 94 this AP also seems to indicate that P3's children were successful in school and career. If so, P3's efforts to provide for them could be viewed as having been successful. Participant #4 (P4). P4 was born November 6, 1912 in a village in the north of France. Her reminiscences included stories from both world wars, her marriages, her pursuits in writing, and her experience of immigrating to Canada. She recounted her experiences with colorful descriptions. The APs of P4's reminiscences present three recurring themes. In reminiscences from early childhood right through to retirement, P4 viewed herself as possessing a strong will that influenced her behaviors and decisions. She indicated that she may have been in a process of coming to terms with some of her decisions and their consequences. She also valued intelligence and creativity, having expressed appreciation for these characteristics particularly in herself and her dad. P4's value for pursuing one's life passions, and value for pursuing life passionately were evident in her stories on marriage, war and writing. The APs also reflect structural aspects of P4's reminiscences. P4 seemed to emphasize character development in expressing her story themes. In turn, she seemed to present story events, elaborate on emotions and contrast images to develop her story characters. AP Examples for P4 In the section, "Childhood - World War I," P4 divided her story into her "first remembrance" and her "second remembrance." I distinguished a third part related to the end of the war and P4's father's return from the army. The AP for Part 1 reads as follows: 95 P4 was looking to see if she had a little brother or sister in the garden. She could hear cannons. Her mother asked i f she would come home. P4 responded that no, she liked the B O O M . From this AP, the reader may sense that P4 viewed herself as a child as inquisitive, imaginative and strong-willed. She seemed to acknowledge that her strong-will could have placed her at risk (e.g. danger of cannons), but could have also brought richness to her life (e.g. " B O O M " sound of cannons.) This AP also conveys information on P4's perspective of her relationship with her mother - one of care, but also some conflict. For Part 2, the AP reads: P4's family had the boss stay with them. He came back with a doll for P4 which was very nice because P4 was a little girl. But she took it, put it on the floor looking at him and saying it was dirty because it was from the German. He responded to P4's mother that if she did not teach that to P4, P4 would not say that. The information preserved in this AP seems to once again convey a story of a bright, strong-willed girl. P4 presented herself as a girl who was still little enough to enjoy the gift of a doll, but was bright enough to recognize the German as an enemy and consider any gift from him, even a doll, as bad. Furthermore, she presented herself as not just defying any adult, or soldier, or enemy, but as defying an enemy soldier leader! P4 again showed that acting on her strong will entailed some risk. But in this story, the risky consequence (the German leader's response) fell upon her mother. The information in this AP also indicates that P4's perspective looked beyond her childhood response. She did acknowledge that "it was nice" of the German to bring her a doll. For Part 3, the AP is: 96 P4's dad asked why her tummy was a little big. She wrote that it was the baguette because that was all she ate. When they were told they were in Switzerland and were welcome, P4 felt it was good and was very impressed. When it was armistice, they were singing. It was not the Second World War, but the first one. After they came back, P4's father was very, very sick. At last he went. But he was a good dad. They were buddies; he read books, literature and poetry. This AP seems to convey a story of P4's closeness to, and identification with, her dad. Not only does it include her perspective on his character and their friendship, but it also highlights details of their communications. Although this AP omits the information that P4 later wrote two plays, it conveys the sense that writing was an interest P4 and her dad shared. This AP also seems to present a story of a labile, unpredictable life. In reminiscing on this time, P4 gave such contrasting highlights as: lack of food choice then welcome in Switzerland; singing at armistice then illness and death of her dad. Together, the APs for the section "Childhood - World War I," convey a few aspects of P4's character-and values. First, she is presented as possessing a strong intellect and will , pursuing her childhood joys ("BOOM!") and voicing her beliefs ("dirty doll") despite potentially risky consequences. Second, P4 is presented as relating more closely with her dad than her mom, appearing to value and identify with his creative interests. The section, "Marriage" is divided into two parts according to the focus of each part. In Part 1, P4 reminisced on the emotions and consequences surrounding her first two marriages. The AP reads: P4 could really have loved to write. She became tired of carrying all the family responsibility. So she married a brave guy. The problem was that she married him not because she loved him, but to be free of her family burden. They had a ,97 boy. Then P4 really fell in love with somebody. She left her husband and boy. This man was not as nice as her first husband. She felt at home and fell in love with his country. While there, her boy was not with her. At that time, the mom who abandoned her child would not get it again. But the force that pushed her was too strong for her. But in Denmark she was happy. She got a job in an embassy, translating everything, everyday. This AP seems to convey a story of following one's passion. Again P4 presented herself as strong willed. She showed that she could accept responsibility, but would not let it stop her from pursuing her passion, and seeking richness in both her work and personal life. This AP also seems to present a tension in P4's reminiscence. In telling of her decision to leave her first marriage for the man she really loved, P4 seemed to view her strong will as key. But, when telling of the consequence of abandoning her son, P4 viewed an external force as key. Such a tension may indicate an ongoing process of coming to terms with her decision. In Part 2, P4 reminisced on her life after leaving her second husband. The AP is: P4 obtained work again in a concrete factory. She was paid very well, but it was an important job. She obtained a divorce from her second husband, but had a very nice boy. She was working with the manager. She experienced a quiet happiness with him that she had never experienced before. Not like the kind of love she and her second husband had for each other. This AP preserves information that indicates a story of coming to terms with lost love. Although it omits the information that P4's second husband had an affair, and that P4 had considered him the big love of her life, the reader can sense that she had grieved over the loss of her second marriage. That P4 viewed the divorce as difficult can be inferred by the way she contrasted it with having a nice boy. That she viewed the love of her second 98 marriage as intense can be inferred from the way she contrasted it with the quiet happiness of her third marriage. In turn, the reader can sense that she was coming to terms with her last love, having seemed to view such aspects as her boy and the quiet happiness of her third marriage positively. This AP also seems to support P4's view of her bright, strong-willed character. In speaking of her work, she acknowledged having been paid well, but emphasized that her job was important. Together, the APs for the section "Marriage," convey further evidence that P4 saw herself as strong-willed and passionate, pursuing her heart's desires in both work and love. She also showed that she understood the consequences of her actions and was at least in the process of coming to terms with those consequences. In the section "Coming to Canada," P4 described the reasons she, and her third husband immigrated and her first impressions upon arriving. The AP reads: P4's son came to Canada. P4 was sorry he had to go. He got married two years later. P4 would not destroy anything, but P4's son's wife wrote for P4. P4's husband was 72, but he said they could try to move. A l l their friends thought they were crazy. But P4's husband knew five languages. Coming to Canada was a shock. Everything over a year was considered "old." P4 couldn't believe it. This AP seems to convey two main themes. First, there appears to be a story of motherly devotion. P4 indicated her devotion (as well as her strong will) in telling how she was sorry her son had to immigrate, how she would not interfere in his marriage and how, for him (through his wife's letter), she and her husband decided to immigrate despite advanced age and discouragement from friends. Second, there appears to be a story of culture shock. In this story, P4's value for the intellect seems to emerge since she emphasized that it was the Canadian mindset (re: age) that shocked her. 99 In "Second World War," P4 reminisced on her experiences and impressions during the Second World War. The AP reads as follows: The ordinary German soldier was not bad to them. But the SS were infamous. The ordinary soldier just wanted to go home to his wife. The Americans were to return home with no bombs left in their planes. There was a bridge that none of the Americans hit. The English were good pilots first, and second, tried not to kill anyone around buildings. P4 ate about 30 oysters/day. Their house stayed up, but an inner wall fell when a bomb of one to two tons, or 1000 kilos fell. The best for P4 was when the coffee came back. This AP seems to convey a story of the person behind the power. P4 presented her perspectives on individuals who were fighting in the war through contrasting images: the ordinary lonely German soldier vs. the "infamous" SS; and the careful, skilled British pilot vs. the bomb-rich Americans. Her contrasts are not enemy vs. ally. Rather, they seemed to be persons with qualities P4 admired or understood vs. persons or groups with power. In this AP, P4's strong-willed nature is indicated through details that showed she could make the most of a difficult situation. She highlighted that she took advantage of a resource (oysters), and did not despair at the effects that a huge bomb had upon their house. She also seemed to present her appreciation for richness in life in her emphasis that the best part of the end of the war was not the return of basic necessities, but of real coffee! In the section "Writing," P4 told about her pursuit of a writing career. The AP reads: The first play was between a man and a woman ending their relationship. P4 didn't know at the time she would do the same thing. The second play was about the last flight. After the war, P4 had no time to write. But writing was what she 100 liked. She went to a reporting school and received her journalist card. She did small stories, but not what she really liked. She did an interview with a deputy which seemed very clear at the time. P4 had no idea the plays she wrote were something. When Radio Paris called she almost fell. She felt happy. She changed only one word. She had two very keen actors, a man and a woman. She met them. They invited P4 and her dad for coffee at "Le Foucet." P4's mother was not artistic. It was tough. But P4 received many letters. As in the section "Marriage - Part 1," this AP seems to convey a story of pursuing one's passion. P4 indicated this plot theme in several highlighted details. First, she explicitly stated that writing was what she liked. Second, she vividly recounted the content of her plays, her excitement of their acceptance by Radio Paris, her need to change only one word, and meeting the actors. Third, she seemed to convey a character of persistence, recounting efforts at journalism. Fourth, she presented contrasting images that seemed to emphasize how meaningful writing was to her. These images included: (a) that writing was what she liked but that she had to stop for lack of time; (b) that she did small journalism stories even though they weren't the kind of writing she enjoyed; and (c) that it was tough that her mother did not share her artistic interest even though P4 received fan letters. Finally, P4 indicated that she pursued writing with no expectation of success, but rather with an expectation of joy in doing it to the best of her ability. This final indication of P4's pursuit of her passion (writing) seems to support the idea that she has valued living life fully. Pilot Study Participant #1 (PS1) PS1 was born in Vancouver, B.C. in 1918 to Chinese parents. In her interview, PS1 reminisced on her experiences of being taken in by another family, encountering prejudice, seeking her vocation and relating to relatives. In telling her stories, PS1 attended to events rather than descriptive elaboration. 101 Together, the APs of PSl ' s interview present a few recurring themes. First, PS1 appeared to focus much attention on family relationship. Of the various types of relationships and interactions she shared within family, the one shared with her "adoptive" mother seemed to have the most significant impact, having appeared most frequently in PS1 's reminiscences. Through the examples of both good and bad types of relationships, PS1 showed that she valued integrity and honoring any obligations inherent in family relationships. Another recurring theme concerns prejudice. PS1 reminisced on both times of hurt and times of victory, but did not express any sense of defeat at the hands of prejudice. Even in reminiscing on her time in school when she was beaten up, she told how she (and siblings) handled the situation in a quiet, nonrretaliatory way. Overall, despite stories of prejudice, abandonment, regret and disappointment, PS1 's recurring focus on how her "adoptive" mother gave her a chance at life leaves an impression that PS1 viewed her own life as a gift. Together, the APs also present a few aspects of the way PS1 has structured her reminiscences. Rather than referring explicitly to emotions or giving complex plot twists, PS 1 conveyed her perspectives through recounting a few events together with her own and others' attitudes. Furthermore, she tended to offer contrasting examples of issues from her past. For instance, she spoke about: (a) abandonment and adoption; (b) sibling conflict and unity; (c) walking away after prejudicial beating and daring to address prejudice head on; and (d) needing to make her own way and lacking confidence. By including such contrasts in her reminiscences, PS1 appeared to possess a broad perspective of the issues, and of her own identity. AP Examples for PS1 I divided the section "Entering a New Family" into two parts because PS1 spoke about the experience on two occasions in her interview. In both parts, she described the turn of events leading to her "adoption," and the responses of the children of the family 102 she entered. (Please note that PS 1 stated she was not officially adopted.) The AP for part 1 reads as follows: PS1 's mother came out from Hong Kong. She died six years after PS1 was born. A lady who became PS1 's friend took PS1 in and gave her a good home. The lady's own daughter was quite bossy. This AP omits the detail that PS 1 's father could not look after her. Rather, it focuses on mother-daughter relationships, and could indicate that such relationships and their meaning figured prominently in PS1 's reminiscences. It also highlights PS1 's perception of the lady's own daughter as being bossy. Thus, the story could be one of the role of a daughter, and could be pointing to conflict between PS1 and the other girl. (Please note that later in her interview, PS1 stated her mother died 6 weeks after PS1 's birth.) The AP for Part 2 is: They resented their mother bringing someone in. It was a wonder PS1 hadn't died. PS1 's own mother had relatives - aunts and uncles - but they wouldn't take PS1. Although this AP omits the detail that PS1 was left alone as a baby for a few days after her mother died, it gives a sense that PS1 perceived herself as unwanted, resented and abandoned. However, it could also give the sense that the woman's action of taking in PS1 rescued PS1 from death, and from abandonment. Together, the APs from Parts 1 and 2 indicate that PS1 viewed her adoption as highly significant, and the woman who took her in with great appreciation. Not only did PS1 state this woman became her friend, but she also noted that the woman took her and gave her a good home when nobody else would, and despite resentment from her own children. PS1 may have gained a lasting sense of acceptance from this woman decision to "adopt." 