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Jin B, Roopnarine JL. The beneficial role of family enmeshment among South Korean immigrants in the United States. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2022; 57:676-684. [PMID: 35323999 DOI: 10.1002/ijop.12843] [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: 02/16/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022]
Abstract
Enmeshment is considered inimical to healthy family dynamics among European Americans. However, recent studies have failed to show negative associations between family enmeshment and individual outcomes among Asian Heritage families. Using structural equation modelling and multiple group analysis, this study examined whether enmeshed relationships are dysfunctional in Korean immigrant families in the United States and whether degree of acculturation moderated the associations between enmeshment and children's socioemotional functioning and academic performance. The sample consisted of 98 South Korean immigrant families with children between 9 and 14 years of age residing in the Greater New York City Area. Results showed that enmeshed family relationships tended to be beneficial to child socioemotional functioning and the association became more evident with lower than higher degree of acculturation. Findings are discussed in terms of the meaning of enmeshment when working with Korean immigrant families in the United States.
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Affiliation(s)
- Bora Jin
- Department of Counseling, Dankook University, Yongin, South Korea
| | - Jaipaul L Roopnarine
- Department of Human Development and Family Science, Syracuse University, Syracuse, NY, USA.,Department of Psychology, Anton de Kom University of Suriname, Paramaribo, Suriname
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Li Q, Xue W, Gong W, Quan X, Li Q, Xiao L, Xu DR, Caine ED, Poleshuck EL. Experiences and perceptions of perinatal depression among new immigrant Chinese parents: a qualitative study. BMC Health Serv Res 2021; 21:739. [PMID: 34311719 PMCID: PMC8311906 DOI: 10.1186/s12913-021-06752-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Immigrant status, acculturation level, race and ethnicity have been found to contribute to the utilization of mental health services in the perinatal period. This study explored perinatal experiences and perceptions among Chinese immigrant mothers and their spouses, as well as the possible barriers and facilitators that affect their health care utilization. METHODS We recruited 13 women ages 18-35 years born in mainland China, living in Rochester, New York, and residing less than 5 years in the United States. Participants primary language was Mandarin Chinese and all had given birth to at least one live infant within the past 7 years. Participants' age was at least 18 years old at the time of delivery. Five spouses also participated. We divided women in two focus groups and held one focus group for men, with data collection including demographic questionnaires and semi-structured focus group questions conducted in December 2014. Data were analyzed following thematic analysis. RESULTS Four themes emerged: experiences of perinatal depression; perceptions of perinatal depression; general preventive and coping strategies; and attitudes toward the supportive use social media applications (apps) and text messaging during the perinatal period. Participants had limited knowledge of perinatal depression and had difficulty distinguishing between normal perinatal mood fluctuations and more severe symptoms of depression. They discussed immigrant-related stress, conflicts with parents/in-laws while "doing the month", the perceived gap between the ideal of "perfect moms" and reality, and challenges with parenting as the causes of perinatal depression. Women approved of screening for the condition but were conservative about follow-up interventions. As for the management of perinatal depression, participants preferred to deal with the problem within the family before seeking external help, due to potential stigma as well as Chinese traditional culture. They were receptive to obtaining pertinent health information from anonymous social media apps, preferring these to personal text messages. CONCLUSION The recent immigrant Chinese parents to the United States in the study had limited knowledge of perinatal depression and did not make full use of mental health services for support due to language and cultural barriers. Screening for perinatal depression is only the first step. Future research should explore what interventions may serve as an acceptable approach to overcoming these gaps.
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Affiliation(s)
- Qiao Li
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wenqing Xue
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China
| | - Wenjie Gong
- HER Team and Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, Hunan, China.
- Department of Psychiatry, University of Rochester, Rochester, NY, 14642, USA.
