Crossing a cultural barrier: A study of beliefs and values in Chinese-born and Euro-American frail elderl

The primary purpose of this study was to ascertain whether Chinese-born, frail elderly homebound persons wish to take part in advance medical decision-making in a similar manner to non-Asian frail elderly. Anecdotal evidence, which may be stereotypical, suggests that Chinese are more fearful of death than others and avoid discussions of the subject; they are culturally geared to being unassertive and do not wish to speak out about their own care; and they are reticent when asked about personal information because their culture is family centered and stresses conformity rather than self-expression. While these attitudes and behaviors are reported by clinicians, there has been no systematic investigative documentation. This study adds a much-needed dimension to research on aging Chinese-born persons in the United States.;To determine whether Chinese-born elderly have attitudes and beliefs that require different treatment approaches or if aging creates problems and perceptions that result in similarities regardless of culture, responses to inventories exploring life events, control beliefs, values and death attitudes were analyzed.;Study participants included Chinese-born immigrant (n = 60), and Caucasian (n = 60) frail homebound elderly men and women. Chinese were interviewed in their native dialects. Two standardized questionnaires, common to gerontological studies, were used to determine statistically significant differences between groups in death attitudes and locus of control. These were quantitatively analyzed by two-tailed t tests. Categorical variables in the values inventory were measured by chi-square. Life events and expressed control beliefs were examined for themes, frequency of specific words and thought patterns.;One of the most significant findings of this study has the greatest implication for further investigation: Chinese-born elderly do freely discuss all aspects of their lives including views on death and dying and appear to have no adverse reaction to the interviews.