'Keeping the Peace': Multiple Perspectives on Decision-making Following Acute Stroke in China: A Constructivist Grounded Theory Study
Year: 2013
Type: dissertation
Abstract: Stroke is a major public health concern in China and worldwide due to its \nsignificant mortality and long-term morbidity. Following an acute stroke both older \npeople and their family carers often have to make major life decisions in a \nrelatively short period of time. This study explores the nature of the decisionmaking process between people with stroke, their family carers and professionals in \nan acute care context in China. \nUsing a constructivist grounded theory approach data were collected through a \ncombination of methods including semi-structured interviews, participant \nobservation, and documentary analysis. This comprised interview data from 19 \npeople with stroke, 28 family carers and 25 professionals together with 55 periods \nof observation to ensure 24 hour coverage and an analysis of key policy and \npractice documents. Constant comparative analysis of the data led to the emergence \nof two core categories, and their associated social processes, these were ‘Keeping \nthe Peace’ and ‘Making Decisions’. \nThe core category ‘Keeping the Peace’ was the most important goal for all three \ngroups of people. This involved both keeping peace of mind for the person with the \nstroke and keeping peace in relationships between different parties (i.e. interprofessional relationships, inter-familial relationships, patient-carer-professional \nrelationships, and relationships between patient/carer from different families). The \ncore category of ‘Making decisions’ comprised three major social processes of \nhiding (permanent hiding, temporary hiding, and tailoring to hide), seeking \n(searching, watching/comparing, and checking) and sharing (informing, advising, \nexchanging, and tailoring to explain). \nThere was a close and dynamic relationship between ‘Making Decisions and \n‘Keeping the Peace’ and both were heavily influenced by Chinese culture, \nespecially the traditional Chinese ideal of maintaining harmony. In addition a broad \nrange of other factors also played a part in the overall decision-making process, \nincluding: the people who were involved; the types of decisions to be were made; \nthe types of knowledge that was used; environmental factors; medical/treatment \nrelated factors; patient-, carer- and professional-related factors. \nThe grounded theory emerging from this study enhances our understanding of \ndecision-making experiences among older patients with stroke, family carers and
Author: Yue Wang
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1546625601