“It's your Liangxin that tells you what to do”: Interpreting workplace-induced emotions in a Chinese nursing home

Abstract

How Direct Care Workers (DCWs) interpret their work and perform care activities undeniably impacts the well-being of institutionalized older adults. Despite the emotionally charged nature of paid care work, little is known about how Chinese DCWs talk about their work and construct meaning within China's unique social context of a burgeoning institutional care market and changing cultural expectations for long-term care. This study qualitatively explored Chinese DCWs' emotion work as they navigate among institutional pressures and low social recognition in an urban government-sponsored nursing home in central China. Results revealed that DCWs used Liangxin (the good heart/mind) – a ubiquitous Chinese moral notion emphasizing the unity of feeling, thought, and action – as an interpretive framework, including its four dimensions (ceyin, xiue, cirang, and shifei), to inform care practice, manage emotions, and find dignity within what can be personally demeaning and socially devalued work. Our study delineated the processes through which DCWs sympathized with the pain and struggles of the older adults in their care (ceyin xin), shamed unjust attitudes and behaviors embedded in institutional care (xiue xin), delivered family-like relational care (cirang xin), and formed and reinforced principles of good (versus bad) care (shifei xin). We also revealed the nuanced role that the cultural value of xiao (filial piety), working in tandem with liangxin, both shaped the emotional terrain of the institutional care setting and impacted how DCWs engaged in emotion work. While recognizing the effect of liangxin for incentivizing DCWs to provide relational care and renegotiate their role status, we were also alerted to the risks of overburdening and exploiting DCWs who relied solely on their liangxin to meet complex care needs.