Mental health of intermarried immigrant women and their children in South Korea

Determinants of positive orientations of adolescents in Korean multicultural families based on the socio-ecological model

The number of multicultural adolescents has been increasing globally, and their psychological well-being has received keen attention. The present study aimed to identify the factors affecting the positive orientations (i.e., self-esteem, optimism, and life satisfaction) of Korean adolescents from multicultural families based on the socio-ecological model. This study comprised a cross-sectional survey that used data from the Multicultural Adolescents Panel Study by the National Youth Policy Institute in South Korea. In total, 1260 adolescents from Korean multicultural families participated. To assess how the factors contributed to positive orientations, we performed a hierarchical linear regression analysis. Of the individual-level factors, gender, appearance satisfaction, social withdrawal, bicultural and multicultural attitudes, and academic achievement satisfaction affected the positive orientations of the adolescents. Among the relationship-level factors, their family support, relationships with their friends, and relationships with their teachers influenced their positive orientations; in particular, family support was the most influential factor. The study identified influential factors on the positive orientations among multicultural adolescents. These findings can help healthcare, educational, and social service professionals develop programs to enhance the positive orientations of adolescents from multicultural families.

Children's bullying victimization and maternal suicidal ideation among multicultural families in South Korea: Heterogeneity by family socioeconomic status

RATIONALE

Children from multicultural families in Korea are vulnerable to bullying victimization. Despite growing evidence on the mental health consequences of bullying victimization for victims, little is known about the spillover effects on their immigrant mothers.

OBJECTIVE

This study examined the association between children's bullying victimization and their immigrant mothers' suicidal ideation. The potential moderating role of family socioeconomic status was also investigated.

METHODS

Using nine waves of the Multicultural Adolescents Panel Study spanning from 2011 to 2019 (N = 1466), this study estimated individual fixed effects models to control for unobserved individual-level heterogeneity. Interaction models were used to investigate potential heterogeneity by family socioeconomic status, including maternal education, household income, and maternal occupational status.

RESULTS

Fixed effects estimates revealed that children's bullying victimization is associated with an increased likelihood of suicidal ideation among marriage migrant mothers (b = 0.012, p < 0.05), even after controlling for unobserved time-invariant confounders as well as a set of time-varying covariates. Family socioeconomic status moderated this association. The association between children's bullying victimization and immigrant mothers' suicidal ideation was stronger for those with low levels of education and household income. No such moderating effects were observed for maternal occupation.

CONCLUSIONS

The findings of this study suggest that efforts to address the mental health consequences of bullying victimization among multicultural family children should extend beyond the victim to their immigrant mothers. When developing interventions to reduce suicidal ideation among immigrant mothers whose children have been victimized, policymakers may wish to consider the moderating role of family socioeconomic status.

Comprehensive Comparisons of Family Health Between Families With One Immigrant Parent and Native Families in Taiwan: Nationwide Population-Based Cohort Study

BACKGROUND

Mothers and children in families with one immigrant parent have been reported to be healthier than those in native families; however, the health of the fathers in these families has rarely been discussed in literature.

OBJECTIVE

We aimed to comprehensively compare the health of all the family members between families with one immigrant parent (native fathers, immigrant mothers, and their children) and native families (native fathers, native mothers, and their children).

METHODS

We conducted a cohort study by using the Taiwan Maternal and Child Health Database to recruit live-born children and their parents from 2004 to 2016. Overall, we identified 90,670 fathers, 91,270 mothers, and 132,457 children in families with one immigrant parent and 1,666,775 fathers, 1,734,104 mothers, and 2,637,191 children in native families and followed up with them from 2004 to 2017. The outcomes comprised common physical and mental disorders, catastrophic illnesses, mortality, and child adversities and accidents. The covariates comprised the child's year of birth, parental age, low-income status, and physical or mental disorder status. Logistic regression was performed to compare the risks of the outcomes between families with one immigrant parent and native families.

RESULTS

The parents in families with one immigrant parent were more likely to be of low-income status and were older than the parents in native families. After adjusting for the covariates, fathers in families with one immigrant parent were found to have higher risks of physical and mental disorders, catastrophic illness, and mortality than fathers in native families. Conversely, mothers in families with one immigrant parent had lower risks of physical and mental disorders, catastrophic illness, and mortality than mothers in native families. Finally, the children in families with one immigrant parent generally had better physical and mental health but higher risks for leukemia, liver diseases, autism spectrum disorder, and road traffic accidents than children in native families.

