Page 193 - Encyclopedia of Nursing Research

160 n ETHNOGRAPHY

older who potentially may choose to live The anticipated peak in population for
with family are Hispanic and Asian immi- older adults by 2050 underscores the trend
E grants mostly from Mexico, Central and of obvious growth in the number of eth-
South America, india, and Pacific islands nic elders and a critical need for research
(Bengston, Kim, Meyers, & Eun, 2000; in ethnogeriatrics. it is imperative that such
Wilmoth, 2001). knowledge is part of the foundation for
The health belief model and the tran- evidence-based nursing care for ethnically
stheoretical model discussed by McBride diverse communities. There is much to learn
and Lewis (2004) were adapted for research about the cultural context of health issues to
on preventive health and health promotion, inform the development of effective guides
respectively, in ethnic elders. The trans- for cultural competence and cultural humil-
cultural assessment evaluates effects of six ity to increase health literacy and eliminate
cultural phenomena on health and illness health disparities in the older racial/ethnic
behaviors (communication, space, social minority groups (McBride & Lewis, 2004;
organization, time, environmental control, Xakellis et al., 2004). A new challenging fron-
and biological variations). These frameworks tier, the American society of the twenty-first
are attractive knowledge silos to initiate eth- century, is an in vivo laboratory for ethno-
nogeriatric nursing research. geriatric nursing research.
The chronic care model (Wagner et al.,
2001), a systems-change guide with six Melen R. McBride
components (community, health systems, Irene Daniels Lewis
self-management support, delivery system
design, decision support, and clinical infor-
mation systems), can be adapted for ethno-
geriatric nursing research. Exploring the Ethnography
interplay between health disparities, health
literacy, health beliefs, and internet technol-
ogy to improve health care for ethnic elders The term ethnography translates as “the writ-
especially the disenfranchised, underserved, ten description of the folk” and refers to
or hard-to-reach groups would contribute to both a specific naturalistic research method
changes in nursing systems. and the written product of that method. As
To assess health literacy level, SPEAK a research process, ethnography is a com-
(Speech, Perception, Education, Access, and parative method for investigating patterns
Knowledge) is a useful guide in working of human behavior and cognition through
with minority elders (Kobylarz, Pomidor, observations and interactions in natural set-
& Heath, 2006). Care models that resonate tings. As a written product, ethnography is
with nursing values are also important a descriptive or interpretive analysis of the
frameworks for ethnogeriatric research. The patterns of beliefs, behaviors, and norms of a
patient-centered care model individualizes culture. Culture, in the ethnographic sense, is
health care, respects the patient’s values an integrated pattern of human knowledge,
and perspectives, and considers the patient symbolic thought, everyday practices, and
to be an expert of his or her illness (Lorig material artifacts that is created, shared, and
et al., 2001). The relationship-centered care modified by people who interact with each
model incorporates the provider’s person- other. The focus on culture and cultural pro-
hood, self-awareness, cultural humility, and cesses is central to ethnography and is one of
empathy into building trust relationships the ways in which ethnography differs from
for a health outcome (Beach & inui, 2006; other naturalistic methods such as grounded
Suchman, 2006). theory (the study of basic social processes)