- Institute and of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Xin Quan
- Department of Family Therapy, Nova Southeastern University, Fort Lauderdale, USA
| | - Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, USA
| | - Lina Xiao
- East China Institute of Social Development, East China University of Science and Technology, Shanghai, China
| | - Dong Roman Xu
- ACACIA Lab for Health Systems Strengthening, Institute for Global Health and School of Health Management, Southern Medical University, Guangzhou, China
| | - Eric D Caine
- Department of Psychiatry, University of Rochester, Rochester, NY, 14642, USA
| | - Ellen L Poleshuck
- Departments of Psychiatry and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, 14642, USA
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Examining the Associations Between Immigration Status and Perceived Stress Among HIV-Infected and Uninfected Women. J Community Health 2019; 43:1172-1181. [PMID: 29926272 DOI: 10.1007/s10900-018-0537-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Stress is associated with poor mental and physical health outcomes. In the United States (U.S.), little is known about perceived stress and associated factors among HIV-infected and immigrant women. Here, we examine these associations within a sample of 305 HIV-infected and uninfected, U.S.-born and non-U.S.-born women who were part of the Women's Interagency HIV Study (WIHS) at three sites (New York, Chicago, and Los Angeles). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10); HIV infection was serologically confirmed, and nativity status was self-reported. Bivariate and multivariable logistic regression were used to identify associations with perceived stress. The majority of participants were U.S.-born (232, 76.1%) and were HIV-infected (212, 68.5%). Mutlivariable analyses found the odds of perceived stress to be lower for those employed [adjusted odds ratio (AOR) = 0.31, 95% confidence interval (CI) = (0.15-0.63)], with high levels of social support (AOR = 0.45, 95% CI 0.26-0.79), and HIV-infected (AOR = 0.44, 95% CI 0.24-0.79). Perceived stress was positively associated with living in unstable housing (AOR = 2.54, 95% CI 1.17-5.51). Here, immigration status was not associated with perceived stress. We identified stress to be higher among women who were unemployed, unstably housed, or who had low social support. Community-based programs should tailor interventions to include stress reduction strategies for participants with identified risk factors to improve mental and physical health outcomes.
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An JY, Moon H, Cha S. Health literacy, depression, and stress among Chinese immigrants in South Korea. Public Health Nurs 2019; 36:603-614. [PMID: 31240741 DOI: 10.1111/phn.12632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/19/2019] [Accepted: 05/30/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study examined health literacy, depression, and stress in Chinese immigrants living in South Korea, and analyzed factors related to these outcomes. DESIGN This is a cross-sectional, descriptive study. SAMPLE Participants were 128 adult Chinese immigrants living in the Jung-gu District of Seoul, South Korea. The majority of the participants were women and in their 40s; had a high school diploma; and were employed and married. Most had lived in Korea for 5-10 years. MEASUREMENTS Outcome variables were health literacy, depression, and immigrant stress; independent variables were sociodemographic characteristics, language proficiency, health, and behavioral factors. Hierarchical multiple regression models based on the conceptual framework were tested. RESULTS The major factor influencing health literacy was perceived economic status (p = 0.021). The factors related to depression were life satisfaction in China (p = 0.032), life satisfaction in Korea (p = 0.040), and stress perception in everyday life (p = 0.001). CONCLUSIONS As the number of immigrants rises, there is increasing demand for public-health-center-based health promotion programs for immigrants. It is recommended that local public health practitioners, including public health nurses, closely analyze the characteristics of their community and immigrants, and develop and implement customized programs accordingly.