103 Because PS1 entered the new family when she was so young, her reminiscence may have been assembled from what she was told by the woman who "adopted" her, and by her mother's relatives. The influences of these sources on PS1 's reminiscence are uncertain, but potentially significant. In the section "Relationship to Father," PS1 described the brief interactions she shared with her father. The AP reads: PSl ' s father did not care to see her. He wrote letters to PS1 asking for money. PS1 didn't bother. This AP omits PSl ' s father's return to Hong Kong and subsequent marriage, that PS1 was only eight or nine years old, and that she sent money once,.but no more. - — Nevertheless, the AP retains the essential idea that PS1 's relationship with her father was one of coldness and brokenness. In PS1 's perspective, neither father nor daughter desired to get to know or help the other. Their only communications seemed to concern money. Just as her "adoptive" mother's attention and care seemed to leave a lasting impression on PS1, so may her father's apparent negligence and exploitation. In "Playing," PS1 told about relationships with peers in her school age years. I divided this section into two parts because PS1 spoke about the topic on two occasions in the interview. Part 1 was short and focused on playing tennis. Its AP is: PS1 loved tennis. PS1 and her Chinese friends played in the tennis courts in the parks early, from seven to eight in the morning. Although this part included information on playing with a Caucasian neighbor, and quitting school in order to make money, the information retained in this AP indicates that PS1 reminisced on playing tennis with great fondness. She played when she was able, making the most of an activity she "loved." The information in this AP could also indicate that tennis was an activity in which PS1 found friendship and acceptance. In Part 2, PS1 elaborated on interactions with non-Chinese peers. Its AP is: 104 They each had a doll, but they also had presents. At school they did play with Caucasian kids, but always got beaten up. They were not the type to fight. Their mother didn't know. In this AP, the reader can sense that despite the resentment mentioned in Part 2 of "Entering a New Family," PS1 experienced some aspects of unity with the children in the family she entered. Not only did she say they each had a doll and presents, but that they all received discrimination and kept the experience from the mother. Perhaps any conflict within the family was not as hurtful as that PS 1 experienced outside her family and ethnicity. This AP also retains information on PS1 's character. PS1 appeared to view herself as someone who would quietly take discrimination without fighting back or complaining. Alternatively, she may-have viewed herself as having been shy or cowardly. However, the AP omits the detail that the children did not want to worry the mother, and their quiet response to beatings seems to indicate an early achievement of maturity. Together, both APs indicate that PS1 viewed herself as a friendly, playful school chum. Perhaps because of prejudice from some Caucasian peers, and resentment within her own family, PS1 may have perceived her experience of playing tennis with Chinese friends to be the most safe and satisfying of any of her peer interactions at school-age. In the section, "The Dare" PS1 addressed the issue of prejudice once again as she reminisced on a surprising interaction with one of her teachers in her teen years. The AP reads as follows: So they didn't walk down the street with a Caucasian until the 1930s. Then, they had an elocution teacher who dared PS1 to walk down Pender Street with him. She did it. Nothing happened. But they spent a lot of time at his studio on Granville and Georgia, and saw new faces everyday. 105 In this AP, the reader can sense PS1 's delight in reminiscing about her walk down the street with not just a Caucasian, but her Caucasian teacher. From the AP, PS1 appeared to view both herself and her teacher as agents in addressing head on the issue of prejudice, and preventing any barriers from arising between them. The absence of any detrimental effects seemed to leave a strong impression on PS1, as evidenced by her declaration that "nothing happened." Although the AP omits the detail that the teacher became a family friend, it does convey the idea that friendship graced their relationship. Moreover, this AP retains information that reveals PS1 's adventurous nature - her acceptance of a dare, and interest in observing new faces. In "Calling," PS1 reminisced on issues related to seeking and developing a career. She spoke about these issues on two separate occasions during the interview. In part 1, she focused on her decision to stay with her "adoptive" mother. The AP is as follows: PS1 said that somebody had to look after the lady. The others were giving PS1 a chance to get away and make something of herself, but she needed to be able to do it herself. This AP seems to preserve the idea of developing her identity. PS1 appeared to reminiscence on this time as one in which she was not content to accept others' views of herself, but instead, needed to do what she thought was right and to establish herself on her own terms. The information in this AP may, on the other hand, indicate that PS 1 resented the others for leaving the lady, and so she would not accept their offers of opportunity. In any case, the information in this AP seems to show that PS1 valued integrity, showing she honored the woman who took her in, and made her own career choices. In Part 2, PS1 discussed her diverse vocational interests. The AP is as follows: They found they couldn't make that 35c" in one hour. PS1 tried everything and learned out of books. She was very fast. She missed her calling. She did paint-106 by-number and was very interested in art. But she missed her calling every time. She had lots of chances but no confidence. In this AP, a tone of regret seems to emerge. In reminiscing on her efforts to find and establish her career, PS1 recounted working hard and developing her talents, but with no sense of accomplishment. Taken together the APs for "Calling" convey the idea that for PS1, as important as integrity opportunities and talent were, they were of little consequence in comparison to confidence in establishing a career. Thus, PS1 appeared to value the characteristic of confidence, and to see herself as lacking it as a young adult. In the section, "Clothes," PS 1 .reminisced on pleasures she enjoyed in her adult . life. The AP for this section is: PSl ' s "adoptive" mother gave PS1 a chance at life. PS1 wore only name brands, but she gave it all away when she had to. In this AP, PSl ' s appreciation of her life, as a gift, appears to be highlighted. Viewing her life as having been given to her, PS1 reminisced on the way in which she lived it fully, both acquiring and giving away material riches. Alternatively, PS 1 may have viewed herself as one worthy of being "adopted" and thus, worthy of wearing only name brands. In the section, "Others" PS1 reminisced on interactions she had, as an adult, with helping and receiving help from others. The AP is: Once they graduated from U B C , her cousins' children got married. Yet PS1 used to cook for them every Sunday. The cousin she liked best bought PS1 cultured pearls. When she took them to the jewelers, the jewelers thought the pearls weren't very good. PS1 's homemaker stole a lot from her. In this AP, information is preserved that seems to reveal PS1 's disappointment in others. Despite helping, liking and hiring these people, they neglected, disappointed or hurt PS1. 107 The events highlighted in this AP present a picture of mistrust and the sense that as an adult, PS1 has had difficulty finding goodness in others. Pilot Study Participant #2 (PS2) PS2 was born near Canton, China. She reminisced on her childhood, career preparation, work life, process of immigrating to Canada, and her relationship with one nephew. Although PS2 gave little descriptive elaboration, she did recount stories on her life experiences. Together, the APs seem to contain certain prevalent content themes. These include PS2's value for maintaining family ties and persevering in one's chosen pursuits. These values appeared separately in some APs (e.g. loneliness in "Childhood," continuing studies in "Career Preparation"), and in combination in other. APs (e.g. helping nephew in "Family-Nephew"). Furthermore, PS2 appeared to esteem herself quite highly, giving recognition to her achievements in studying, working and in supporting her nephew. Together, the APs seem to indicate that PS2 structured her reminiscences on the impacts events and her own attitudes had upon her decisions and actions. The APs appear explanatory and logical. Indeed, one AP (for "Coming to Canada - False Starts") included an introductory statement that set up the rest of the statements included in the AP. AP Examples for PS2 In the section, "Childhood," PS2 discussed her family and school life as a young girl. The AP reads as follows: When PS2's second brother was very young, the brothers went to Malaysia. So PS2 did not see her brother for a long time. The family farm was not like farms here. Her family was neither rich nor too poor. PS2 liked to study. They led a simple life then. PS2's school was a missionary school that was very near. 108 From this AP, the reader can sense that PS2 viewed her childhood life as one of quiet simplicity. Not only did she explicitly state that they led a simple life, but also that they were comfortable (neither too rich nor too poor), school was close (therefore probably easy to reach), and she liked to study (therefore school was probably not a hardship). Furthermore, with her brothers away, PS2 probably experienced fewer distractions and complications than if they lived at home. Yet, her reminiscence of her brothers' absence (especially that of her second brother) denoted not only quietude, but also a tone of loneliness. This tone emerged from the statement that PS2 did not see her brother for a long time. In "Career Preparation," PS2 discussed the events surrounding her choice of, and training for, a nursing career. The AP is as follows: Her teacher said that he would fix everything for PS2 if she got herself out to Peking. Her mom was better from her stroke, and said that PS2 could not continue teaching all her life. PS2's friend left, but PS2 carried on with studying. This AP omits such information as PS2's inability to go to Peking upon high school graduation because of her mother's stroke, and PS2's dislike for teaching. But the AP retains information that indicates PS2 viewed herself at that time as having the potential to pursue further studies and a career. Furthermore, she appeared to value the encouragement she received from her mother and teacher. Although the AP omits the detail that PS2 initially had little interest in nursing, it does convey the idea that PS2 possessed determination with the statement that PS2 continued her studies despite her friend's departure. This statement may also indicate that PS2 saw herself as having been academically bright and a better student than her friend. In "Career Progress," PS2 reminisced on the circumstances and locations in which she worked as a nurse. The AP reads as follows: 109 PS2 was at the hospital in Shang Hai during and after the war. She was very lucky to go to Hong Kong with some other nurses. She worked at that hospital for 23 years. She couldn't work another year. Upon initial examination, this AP seems to convey little information. It omits such details as PS2's admission that the work was hard and the patients were fussy, and that in Hong Kong the nurses lived in nice quarters and enjoyed music and dancing. But perhaps the key information in this story is that PS2's work life as a nurse was significant, perhaps an important component of her identity. She worked under conditions of war and peace, in different hospitals and until she could no longer work. The statement that PS2 was very lucky to go to Hong Kong indicated that it was an honor and/or a luxury to work there. This AP also conveys the idea that PS2 possessed determination, working at the same place for 23 years, until she could no longer work. This AP may also indicate that PS2 excelled as a nurse, able to stay at the Hong Kong hospital for her whole work life. In the section, "Family-Nephew," PS2 reminisced on her relationship, as an adult, to her brother and his family. The AP is as follows: PS2 couldn't go to her family during the war. She had lost all her family except her brother in Malaysia. She found him. She told him that the place had no future for him or his family. PS2 wanted to act. She took the third nephew. She supported him through everything. She bought and sold, and her money grew. He graduated from university. This AP retains several explanatory details that provide information on PS2's motivation and character. She appeared to view herself as someone who liked to take action and provide help. Furthermore, she appeared to see sufficient motivation for helping her brother in noting that she found him after losing everyone else in her family. She may have wanted to do everything she could to keep their connection alive. The AP 110 highlights PS2's ingenuity (supplementing her salary opportunistically) and discrimination (choosing which nephew to help and how to help him). Finally, the information in the AP seems to build to a climax, indicating that in PS2's perspective, her nephew's graduation may have been the hallmark of her success. Highlighting this graduation may also show that PS2 viewed herself as being right in choosing that nephew and taking him away from a place she said held no future. In "Coming to Canada-False Starts," PS2 talked about unfulfilled opportunities to immigrate to Canada. The AP reads as follows: How PS2 went from Hong Kong to Vancouver was all very funny. The man in charge of the refugee program said he could help her. He asked why she would want to move if she was comfortable. PS2 thought that in America, she would have to do everything herself, and decided she wasn't going. PS2 looked after a French lady who asked PS2 to go with her. But PS2 didn't want to since the people were too rich and she would be neither a servant nor a friend. She wouldn't be happy. The lady begged PS2 because she liked her. This AP seems to present PS2's story as one of both constancy and change. Change appeared in the information concerning PS2's process of decision-making. She seemed to view such details as others' encouragements, or lifestyle differences, as factors that influenced her changing attitudes towards immigrating. Constancy appeared in the outcome of PS2's decision-making. She seemed to view her need at that time for a role and lifestyle in which she could be comfortable as the constant factor leading to her decision to stay in Hong Kong. This AP may also permit PS2's story as one of recognizing self worth and increased self knowledge. PS2 seemed to view herself as coming to recognize her preferred lifestyle, and that her role at work was worthwhile and she performed1 it well, satisfying the French lady. I l l In "Coming to Canada - At Last," PS2 reminisced on the circumstances surrounding her actual immigration to Canada. The AP is: So one day PS2 looked after a lady. But PS2 said that she had no money. But the lady said that no, PS2 could try to go to Canada. PS2 said that her friend was only an immigrant, not a Canadian citizen yet. The lady's son replied that he would write a letter. So PS2 got her visa. At that time she went to see her brother. Her shares dropped but she still made some money. She came in 1973. There were four girls together. This AP seems to present PS2's story as one of overcoming hurdles to reach an outcome. Unlike in the previous story, PS2 seemed to view herself.in this story as having reached a point where her attitude towards immigrating was positive and unchanging. Instead, what changed were factors that seemed like insurmountable hurdles at first until she accepted help from others. Then, she was able to obtain a visa, visit family, make money (despite dropping shares), obtain accompaniment, and head to Canada, at last! Pilot Study Participant #3 (PS3) PS3 was born in Canton, China in 1921. In his interview, he answered questions with minimal elaboration. Furthermore, the interview transcript contained several gaps. In one section, PS3 seemed to reminisce a little more readily, so I filled in a few of the gaps by inference and analyzed it. The resulting AP and interpretation may best be viewed as rough estimates of PS3's reminiscence on his experience. This section, called "Family Development," concerned aspects of PS3's married life. Overall, PS3 appeared to look back on his married life with contentment, and seemed to reminisce with a positive perspective. The AP reads as