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The quest for cultural sensitivity: how cultural sensitivity can be practised while mitigating othering in Swedish eldercare
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (Welfare research)ORCID iD: 0000-0001-8030-153X
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The need to provide culturally sensitive care for older adults with immigrant backgrounds has been expressed by care professionals. Meanwhile there is a lack of consensus about how this should be done, and critical perspectives in research highlight the danger of causing this group to be viewed as problem bearers. This thesis explores the possibility of using the welfare theory of health to achieve cultural sensitivity while limiting the risk of othering. It uses a goal-oriented perspective of health that could be useful in an active ageing context. Study I used a mixed-methods design and the Delphi method. Study II used a quantitative design and survey method. Study III used a qualitative design and semi-structured interviews. Study IV used a qualitative design and vignette method.

Study I showed that municipal decision-makers in eldercare find it hard to agree on what cultural sensitivity entails. They prefer to consider individual preferences in less complex cases, but look for fixed cultural categories in more complex cases. Study II showed that the welfare theory of health can be used as a viable, personal, holistic approach to health among older adults, and that it can be measured with the HACT questionnaire. Study III built on the questionnaire in Study II, expanding it to include immaterial capital theory. It elucidated how immaterial resources of older adults with immigrant backgrounds, such as social capital, influence their goals related to good ageing. Study IV showed that assistant nurses could use the welfare theory of health to increase cultural sensitivity in their work. However, like the decision makers, they looked for fixed cultural categories in more complex cases.

The thesis shows how the welfare theory of health can be used to conceptualize cultural sensitive care with a starting point in the personal goals of older adults with immigrant backgrounds. With the help of immaterial capital theory, the thesis can shed light on the importance of immaterial resources, such as social capital, both in forming those goals and as resources to achieve them. With this knowledge, decisions and practices aiming to provide culturally sensitive care could be based on assessments of needs and resources without relying on preconceived and fixed ideas about other cultures.

Place, publisher, year, edition, pages
Eskilstuna: Mälardalens universitet, 2023. , p. 83
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 378
Keywords [en]
Older adults with immigrant background, cultural sensitivity, eldercare, welfare theory of health, active ageing, othering, social work
National Category
Social Work
Research subject
Social Work
Identifiers
URN: urn:nbn:se:mdh:diva-62235ISBN: 978-91-7485-596-8 (print)OAI: oai:DiVA.org:mdh-62235DiVA, id: diva2:1752382
Public defence
2023-06-09, C1-007 och digitalt via zoom, Mälardalens universitet, Eskilstuna, 10:00 (Swedish)
Opponent
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareMälardalen UniversityAvailable from: 2023-04-24 Created: 2023-04-21 Last updated: 2023-05-19Bibliographically approved
List of papers
1. Swedish experts' understanding of active aging from a culturally sensitive perspective - a Delphi study of organizational implementation thresholds and ways of development
Open this publication in new window or tab >>Swedish experts' understanding of active aging from a culturally sensitive perspective - a Delphi study of organizational implementation thresholds and ways of development
2022 (English)In: Frontiers in Sociology, E-ISSN 2297-7775, Vol. 7, article id 991219Article in journal (Refereed) Published
Abstract [en]

BackgroundInternational migration and aging populations make for important trends, challenging elderly care regimes in an increasingly globalized world. The situation calls for new ways of merging active aging strategy and cultural sensitivity. This study aim to illuminate the gap between cultural sensitivity and active aging to identify perceived thresholds by Swedish municipal officials in the understanding of older late-in-life-immigrants situation. MethodsDelphi methodology in three rounds. Twenty-three persons in municipal decision-making positions participated and generated 71 statements, of which 33 statements found consensus. ResultsThe 33 statements show that the decision makers prefer not to use cultural sensitivity as a concept in their work, but rather tailor interventions based on individual preferences that may or may not be present in a certain culture. However, as the complexity of care increases, emphasis drifts away from personal preferences toward text-book knowledge on cultures and activity.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA, 2022
Keywords
welfare organization, welfare theory of health, culturally sensitive elderly care, active aging, older adults
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-61615 (URN)10.3389/fsoc.2022.991219 (DOI)000907680200001 ()36619357 (PubMedID)2-s2.0-85145692940 (Scopus ID)
Available from: 2023-01-25 Created: 2023-01-25 Last updated: 2023-05-09Bibliographically approved
2. Holistic health amongst older adults – A validation study of the health measure Health as Ability of Acting
Open this publication in new window or tab >>Holistic health amongst older adults – A validation study of the health measure Health as Ability of Acting
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-62432 (URN)
Available from: 2023-05-09 Created: 2023-05-09 Last updated: 2023-05-09Bibliographically approved
3. Spotting good ageing: using welfare theory of health to frame the agency of older adults with immigrant backgrounds to attain good ageing
Open this publication in new window or tab >>Spotting good ageing: using welfare theory of health to frame the agency of older adults with immigrant backgrounds to attain good ageing
(English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Article in journal (Refereed) Epub ahead of print
Abstract [en]

Care providers for older immigrants in Sweden find themselves in a paradox. Individuals and associations call for culturally sensitive elderly care. However, implementing this comes at the risk of over-culturizing needs and behaviours, drawing a negative picture of ‘the problem of immigrants’ that needs to be solved with special interventions. To find a balance in this paradox, we applied the welfare theory of health to grasp a new understanding of the phenomena and draw a holistic picture of a person’s needs and resources available to achieve good ageing, reaching beyond the cultural paradox. Semi-structured qualitative interviews were conducted with older adults with immigrant backgrounds in Sweden. The interviews were analysed using content analysis. Combining welfare theory of health with immaterial capital theories offered a holistic theoretical approach to good ageing. This took its departure from the agency of older adults, mitigating the gap between their vital life goals and available resources to reach these goals. Although informants wanted caring interventions from close family, we identified distinct responses to mitigate the diminished trust older adults had in the capability of welfare institutions to provide adequate elderly care.

National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-60231 (URN)10.1080/2156857x.2021.1902377 (DOI)2-s2.0-85145681710 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareMälardalen UniversityForte, Swedish Research Council for Health, Working Life and Welfare, 2017-00031
Available from: 2022-10-17 Created: 2022-10-17 Last updated: 2023-05-24Bibliographically approved
4. Culturally sensitive active ageing through the Welfare Theory of Health. Views of assistant nurses
Open this publication in new window or tab >>Culturally sensitive active ageing through the Welfare Theory of Health. Views of assistant nurses
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-62434 (URN)
Available from: 2023-05-09 Created: 2023-05-09 Last updated: 2023-05-09Bibliographically approved

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