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Wang J, Huang Y, Zhang Y, Wu F, Wu B. Domestic Helpers as Frontline Workers in Home-Based Long-Term Care in China: Opportunities and Challenges. J Aging Soc Policy 2023; 35:611-630. [PMID: 36453693 DOI: 10.1080/08959420.2022.2120323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 03/30/2021] [Indexed: 12/05/2022]
Abstract
Domestic helpers (also called baomu or jiazhengfuwuyuan in Chinese) enter personal residences to provide care and services. This study explored challenges and opportunities facing the long-term care (LTC) domestic service in urban China from the perspectives and experiences of domestic helpers (n = 25) and their employers (older adults or their family, n = 25), domestic service company managers (n = 8) and industry association staff (n = 6). Challenges identified pertain to the domestic helper-older adult relationship, day-to-day care, training, domestic service company role, and workforce shortages and instability. Opportunities include possibilities for supporting career development and increased access to social welfare and medical assistance, enhancing person-centered care for older adults by helping domestic helpers build core competencies, and establishing peer support and connections through mobile technologies.
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Affiliation(s)
- Jing Wang
- Assistant professor, School of nursing, Fudan University, Shanghai, Yangpu, China
| | - Yahui Huang
- Associate professor, Tourism and social admistration college, Nanjing Xiaozhuang University, Nanjing, Jiangsu, China
| | - Yaqing Zhang
- Chief editor, Editorial Department of Journal of Shanghai Jiao Tong University (Medical Science), Shanghai Jiao Tong University, Shanghai, Minhang, China
- Student, Nursing Management Research Center of China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, Minhang, China
| | - Fangqi Wu
- Assistant professor, School of nursing, Fudan University, Shanghai, Yangpu, China
| | - Bei Wu
- Associate dean of research/Professor, Rory Meyers College of Nursing, New York University, New York, NY, USA
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Kriegsmann-Rabe M, Maus K, Hiebel N, Klein C, Geiser F. Live-in migrant home care workers in Germany: Stressors and resilience factors. PLoS One 2023; 18:e0282744. [PMID: 36947488 PMCID: PMC10032493 DOI: 10.1371/journal.pone.0282744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/21/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Thousands of Eastern Europeans find employment caring for older individuals as transmigrating live-in home care workers in private households in Germany. Studies have shown that the stressors threatening their well-being are multifaceted and include inequalities and a high practical and emotional workload, but research on protective factors is still scarce. AIM & METHODS This qualitative descriptive study focuses on both the stressors and factors that promote care workers' well-being and contribute to their psychological resilience. In guideline-based interviews, 14 female and one male care workers were asked about their stressors and the factors that help them cope. RESULTS Identified stressors included separation from their own family, strained relationship with either or both the care recipient (dementia) and their relatives (violation of worker´s rights and devaluation of care work), and permanent availability and lack of free time due to a 24-h care schedule. Resilience factors were both external and internal and included positive social relationships, self-determination, experience in care work, and intrinsic job motivation. CONCLUSION Live-ins reside in an ambiguous setting, exposed to both structural and individual strains. However, external and internal resilience factors contribute to a generally positive attitude toward their job and indicate the agency of this precariously employed group. A socially anchored appreciation of their work and an officially controlled expansion of free time are mandatory to improve the working conditions of live-in care workers.
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Affiliation(s)
- Milena Kriegsmann-Rabe
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Katja Maus
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Nina Hiebel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Constantin Klein
- University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
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Hoens S, Smetcoren AS. Hiring Live-in Migrant Care Workers: Motivations and Experiences of Older People and their Families. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09351-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hodzi MB, Annor F, Darkwah E. An exploration of work-related experiences of domestic workers in Accra, Ghana. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2021. [DOI: 10.1080/15555240.2021.1941068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Francis Annor
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Ernest Darkwah
- Department of Psychology, University of Ghana, Accra, Ghana
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Nowicka M, Bartig S, Schwass T, Matuszczyk K. COVID-19 Pandemic and Resilience of the Transnational Home-Based Elder Care System between Poland and Germany. J Aging Soc Policy 2021; 33:474-492. [PMID: 34016033 DOI: 10.1080/08959420.2021.1927615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
As COVID-19 puts older people in long-term institutional care at the highest risk of infection and death, the need for home-based care has increased. Germany relies largely on migrant caregivers from Poland. Yet the pandemic-related mobility restrictions reveal the deficiencies of this transnational elder care system. This article asks if this system is resilient. In order to answer this question, the research team conducted interviews with 10 experts and randomly selected representatives of brokering and sending agencies in Germany and Poland. We interviewed 13 agencies in Germany and 15 in Poland on the agencies' characteristics, recruitment strategies, challenges of the pandemic, and impact of legal regulations in the sector. The analysis shows that the system could mobilize adaptive capacities and continue to deliver services, but its absorptive capacity is limited. To enhance resilience, policies working toward formalization and legalization of care services across national borders are required.
