Abstract: Formal Caregiving Relationship in the Chinese Nursing Home: From a Dyadic Perspective (Society for Social Work and Research 23rd Annual Conference - Ending Gender Based, Family and Community Violence)

Formal Caregiving Relationship in the Chinese Nursing Home: From a Dyadic Perspective

Friday, January 18, 2019: 9:00 AM
Golden Gate 1, Lobby Level (Hilton San Francisco)
* noted as presenting author
Lin Chen, PhD, Associate Professor, Fudan University, Shanghai, China
Minzhi Ye, MA, Doctoral Student, Case Western Reserve University, Cleveland, OH
Qiang Zhu, MSW, Student, Fudan University, Shanghai, China
Jianchao Lai, MSW, Doctoral Student, University of California, Los Angeles, Los Angeles, CA
Background and Purpose: Nursing home care has become an important way to meet the eldercare needs in China. Formal caregiving relationship between elderly residents and nursing aides is fundamental in terms of service delivery and quality of care in the institutional caregiving settings. However, existing evidence has seldom investigated formal caring relationship between elderly residents and nursing aides simultaneously. Drawing on a dyadic perspective, this study aims to explore how the formal caring relationship between elderly residents and nursing aides established and developed in Shanghai.

Methods: In a government-sponsored nursing home in Shanghai, 20 matched resident-nursing aide dyads participated in semi-structured, in-depth interviews (N=40). On average, elderly residents were 82.9 years old, ranging from 70 to 93. Most of them were long-term residents, averagely living for 5.5 years in the nursing home, from 1 to 15 years. Most nursing aides were middle-aged, averagely 44.5 years old, from 35-51. They worked in the nursing home for an average of 5 years. Only one of nursing aides was male, other 19 were female.

Interview questions included “How they met the nursing aide (elderly resident)?”, “How has this caregiving relationship changed so far?”, “Under what circumstances that you found you begin to reflect on this relationship?” Participants’ understandings, perceptions, and experiences were identified and ex­tracted from the stories. Themes emerged from recurrent categories of perceptions, feelings, and behaviors, which were labeled and defined with consensus among authors.

Findings: Results reveal that in the early stage of their relationship, the resident-nursing aide dyads reported mistrust and remoteness as nursing aides only followed the facility regulations. With the development of the caring relationship, interactions and exchanges evolved in the resident-nursing aide dyads, shifting from instrumental to emotional. Meanwhile, elderly residents became to trust in their nursing aides as their rapport became solid.

Based on different perceptions and experiences among dyads, this study constructed and analyzed four types of relationships: (a) parent-child semblance, (b) intergenerational friend, (c) unidirectional cordialness, and (d) regulatory detachment. 

Conclusion and Implications: This study informs nursing homes should recognize that formal caring relationships is the foundation of the quality of care. Elderly residents need attention to various psychosocial support, while nursing aides need training to foster a strong caregiving relationship. Nursing homes in China should advocate person-centered care and conduct interventions targeting formal caregiving relationships.