follows: PS3's mother passed away. They managed. PS3 was young, about 14 when he met his wife. Her mother said it was okay for PS3 to marry her. PS3 made his living in the army. That was a happy time. Their oldest daughter was born in 112 China. A l l three sons were born in Hong Kong. PS3 worked in enamel wear in Hong Kong. It was a good move to come to Canada. PS3 was happy. This AP not only conveys information in a positive light, but perhaps conveys a story of living life with a positive outlook. PS3 did not omit, but rather highlighted events that could have led to discouragement. Moreover, he highlighted positive responses to those events (e.g. his mother died - they managed; he worked in the army - that was a happy time; the move to Canada was good - he was happy). Responses to Culture Tales Culture tales may be seen to have a place in reminiscence through the function of prompting a reminiscence response. Responses to culture tales were obtained from one participant (P3) I interviewed and two pilot study participants (PS2 and PS3). A l l three participants were of Chinese background and listened to excerpts from culture tales of Chinese elders. Each participant's immediate verbal response was unique in content. I will discuss these immediate responses. Response of PS2 PS2 had already begun reminiscing on her childhood when the interviewer offered a few details concerning the childhood described in one elder's culture tale. These details included the experience of poverty with lots of work and little play. To these details PS2 simply responded, "Oh." The interviewer then added that in the culture tale the children had no toys from the store. PS2 replied, "No, no, that's also no." The interviewer asked PS2 if as a child she had time to play with her brothers. She said that she didn't, but rather, liked to study. She added that: (a) her brothers were different; (b) that as children, she and her brothers had no toys; and (c) that at that time, life was very simple. Then the interviewer mentioned that in the culture tale, the elder reminisced on playing marbles with stones, and making things out of tall grasses. PS2 simply responded, "No." Later the interviewer told PS2 about the culture tale elder's 113 reminiscence on having to walk and take a train every morning to another village in order to go to school, and asked PS2 what it was like for her to go to school. PS2 responded that "No, my school is missionary, very near." She elaborated upon receiving a few minor prompts from the interviewer, on the ease of obtaining schooling, liking school and achieving well in her studies. In her interview, PS2 tended to give a very brief initial response. But within a few exchanges, would expand on that initial response. She appeared to consider the culture tale information and compare it to her perspective on her own childhood experience. The content of her expanded response would then relate directly back to the information content of the culture tale excerpt. Response of PS3 The interviewer began PS3's interview with excerpts from a Chinese elder's culture tale. The interviewer outlined the elder's year and place of birth, and status in the family. PS3 replied that he was born in the same year. The interviewer went on to expand on the elder's status in the family including information on number and gender of siblings. PS3 responded that he had one sister and four brothers. With another interviewer prompt re: age, PS3 replied "younger." The interviewer sought clarification on PS3's status in the family but PS3 answered that all his siblings passed away around 1990. The interviewer described details of the village in which the culture tale elder grew up, and asked PS3 where he was born. PS3 replied, "Oh, Canton." Several minor prompts were given before PS3 gave the information that he grew up in a small village of about twenty houses in the country. Throughout most of his interview, PS3 gave short answers to frequent prompts. Hearing culture tale excerpts did not appear to change this pattern. He appeared to give only minor consideration to the information content of the culture tale excerpts in 114 formulating his responses re: year of birth and numbers and types of siblings. He gave no further elaborations to show that the culture tale information influenced his responses. Response of P3 P3 had already reminisced on his business career and retirement when I read him a few paragraphs from a culture tale of a Chinese elder. When I finished, P3 stated that while I was reading the excerpt, he was going to say something, but then forget what it was. He added that worrying too much has caused him to forget, but he has been trying not to worry because he needs to look after himself. When prompted to discuss his own childhood, P3 spoke mostly about his father's career. In stating that he was going to give a verbal response, but forgot itbefore he had the opportunity to share it, P3 seemed to indicate that he did compare the information content of the culture tale excerpt to his own past lived experience. Thus, i f I had read the culture tale in shorter excerpts, perhaps with a few prompting questions, P3 may have verbally responded with reminiscences related to the content of the excerpts. Summary Responses to excerpts of culture tales varied among individuals. Culture tales appear to have potential in providing content information that individuals can use to compare to their own experiences and formulate reminiscence responses. Illustrations of Cultural Expression in Reminiscence Findings from the AP method (Polanyi, 1985) involve interpretations on individuals' values, identities and life themes as well as on structural features of reminiscences. Interpretations of responses to culture tale excerpts include ways individuals may consider the tales in formulating and expressing their reminiscences. Bringing together interpretations of AP findings and culture tale responses may illustrate potential means of cultural expression in reminiscence. As in the literature review, the 115 following illustrations will address cultural expression via identity development, contextual perspective, memory, oral performance and spirituality. Cultural Expression and Identity Development The APs of several narratives revealed content information that appeared to focus on identity. I will present findings that seem to demonstrate relationship between cultural expression and the identity development perspective. Ethnicity and Personal Identity According to Luborsky and Rubinstein (1987), ethnicity's influence on one's personal identity can vary with family history, cohort history (e.g. wars), significant life events (e.g. immigrating) and personal past ethnic experiences; The content interpretations from P i ' s and P2's APs can be considered in terms of these four variables. Family history. PI's AP interpretations include a personal survivor/overcomer identity associated with his resourceful, responsible and hard-working character. Moreover, P i ' s whole family can be seen as survivors and overcomers. In the member validation interview, PI attributed much of this survivor identity to his mother's coaching. He also stated that the Germans were a people who shook off oppression and moved on with their lives without therapeutic help. P i ' s family history of survival seems to reinforce his perception of a German ethnic identity of survival. In P2's APs, P2's father appears to exhibit a traditional parental role in such actions as trying to arrange a marriage for P2 with someone from Japan, and such attitudes as initial disapproval of P2's desire to go to America for college. Luborsky and Rubinstein (1987) suggest that ethnicity can provide a point of conflict and source of redefinition of cultural values and identity between family generations. In these APs, P2 seems to view the more traditional aspects of her father's influence as conflictual. If so, such a perspective may contribute to a process of identity redefining for P2. 116 Cohort history. The historical event of the Second World War seems to serve as an important background in many of PI's reminiscences. In his stories of such co-experienced events as getting bombed and being shipped by train, P i ' s survivor identity appears strong and well supported. Although P2 highlighted the effect of fear in her reminiscence on living during the Second World War, she did not clearly link this effect to her Japanese ethnicity. However this effect may have set a tone of uncertainty in the value of her ethnicity since the fear was described in relation not only to observing the bombing of a nearby city, but perhaps also in relation to the bullying she received from Japanese peers. In the section "Adjusting to Life in America," P2 emphasized the responses of others to.her Japanese., ethnicity. P2 described one of the responses, warnings of prejudice, as related directly to the historical role of Japan in the Second World War. Overall, from P2's APs, the experience of the Second World War does not appear to have strengthened any connection between her personal and ethnic identities. Significant life events. The significant life event of immigrating also appears as an important factor in PI's reminiscences. Such situations surrounding immigration as learning English may have had potential to alter P i ' s ethnic identity. Yet, the APs indicate that even in telling about experiences in the new country, PI continued to focus on surviving and overcoming through hard work and resourcefulness. Interpretations of P2's APs indicate that her current ethnic identity has been shaped by such significant life events as going to college in America, marriage, and moving. In the APs for "Going to America" and "Adjusting to Life in America," contact with Americans appears to have influenced P2. For example, P2's contact with an American missionary seems to have inspired in P2 a dream of going to America. This contact may have acted to weaken P2's ethnic identity. However, in her reminiscence on the town of her first college experience, P2 seemed to perceive in Americans an 117 admiration for her Japanese ethnicity. She appeared to look back on the connection between her ethnic and personal identities during that time as strong, stating she became proud. In the section, "Getting Married," P2 told about dating a boy from another culture, but finding the right one from within her own Japanese culture. Such an experience may have strengthened her ethnic identity. In the section, "Family Development," P2 highlighted such significant life changes as a miscarriage, having children and moving to England and Canada. Although she did not relate these experiences directly to a sense of her ethnic identity, she seemed to express an acceptance of these changes. Such acceptance may relate, at least in part, to exposure to, and acceptance of, a variety of cultures including her own. Personal past ethnic experiences. From Pi ' s APs, no specific personal past traditional ethnic experiences can be identified. Thus, such traditions may exert less influence on his present day ethnic meaning then the experiences associated with his family history, cohort history and significant life events. The personal past ethnic experiences conveyed in P2's APs include life with her grandparents in a village during the Second World War, her father's expression of the traditional parental role and responses of Americans to her Japanese ethnicity (e.g. bringing her rice). P2 seemed to view most of these experiences as having been difficult; and through them, P2 may have been encouraged to take caution in connecting her personal identity very strongly with her ethnic identity. Disman (1987) suggests that the significance of ethnicity over the lifespan, in terms of external ethnic features such as language and food, relates to an elder's overall identity. According to her APs, P4 emphasized a few external ethnic features in her reminiscences. For instance, in the section "Childhood - WWI" Part 3, P4 told about eating only baguettes. In "Second World War," she highlighted her enjoyment of real coffee and in "Writing," she highlighted her experience of sharing coffee with French 118 actors at a famous Paris restaurant. P4 indicated the significance of retaining her French language by highlighting her translating job in "Marriage" Part 1. (While telling her stories, P4 occasionally used French expressions and stated that her English was poor.) Although P4 indicated a strong appreciation for Danish culture, emphasizing in "Marriage" Part I that she fell in love with Denmark, interpretations of her APs show that in terms of external features, P4's French ethnicity has remained significant to her identity throughout her life. Ethnicity, Identity and the Life Course Perspective According to Barresi's (1987) model on the life course, ethnicity can influence identity over time, role transitions within the ethnic group and degree of fit between host -culture and ethnic group. In line with this model, ethnically diverse elders may exhibit varied degrees of introspection, varied perspectives on role transitions and varied degrees of fittedness within the host culture. According to the APs, PI appears to exhibit the highest degree of introspection from among the participants. P4, P2 and PS1 also demonstrate a certain degree of introspection, each seeming to express a process of learning about, or coming to terms with aspects of identity. Perspectives on role transitions can be interpreted from the APs of PI, P4, P2 and PS 1. Both PI and P4 told about their experiences associated with assuming adult work roles in their teenage years. They related the early timing of this role transition to the factors of war and economy. Thus, they seem to perceive this timing as abnormal, perhaps too early in relation to their ethnic norms. P2's APs include brief reflections on such role transitions as becoming a college student, wife and mother. PS1 told about becoming a family caregiver. Although neither P2 nor PS 1 seemed to relate these transitions directly to their ethnicities, they indicated ways in which these transitions related to their values and relationships. 119 Aspects of PI's APs may be seen as examples of how ethnicity can influence degree of fit between host culture and ethnic group. PI appeared to view the lack of fit he experienced between his German ethnicity and the host Canadian culture as one more struggle to overcome in order to survive. For example, in "Adjusting to Canada," he told of having to perform hard, physical ranch work. His emphasis on this work may have derived in part from the valuable role the work played in helping P1 fit into the Canadian prairie way of life. According to the AP for "Career Development," PI overcame a lack of fit in language by learning English. In "Coming to Canada," P4 highlighted not only her anticipations of not fitting into the Canadian culture, but also her sense of shock upon arriving. P4 seems to attribute her lack of fit to the Canadian culture with her French ethnicity, emphasizing the difference in perspectives on what is "old." Identity and Immigration Through the process of acculturation, immigration can affect the degree of cultural identity maintained by an elderly individual (Gelfand, 1994; Kalin & Berry, 1994). Thus, the influences and effects associated with acculturation may be expressed in reminiscences of ethnic elders. The APs of PI's reminiscences include limited expression of external features of his homeland culture. However, during the initial interview, PI presented a special map of his homeland; and during the validation interview, he talked about meeting with fellow Germans. Therefore, P i ' s APs may indicate a higher degree of assimilation than he has actually experienced. Still, the APs do convey a focus on P i ' s efforts and achievements in the context of both his homeland and host country. The themes of surviving and overcoming may derive from plots within both cultures. His cultural identity may derive from the type of acculturation known as integration in which the immigrant desires both cultural maintenance and contact with host individuals (Kalin & Berry). 