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Affiliation(s)
| | | | | | - Kamil Matuszczyk
- Faculty of Political Science and International Studies, Centre of Migration Research, Uniwersytet Warszawski, Warsaw, Poland
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Cohen-Mansfield J, Golander H. Predictors of Migrant Live-in Care Workers' Burden/Burnout and Job Satisfaction When Caring for Frail Older Persons in Israel. J Gerontol B Psychol Sci Soc Sci 2020; 76:1151-1160. [PMID: 33031515 DOI: 10.1093/geronb/gbaa171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To clarify how work characteristics affect migrant live-in care workers' burden/burnout as well as their job satisfaction. METHODS Data from 116 migrant live-in care workers were collected in 2013-2014 in Tel Aviv and Jerusalem through structured interviews about their job satisfaction and their degree of burden/burnout. Due to the conceptual and empirical similarity (zero-order correlation and joint internal reliability), of burden and burnout, the 2 were combined into one variable. These outcome measures were examined in connection with the older person's level of disability, care workers' relationship with the older person, and their employment conditions. RESULTS According to the regression models, work characteristics (care recipients' functional status and care workers' relationship with the care recipient) had a direct impact on burden/burnout. Employment-related variables (employment conditions and satisfaction with those conditions) had an indirect effect. A combination of work characteristics (relationship with the older person) together with the care worker's response to employment conditions (satisfaction with employment conditions) had a direct influence on the care workers' job satisfaction. Problematic employment conditions had an indirect effect. DISCUSSION The results suggest that fostering better relationships and improving employment conditions could help reduce care workers' burden/burnout as well as improve their degree of satisfaction.
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Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Israel
| | - Hava Golander
- Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Israel.,Department of Nursing, The Stanley Seyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Perceptions and experiences of live-in carers: why acknowledging versus neglecting personal identity matters for job satisfaction and wellbeing. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractFor some older people and their families, live-in care offers a way of continuing to live independently at home in their local community. While research in the care industry has consistently highlighted the effects of caring on workers, little research has specifically explored the experiences of live-in carers. The current study examines the ways in which live-in carers construct their role, the different challenges they face and the strategies they use to mitigate them. Semi-structured interviews were carried out with 21 live-in carers in the United Kingdom and the data were analysed using thematic analysis. The findings suggest that carers perceive their role as complex and characterised by a heavy workload and tiredness. Participants emphasised the variability which was introduced to the role as a function of the quality of agency support, the character and condition of the client, and the carer's relationships with the client's family. Participants’ accounts reflected an acknowledgement of the need to orient and respond constantly to the needs and routine of the client. While this orientation was recognised as necessary for effectively fulfilling the demands of the role, it was also linked to feelings of dislocation and loss of identity. Drawing on understandings of personal and social identity, the implications of these findings for the psychological wellbeing of live-in carers and organisational support are discussed.
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Cohen-Mansfield J, Golander H, Iecovich E, Jensen B. Social Engagement Care for Frail Older Persons: Desire for It and Provision by Live-In Migrant Caregivers. J Gerontol B Psychol Sci Soc Sci 2020; 74:1062-1071. [PMID: 28475774 DOI: 10.1093/geronb/gbx052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 04/20/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To describe social engagement care (SEC) provided by live-in migrant caregivers for frail older adults compared with care recipients' and families' wishes for such care. METHOD Interviews with care recipients, family members, and migrant caregivers assessed preferences for and provision of five types of SEC activities: knowing the older person as a person, knowing their main concerns, having personal conversations, going for walks, and sharing social or leisure activities. RESULTS Care recipients and family proxies reported a moderate desire for SEC from migrant caregivers, except for sharing leisure activities, for which there was only a slight preference. Migrant caregivers reported these practices at somewhat higher levels compared with the other respondents. Migrant caregivers' reports of practice show little relationship with care-recipients' preferences, but care recipients tended to perceive practice as agreeing with their own wishes. DISCUSSION It is important to include SEC as part of the role of live-in migrant caregivers of older persons. However, there is a need to differentiate among types of SEC and subsequently optimize the match between the care-recipient's wishes and needs and the actual care provided.
