Author Identifier

Gertrude Phiri

https://orcid.org/0000-0001-8914-6660

Date of Award

2024

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Nursing and Midwifery

First Supervisor

Davina Porock

Second Supervisor

Joyce Muge-Sugutt

Abstract

African migration to Australia has grown in the past 20 to 25 years with many migrants staying permanently. This has led to migrants dying away from their birthplaces where family is responsible for end-of-life care planning for the individual. Although migrating to Australia is considered a great achievement, many migrants also experienced challenges. Previous studies have explored the barriers faced by migrants in relation to end-of-life care but have not addressed the cause of those challenges. This constructivist grounded theory study examines how migrants from three African countries, Malawi, Zambia, and Zimbabwe (MZZ) prepare for end-of-life in Australia. The study objectives are to: 1) Describe the experience of migration and settling in Australia for migrants from MZZ, and how they plan for end-of-life; 2) Examine family relationship structures and their impact on preparations for end-of-life for migrants from MZZ; and 3) Describe the social processes of African immigrants from MZZ as they prepare for end-of-life in Australia.

Face-to-face in-depth, semi-structured interviews, using semi-structured, open-ended questions were conducted with 14 participants on two occasions, two to four weeks apart. Participants were migrants with indigenous heritage from either Malawi, Zambia, or Zimbabwe, and living in Australia. Data analysis occurred concurrently with data collection, using constant comparative analysis to guide both ongoing data collection and analysis. Categories exploring relationships and dimensions are developed here into a substantive grounded theory, named ‘The dynamic process of toing and froing’ (DPTF).

Migrants’ ability to prepare for end-of-life in Australia is impacted by the challenges they face in relation to culture, at every level of their lives, from migration to resetting the life button, shuffling back and forth, disintegrating family dynamics, finding equilibrium, and pursuing the horizon. Migrants’ lives appear to be on a non-linear continuum, that is, participants' lives were notably going back and forth in various circumstances, in their attempts to find equilibrium, and pursue the horizon. However, even when a state of equilibrium was thought to have been realised, the DPTF continued, triggered by prevailing circumstances related to their immediate and extended family members both in Australia and in their respective countries of origin.

The significance of this study is that it reveals the processes that African migrants from MZZ go through as they attempt to adapt to the culturally foreign concept and find new ways of planning for their end-of-life in Australia. This gives rise to the DPTF which frames the continuum on which African migrants from MZZ must find culturally appropriate palliative care services. This study recommends the co-designing of education resources for healthcare professionals, including for intervention strategies, and adopting a public health approach to palliative care, would result in increased utilisation of services, including planning for end-of[1]life by African migrants from MZZ. This study identifies implications for policy, professional practice, and future research in relation to African migrants from MZZ in Australia and their preparations for end-of-life.

DOI

10.25958/pema-fd93

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