120 As discussed in terms of the continuity perspective, P4's APs appear to express numerous features of her homeland culture (e.g. foods, childhood memories, famous French locations), indicating maintenance of original cultural identity. This finding corresponds with the factors that she grew old in her homeland, has expressed concern with learning the host language, and left her homeland for a reason other than her own desire to leave. Like P4, PS2 immigrated to Canada at a later age. Unlike P4, PS2 indicates in the AP for "Coming to Canada - At Last" that she immigrated out of her own desire. This difference in reason may influence a difference in expression of features of homeland culture. PS2's APs appear to convey stories of filial devotion within her homeland, but seem to include fewer homeland expressions than P4's APs. Summary Interpretations of APs for PI and P2 reflect varied examples of cultural expression in terms of Luborsky and Rubinstein's (1987) model of ethnicity and personal identity. P4's APs can be seen as examples of the significance of continuity of ethnicity to an elder's overall identity as suggested by Disman (1987). APs of PI, P2, P4 and PST can be interpreted in terms of Barresi's (1987) model linking life course, ethnicity and identity. Finally, the APs of PI, P4 and PS2 can be interpreted for ways in which immigration and an elder's cultural identity may relate. Thus, examples from the APs illustrate how reminiscences of ethnic elders can include reflections on factors relating personal and ethnic identities, and on how these factors and their effects can change over time. Cultural Expression Via Contextual Ways If a person can express meaning of experiences through reminiscence, then contextual factors affecting meaning and expression may influence, and present, in the reminiscences of ethnic elders. Content and structure information of AP findings, as well 121 as responses to culture tales indicated connections with contextual factors. I will present examples from the APs that appear to support contextual means of cultural expression in reminiscence. Meaning Making Rather than only inward and autonomous, the self can also be viewed as shaped by things that matter in a person's community (Carnavale, 1999). This cultural meaning of self is based on the idea that human experience is constituted through encountering and deriving meanings (Carnavale). Narrative can be seen as socially constructed through interactions with others, and as giving meaning to experience through its presentation from a certain viewpoint (Abma, 1998; White & Epston, 1990). If so, personal reminiscence will derive its meaning in part from what is culturally and historically valued in the community, as well as from how it is expressed in interactions with others. Recurrent ideas in the APs have been interpreted as themes, values or characteristics of importance to the participants. Such ideas and their importance may have been derived within the past contexts of the participants' communities and valued within those communities. For instance, P3 and PS 1 appear to place high value on family ties. P3 indicated this value through his emphasis on providing for his family by working hard. PS1 seemed to emphasize the importance of honoring family obligations through caregiving. P4's APs also convey a value for family ties, but seem to focus more on a value for pursuing one's passions in life. Her focus on this value can be interpreted from her admission of the risks she took in order to pursue her passions. Lack of any inside knowledge of each participant's larger community makes a connection of themes, values and characteristics to community values difficult. Nevertheless, support for the contextual construction of these perspectives can be taken from descriptions participants have given of their family backgrounds. For instance, P3's value for providing for his family appears consistent with the highlights he gave of his 122 father's business life. PS1 's value for honoring family obligations through caregiving seems in line with her perspective on the care she received from her "adoptive" mother. P4's value for pursuing passion in life seems to follow from her expressed closeness to her father and identification with his creative interests. Thus, each participant's view on family values seems to give meaning to his or her experience as expressed in reminiscing. Relationship — Kin If meaning can be derived through interactions with others (White & Epston, 1990), interactions with kin may take meaning from the cultural nature of the kin relationship. Findings of studies focusing on relationships within Asian families have indicated that status of the aged in families is influenced by the degree to which children fulfill obligations of obedience, support and career success, as well as by the core values of group cohesiveness and intimate relationships (Kiefer, 1974 as cited in Trela & Sokolovsky, 1979; Ujimoto et al., 1995). Reminiscences of Asian elders in this study seem to include reflections on filial devotion, family cohesiveness and changes in status with age. From the APs of her reminiscences, P2's perspective on her relationship with her father, and his status in the family, appears complex. She has highlighted experiences ranging from his dominance and her obedience, to his weakness and her support. In the AP on the section "Relationship with Elderly Parents," P2's story may be interpreted as one of a process of reconciliation - of her father becoming reconciled with God, and seeking reconciliation with her mother. The AP includes both conflictual and peaceful aspects of relationship within the family, and may also tell a story of P2's own process of coming to terms with her relationship with her father. From the AP, this process of coming to terms may be viewed as related to a conviction of filial devotion within the Asian context of kin relationship, or as related to a personal conviction of forgiveness or perhaps as a combination of both. 123 P3 reminisced only briefly on his relationship with his father. The source of this reminiscing is unclear since it focused on a time when he and his father were apart. But in the section, "Retirement and Family," P3 reminisced on relationships with his own children. The AP for this section includes statements on his children's efforts to establish their careers and his support for them. Thus, a cultural influence on fdial obligation appears to have found expression in P3's reminiscence. From the AP on "Relationship to Father," PS1 appears to view this relationship as limited, reduced to mere economics. She told how, when she was just a child, her father requested financial support from her. His motive cannot be interpreted from the AP. PS1 may perceive his motivation as related to a sense of filial obligation and/or a sense that her "adoptive' family was in a financial situation from which he could draw. But any sense of obligation PS1 may have experienced seems to have disappeared from her perspective and she emphasized that she did not bother with him. PS1 's reminiscence on her father seems to support the suggestion by Lubben and Becerra (1987) that economic need can confound findings concerning the influence of cultural values on intergenerational relationships. From her APs on the sections "Entering a New Family," "Calling" and "Clothes," PS 1 seems to highlight a mutually supportive relationship between herself and her "adoptive" mother. Such expression of support may derive from a cultural sense of filial devotion. At the same time, PS1 's expression may be influenced by her experience of being taken in and given an opportunity to live by her "adoptive" mother. Indeed, according to the AP for "Calling," PS1 seems to express the view that she fulfilled her obligation as a daughter more fully than did the mother's own children. Overall, the relative influences of cultural values and the experience of abandonment and "adoption" on PS1 's reminiscences are difficult to distinguish. 124 PS2's APs divulge few details on relationships with parents. Yet, from the AP for "Career Preparation," one can interpret a sense of filial obligation and intimate relationship between PS2 and her mother. According to this AP, PS2 indicates that in order to care for her mother she gave up an opportunity to go to Peking for career training. But that once on the mend, her mother encouraged PS2 to go. In the section, "Family Nephew," PS2 reminisced on her relationship with her brother's family. From the AP, PS2 seems to highlight her reunion with them and her support for one nephew through to his university graduation. A cultural view on the core value of group cohesiveness and on children fulfilling obligations through career success appear to contribute to the meanings highlighted in the AP. Personal meanings related to the reunion with her brother after losing the rest of her family may also derive significance from meanings of kin relationship within the cultural context. Relationship - Reminiscer and Listener Meaning derived through negotiation in interaction (Neugebauer-Visano, 1994) may be influenced by the relationship and degree of cultural understanding between those interacting. If authorship of meaning is shared (Cotterell & Turner, 1989) between a reminiscer and listener, stimulation and depth of reminiscence may be influenced by the reminiscer's perception of the degree to which his or her culture is understood by the listener. Responses to culture tale excerpts may be examined for any influence of cultural understanding and relationship between reminiscer and listener. Responses by Chinese elders to excerpts of Chinese culture tales varied. PS2 did appear to consider information in the culture tale when formulating her own responses, briefly expressing agreement or disagreement and then elaborating in a few sentences. PS3 gave a few brief responses with minimal elaboration. P3 stated he was going to give a response, but forgot what it was before he could express it. Thus, the findings seemed to give no indication of a strong prompting influence by culture tales. 125 Without examining cultural differences and similarities between interviewer and reminiscer in this study, it is difficult to extract the nature and degree of influence relationship and perception of cultural understanding may have exerted on the stimulation and depth of reminiscence. Although P3 expressed comfort with me and the interview process, and received prompting by a culture tale excerpt, he conveyed less comfort than the other three participants I interviewed. PI showed greater ease, but expressed the wish to avoid talking about some aspects of his past lived experience. P2 and P4 demonstrated greatest ease and openness. They stated they were willing to share all of their lived experiences, and expressed a wide variety of emotions associated with the events in their stories. It is possible that varying levels of comfort related back to the cultural context of relationship and perception of cultural understanding, as well as forward to the varying levels of openness and depth of reminiscence. Summary Interpretations of APs for P3, P4, and PS1 include examples of how themes, values and characteristics meaningful to the elder may be shaped within the cultural and historical contexts, as well as within interactions of his or her community (Abma, 1998; Carnavale, 1999; White & Ebson, 1990). APs of P2, P3, PS1 and PS2 can be interpreted for such meanings as filial devotion, family cohesiveness and status of the aged as derived within the cultural context of kin relationship (Kiefer, 1974 as cited in Trela & Sokolovsky, 1979; Ujimoto et al., 1995). Culture tale responses by P3, PS2 and PS3 can be interpreted in terms of degree of sharing of authorship of meaning within the context of the reminiscer-listener relationship (Cotterell & Turner, 1989). Thus, examples from the APs illustrate how reminiscences of ethnic elders may contain expressions of contextual influences. 126 Cultural Expression Via Memory Harris (1999) suggests that the process of reminiscing reveals a complex interaction of memory and language in which language improves qualitatively when preferred topics are evoked. Preferred topics for older adults tend to be those of autobiographical and historical content as expressed when reminiscing (Harris). Park et al. (1999) suggest that memory varies with age and culture such that memory concerning world knowledge (knowledge activated by exposure to culture) will show cultural divergence in effectiveness of recall cues over the lifespan. If memory varies with both age and culture, reminiscences involving world knowledge memory may be facilitated by cues that complement the reminiscer's cultural bias, as demonstrated by qualitatively better language. According to Park et al. (1999), Chinese tend to process information holistically and show increased responsiveness to cues involving contextual, physically interacting figures. Each participant in this study who received the culture tale cue was of Chinese ethnicity. Each one's response to the cue was fairly limited. PS2 seemed to show the greatest response, giving an initial brief agreement or disagreement to the culture tale excerpt and then a brief elaboration. Quality of language was not examined closely but did not appear to change after exposure to the culture tale excerpt. The culture tale cue consisted of written text read in excerpts to each of the three participants. Although the content of the cue consisted of information taken from another elder of Chinese ethnicity, its conceptual nature may not have adequately complemented the Chinese participants' potential cultural bias for holistic, physical, contextual cues and thus did not strongly facilitate their reminiscing. Cultural Expression Via Oral Performance Coffey and Atkinson (1996) state that storytelling success depends on culturally shared conventions about language and listening. They suggest that "how things are said" (p. 77) is as important as what is said. The AP findings in this study can be 127 interpreted not only for content information, but also for structural information. Such structural information includes the use of events to highlight character development (as in P i ' s APs); the use of events as main structural features (as in P3's APs) and the use of contrasting images (as in the APs of P4's stories). Each participant's essential purpose in his or her use of particular structural devices may be interpreted in terms of presentation. In this study, the participants used structure to present themselves, their actions, and their stories as at least reasonable or logical. For instance, P i ' s characters could only develop as they did given the events; P2's emotions were reasonable responses to the events; and PS2's decisions were logical in terms of the events and attitudes she described. It is possible that conventions within each elder's cultural background influenced his or her choice and use of structural features in order to achieve a logical presentation. Cultural Expression Via Spirituality Through spirituality, individuals may find meaning and purpose in their lives (Bender et al., 1999). If culture is the way of life of a group, then through spirituality, members may find meaning and purpose in their cultural ways of life. If so, reminiscences may reflect how cultural values and elements have influenced a member's spirituality in terms of the role of religion in his or her life, or in terms of the individuals' sense of self worth and sense of meaning in life. Furthermore, Davies, Chekryn-Reimer, Brown and Martens (1995) suggest that the purpose and nature of an individual's search for meaning can influence the meaning derived. Thus, reminiscence may derive meaning from the purpose and nature of a reminiscer's search for meaning. As indicated in the APs of her reminiscences, P2 reflected on aspects of her Christian religion. These reflections can be interpreted as ways in which practices of P2's religion influenced aspects of her decision making and family relationships. For instance, in the section "Family Development," P2 stated how prayer influenced the 128 decision she and her husband made to move back to Vancouver from Montreal. In "Relationship with Elderly Parents," P2 told how a crusade, prayer, church, pastor and baptismal ceremony played a role in changing her father's life. She also described the role she and her sister played in this change (e.g. inviting their father to the crusade). Thus, P2's description seems to weave together a cultural sense of filial obligation with her religious faith. P2's APs seem to show that she is in a process of learning. This process may be interpreted as a search for meaning with the purpose of gaining insight on relationship and on herself. The nature of the search appears to involve examining her feelings in response to past events. For example, in "Getting Married," P2's reminiscing seems to derive meaning (of discovering the "right one") as she examines her past heart's desires in response to dating and her father's attempts at marriage arranging. Her view that she matured and came to know what the "right one" meant for her may be influenced by the purpose of gaining insight on herself, in her search for meaning. PSl ' s APs may be interpreted to show how cultural values have influenced her sense of self worth and meaning in life. In the sections "Playing" Part 2 and "The Dare," PS1 highlighted the issue of prejudice. PS1 's descriptions of her responses to prejudice against her Asian background (e.g. not fighting