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Affiliation(s)
- Jiska Cohen-Mansfield
- Minerva Center for the Interdisciplinary Study of End of Life, Tel-Aviv University, Israel.,The Herczeg Institute on Aging, Tel-Aviv University, Israel.,Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Israel.,Innovative Aging Research, Silver Spring, Maryland
| | - Hava Golander
- The Herczeg Institute on Aging, Tel-Aviv University, Israel
| | - Esther Iecovich
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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Ho KHM, Chiang VCL, Leung D, Cheung DSK. A feminist phenomenology on the emotional labor and morality of live-in migrant care workers caring for older people in the community. BMC Geriatr 2019; 19:314. [PMID: 31744456 PMCID: PMC6862863 DOI: 10.1186/s12877-019-1352-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Global societal changes, such as increasing longevity and a shortage of family caregivers, have given rise to a popular worldwide trend of employing live-in migrant care workers (MCWs) to provide homecare for older people. However, the emotional labor and morality inherent in their interactions with older people are largely unknown. The aim of the present study is to understand the corporeal experiences of live-in migrant care workers in the delivery of emotional labor as seen in their interactions with older people by: (1) describing the ways by which they manage emotional displays with older people; and (2) exploring their morality as enacted through emotional labor. Methods We performed a secondary analysis drawing on feminist phenomenology to thematically analyze data from interviews with 11 female MCWs. Follow-up interviews were conducted with 10 participants. The participants had two to 15 years of experience in caring for older people in their homes in Hong Kong. Results Performing emotional labor by suppressing and inducing emotions is morally demanding for live-in MCWs, who experience socio-culturally oppressive relationships. However, developing genuine emotions in their relationships with older people prompted the MCWs to protect the interests of older people. Through demonstrating both fake and genuine emotions, emotional labor was a tactic that live-in MCWs demonstrated to interact morally with older people. Conclusions Emotional labor allowed live-in MCWs to avoid conflict with older people, and to further protect their own welfare and that of others. This study highlights the significance of empowering live-in MCWs by training them in ways that will help them to adapt to working conditions where they will encounter diverse customs and older people who will develop an increasing dependence on them. Thus, there is a need to develop culturally appropriate interventions to empower live-in MCWs to deliver emotional labor in a moral manner.
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Affiliation(s)
- Ken H M Ho
- School of Nursing, Tung Wah College, 31 Wiley Road, Kowloon, Hong Kong SAR
| | - Vico C L Chiang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR.
| | - Doris Leung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
| | - Daphne S K Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR
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Ho KHM, Chiang VCL, Leung D, Ku BHB. When Foreign Domestic Helpers Care for and About Older People in Their Homes: I Am a Maid or a Friend. Glob Qual Nurs Res 2018; 5:2333393617753906. [PMID: 29404382 PMCID: PMC5791470 DOI: 10.1177/2333393617753906] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 11/16/2022] Open
Abstract
We examine the lived experiences of foreign domestic helpers (FDH) working with community-dwelling older people in Hong Kong. Unstructured interviews were conducted with 11 female FDHs, and thematically analyzed. The theme inescapable functioning commodity represented the embodied commodification of FDHs to be functional for older people in home care. Another theme, destined reciprocity of companionship, highlighted the FDHs' capacity to commit to home care and be concerned about older people. The waxing and waning of the possibilities of commodified companionship indicated the intermittent capacity of FDHs to find meaning in their care, in which performative nature for functional purposes and emotional engagement took turns to be the foci in migrant home care. This study addresses the transition of FDHs from task-oriented relation to companions of older people through care work. Discussion draws on the development of a kin-like relationship between FDHs and older people with emotional reciprocity grounded in moral values.
