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Experiences of First-Generation Vietnamese Americans with the Healthcare System in the United States and Impact on Quality Care

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Experiences of First-Generation Vietnamese Americans with the Healthcare System in the United States and Impact on Quality Care 1 Experiences of First-Generation Vietnamese Americans With the Healthcare System in the United States and Impact on Quality Care A Qualitative Methodology by Anh Thu Thai Copyright 2020 in Partial Fulfillment of the Requirements for the degree of Doctor of Health Administration Franklin University April 2, 2020 2 The Dissertation Committee for Anh Thu Thai certifies approval of the following dissertation: EXPERIENCES OF FIRST-GENERATION VIETNAMESE AMERICANS WITH THE HEALTHCARE SYSTEM IN THE UNITED STATES AND IMPACT ON QUALITY CARE: A QUALITATIVE METHODOLOGY Committee: Dr. Leslie Mathew, MD, MS, EMBA, ACHE Chair Dr. David Meckstroth, DHA, Committee Member Dr. Alyncia Bowen, PhD Committee Member _________________________ Leslie Mathew, MD, MS, EMBA, ACHE Chair, Master of Health Administration Program Chair, Master of Business Administration Program Faculty, Doctorate of Healthcare Administration Program _________________________ David Meckstroth, DHA Adjunct Faculty & Doctoral Faculty Advisor _________________________ Alyncia M. Bowen, PhD Dean, Ross College of Business and Chair of the DHA _________________________ Alyncia M. Bowen, PhD Dean, Ross College of Business and Chair of the DHA Franklin University Date Approved: _____________ 3 Abstract The purpose of this study was to explore the healthcare experiences of Vietnamese Americans in Ohio and how those experiences impact the quality of care. 11 first-generation Vietnamese Americans who immigrated to the United States from the Vietnam War and were born between the years 1925-1955 were interviewed based on their experiences during healthcare visits and how they believe certain factors impact the quality of care. The study investigated how aspects like immigration, identifying as a refugee, acculturation, and healthcare practices may have an impact on the experiences of first-generation Vietnamese Americans with the healthcare system in the United States. This study followed a qualitative approach by using semi-structured interviews where the researcher will ask individuals 13 questions. Participants read a short description about the study and signed an informed consent to participate in this research. Recordings of the interviews were transcribed, analyzed, and coded by using Atlas.ti software to determine trends and patterns from the respondents. Keywords: First-generation Vietnamese Americans, Immigration, Refugee, Acculturation, Healthcare, Quality 4 Dedication I dedicate this dissertation to my family, Oscar, Kyen, my grandparents, parents, siblings, aunts, uncles, and cousins. You have all been an amazing source of inspiration, love, and support. This dissertation is also dedicated to Dr. Leslie Mathew, Dr. David Meckstroth, Dr. Alyncia Bowen, and Dr. Bora Pajo for pushing me to move forward and keep typing on. Thank you so much. 5 Acknowledgements I acknowledge and thank my doctoral chair, Dr. Leslie Mathew for his guidance and support throughout the entire process. Dr. Leslie Mathew gave me the encouragement that I needed and reminded me to keep working hard towards my goal of achieving a doctoral degree. He went above and beyond his role as my committee chair because I could always reach out to him about my research and he would help me without any question. I am very thankful that he is my mentor and committee chair. I would like to recognize my parents, Hung Thai and Thuy Pham, because they have provided the endless support since day one. They are my inspiration and motivation in life. Being a child of immigrant parents, I will never forget the sacrifices they have made for me. My grandparents, siblings, aunts, uncles, and cousins have been my pillars of support throughout my doctoral journey. They are the reason I am able to balance my life with school, work, and being a wife and mother. Lastly, I acknowledge my husband, Oscar Wu, who is always there for me. My husband is incredible because he provided the positivity, drive, and reinforcement that I needed during the doctoral program. 6 Table of Contents Chapter 1: Introduction ......................................................................................................11 Background of the Problem ...........................................................................................12 Problem Statement .........................................................................................................13 Purpose of the Study ......................................................................................................14 Population and Sample ..................................................................................................15 Significance of the Study ...............................................................................................15 Nature of the Study ........................................................................................................16 Research Questions ........................................................................................................17 Overview of Methodology .............................................................................................18 Description of Research .................................................................................................18 Definition of Terms........................................................................................................20 Assumptions, Limitations, and Delimitations ................................................................21 Summary ........................................................................................................................21 Chapter 2: Literature Review .............................................................................................22 Review of Literature ......................................................................................................22 Summary ........................................................................................................................28 Chapter 3: Research Methodology.....................................................................................30 Research Method and Design Appropriateness .............................................................31 Conceptual Framework ..................................................................................................32 7 Operationalization of Variables .....................................................................................35 Description of Research Participants .............................................................................36 Reliability, Validity, and Researcher’s Bias ..................................................................37 Research Setting.............................................................................................................38 Research Sample and Data Sources ...............................................................................38 Data Collection Methods ...............................................................................................39 Data Analysis Methods ..................................................................................................40 Intellectual Merit ............................................................................................................41 Broader Impacts .............................................................................................................41 Summary ........................................................................................................................42 Chapter 4: Analysis and Results ........................................................................................43 Research Questions ........................................................................................................43 Data Collection ..............................................................................................................44 Demographics ................................................................................................................47 Data Analysis .................................................................................................................50 Results ............................................................................................................................52 Summary ........................................................................................................................58 Chapter 5: Conclusions and Recommendations ................................................................60 Research Questions ........................................................................................................60 Discussion of Findings ...................................................................................................61 8 Limitations .....................................................................................................................68 Recommendations to Leaders and Practitioners ............................................................69 Recommendations for Future Research .........................................................................71 Summary ........................................................................................................................73 Reflection ...........................................................................................................................75 References ..........................................................................................................................76
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