back; refusing to be seen with a Caucasian until dared by a teacher) may indicate that PS1 views her sense of self worth to have been low while in school. In "Calling" Part 2, PS1 again indicates she has experienced a sense of low self worth, stressing that despite her abilities and interest, she has missed her calling due to a lack of confidence. Furthermore, PS1 seems to view the possession, pursuit and fulfillment of a calling, as well as possession of confidence, to be of value in her family. For example, according to the AP for "Calling" Part 1, PS1 emphasizes how other family members urged her to make something of herself. Thus, in reminiscing on missing her calling because of her lack of confidence, PS1 appears to 129 perceive her life as having fallen short of its full potential for meaning. Yet, in reminiscing on aspects of filial devotion, PS1 does appear to see her life as meaningful. Not only does she seem to appreciate the kindness of her "adoptive" mother, but she also seems to see herself as moving from a state of abandonment, to one of receiving care and finally to one of being able and choosing to give care. Overall, in reminiscing on career and family relationship, PS1 seems to connect cultural values with such aspects of spirituality as a sense of self worth and life meaning. In reminiscing on her pursuit of a writing career, P4 seems to express ways in which her culture has influenced her spirituality. According to the AP for "Writing," P4 indicates that art and theater are important features of her culture (e.g. highlighting Radio Paris and Le Foucet). In describing how keen her interest in the art of writing was, how happy she was to receive recognition for her writing, and how tough it was that her mother did not share her interest, P4 seems to show how the development of her art has added meaning and purpose to her life. She seems to connect the cultural significance of art and theater to her sense of life meaning. In conveying such details as the themes of her plays, and journalistic interviews, P4 also appears to connect the cultural value for art with her sense of uniqueness. Member Validation The AP method of narrative analysis is used to uncover information given in an individual's story that demonstrates understanding of that story (Polanyi, 1985). Nevertheless, recognition of the various levels of representation (e.g. awareness, telling, analyzing) encourages caution in claiming any single true story (Reissman, 1993). One way in which caution can be exercised is through member validation (Reissman). As noted in Chapter Three, member validation is one approach to seeking trustworthiness in narrative interpretation and involves taking work back to study participants to check if the researcher's interpretations correspond to those of the participants (Reissman). 130 In this study, the member validation approach has revealed information about interpretations derived from the APs. Validating responses were sought from three of the participants I interviewed. A l l three addressed the interpretations I shared verbalizing their agreement, hesitation or disagreement. In addition, PI and P2 gave information they had not disclosed during their initial interviews. The participants showed strongest agreement with those interpretations based on information that seemed to recur frequently and receive most emphasis in their initial interviews. They hesitated to agree, or disagreed with interpretations based on information that seemed to receive less emphasis. Strong Agreement PI readily agreed that he has perceived himself as a survivor and overcomer, and that his abilities to survive, overcome and succeed in a career have developed through his own resourcefulness and hard work. P2 agreed that she has valued the ability to show appreciation for others. She also agreed that she is a person who is accepting of change, having adjusted well to many changes over her lifetime. P4 heartily agreed that she appreciates imagination and intelligence. Indeed, she said she has valued intelligence more than beauty, and that one cannot be a person without imagination. She also confirmed that she is very strong-willed, saying everybody has told her that. Hesitant Agreement Although P2 agreed that she is a person of kindness, she hesitated to agree that she is a person of gratitude, honor and integrity. She stated that she falls short of these characteristics, and is striving to overcome a fear of people that causes her to fall short. -P4 hesitated to agree that she has cared for the ordinary person despite being reminded of her words concerning the "ordinary German soldier." She stated she wishes she would care more, but if she has no interest in a person, she will not give her time to that person. 131 Disagreement PI disagreed that he perceived his father as a role model. He stated that before the war, his father was not around much since work took him away from home frequently. PI emphasized that his mother was more influential. P2 disagreed that at university she truly valued friendships. She stated that she had been influenced by American culture to obtain a boyfriend. She found a popular boy but knew in her heart she did not respect him and now feels guilty for having used the boy. P4 denied that the word "relationship" was especially significant to her, stating that she had fallen in love many times, but was not really one for eternal love. Reissman's (1993) discussion on levels of representation may provide clues to the existence of different levels of participant agreement. Information present at most or all levels of representation may appear more frequently and receive more emphasis in reminiscences. Thus, those interpretations considered adequate (e.g. PI as a survivor, P4 valuing intelligence) may be based on information present at most or all levels of representation; whereas interpretations considered less than adequate (e.g. P i ' s father as a role model; P2 valuing friendship at university; P4 caring for the ordinary person) may be based on information present at only one or a few levels of representation. Factors surrounding the presence of reminiscence information at various levels of representation may be considered in light of the identity development and contextual theoretical bases of reminiscence. Identity Development Degree of identity development and conflict resolution may relate to presence of reminiscence information at varying levels of representation. Information that recurs frequently and receives emphasis may contribute well to the person's identity. For example, in examining his past lived experiences and resolving past conflicts, PI may conclude that his life has taken on most meaning in having overcome difficult obstacles, 132 and that his identity has resolved as a survivor and overcomer. On the other hand, PI may be uncertain as to the significance of his father's role in the process of conflict resolution. So, although he seemed to highlight his father's role in the initial interview, PI disagreed in the validating interview that his father was a role model. Thus, information on his father's role may be represented at the awareness and telling levels at some, but not at all times. Similarly, information PI gave only in the validating interview on an ethnic historical perspective of his identity may not contribute as significantly, or with as much certainty, to his identity. If so, perhaps ways in which such processes as acculturation, and degree of ethnic fit (Barresi, 1974) have influenced P i ' s experience in the past continue to influence his experience now, and change the level of representation of historical information from one reminiscing time to another. In her validating interview, P2 seemed to describe aspects of her current process of identity development and conflict resolution. She disagreed with the view that she has been a person of gratitude, honor and integrity, suggesting that she has tended to be a person of fear. However, she also suggested that she sees herself as overcoming fear and becoming more honest and true. Thus, information on the characteristics of fear, gratitude, honor and integrity may contribute only partially to P2's current state of identity. If so, a resulting imperfect and partial representation of this information at the experiencing and telling levels may contribute to an imperfect and selective interpretation of this information at the analyzing and reading levels. From a continuity perspective, information represented at all levels may indicate that such information has been considered significant over several stages of life. For example, P4's perspective on her creativity and strong will may have been highly significant to her as a child, a young woman in love, a divorced woman and now as an elderly widow. Thus, such information may have contributed significantly to her identity throughout her life, and consequently be represented at most, or all levels in her reminiscences. Contextual Ways If narrative is socially constructed (Abma, 1998; White & Epston, 1990); its meaning will derive in part from what is culturally and historically important to the community, as well as how it is expressed in interactions with others. Thus, information present at most or all levels of representation may indicate that it is important to the teller's community and has been expressed in interactions with others in that community. For instance, the adequate interpretation that P4 appreciates imagination and intelligence may be information that has become highly meaningful to her since she has perceived these characteristics to be culturally and historically important to her community. In expressing such information to others in her community, P4 may have received positive reinforcement. Although not included in the APs, P4 did mention in her initial interview that the French are very intellectual. On the other hand, the inadequate interpretation that P4 cared for the ordinary person may have derived from information that has not been considered important in her community; and she may not have expressed it to others in her community. Indeed, P4 commented in her initial interview that she may be considered a traitor by the French for expressing any sympathy towards the ordinary German soldier. Meaning derived in the contextual community of kin relationships may influence the levels of representation of reminiscence information. Information represented at most or all levels may be considered significant within the family; whereas information represented at only one or a few levels may find less value within the family. For example, P2 expressed information on her grandmother's lack of care only in the validating interview. This information may be present at the telling level of representation only occasionally because P2 has perceived it as of little value within her 134 family. Moreover, in relation to filial devotion, P2 may perceive silence concerning this information to be of greater value to her family. Levels of representation of reminiscence information may also be influenced by the context of the reminiscer-listener relationship. If information is represented at most or all levels, the sharing of authorship with a high degree cultural understanding between reminiscer and listener may exist. In all three validating interviews, some interpretations received strong validation while other interpretations did not. Inadequate interpretations may be evidence that authorship was not evenly shared and/or cultural understanding between reminiscer and interviewer was limited. Summary A l l three participants expressed agreement with interpretations on themes that appeared fairly well supported through recurrence in their APs. They expressed hesitant agreement or disagreement with interpretations that received weaker support, either appearing fewer times (e.g. P i ' s dad as a role model), or being based on less complete initial data (e.g. P2 truly valuing friendship at university; P4 having care for the ordinary person). Disagreement may have also been influenced by a difference in perspective on the validating question. For instance, in asking P4 if the word "relationship" was particularly significant, I sought her feelings on relationship in general, including parent-child relationships. P4 appeared to perceive the question only in terms of romantic relationships. Differing levels of support for themes, and consequent differing levels of participant agreement may be explained in terms of levels of representation. Moreover, the extent of reminiscence information present at various levels of representation may be explained in terms of the identity development and contextual perspectives on reminiscence. 135 Chapter Summary Through the AP method (Polanyi, 1985) of narrative analysis, I derived APs from each participant's reminiscences. I then interpreted these APs and discovered that they seemed to retain key plot information from the reminiscence stories. Such information included content themes revealing participant values and characteristics. The APs also seemed to reveal such structural aspects of participant reminiscing as focusing on action, characterization or emotion, or contrasting images. I also analyzed participant responses to excerpts from culture tales. The responses were unique to the individual and seemed to show that culture tales may provide content information to which individuals can compare their own experiences in formulating reminiscence responses. The content and structure information revealed in the APs and culture tale responses seem to indicate ways in which culture can be expressed in reminiscences. I have explored these expressions in light of theories concerning identity development, contextual ways, memory, oral performance and spirituality. To exercise caution in claiming AP interpretations as the true themes of participants' reminiscences, I conducted member validation (Reissman, 1993). Results of member validation revealed varying degrees of adequacy of AP interpretations. By exploring these variations in terms of levels of representation, I discovered potential foundations for varying levels of representation of reminiscence information within the identity development and contextual perspectives. In the next chapter, I will discuss findings of the exploration on ways of cultural expression in reminiscence, and on member validation/levels of representation. I will then suggest ways in which ethnic elders construct their reminiscences. Finally, I will present potential implications of this study for research and nursing practice. 136 C H A P T E R F I V E : DISCUSSION A N D I M P L I C A T I O N S Introduction In this study, how ethnic elders construct their reminiscences is under exploration. A review of the literature indicates that the theoretical basis of reminiscence is complex and that questions remain concerning how culture and reminiscence relate. An examination of theories on culture, aging and reminiscence reveals several means through which culture may be expressed in reminiscence. By considering these potential means of cultural expression, we may learn about reminiscence construction by ethnic elders. As noted in the previous chapter, findings from the AP method (Polanyi, 1985) involve interpretations of individuals' values, identities and life themes as well as on structural features of reminiscences. Interpretations of responses to culture tale excerpts include considerations of how individuals may consider the tales in formulating and expressing their reminiscences. Although this exploratory study is being conducted without a basis of inside knowledge on participants' cultures, the AP and culture tale findings can be interpreted for insights on cultural expression in reminiscence via theories on identity development, contextual ways, memory, oral performance and spirituality. In this chapter, I will discuss these insights on cultural expression in reminiscence. Interpretations of member validation and levels of representation will also be addressed. Then, I will bring together ideas from the exploration of cultural expression to suggest aspects involved in reminiscence construction by ethnic elders. I will conclude the chapter with a discussion on the contributions of the AP method and findings of this study for reminiscence research and practice with ethnic elders. Cultural Expression and Identity Development In this study, ideas on relationships between the personal and ethnic identities have been informed by a study on life reorganization (Luborsky & Rubinstein, 1987), a continuity perspective (Disman, 1987), a model relating ethnicity to the life course 137 (Barresi, 1987), and ideas on effects of immigration (Kalin & Berry, 1994). If reminiscence contributes to the configuration of identity as suggested by perspectives on identity development (Lewis & Butler, 1974; Polkinghorne, 1996; Randall, 1999), then factors relating ethnic and personal identities may be expressed in reminiscences of ethnic elders. The reminiscences examined in this study included stories derived in diverse ethnicities, as well as across a wide age span. In reminiscing on their lives, a few elders covered not only all of the years associated with Erikson's (1963) stages of lifespan development, but also covered more than one historic world event (e.g. two world wars). Although effects of age span were not addressed, reminiscences across such a wide age span could be said to offer a rich resource from which to extract examples of cultural expression associated with identity development. In the following sections, I will discuss these examples. Ethnicity and Personal Identity Content interpretations of APs were considered for expressions of influence of ethnicity on the personal identities of ethnic elders. In terms of Luborsky and Rubinstein's (1987) model on life reorganization, the APs of PI and P2 offered alternative expressions. Whereas P i ' s APs involving family history, cohort history and significant life events indicated that he strongly connected his ethnic identity and personal survivor identity, P2's APs indicated she exercised caution in connecting her ethnic and personal identities. The capacity of Luborsky and Rubinstein's model to explain such divergent effects may testify to the model's strength. According to Disman (1987), the continuity perspective is important in explaining the significance of ethnicity to an elder's overall identity. P4's APs appeared to exemplify this continuity perspective, highlighting external ethnic features of food and language in stories from both early and later stages of her lifetime. 