The power of "altruistic" healthcare and its impacts on the health-seeking behaviour of Korean immigrants in New Zealand

Abstract

<p>Immigrants’ health-seeking behaviours are reconstructed during their healthcare adapting process as a consequence of interaction with the host health services. How Korean immigrants, who came from a very different healthcare system, reconstructed their health-seeking behaviours by adapting in New Zealand, and the factors affecting their healthcare decisions and behaviours were the main concerns of the research. Korean immigrants’ experiences were explored and theorised in order to provide a theoretical understanding of their health-seeking behaviours. Glaser’s classic grounded theory was used to generate a conceptual theory with emergent fit. Forty-eight participants were recruited from Wellington and Auckland. The primary data were collected from unstructured face-to-face individual interviews (n=23), seven two-person interviews (n=14 [two people attended twice]), and four group interviews (n=14 [one person attended twice]). In order to develop a theory grounded in the participants’ experiences and perspectives, data were collected, coded and analysed congruently and iteratively with the constant comparison and theoretical sampling methods. The Healthcare Acculturation Theory that emerged from this research elucidated Koreans’ healthcare adapting process and provided insights into their health-seeking behaviours in New Zealand. Koreans’ health-seeking behaviours were largely categorised into four positions: “rejecting”, “attuning”, “attuning but negotiating”, and “rejecting but negotiating”. They were found to be in one of the four positions at any one point in time and each position reflected their responses toward the New Zealand healthcare system. Once a specific position was held, their healthcare decisions and behaviours were directed by the said position. As their healthcare experiences were ongoing, their chosen positions were not end-outcomes in themselves. When their existing perceptions and behaviours were challenged by new experiences their healthcare positions transitioned or reinforced, and these changes informed the Healthcare Acculturation Theory. When Korean immigrants, who came from a commercially driven healthcare system, experienced healthcare (emergency care rather than elective) at the public services in New Zealand they were deeply touched. The healthcare they received was caring, empathetic, and responsive care delivered in a person-centred way that they had never experienced before. This experience rendered a turning point in their healthcare adapting process. Participants who reached such a point experienced transitions, not only in their healthcare positions, but in their life beliefs and values as well, which went far beyond simply a shifting perspective but can be likened more to a “conversion”. It was conversion to a new understanding. This research articulates the major contributing factor to immigrants’ acceptance of healthcare, which was receiving care that Koreans perceived as “altruistic”. It is related to the ambience of health services that resulted in sincere and empathetic care, rather than the barriers to healthcare that immigrants face in the host country. This thesis makes an important contribution to the existing body of knowledge on acculturation demonstrating new knowledge and a theoretical understanding of health-seeking behaviour, in the development of a substantive theory based on the experiences of Korean immigrants in New Zealand.</p>