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Affiliation(s)
- Ji-Young An
- Azwie Foundation, Mt. Laurel, New Jersey.,School of Nursing, Rutgers, The State University of New Jersey, Camden, New Jersey
| | - Hyunjung Moon
- Department of Nursing, Far East University, Chungbuk, Korea
| | - Sunkyung Cha
- Department of Nursing Science, Sunmoon University, Chungnam, Korea
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The Relationship between Acculturation and Experimental Pain Sensitivity in Asian Americans with Knee Osteoarthritis. Pain Res Manag 2019; 2018:9128015. [PMID: 30607217 PMCID: PMC6304828 DOI: 10.1155/2018/9128015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/18/2018] [Indexed: 01/03/2023]
Abstract
Multiple studies in healthy populations and clinical samples have shown that ethnic minorities have greater pain sensitivity than their majority counterparts. Acculturation is speculated to be one of the sociocultural factors contributing to pain sensitivity since cultural beliefs and practices can influence the way patients perceive and respond to pain. However, the relationship of acculturation to pain sensitivity in minority populations remains poorly understood. Therefore, in this cross-sectional study, we examined the relationship between acculturation and experimental pain sensitivity in 50 Asian Americans residing in North Central Florida with knee osteoarthritis pain. The Suinn-Lew Asian Self Identity Acculturation Scale was used to assess acculturation, and multimodal quantitative sensory testing was performed to measure experimental sensitivity, including heat pain tolerance, pressure pain threshold, and punctate mechanical pain. Descriptive and regression analyses were performed. Participants' mean age was 55.7 years, and about half of this sample were Korean American (56%). The participants had lived in the United States for 21 years on average. Regression analyses indicated that lower acculturation to American culture may contribute to greater experimental pain sensitivity. Asian Americans who were more acculturated to the American culture had higher heat pain tolerance (beta = 0.61, P=0.01), higher pressure pain threshold (beta = 0.59, P=0.02), and lower ratings of punctate mechanical pain (beta = -0.70, P < 0.01). These findings add to the literature regarding sociocultural factors associated with pain in Asian Americans; additional research with a larger and more diverse sample of Asian Americans is warranted for cross-validation.
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Lee M, Nezu AM, Nezu CM. Acculturative Stress, Social Problem Solving, and Depressive Symptoms among Korean American Immigrants. Transcult Psychiatry 2018; 55:710-729. [PMID: 30131019 DOI: 10.1177/1363461518792734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study examined the relationship among acculturative stress, social problem solving, and depressive symptoms among 107 Korean American immigrants. Hierarchical regression analysis showed that acculturative stress significantly predicted depressive symptoms controlling for different domains of acculturation. With regard to the role of social problem solving, among the five dimensions of social problem solving (i.e., positive problem orientation, negative problem orientation, rational problem solving, impulsive/careless style, and avoidant style), negative problem orientation and impulsive/careless style significantly predicted depressive symptoms. Avoidant style significantly interacted with acculturative stress, indicating that avoidant style is associated with depressive symptoms when acculturative stress is high. The study underscores the impact of culture as well as severity of stress on the relationship among acculturative stress, coping, and depressive symptoms among Korean American immigrants.
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Affiliation(s)
| | - Arthur M Nezu
- Drexel University, Philadelphia Veterans Administration Medical Center
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Traumatic exposure, acculturative stress and cultural orientation: the influence on PTSD, depressive and anxiety symptoms among refugees. Soc Psychiatry Psychiatr Epidemiol 2018; 53:931-941. [PMID: 29931441 DOI: 10.1007/s00127-018-1532-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Acculturation studies conducted with refugees have predominantly concentrated on investigating the impact of acculturative stress on mental health, and have neglected to investigate the impact of cultural orientations towards the host and ethnic cultures. Furthermore, exposure to traumas is highly prevalent in refugees and strongly associated with mental health outcomes, however, rarely included in investigations of acculturative process of refugees. METHOD Using structural equation modelling, this study tested an integrated model of the relationship between traumatic exposure, acculturative stress, host and ethnic cultural orientations and posttraumatic stress disorder (PTSD), depression and anxiety symptoms among 138 Bosnian refugees resettled in Australia and Austria. RESULTS The model showed an overall good fit and noteworthy amount of variance indicating that traumatic exposure is the strongest direct and indirect predictor of PTSD, depression and anxiety symptoms. Furthermore, acculturative stress was identified as a significant risk factor influencing host cultural orientation, mediating the effect of traumatic exposure on all mental health outcomes. CONCLUSION Acculturative stress and cultural and social stressors that are related to acculturation need to be addressed alongside provision of effective psychotherapy, especially since they are significant impediments to host cultural orientation and constructive engagement with mental health services in refugees.