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Affiliation(s)
| | | | - Doris Leung
- The Hong Kong Polytechnic University, Hong Kong
| | - Ben H B Ku
- The Hong Kong Polytechnic University, Hong Kong
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11
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Vahabi M, Wong JPH. Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada. BMC Public Health 2017; 17:498. [PMID: 28535792 PMCID: PMC5442647 DOI: 10.1186/s12889-017-4431-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/15/2017] [Indexed: 11/16/2022] Open
Abstract
Background Canada depends on Temporary Foreign Workers (TFWs), also known as migrant workers, to fill labour shortage in agriculture, hospitality, construction, child/senior care, and other low-skilled occupations. Evidence shows that TFWs, especially women live-in caregivers (LC), constitute a vulnerable population. Their health is compromised by the precarious and harsh working and living conditions they encounter. There is a paucity of research on the mental health of LCs, their support systems and access to mental health services. Method In this community-based exploratory study, we used mixed methods of survey and focus groups to explore the work related experiences and mental health of migrant live-in caregivers in the Greater Toronto Area in Ontario, Canada. Convenience and snowball sampling were used to recruit participants. The inclusion criteria were: being 18 years or older, initially migrated to Canada as TFWs under LC program, resided in the Greater Toronto Area, and able to understand and converse in English based on self-report. This paper reports on the focus group results derived from inductive thematic analysis. Results A total of 30 women LCs participated in the study. Most of them were from the Philippines. A number of key themes emerged from the participants’ narratives: (1) precarious migration-employment status (re)produces exploitation; (2) deskilling and downward social mobility reinforce alienation; (3) endurance of hardship for family back home; (4) double lives of public cheerfulness and private anguish; and (4) unrecognized mental health needs. The study results reflected gross injustices experienced by these women. Conclusion A multi-faceted approach is required to improve the working and living conditions of this vulnerable group and ultimately their health outcomes. We recommend the following: government inspection to ensure employer compliance with the labour standards and provision of safe working and living conditions; change immigration policy to allow migrant caregivers to apply for permanent residence upon arrival; the TFWs Program to establish fair wages and subsidized housing so that caregivers can truly access the live-out option; and local ethno-specific, settlement and faith organizations be leveraged to provide TFWs with social support as well as information about their rights and how to access health and social care.
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Affiliation(s)
- Mandana Vahabi
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada. .,Daphne Cockwell School of Nursing, Faculty of Community Services Ryerson University, Toronto, ON, Canada. .,Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada. .,Ryerson Centre for Global Health and Health Equity, Toronto, ON, Canada.
| | - Josephine Pui-Hing Wong
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada.,Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada
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Abstract
Although domestic work scholarship in Canada has focused primarily on the immigration/migration and labour experiences of domestic workers under the Foreign Domestic Movement and the Live-in-Caregiver Program, research is scarce on how these workers retire and consequently age in Canadian society. This article focuses on the aging experiences of retired Filipino domestic workers who, upon entering retirement, find themselves working in the secondary and/or underground economy while providing and receiving care from spouses, grandchildren, and local/transnational family members. Data were drawn from six qualitative, in-depth interviews with older Filipina domestic workers who discussed experiences of immigration, caring labour, retirement, and aging. Findings underscore (1) the poverty that older Filipino domestic workers encounter as they approach their retirement; (2) the necessity but insufficiency of the state's retirement provisions; (3) the need to find work in the unreported labour market; and (4) how caring labour is provided intergenerationally as a survival strategy.
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Munkejord MC. ‘I Work With my Heart’: Experiences of Migrant Care Workers in a Northern, Rural Context. JOURNAL OF POPULATION AGEING 2016. [DOI: 10.1007/s12062-016-9157-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ho KHM, Chiang VCL. A meta-ethnography of the acculturation and socialization experiences of migrant care workers. J Adv Nurs 2014; 71:237-54. [PMID: 25092486 DOI: 10.1111/jan.12506] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2014] [Indexed: 12/01/2022]
Abstract
AIM To report a meta-ethnography of qualitative research studies exploring the acculturation and socialization experiences of migrant care workers. BACKGROUND Migrant care workers are increasingly participating in health and social care in developed countries. There is a need to understand this increasingly socioculturally diversified workforce. DATA SOURCES A comprehensive search through 12 databases and a manual search of journals related to transculture for studies on socialization and acculturation experiences (published 1993-2013) was completed. The inclusion criteria were peer-reviewed studies on the acculturation or socialization experiences of migrant care workers published in English in any country, using a qualitative or mixed-methods approach. DESIGN AND REVIEW METHODS This meta-ethnography employed the seven-phase Noblit and Hare method with reciprocal translation, refutational synthesis and lines-of-argument to synthesize qualitative studies. RESULTS Three main themes were identified: (a) schema for the migration dream: optimism; (b) the reality of the migration dream: so close, yet so far; and (c) resilience: from chaos to order. A general framework of motivated psychosocial and behavioural adaptation was proposed. This meta-ethnography also revealed the vulnerabilities of migrant nurses in the process of acculturation and socialization. CONCLUSIONS The general framework of behavioural and psychosocial adaptation revealed factors that impede and facilitate behavioural and psychosocial changes. Strategies to enrich external and internal resources should be targeted at encouraging multiculturalism and at improving the psychosocial resources of migrant care workers. It is suggested that research investigating the prominence of nursing vulnerabilities be conducted.
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Affiliation(s)
- Ken H M Ho
- The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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