CONCLUSIONS

The health status of the members of families with one immigrant parent was nonhomogeneous, and the poorer general health of fathers in such families suggests health inequalities in families with one immigrant parent.

Interventions to improve immigrant women's mental health: A systematic review

AIMS

To identify the effectiveness of interventions for improving immigrant women's mental health and explore the role of these interventions in nursing practice.

BACKGROUND

Immigrant women rearing children and living in a foreign country experience many mental health problems during pregnancy, child-rearing, and acculturation. Mental health problems can be controlled or modified through effective practices. Few studies have examined the role of different types of interventions in alleviating these mental health issues in immigrant women in the perinatal period, and it is unclear whether such interventions are effective.

METHODS

This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. Studies form December 1948-August 2021 were retrieved from four databases: MEDLINE, CINAHL, EMBASE, and Cochrane Library. This systematic review's protocol was registered at PROSPERO (CRD42020210845). The data were summarised using narrative analysis.

RESULTS

Eight studies met the inclusion criteria and were included in the final analyses. There were few mental health improvement interventions for immigrant women. The interventions included home visit programmes, asset-building mental health interventions, cognitive-behavioural interventions, nursing interventions, perinatal education interventions, and mindfulness interventions. Home visit programmes and asset-building mental health interventions have reported positive outcomes in improving depressive symptoms and mental health.

CONCLUSIONS

There are few interventions for improving immigrant women's mental health. Most existing interventions are conducted through group education, but there are no explicit significant effects. Home visits may be an effective approach for conducting interventions to improve immigrant women's mental health. An effective nursing intervention should be developed, and more research is needed in improving immigrant women's mental health.

RELEVANCE TO CLINICAL PRACTICE

This review provides evidence for nurses and midwives to practice appropriate and effective approaches and strategies for improving immigrant women's mental health. We suggest possible future interventions for this cohort of immigrant women in the perinatal period.

Household decision-making and the mental well-being of marriage-based immigrant women in South Korea

OBJECTIVE

We assessed the association between household decision-making and mental well-being among Asian immigrant women residing in Korea. We also investigated if the impact varies by the regional origin and examined potential factors for joint decision-making.

METHODS

We conducted a cross-sectional study using the Korean National Survey of Multicultural Families 2015 and logistic regression. We analyzed data from 11,188 married immigrant women ages 20 to 59 who were originally from East Asia or Southeast/South Asia and co-living with their spouses. We defined households as joint-decision, wife-decision, or husband-decision based on who decides how living expenses are spent. Mental well-being encompassed a depressive mood for two consecutive weeks, and life and marital satisfaction.

RESULTS

After controlling for covariates, we showed that immigrant women in husband-decision households were more likely to have depressive mood (odds ratio [OR] 1.26, 95% confidence interval [CI]: 1.14-1.38), poorer life satisfaction (OR 1.49, 95% CI: 1.24-1.78), and poorer marital satisfaction (OR 1.81, 95% CI: 1.47-2.22) than women in joint-decision households. Immigrant women in wife-decision households had a similar but slightly lower odds of poor mental well-being. This association was less prominent for Southeast/South Asian origin than East Asian origin, while the age-adjusted prevalence rates of poor mental well-being among them were higher than their East Asian counterparts. Factors that restricted the odds of husband-decision did not necessarily guarantee wife-decision.

CONCLUSIONS

This study suggests one-sided decision-making can be a risk factor for immigrant women's poor mental well-being, while joint decision-making is protective. Differences across regional origins suggest domestic decision-making might be a less important predictor for mental well-being in immigrants more occupied with adapting to the host society. Factors for joint decision-making should be addressed to improve the mental well-being of immigrant women.

Resilience in Multicultural Families of Children With Disabilities in Korea: A Path Analysis Using National Data

PURPOSE

The number of multicultural families has increased globally, and Korea has also witnessed a surge. Along with the various challenges experienced by these families, a child with a disability can pose additional challenges. In-depth knowledge about resilience factors among multicultural families of children with disabilities is important. The aim of this study was to examine relationships between family demands, family appraisals, family problem solving and coping, family resources, and family adaptation in multicultural families of children with disabilities in Korea as perceived by married immigrants.