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Lai DWL, Li L, Daoust GD. Factors Influencing Suicide Behaviours in Immigrant and Ethno-Cultural Minority Groups: A Systematic Review. J Immigr Minor Health 2018; 19:755-768. [PMID: 27640011 DOI: 10.1007/s10903-016-0490-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This paper reviews recent literature on factors influencing suicide behaviours, including thoughts, plans, and attempts, in immigrant and ethno-cultural minority groups, to inform a more comprehensive understanding of suicide behaviours in increasingly culturally diverse populations. Thirty-three studies published between 2002 and 2013 were identified through digital databases searches and included in this review. Analysis of study findings focused on impacts of ethno-cultural identity and acculturation, other cultural and immigration influences, and family and community supports on suicide behaviours. Policy, practice, and research recommendations are identified, to inform relevant suicide prevention efforts and enhance mental health supports for immigrant and ethno-cultural minority populations.
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Affiliation(s)
- Daniel W L Lai
- Department of Applied Social Sciences, Institute of Active Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada.
| | - Lun Li
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Gabrielle D Daoust
- Department of International Relations, University of Sussex, Brighton, UK
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Acculturation, Acculturative Stress, and Depressive Symptoms in International Migrants: A Study with Vietnamese Women in South Korea. J Immigr Minor Health 2017; 20:1103-1108. [DOI: 10.1007/s10903-017-0661-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Aroian K, Uddin N, Blbas H. Longitudinal study of stress, social support, and depression in married Arab immigrant women. Health Care Women Int 2017; 38:100-117. [PMID: 27791495 PMCID: PMC5607736 DOI: 10.1080/07399332.2016.1253698] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Using a stress and social support framework, this study explored the trajectory of depression in 388 married Arab immigrant women. The women provided three panels of data approximately 18 months apart. Depression at Time 3 was regressed on Time 1 depression, socio-demographic variables, and rate of change over time in stress and social support. The regression model was significant and accounted for 41.16% of the variation in Time 3 depression scores. Time 1 depression, English reading ability, husband's employment status, changes over time in immigration demands, daily hassles, and social support from friends were associated with Time 3 depression.
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Affiliation(s)
- Karen Aroian
- a College of Nursing , University of Central Florida , Orlando , Florida , USA
| | - Nizam Uddin
- b Department of Statistics , University of Central Florida , Orlando , Florida , USA
| | - Hazar Blbas
- c Department of Statistics , Salahaddin University-Erbil , Hawler , Iraq
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Boyer P, Firat R, van Leeuwen F. Safety, Threat, and Stress in Intergroup Relations: A Coalitional Index Model. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2016; 10:434-50. [PMID: 26177946 DOI: 10.1177/1745691615583133] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Contact between people from different groups triggers specific individual- and group-level responses, ranging from attitudes and emotions to welfare and health outcomes. Standard social psychological perspectives do not yet provide an integrated, causal model of these phenomena. As an alternative, we describe a coalitional perspective. Human psychology includes evolved cognitive systems designed to garner support from other individuals, organize and maintain alliances, and measure potential support from group members. Relations between alliances are strongly influenced by threat detection mechanisms, which are sensitive to cues that express that one's own group will provide less support or that other groups are dangerous. Repeated perceptions of such threat cues can lead to chronic stress. The model provides a parsimonious explanation for many individual-level effects of intergroup relations and group-level disparities in health and well-being. This perspective suggests new research directions aimed at understanding the psychological processes involved in intergroup relations.
