Native Hawaiians, the indigenous people of Hawai’i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai’i. Six listening meetings were conducted, involving 41 community-dwelling kūpuna (Native Hawaiian elders) and ‘ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories—life course perspective, minority stress theory, and historical trauma—that guided the design of this study and provided the study’s context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers.
Although indigenous peoples have lower life expectancies than the social majority populations in their countries, increasing numbers of indigenous people are living into old age. Research on indigenous elders is informed by a number of research traditions. Researchers have mined existing data sets to compare characteristics of indigenous populations with non-indigenous groups, and these findings have revealed significant disparities experienced by indigenous elders. Some investigators have attempted to validate standardized research tools for use in indigenous populations. Findings from these studies have furthered our knowledge about indigenous elders and have highlighted the ways in which tools may need to be adapted to better fit indigenous views of the constructs being measured. Qualitative approaches are popular, as they allow indigenous elders to tell their stories and challenge non-indigenous investigators to acknowledge values and worldviews different from their own. Recently, efforts have extended to participatory and decolonizing research methods, which aim to empower indigenous elders as researchers. Research approaches are discussed in light of the negative experiences many indigenous peoples have had with Eurocentric research. Acknowledgment of historical trauma, life-course perspectives, phenomenology, and critical gerontology should frame future research with, rather than on, indigenous elders.
Spiritually based resources (SBR) generally have a salutary effect on coping with cancer diagnosis and treatment. Few studies address this relationship in long-term cancer survivorship, however. As part of a study on long-term prostate cancer survivorship, wives' ways of coping with cancer-related issues were explored through longitudinal interviews.This article describes findings from a subset of women who reported SBR use (N = 28). Wives completing a quality-of-life survey were purposively sampled by age and race and ethnicity and invited to participate in semistructured interviews. Interview transcripts were analyzed using content analysis and grounded theory. Validity was ensured through researchers' consensus, participants' verification, and key informant interviews. Although wives' spiritual beliefs were rooted in diverse traditions, common themes in SBR use were detected. An embracing spirit was the overarching theme, as characterized by acceptance of change, adversity as opportunity for growth, and proactive coping. SBR facilitated adaptation in four core areas: marriage preservation and couple intimacy, personal growth and continuous learning, health-related attitudes and behaviors, and community connections. A conceptual model of SBR use is proposed, and considerations for research and practice are offered.
Increasingly evident is the important role of partners in patients' adaptation to diagnosis, treatment, and recovery. Yet, little is known about partners' adaptation when patients reach the benchmark known as long-term survival. This study describes elderly wives of prostate cancer survivors' perspectives of adaptation to the enduring challenges of prostate cancer survival and considers their experience in the context of ethnicity. Content analysis and grounded theory methods guided data collection and analysis of two waves of in-depth interviews with 26 elderly Asian/Pacific Islanders (Chinese, Filipino, Japanese, Native Hawaiian) living in Hawai'i. Continuous learning was the most common phenomenon as reflected in four types of adaptive work: involvement in husband's health, affirmation of the marital bond, normalization of adversity, and participation in personally meaningful acts. Issues are highlighted for consideration in developing culturally relevant, age-appropriate, and strengths-based interventions.
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