DESIGN

This study was based on a secondary analysis of national survey data in 2015 and 2018 in Korea.

METHODS

A total of 256 multicultural families who have children with disabilities participated. Family demands were identified by examining marital conflict, cultural differences, marital status, and public assistance recipient households. Family appraisal was assessed by how the family perceived the married immigrant's culture. Family problem solving and coping were examined by how actively a married immigrant participated in social activities. Family resources were assessed by examining Korean language competency and the health status of immigrants. Family adaptation was identified by how immigrants perceived their life satisfaction. Path analysis was used to assess the factors.

FINDINGS

Family demands had a direct impact on family resources and family adaptation. Family appraisal had a direct impact on family adaptation. Family resources mediated the effect of family demands on family adaptation.

CONCLUSIONS

This study demonstrated that although a multicultural family of a child with a disability struggles with family demands, if the family receives positive resources from family members, they can adapt well. Current findings can be used to develop interventions that can foster greater resilience among families.

CLINICAL RELEVANCE

This study provides evidence that nurses can target modifiable family aspects, including immigrants' health and family perceptions of immigrants' cultures identified in this study to enhance the immigrant and family adaptation.

Analyzing Gender Differences in Factors Affecting Depression among Multicultural Adolescents in South Korea: A Cross-Sectional Study

Suicide is the topmost cause of death among adolescents in South Korea and is deeply related to depression. This study aimed to identify gender differences in the factors affecting depression among multicultural adolescents. This study is a secondary analysis using data from a national survey, the Multicultural Adolescents Panel Study (MAPS) conducted in 2017. The participants were 1160 multicultural adolescents ranging from 15 to 18 years, living in Korea, and whose fathers were Koreans and mothers were foreigners. The results showed that depression scores were higher for females (18.35) than males (16.38, t = 6.42, p < 0.001). In total, seven factors affected depression among male multicultural adolescents’ and the model explained 50.5% of the total variance (F = 77.99, p < 0.001), while four factors affected female multicultural adolescents’ depression, and the model explained 51.4% of the total variance (F = 100.02, p < 0.001). Significant gender differences were found in factors that influence depression among multicultural adolescents. Therefore, depression prevention programs for multicultural adolescents need to vary according to gender. Additionally, these programs should target families and teachers of multicultural adolescents as well.

Factors associated with delayed emergency room visits in adult immigrant patients with mild abdominal pain in Korea

Objective

To determine the factors associated with unmet needs in immigrant patients complaining of abdominal pain, by analyzing those associated with the time from symptom onset to emergency room visit.

Methods

We retrospectively reviewed the medical records of immigrants with abdominal pain who visited a tertiary hospital emergency department from January to December 2016. The dependent variable was the time from symptom onset to emergency room visit. The independent variables were age, sex, vital signs, disposition, health insurance status, date of visit, time of visit, level of education, employment status, economic satisfaction, marital status, living with family, duration of residence, having a native spouse, and subjective proficiency in Korean. We analyzed the association of the dependent variable with each independent variable.

Results

In total, 102 immigrant patients with abdominal pain were enrolled in this study. The patients who had earlier visits had good subjective proficiency in Korean, high economic satisfaction, longer durations of residence, a tendency to have a native spouse, and a high employment rate. After linear regression analysis, the time from symptom onset to emergency room visit was negatively associated with employment (adjusted odds ratio, -13.67; 95% confidence interval, -23.25 to -4.09; P=0.006) and having a native spouse (adjusted odds ratio, -11.7; 95% confidence interval, -20.61 to -2.8; P=0.011).

Conclusion

The factors influencing the time from symptom onset to emergency room visit in immigrant patients with abdominal pain are associated with social capital, which improves access to emergency care. Policies that improve immigrant access to emergency care should be considered.

A Scoping Review of the Health of East and Southeast Asian Female Marriage Migrants

The number of female marriage migrants in East and Southeast Asia has grown significantly over the past three decades. However, little is known about the health of this population. Following Arksey and O'Malley's (Int J Soc Res Methodol 8(1):19-32, 2005) framework, a scoping review of English language research databases was used to synthesize knowledge on the health of Asian marriage migrants. This will be used to inform recommendations for health care practice and research. Fifty-five eligible studies were included and presented using five identified categories-mental health, women's health and maternal-child health, public health, general well-being, and social challenges. Overall, studies consistently document that marriage migrants experience worse health outcomes, multiple barriers to health care services, and multilevel social challenges compared with the native population in the receiving countries.

