Health beliefs, health behaviours and perceived support needs among older Vietnam-born people living with chronic disease in the Australian context: A focused ethnographic study

Culture plays an important role in shaping how people think and feel about their health, when and where people seek health care, and how they respond to recommendations for a lifestyle change, health-care interventions, and treatment adherence. Older Vietnamese-born people are one of the largest culturally and linguistically diverse communities in Australia. However, literature on the health beliefs and behaviours of this group are minimal. This study employed a focused ethnographic methodology to explore the influence of culture on the health beliefs, health behaviours and perceived support needs of older Vietnamese-born people living with chronic disease in Western Australia. Twelve participants (two couples) aged 61 to 96 years and living with chronic disease participated in this study. Participants were recruited through purposive sampling and snowball sampling. Ethnographic data were collected by participant observation and in-depth interviews over a seven-month period (March to September 2018). The analysis of ethnographic data comprised three stages, including description, analysis, and interpretation. Findings of this study were presented through stories portraying individual participants and through a thematic analysis. Ten stories were constructed to portray and give voice to each individual participant while living with chronic disease. Four themes emerged from the thematic analysis: beliefs relating to the development and causation of chronic disease; beliefs and behaviours relating to chronic disease self-management; contextual factors that influenced chronic disease self-management; and perceived support needs. While health beliefs toward chronic disease among older Vietnam-born people was significantly shaped by Vietnamese cultural values, practices related to chronic disease self-management reflected a blended approach combining both Vietnamese-oriented and Western-oriented practices. Factors relating to individuals including English proficiency, education, gender, and migration were identified as influential on the individual health practices and perceived support needs of older Vietnamese-born people living with chronic disease. Findings from this study align with and reflect fundamental tenets of Leininger’s theory of Cultural Care as well as provide new insights, with recommendations for the adaptation of Leininger’s theory. The provision of culturally competent care underpins cultural safety and in turn, health equity. Health professionals must strive to achieve health equity through the provision of culturally safe care. This study concludes by setting out essential recommendations for policy, education, practice and research that foster the improvement of culturally competent care