138 Whether through such life reorganization variables as family history, or through continuity of external features, ethnicity appears to influence the personal identities of ethnic elders. The nature and direction of that influence can find expression in the reminiscences of these elders. Ethnicity, Identity and the Life Course Perspective Interpretations of APs of PI, P2, P4 and PS1 presented examples of varying degrees of introspection, varying perspectives on role transitions and varying degrees of fittedness within the host culture. Because they were derived from elders of diverse ethnicities, these examples seemed to support the proposition in Barresi's (1987) model on the life course that ethnicity can influence personal identity over time, role transitions within ethnic group, and degree of fit between host and ethnic group. In turn, these examples indicate that the nature of ethnicity's influence on an ethnic elder's life course can find expression in reminiscence. Identity and Immigration Immigration has been linked to cultural identity through ideas on acculturation (Gelfand, 1994; Kalin & Berry, 1994). Interpretations of APs of PI, P4 and PS2 indicated that degree of cultural identity maintenance by an ethnic elder is complex and cannot be concluded from examining in isolation such features as expression of homeland culture or expressed reason for immigrating. Still, the APs did present examples that seemed to find potential explanations in theories concerning identity and immigration. Thus, cultural identity maintenance after immigrating can find means of expression in reminiscences of ethnic elders. Summary Interpretations of AP findings indicate that reminiscence expressions of culture can be associated with identity development. Support for models of Luborsky and 139 Rubinstein (1987), Barresi (1987), Disman (1987) and ideas on identity and immigration emphasizes the complex nature of relationship between culture and identity. From the A P interpretations, this relationship appears to be one of reciprocity and fluidity. Culture and identity may be viewed as threads weaving through the tapestry of an ethnic elder's life. It is possible that at times, culture threads influence the placement and appearance of identity threads; while at other times, identity threads influence the placement and appearance of culture threads in the tapestry. Similarly, in one reminiscence, an elder may highlight cultural features and influences; whereas in another reminiscence, he may emphasize the influence of identity. Whether a reminiscence once constructed acts like a lens reflecting a particular piece of the tapestry with a particular culture/identity composition and appearance, or whether reminiscence is a process used by the ethnic elder to influence the weaving of the threads is uncertain. Nevertheless, AP findings indicate that the relationship between culture and identity is far from unidirectional and that an ethnic elder is far more than a product of either culture or identity alone. Cultural Expression Via Contextual Perspective The meaning and expression of a person's experience has been linked to such contextual influences as the person's community (Carnavale, 1990), kin relationships (Ujimoto et al., 1995) and relationship with a listener (Cotterell & Turner, 1989). In this study, an attempt has been made to explore APs for examples of contextual influences on ethnic elders' reminiscences. Meaning Making Meaning expressed in the ethnic elders' reminiscences included content themes, values and characteristics. Such content, revealed in the APs of P3, P4 and PS 1, was interpreted as having been shaped by meanings valued within each elder's community. However, because of a lack of inside knowledge on the cultural and historical values of 140 each elder's larger community, interpretations on the influence of community values were derived indirectly from information on family values highlighted in each elder's APs. How representative of the larger community was each family is uncertain and thus interpretations on community meaning making may be weak. These interpretations could perhaps be strengthened by seeking within the APs, indications of values shared with extended family members or friends. Relationship - Kin The potential influence of the cultural nature of kin relationship on meaning expressed in reminiscence was sought amongst the APs of Asian elders in this study. In attempting to keep with this study's definition of culture, only AP examples from Asian elders were used to illustrate ideas derived from the literature, since the literature on kin relationships focused on Asian families. The APs could be interpreted for such examples of Asian cultural meanings of kin relationship as: filial obligations of children and the core value of group cohesiveness. Kin Relationship and Meaning Making Knowledge from the literature on the cultural nature of kin relationships of Asian families may lend support to interpretations on meaning making derived from the APs of P2, P3 and PS1. These Chinese elders appeared to express a high value for family ties that seemed consistent with each one's perspective on the roles of filial devotion played within his or her family (eg. P2's obedience to her father; P3's respectful view of his father and PS1 's decision to look after her "adoptive" mother). Thus, i f family does reflect the larger community, these AP interpretations could illustrate contextual meaning making by the community. According to Kiefer (1974 as cited in Trela & Sokolovsky, 1979) and Ujimoto et al. (1995), obligations, cohesiveness and intimacy within family are indeed valued by larger Asian communities. 141 Relationship-Reminiscer and Listener Responses to culture tale excerpts by Chinese elders were examined for indications of any influence by cultural understanding and relationship between reminiscer and listener. Because specific cultural similarities and differences between reminiscer and listener were not identified, the exact nature and degree of influence of cultural understanding and relationship could not be determined. A greater expression of comfort with listener seemed to coincide with greater ease and openness of reminiscing. However, the connection between level of comfort and cultural understanding of reminiscer and listener remains uncertain. Responses gave little indication of a strong prompting influence by culture tales. If authorship of meaning is shared (Cotterell & Turner, 1989), the culture tales may not have given a convincing demonstration of cultural understanding by the listener. On the other hand, if authorship rests chiefly with the reminiscer, these reminiscers may have given little regard to the listener's cultural understanding, and so the culture tales may have exerted little influence. Other factors (e.g. P3's expressed short-term memory loss) may have exerted greater influence. Summary AP interpretations provide examples indicating that community and kin relationships can influence meaning and expression in the reminiscences of ethnic elders. Any influence by relationship between reminiscer and listener, through cultural understanding or authorship of meaning is possible but its nature is unclear from culture tale responses. Cultural Expression Via Memory Responses to culture tale excerpts by Chinese elders were considered for indications of influence of memory cueing on reminiscing. Because responses were fairly limited and quality of language appeared unchanged, the culture tale's effectiveness 142 as a memory cue seemed minimal. This apparent low effectiveness could be related to the textual nature of the tale. Park et al. (1999) suggest that Chinese individuals respond more strongly to cues of a contextual, physically interactive nature. Despite their brevity, responses did indicate that ethnic elders might compare culture tales with memories of their own experiences in formulating reminiscences. If reminiscing involves a complex interaction between memory and language (Harris, 1999), perhaps some aspect of this interaction precluded any strong cueing effect of the culture tale, or any elaborate expression of response to the tale. Overall, the exact influence of memory on meaning and expression in the reminiscences of ethnic elders remains uncertain. Cultural Expression Via Oral Performance Structural features of APs were examined for indications of influence of performance, or presentation, on reminiscing by ethnic elders. Such features as character development, emotional responses and decision-making processes could be interpreted as storytelling performance conventions to produce a logical or reasonable presentation of the self, behaviors or stories. The exact influence of cultural background on choice and use of storytelling conventions remains uncertain. In this study, although structural features varied somewhat among individuals, no relationship was found between use of specific features and cultural background. Also, the apparent outcome of a logical or reasonable presentation seemed to occur across cultures. Thus, culture may find means of expression in oral performance, but the nature of the means is uncertain. Cultural Expression Via Spirituality APs were interpreted for ways in which cultural values and elements related to such aspects of an elder's spirituality as religion, sense of self worth and sense of life meaning. P2's APs included an example of a relationship between a cultural value (filial obligation) and religious faith. PSl ' s APs illustrated ways in which such cultural values 143 as career success and filial devotion related to such spirituality aspects as sense of self worth and life meaning. P4's APs included an example of how the cultural elements of art and theater related to a sense of life meaning and self worth. Spirituality is difficult to define clearly. Only to the extent that such aspects as religion, sense of self worth and sense of life meaning reflect the essence of spirituality can the AP examples illustrate any relationship between an ethnic elder's culture and spirituality. In terms of these aspects, culture seems to find expression through spirituality. Member Validation and Levels of Representation In Chapter Four, the derivation of alternative interpretations for certain APs (e.g. AP for PS2's section, "Coming to Canada-False Starts") gave an indication that the AP method does not necessarily lead to one essential understanding of a story. Member validation appears to confirm the idea that interpretation of APs may reveal only a partial understanding of an individual's story. The idea of varied levels of representation of narrative material (Reissman, 1993) offers one way to explore the varying degrees of adequacy of AP interpretation. One may argue that instead of levels of representation, it is the method of constructing an AP that influences member validation since non-storyworld clauses cannot be directly included in the resulting AP. In another telling, the reminiscer may verbalize these clauses such that they become storyworld clauses (e.g. instead of saying "things were always done like that," he or she may state in another telling "I did it like that"). The information in these clauses would then receive greater emphasis and contribute more directly to the interpretations. Nevertheless, the choice of verbalizing clauses as non-storyworld vs. storyworld may relate to different levels of representation and factors surrounding these levels. At least a few of the AP interpretations were considered adequate by the elders who participated in the member validation. Such support may indicate that this 144 exploratory study has discovered a few of the means by which ethnic elders express culture in their reminiscences. In the next section, these means and the construction of reminiscence by ethnic elders will be addressed. Construction of Reminiscence by Ethnic Elders This exploration of cultural expression in reminiscence has incorporated ideas from the theoretical bases for reminiscence, culture and aging. Thus, the findings and interpretations may offer information on the foundations from which an ethnic elder may derive the content, structure, formulation and purpose for constructing a reminiscence. Content From the APs, interpretations on such reminiscence content information as values, identity characteristics and themes of life story plot lines can be derived. Results of member validation indicate that these interpretations are sometimes inadequate, possibly in relation to factors influencing levels of representation. Nevertheless, both the interpretations of content and factors influencing levels of representation can be associated with theories in the identity development and contextual perspectives. Interpretations of content can also be linked to perspectives on spirituality. These three perspectives appear to contain resources from which ethnic elders draw for the content of their reminiscence narratives. Such resources include: internal means of taking one's own narrative plot line from an honored cultural plot line (Polkinghorne, 1991); internal means of connecting personal and ethnic identities over time (Luborsky & Rubinstein, 1987); contextual means of sharing authorship between reminiscer and listener (Cotterell & Turner, 1989; Harris, 1999); and spiritual means of developing one's sense of self worth and life meaning (Bender et al., 1999). Certain resources such as degree of fit between ethnic and host cultures (Barresi, 1987) seem appropriate to both identity development and contextual perspectives. 145 How an ethnic elder chooses upon which resources to draw is not clear from an examination of the resources alone. However, elders appear to have the ability to draw from more than one resource. For example, P4's reminiscences of her writing passion and P2's reminiscences on her relationships with her parents contain content information that appear to be drawn from resources within the identity development, contextual and spirituality perspectives. How an ethnic elder chooses which resources to draw upon is also unclear from an examination of the content alone. For example, attempts to make direct links between identity characteristics and the identity development perspective, between values and the contextual perspective or between religion and perspectives on spirituality do not appear fruitful. For example, P2's reminiscence on "Relationships with Elderly Parents" seems to include information that can be interpreted as showing her own process of identity development, religious and family values and a theme of reconciliation. These pieces of information may be explained in terms of all three perspectives. In summary, the content used in constructing reminiscences includes such information as plot themes, values and identity characteristics. Ethnic elders may draw this content information from resources within the identity development, contextual and spirituality perspectives. Structure Information on structural aspects of reminiscences may be interpreted from the APs. Among such aspects are events as background, events as main features, character development as a main feature, emotional elaboration as main features, and contrasting images. Please note that in considering emotional elaborations as structural devices, there is no intention to negate the possibility and significance of emotions as products of reminiscence. Here, the focus is on the words used to describe past emotions and the reminiscer's choice to give verbal expression to those past feelings. 