Personal and Environmental Predictors of Depression Among Victims of Intimate Partner Violence: Comparison of Immigrant and Israeli-Born Women

In the present study, ecological theory was used as a basis for predicting depression among women who survive intimate partner violence (IPV). The predictors examined in the study derived from three ecological systems: the microsystem (background variables and frequency of the violence), the ontogenic system (personal resources), and the mesosystem (support resources). One hundred twenty-five women who immigrated from the Former Soviet Union and 149 Israeli-born Jewish women filled in questionnaires when they entered shelters for victims of IPV. The research findings indicate that background variables, including immigration, did not contribute significantly to the women's depression. Frequency of violence contributed slightly to depression, whereas the women's sense of mastery and social support contributed most significantly. The results highlight the need to strengthen these resources when women are in shelters, and to conduct further research to determine whether these results also hold true for women who receive services for prevention of violence in the community.

The mental health of married immigrant women in South Korea and its risk and protective factors: A literature review

BACKGROUND AND AIMS

Married immigrant women in South Korea undergo a wide array of psychosocial challenges in the process of adapting to a new culture and marriage with a Korean husband. For an integrative understanding of women's mental health status and to determine the key risk and protective factors, we systematically reviewed empirical articles about the mental health of married immigrant women.

METHODS

We searched and reviewed articles from nine online databases: PubMed, Scopus, PsycINFO, Embase, DBpia, KISS, KMbase, KoreaMed and RISS, which were published up until January 2017. We identified 38 quantitative studies that examined psychiatric symptoms and pertinent factors for this population.

RESULTS

The relative risks of psychiatric symptoms among married immigrant women varied across diverse samples. We summarized the associated factors existing prior to and after marriage migration that may moderate their mental health consequences. We identified five key risk factors: acculturative stress, country of origin, family stress, domestic violence and extended family structure, and two protective factors: social support and marriage satisfaction, which were consistently supported by the included studies.

CONCLUSION

With the paucity of prospective studies, longitudinal research is needed that addresses the long-term processes of married immigrant women's psychological adaptation and the underlying risk and protective factors at diverse settlement phases. Furthermore, we suggest that future research should focus on how women's personal attributes interact with macro-level, socio-cultural contexts, including familial relationship and the community social-support system. Future evidence-based policy and interventions should comprehensively address married immigrant women's socio-cultural, economic and mental health needs.

Relationship between School Violence and Depressive Symptoms among Multicultural Families' Offspring in South Korea

The aim of the study was to evaluate the effect of school violence on depressive symptoms among the offspring of multicultural families in South Korea. Data from the National Survey of Multicultural Families 2012, conducted by the Korean Women's Development Institute and Statistics Korea, were used in this study. Complex samples logistic regression was performed to determine the effect of school violence on depressive mood. The survey participants were 3999 students between the ages of 9 and 24. Of the participants, 22.1% reported experiencing depressive symptoms and 9.1% reported experiencing school violence within the last year. School violence was a strong risk factor (OR=5.142, 95% CI=4.067-6.500) for depressive symptoms after adjusting for personal, familial and school factors. School violence is a serious contributor to depressive mood among the offspring of multicultural families. There is a significant need to monitor school violence among this vulnerable group.

Exploring the acculturation profiles and adaptation of children in multiethnic families in South Korea

Using a latent class analysis approach, this paper examined the acculturation profiles of children in multiethnic families in South Korea and explored whether youth’s psychological and educational adaptation varied across these profiles. The study utilized a nationally representative face-to-face survey of 2,811 native-born multiethnic youth (ages 9–15) and identified four styles of acculturation: assimilated; linguistically assimilated but psychologically diffused; integrated; and marginalized. Accounting for socio-demographic background and factors associated with acculturative stress, logistic regressions revealed that, compared to assimilated youth, marginalized youth exhibited significantly higher odds of self-reported depressive symptoms, difficulty in school work and low educational aspirations; linguistically assimilated but psychologically diffused youth were more likely to express difficulty in school work; while integrated youth did not manifest higher odds of adaptive problems. The importance of considering the context of acculturation and its implications for youth adaptation is highlighted. Limitations as well as policy implications are further discussed.