{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:56:19Z","timestamp":1791248179531,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03AG080374"],"award-info":[{"award-number":["R03AG080374"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R24AG063718"],"award-info":[{"award-number":["R24AG063718"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Older Chinese immigrants have lower rates of end\u2010of\u2010life (EOL) care planning and use than non\u2010Hispanic White counterparts, resulting in unmet palliative and hospice care needs. While acculturation is identified as a facilitator of end\u2010of\u2010life care planning, little is known about how perceptions shift throughout the acculturation process. Guided by the process model of acculturation, this qualitative study explored how perceptions of EOL care among older foreign\u2010born Chinese immigrants changed during acculturation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A qualitative descriptive design with language\u2010matched focus groups was used. Thirty\u2010one Chinese\u2010speaking older immigrants satisfied eligibility criteria. Five focus groups were conducted in Mandarin (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) and Cantonese (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). Participants' mean age was 76.4 (SD\u2009=\u20096.3; range 63\u201386) with an average of 22.9\u2009years in the U.S. (SD\u2009=\u200911.1).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Using a thematic constant comparison approach combined with inductive coding, guided by the process model of acculturation, we revealed how participants' perceptions of EOL care evolved through the acculturation process at familial, institutional, and societal levels. Familial and social networks served as key sources of new information; encounters with healthcare and other institutions reshaped care preferences and decision\u2010making; and broader cultural contexts facilitated deeper attitudinal shifts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants reflected a dynamic interplay between exposure to U.S. healthcare, social network influences, and cultural or religious frameworks. Through this process, they developed new understandings of hospice and palliative care, reconciled these concepts with traditional values (e.g., filial piety), and gradually embraced more person\u2010centered decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70861","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:35:07Z","timestamp":1791246907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cCollision of Eastern and Western Cultures\u201d: A Qualitative Study on Changing Perceptions of End\u2010of\u2010Life Care Among Older Chinese Immigrants"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4203-4749","authenticated-orcid":false,"given":"Peiyuan","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Social Work University of Alabama  Tuscaloosa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7791-671X","authenticated-orcid":false,"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Health and Human Services University of New Hampshire  Durham USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6291-1879","authenticated-orcid":false,"given":"Fei","family":"Sun","sequence":"additional","affiliation":[{"name":"School of Social Work Michigan State University  East Lansing USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyouxiang","family":"Li","sequence":"additional","affiliation":[{"name":"Morgridge College of Education University of Denver  Denver USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaofeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Michigan State University Global Health Institute  East Lansing USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2206-4318","authenticated-orcid":false,"given":"Kaipeng","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Social Work University of Washington  Seattle USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0283"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.08.003"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648221146774"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08959420.2020.1745737"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.11.027"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.zefq.2023.05.006"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314526272"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2015.0367"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2019.09.017"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17913"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13309"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igab046.2188"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648231176142"},{"key":"e_1_2_11_15_1","unstructured":"National Hospice and Palliative Care Organization \u201cFacts and Figures Report 2024 Edition. 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