146 These structural aspects may be explained in terms of ideas within the contextual perspective as well as in terms of oral performance. Within both of these perspectives, the teller-listener context is considered. In discussing oral performance, Coffey and Atkinson (1996) state that cultural conventions regarding language and listening influence how a story is told. Ayres and Poirier (1996) suggest that the relational context of the teller and listener is thought to influence the meaning of a narrative. Thus, the degree to which cultural understanding is demonstrated in the teller-listener context may influence the depth and stimulation of reminiscence (see Feinberg, 1996; Liton & Olstein, 1969). With no examination of such specific cultural conventions as language usage, basing any explanation for differences in reminiscence structure among ethnic elders on their cultural differences, or on cultural differences between each elder and interviewer seems impossible. Perhaps more accessible is the recognition that each ethnic elder may draw from the context of performance, or relationship, a structural framework that suits him or her. This suitability may relate to such outcomes as storytelling success (Coffey & Atkinson, 1996) or perhaps the sharing of authorship (Cotterell & Turner, 1989). In summary, an ethnic elder may use such structural devices as event details or emotional elaborations in constructing his or her reminiscences. He or she may draw these devices from ideas related to oral performance or contextual relationship of teller-listener. Although these perspectives may not contain the actual devices, their ideas of storytelling success, authorship and cultural understanding may guide the reminiscer in choice and use of the devices. Formulation Interpretations regarding steps used by the elders in the study to piece together content and structural information in the process of constructing reminiscences are 147 limited. From the AP findings, suggestions have been offered regarding general structuring, but no interpretations on the nature and order of specific steps have emerged. Nevertheless, culture tale responses can be interpreted to show that at least sometimes the process includes steps of receiving a cue and cognitively comparing that cue to some level of representation of one's own experience. If so, the process of formulating a reminiscence, at least one in response to an external cue, may be linked to theories concerning the cognitive process of memory. Theories on memory contain ideas on where information relevant to reminiscence is stored (Harris, 1999; Parker, 1995), and ideas on the facilitation of such memory information (Park et al., 1999). Ideas on facilitation involve variables of age and culture. Park et al. (1999) suggest that although the research is limited, memory in Chinese elders shows greater facilitation with contextual cues than with conceptual ones. This finding seems to coincide with the culture tale responses in this study. The Chinese elders appear to have shown little facilitation with the conceptual culture tales cues. Still, such factors as selectivity and deficits may influence results concerning memory. Lawler (1989) suggests that memory's selectivity influences personal narrative. Such selectivity may contribute to Polkinghorne's (1991) idea that we revise plotlines to ensure integration of plots into a meaningful whole. Memory deficits may interrupt communication of past lived experiences. P3 stated that his poor memory inhibited his ability to respond to the culture tale cue. In summary, the process of formulating a reminiscence may involve steps of combining content and structure information. Although knowledge and recognition of these steps seems limited, culture tale responses indicate that ethnic elders may draw on cue facilitation as discussed within studies on the cognitive process of memory. 148 Purpose In this section, the term "purpose" refers not to the overall reason for reminiscing. Rather, it refers to the reason underlying the particular means by which a reminiscence has been constructed at the time and local context of its telling. To learn about the purpose of a particular mode of construction at a given time, an examination of the structure seems useful. Content seems too massive and varied a source of information since it is unique to each participant and perhaps subject to variation with levels of representation. Formulation seems too limited a source of information. Upon considering the structures of each participant's reminiscences, a motive beyond simply answering the interviewers questions seems to emerge. Each participant appears to have used structural devices to present himself or herself (e.g. as in past emotional responses or decisions made) as reasonable and congruent with his or her life values. In order to present the self as reasonable, each ethnic elder may turn to ideas related to oral performance or the contextual relationship of teller-listener. A purpose concerning presentation may connect to ideas concerning the overall purpose of reminiscing. Using structural features to present oneself as reasonable and congruent offers support to the idea of emplotment in which events are drawn together to form an integrated identity (Polkinghorne, 1991). Such a purpose of presentation may also support the idea of Crites (1986) that interest in the future (e.g. achieving a particular impression) directs remembrance of the past. Furthermore, perhaps the nature and purpose of a reminiscer's search for meaning (Davies et al., 1995) is connected to the purpose of a reminiscence construction. For example, any use of emotional elaboration to present oneself as reasonable and congruent may be connected to an overall process of learning about the self and relationships to others by P2. In summary, the purpose of constructing a reminiscence in a particular way at a particular time can be examined in terms of the structure of the reminiscence. In this 149 study, the purpose seems to relate to presenting the self as reasonable and congruent with life values. An ethnic elder may derive this purpose from ideas on oral performance and/or teller-listener context. Also, ethnic elders may draw from perspectives on identity development and spirituality for their purpose of mode of reminiscence construction. Summary Construction of reminiscences by ethnic elders may involve such aspects as content material, structural features, formulation steps and a purpose for the particular mode of construction. Each of these aspects may be linked to one or more of the perspectives underlying ways in which culture is expressed in reminiscence. Content materials may be drawn from perspectives on identity development, contextual ways and spirituality. Structural devices and purpose may derive from ideas on oral performance and the contextual relationship between reminiscer and listener. Purpose may also indirectly draw from perspectives on identity development and spirituality. Formulation steps may be drawn from ideas found within theories on memory. This outline of construction aspects is highly tentative and offers little suggestion for ways in which the aspects may work together. Yet, it does suggest that while no one theoretical perspective accounts for the whole of reminiscence construction, certain perspectives may be more closely linked to certain aspects of the construction. Implications Although interpretations of AP and culture tale findings may support the discussion on reminiscence construction by ethnic elders, many questions remain. Questions involving the nature and order of formulation steps, choices of structural devices and the relative importance of cultural understanding to other variables in the teller-listener context are but a few. Answers to these questions may help 150 demonstrate how the aspects of construction work together. In this way, a more complete understanding of how ethnic elders construct their reminiscences may emerge. AP Method The steps involved in the AP method of narrative analysis (Polanyi, 1985) may give clues as to the formulation process in construction of reminiscence. Segmenting a story into its component clauses and encoding those clauses can introduce the analyst to the complexity of piecing together content and structure. Furthermore, the AP method draws attention to the fullness of an experience's meaning that can be captured and demonstrated in the telling of a story. Yet, a reminiscence story seems to be more than the sum (AP) of its parts (of the method steps),.and the essence of the story still appears to be subject to such issues as levels of representation in that story information represented at only one or a few levels may be misinterpreted in the AP analysis and receive an inadequate paraphrase. Although the AP method (Polanyi, 1985) is designed to identify culturally salient information in stories, such identification was constrained in this study by a limited understanding of the reminiscer's cultural world. Nevertheless, despite this limited understanding, and slight language difficulties with a few of the elders, each one's stories could be interpreted meaningfully by a Canadian interviewer. Harris (1999) suggests that older adults use qualitatively better language when conversing on preferred topics as when reminiscing. Thus, the ability of each elder (including P3 and P4) to find the words to express his or her story meaningfully may have been facilitated by the use of preferred topics. This ability to express stories so they are understood at a meaningful level is not only a strength for this study, but also important for each elder's daily interfaces with Canadians. Certain factors seemed to lend aspects of ambiguity to the analysis. For example, my decision on which proposition to place an evaluative device was not always clearly 151 determined by the type of proposition. My decision could sometimes be swayed by the context of surrounding propositions and by the main idea appearing to emerge from several propositions. Furthermore, particularly for the pilot study interviews, I found my decisions on which propositions to place evaluative devices could be influenced by my own impressions of the events, as well as by the way in which those events were being told by the participants. In turn, my decisions for placing evaluative devices sometimes varied over time, and across interviews. Polanyi (1985) seemed to acknowledge the variable nature of decision-making within the AP method, stating that the weighting of an evaluative device could change upon reflection. Future research aimed at gaining a more complete understanding of culture and reminiscence may include with the AP method (Polanyi), such methods as Poetic Structures (Gee, 1991). In the Poetic Structures method, levels of structure within a narrative text are analyzed to help identify key images in stories and connections between these images and individuals' cultural worlds (Gee). Use of Culture Tale The effectiveness of culture tales in facilitating reminiscence either through enhancing cultural understanding between reminiscer and listener, or by cueing memory cannot be ascertained from the findings of this study. Further research involving identification of cultural similarities and differences between reminiscer and listener, or use of culture tales as prompts for reminiscing by western elders (since Park et al. (1999) suggest that Americans respond more strongly to cues of a conceptual nature) may reveal more definitive information on the effectiveness of culture tales. Contribution of this Study From the literature, the dynamic formulation process appears to render reminiscence its essence. This view can be taken from the idea of cognitive configuration (Polkinghorne, 1991) within the identity development perspective as well 152 as from significance placed on dynamic exchange during communication (Neugebauer Visano, 1995) found within the contextual perspective. By exploring ways in which culture is expressed in reminiscence, and then applying these possible ways to a tentative outline of reminiscence construction by ethnic elders, this study perhaps gives greater recognition to the significance of content, structure and local purpose. Implications for Practice This greater recognition may encourage health professionals engaging clients in reminiscence to look beyond stimulus factors and the progression of events, actions and achievements told. They may be encouraged to attend to such content information as personal values and identity characteristics, such structural features as character development and contrasting images, and such local purposes as presenting one's self as reasonable and congruent within the client-professional context in which the reminiscence is told. An increased awareness of the reciprocal and fluid relationship between culture and identity may encourage health professionals to assess carefully the impacts of both ethnic and non-ethnic expressions in reminiscence. In attending to ways in which an ethnic elder sometimes brings culture to the forefront in reminiscence, and sometimes leaves culture in the background, health professionals may gain a clearer understanding of the elder's current self perception. The association found between varying levels of representation and interpretations of APs in this study may serve as a caution to reminiscence listeners to such hazards as jumping to conclusions about an ethnic elder's narrative. Rather, such professionals may be directed to consider a number of possible interpretations, to consider various factors ranging from the reminiscer's process of conflict resolution to the level of trust shared by reminiscer and listener, and to seek validation of interpretation. 153 Recognition of a construction process may encourage health professionals to give an ethnic elder as much time as possible to respond to a prompt, to speak and to pause during reminiscence sessions. Also, the professional may allow for additions to, or subtractions from, the story in subsequent reminiscences. Such changes may be in relation to memory processes, ongoing conflict resolution and search for life meaning, as well as to such factors as cultural standards of oral performance, filial respect and obligation. Overall, the findings can encourage health professionals engaging ethnic elders in reminiscence to listen closely to both content and structure, and to listen non-judgmentally. These listeners can assign substantive significance to single, brief moments of reminiscence as well as to longer reminiscence sessions. In a time of fiscal constraints within the healthcare system, reminiscence may not seem sufficiently significant to incorporate into a nurse's demanding schedule. The nurse may ask the question, "why bother?" One might respond to this question and encourage nurses to engage in reminiscence with ethnic elders by considering the following. Since the process of reminiscence appears to allow the elder to express the fluid and reciprocal relationship between culture and identity, reminiscing may in turn allow the elder to discern those aspects of her or his culture that have been beneficial or harmful in her or his life. Such discernment may facilitate identity integration. Furthermore, the use of preferred topics in reminiscing may facilitate the elder's ability to find and express words to make herself or himself (including her or his perspectives and needs) understood better by others. Finally, reminiscence appears to be a process of construction that is purposeful and complex. If so, it is deliberate rather than random, and significant rather than superficial. Thus, by engaging ethnic elders in reminiscence, each nurse may be promoting: (a) integration of identity, (b) search for life meaning, (c) making sense of and gaining meaning in the local or extended context, (d) accessing memory and (e) 154 communicating meaning. Through valuing each reminiscing moment as well as through efforts to enhance the reminiscer's perception of being listened to and heard, the nurse may not only support, but also find greater meaning in the client-nurse relationship. Therefore, a conscious effort by nurses to engage in reminiscence with ethnic elders has the potential to promote cultural as well as personal understanding. In turn, such reminiscing should promote quality health care (culturally sensitive care) in the face of diversity. Implications for Research In addition to ideas on types of reminiscence, types of reminiscers and therapeutic effects of reminiscing, researchers may be encouraged to closely consider the potential . nature and significance of connections among internal, contextual and spiritual factors involved in any single reminiscence. For example, a strong connection between contextual meaning making and spiritual worship may lead an elder to reminisce around a content theme of participation and recognition gained in a community church gospel choir, told with much emotional elaboration and perhaps with musical, rhythmic tones and gestures. Researchers may seek the permanence or fragility of a connection - can other connections (e.g. to identity changes with immigration) weaken or change it? Can factors of current context or deteriorating memory change it? Explication of the nature and significance of such connections may lead to the development of effective reminiscence prompts. For instance if found to be significant, connections may stimulate the combining of different types of prompts. For the example above, a story of a gospel singer combined with an excerpt of gospel music may be more effective in facilitating reminiscence than a photo of a gospel choir. In looking beyond seeking support for the theoretical perspective that best explains reminiscence, and seeking these connections of factors, researchers may gain greater understanding of the person who is both within the reminiscence and expressing 155 the reminiscence. Interpretations of this study indicate that a person's culture and identity are interwoven such that the removal of either one would likely cause an unraveling of the whole tapestry, or life narrative. Greater knowledge on the internal, contextual and spiritual connections involved in single acts of reminiscence may help elucidate the process of the weaving together of culture and identity. Just as any act of reminiscing may involve various connections of internal, contextual and spiritual factors, this study indicates that interpretation of the reminiscence involves variation in levels of representation. Addressing more closely these levels and their associations to identity development and contextual perspectives may also reveal more knowledge on the timing and degree to which a person expresses his or her culture. For instance, might such knowledge show that in addition to content, interpretation of structural devices can vary with varying levels of representation? At the end of Chapter Two, values appeared to influence all the potential means of cultural expression in reminiscence. The discovery of how cultural and individual values have influenced ethnic elders' lives was posed as a possible outcome of exploring ethnic elders' reminiscences and responses to culture tales. In this study, AP interpretations have indicated that values not only contribute to the content of reminiscences, but also appear to influence the local purpose, and in turn, the structural devices used in the construction of a reminiscence. A closer examination of the actual values expressed as content, together with the structural devices used, and investigation of the values of the elder's culture may shed light on the inter play between cultural and individual values, and the effects of this interplay on the elder's life. In turn, such research may add to knowledge on the nature of the relationship between culture and identity. Furthermore, researchers may be encouraged to take the idea that the local purpose of a reminiscence is to present the self as reasonable and congruent with values, 156 and investigate such potential functions of reminiscence as acting like a reflecting lens, or as a tool to influence the weaving of culture and identity in an ethnic elder's life. Implications for Education If health professionals are to give greater recognition in practice and research to the construction and interpretation of reminiscence in ethnically diverse elders, education concerning these issues is warranted. Education concerning reminiscence and culture could be incorporated into undergraduate nursing curricula in courses addressing issues of identity development, aging, culture, communication and health promotion. Specialty nursing programs in gerontology as well as professional workshops or seminars could also act as vehicles for promoting understanding of culture and reminiscence. The findings of this study might direct educational content to focus on the influences on reminiscence of the relationship between culture and identity, as well as culture and contextual factors, oral performance, memory and spirituality. In addition, issues of interpretation and levels of representation would receive attention. Educational content could include the outline of reminiscence construction proposed in this study. Although tentative, this outline could be used to facilitate recognition of the significance of both content themes and structural devices. Furthermore, attention to the construction of reminiscence could stimulate thought on the local and overall purpose of a person's reminiscence, as well as on such factors as memory and prompts involved in the formulation of each reminiscence. This study indicates that readings from such topic areas as reminiscence theory, narrative theory and analysis, sociological theories on aging and culture, memory and spirituality could be selected for the basis of discussions. Perhaps most useful would be assignments designed to give students the experience of engaging another person in reminiscence, and then analyzing both the experience and expression within the reminiscence and possibly construction of the reminiscence. Journals kept by students to 157 record reflections on reminiscence encounters could be useful learning tools for exploring interpretation and levels of representation. The findings of this exploratory study indicate that reminiscence can be both the object and means of learning. Within a reminiscence, layers of meanings involving a person's identity, culture, spirituality, relationships and values can be interpreted. Sensitivity to such meanings can be produced and encouraged only through education, interest and experience. Conclusion Exploring the expression of such a multifaceted concept as culture has perhaps contributed to a broad view of potential connections between aspects of reminiscence construction and theoretical perspectives. Indeed, from this study come suggestions of ways in which various perspectives on reminiscence, aging and culture may work together. 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Distinguish main clauses from subordinate clauses in the storyworld. 4. Consider the verb of each main clause. 5. Determine which main clauses fulfill event criteria (active, affirmative, punctual, noniterative, completive) and are in the simple past or historical present tense and list these as Main Story Line Events. Exclude event clauses which are off the main time line (e.g. flashbacks). 6. Determine the propositional content in Main Line Story Event clauses and list as Event Propositions. 7. List all nonevent storyworld clauses as Durative-Descriptive, and their propositional content as Durative-Descriptive Propositions. 8. Consider how each storyworld Proposition is encoded: a. Examine sections of a few clauses for encodings that stand out from the locally established encoding norm. Consider such encodings evaluative. b. Examine the whole text for such discourse level evaluations as: repetitions of words, phrases, clauses; redundancy of propositional content, extensive details, delays in giving expected information, flashbacks or flashforwards, conversational interludes concerned with the storyworld. 172 c. Examine nonstoryworld causes and para-linguistic phenomena such as laughter for reference to storyworld propositions and consider these as discourse level evaluations. 9. Keep track of approximately how much evaluation each storyworld proposition is given. 10. List the most highly evaluated Main Line Story Event Propositions in same order as in text. 11. List the most highly evaluated Durative-Descriptive Propositions in the order they occurred in the text. 12. Combine the Key Events (from step 10) and the Crucial Contextualizing Information (from step 11) in the order in which they occurred in the text. 13. Adjust the syntax and style of text produced in step 12 so the resulting paraphrase is comprehensible / TJ CD re % « 3 UJ re w o w u> = ' £ ^£ re > UJ o u V Q O oo" o CO U= CD CO o o M" 0 CO _ro o I cz o •*—> CO O 1*= o CD C L cn oo CO I 0 C L 0 o l cz o "to o o 0 CL CO CM o" •sr I cz o ro o o 0 C L CO CN •<3-o" I d o ro o o 0 C L CO CM o" I cz o -4—< CO o o 0 CL CO c 0 c „ O c o o og « Is « LU (0 o Q. O 0 E CD O CO CZ CD O * L _ 0 E < 0 CZ 0 x : c CD E 0 CD CO T J > S -jT£ 8 c 2 ° T J 0 X I E o x i -*—< o CO 0 0 > O 0 0 E cz ro ro o o. cz ° — „ s s . i f 3 U m 0 E _ _ < CD CJ =5 < D £ S O £ 1 CO £Z o X ) 0 L _ 0 0 « o 0 ~ 1 8 ° 0 CD 0 ¥ CO 0 ±= ^ 0 l«— CO co O cz 2 ZJ N 3 o O U C 0 >• "P- x 0 E ~ x: o >. I— O X ! co X I E o x i CO X I o X ) 0 T J ro o CZ ZJ T J 0 T J 0 0 P ~° 0 ^ 1 c O o CZ >• cnro 0 cz o -CZ : — ^_ i l l ro 3 E W Q 0 .£ r! 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(/} O CO c 0 J O — 0) iT | "53 >,"E" ~ 0 o 12 £ £ ~ ~ ro 5 0 o Lj= o C L 8 S 0 0 £ £ £ CD l c o '-+-» ro o M — o CU C L in 0 0 w 3 o o S Q5 5 CD CU CO M" I c o ro o o 0 C L in LO I "5 co CU -g o 32 CO > f= ° o ^ ^ 8 CU = £ E y o *= «= CO t CO o ro o o C L o LO ro o '•*—> TD C o o 3 o co E o o 0 L _ 0 > , 0 0 £ 0 CD I c o ro o L ^ o 0 C L (/) 1 0 in O LO 3 0 (/) CL 0 0 0 O ro C L TD c: ro ro 0 0 Q-.c TD E CO 3 o T 3 0 L^ 3 o 03 i a o c: CO a 3 E o o 0 ide ativ atio sz 0 o -4—' C L L i -up LUI nn pu 3 0 E o o > . 0 (negativ aded Th (negativ _o Q co 3 re co c 0 = _ 0 0 5 1 » T 3 0 C — < " O C L 3 E 0 sz -4—' 0 0 CO T 3 3 o o Is 0 5 0 3 o c 0 I 2 0 f | S, o C 0 " O 0 to 0 ® * E -n 0 3 o CO c ' E o o 0 1_ 0 > , 0 0 0 TD 0 O ro C L TD c I > o a) co £ o 3 E o o +-» 0 ro o in 3 o « z (0 d *r re Z ° > LU CD 00 o to LO CO LO •<3-LO LO LO + CN 175 For this part, I chose to include propositions that accumulated five or more evaluations. Thus, the AP included propositions corresponding to clauses 40, 46, 52 and 53. With a few syntactical adjustments, the AP was constructed: They got bombed. They could tell by the direction the bombs were falling when they had to duck and find a place to hide. Definitions for Terms used in Appendix II Contential Evaluation - type of evaluative device found within the context of the proposition. Diecitic Evaluation - type of evaluative device from other clauses. Specification - evaluative device that gives more specific information (e.g. answers the questions "what type?" "where?" "when?" "how?" "why?") Repetition - evaluative device that indicates clause/proposition is repeated very closely in another clause/proposition. Modification - evaluative device that acts like an adjective to describe something. Imperative - evaluative device that indicates a necessary action or result. Result - evaluative device that indicates an outcome. Loaded - extra emphasis added to the evaluative device (device given slightly more weight). Negative - indicates such adjectives as "no," "not any," "none" added to the evaluative device. 176 T H E U N I V E R S I T Y OF B R I T I S H C O L U M B I A School of Nursing T201-2211 Wcsbrook Mall Vancouver, B.C. Canada V6T 2B5 Tel: (604) 822-7417 Pax: (604) 822-7466 APPENDIX III: LETTER OF CONTACT Title of Study: Ethnic Elders' Narratives and Responses to Culture Tales: A Study of Culture and Reminiscence My name is Glenna Stewart and I am a registered nurse pursuing a Master of Science in Nursing degree at the University of British Columbia. For my thesis, I am studying reminiscence in different cultural groups. More specifically, I am examining how an elderly person of diverse cultural background responds to a culture tale relevant to his or her background. The culture tale is a short narrative elicited from an elderly individual of diverse culture that is designed to capture relevant historic and cultural information. Thus I will be interviewing some individuals to obtain culture tales, and will be interviewing others to obtain response to the tales. These interviews may last up to an hour and will be tape recorded. By analyzing the interviews, I hope to discover ways in which culture is expressed in reminiscence. I anticipate that such knowledge may assist healthcare professionals to support culturally diverse elderly persons in sharing their past lived experiences through reminiscence. Individuals eligible to participate in this study are those who: (1) are cognitively intact (2) are 65 years of age or older (3) are living in the Lower Mainland or Fraser Valley (4) demonstrate ethnicity as a social differentiation based on such cultural criteria as a sense of peoplehood, language preference, sense of exclusiveness from mainstream English speaking Canadian culture and awareness of being a member of a distinct and bounded social group (5) are willing to share their reminiscences Date Dear 177 To carry out this study, I am approaching people like you to see if you would be willing to participate in the nomination process. If you know of any individuals who meet the criteria for the study, please show them this letter to invite their participation and ask if I may contact them. If they agree to be contacted, please provide me with their contact information. I will then attempt to contact them and obtain informed consent. A copy of the consent form has been appended for your interest. If you have any questions or concerns about my request, please contact me at xxx-xxxx, Dr. JoAnn Perry at xxx-xxxx or Dr. Richard Spratley at xxx-xxxx. Thank you very much for your consideration of this request. Sincerely, K. Glenna Stewart 179 Participating in this study is voluntary, and not linked to your care in any way. Anyone participating in this study may refuse to answer any question, at any time during the interview. Anyone participating in this study can withdraw at any time without any consequences to the care they receive. The information from the study may also be used for educational purposes. The interviews will be tape recorded, and the recordings will be transcribed. The tape will be reviewed by the research team to identify important parts of the interaction. You will have the opportunity to review the taped interview and edit it. Exclusions Any individual who cannot provide informed consent will be excluded from the study. Risk, Stress or Discomfort No risk, stress or discomfort is anticipated, or known to be associated with this study. Benefits There are no known benefits to participating in this study. It may be pleasant to talk about the past and to have the opportunity to contribute to the "Culture Tale" for your culture. The major outcome of this study will be to see if the "Culture Tales" are helpful in prompting reminiscing. Confidentiality A l l the information will be confidential, and seen only by the research team. The only place that your name will appear is on this consent form, and on a code list with will be on file in a computer that has a security system. The consent form will be filed separately from the data. The code list will be destroyed when the research is completed, but the data will be kept indefinitely. Any information that you wish to add to the "Culture Tale" will be read back to you, after it has been transcribed. You will be encouraged to make changes or additions to be sure that it conveys what you want to convey. Contact People participating in this study should contact Dr. Perry at xxx-xxxx or Glenna Stewart at xxx-xxxx at any time if they have any questions or desire further information with respect to this study. People who have agreed to participate in this study should contact the Director of Research Services at the University of British Columbia, Dr. Richard Spratley, at xxx-xxxx if they have any concerns about treatment or rights of the research participant. (page 2 of 3) 180 T H E U N I V E R S I T Y O F B R I T I S H C O L U M B I A School of Nursing T201-2211 Wc.sbrook Mall Vancouver, B.C. Canada V6T 2B5 Tel: (604) 822-7417 Fax: (604) 822-7466 Participant Consent I have read the above information and have had the opportunity to discuss the study, and ask questions to help me understand what my participation would involve. I understand that my participation in this study is entirely voluntary, and that I may withdraw from the study at anytime without any consequences. I understand that I may refuse to answer any question, at any time during the interview. I understand that participation in this study is not linked to the care I receive. I have received a copy of this consent for my own records. I consent to participate in this study. Signature of Participant Date Signature of Witness Date Signature of Investigator Date (page 3 of 3)