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Affiliation(s)
- Pascal Boyer
- Departments of Psychology and Anthropology, Washington University in St. Louis
| | - Rengin Firat
- Laboratoire Dynamique du Langage, Universite de Lyon, France
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Abstract
Migration to a new country can be very difficult for adolescents as they are also experiencing a critical transition into adulthood. The current study investigates cross-cultural transition issues facing Iranian immigrant adolescents living in Malaysia. Data were gathered from individual interviews with 100 Iranian adolescents (ages 14-18 years), who have lived in Malaysia for between 2 months and 5 years. Descriptive phenomenology qualitative research was used to explore the impact of the migration process on Iranian adolescents. Analysis revealed five major themes regarding participants’ life experiences in Malaysia: (a) initial expectations; (b) differences in ethnicity, religion, and beliefs; (c) communication barriers; (d) differences in personal evaluations; and (e) psychological issues. The results of this study clearly show that migration for Iranian adolescents in Malaysia is a time of unexpected challenges that may not be experienced by other migrant adolescents in other countries. Our findings contribute to the literature on the unique experiences of Iranian adolescents living in Malaysia and also build on the current research on adolescents who have recently immigrated. In addition, our results further uncover the process of immigration for individuals who are moving from a monocultural society (such as Iran) to a multicultural context (such as Malaysia).
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Affiliation(s)
| | | | - Zuria Mahmud
- Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Amla Salleh
- Universiti Kebangsaan Malaysia, Selangor, Malaysia
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Behrens K, del Pozo MA, Großhennig A, Sieberer M, Graef-Calliess IT. How much orientation towards the host culture is healthy? Acculturation style as risk enhancement for depressive symptoms in immigrants. Int J Soc Psychiatry 2015; 61:498-505. [PMID: 25466582 DOI: 10.1177/0020764014560356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS As the specific acculturative tasks and challenges involved in the migration process can lead to an increased risk for depressive symptoms, the study was designed to gain further insight into the interrelation between acculturation styles and mental health. METHODS A total of n = 90 patients with different ethnic backgrounds from an outpatient consultation service for immigrants at the Hannover Medical School were investigated by the Hannover Migration and Mental Health Interview (HMMH), the Centre for Epidemiologic Studies Depression Scale (CES-D) and the Frankfurt Acculturation Scale (FRAKK). RESULTS The majority of the subjects (84.4%) had a clinically significant depression. The extent of depressive symptoms was determined by the selected acculturation style (1) (F = 3.29, p = .025): Subjects with integration as acculturation style showed less depressive symptoms than subjects with assimilation as acculturation style. Furthermore, subjects with segregation as acculturation style also showed less depressive symptoms than subjects with assimilation. CONCLUSION The results suggest that even when undergoing extreme emotional distress, eventually leading to mental disorder, integration, as an acculturation style, seems to serve as a protective resource and possibly prevents further decline.
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Affiliation(s)
- Katharina Behrens
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Melina A del Pozo
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Anika Großhennig
- Institute of Biostatistics, Hannover Medical School, Hannover, Germany
| | - Marcel Sieberer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Iris T Graef-Calliess
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany Center for Transcultural Psychiatry & Psychotherapy, Wahrendorff Clinic, Sehnde, Hannover, Germany
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Sin MK. A qualitative analysis of stress and coping in Korean immigrant women in middle-age and older-adulthood. Issues Ment Health Nurs 2015; 36:52-9. [PMID: 25517124 DOI: 10.3109/01612840.2014.942447] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This qualitative grounded theory study explored stress-coping mechanisms in 14 Korean immigrant women (age ≥40) in the USA, by analyzing existing focus group data about relevant concepts that had been collected in a parent study. Using content analysis, stressors related primarily to socioenvironmental changes following immigration: language barriers, lack of trusting human relationships, and role changes were identified. Both healthy (activities, church, staying busy) and unhealthy (being alone and keeping negative feelings inside) coping strategies were reported by participants. The findings reveal unique aspects of stress-coping among Korean women who had immigrated after being culturally engrained with Confucian influences.
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Affiliation(s)
- Mo-Kyung Sin
- College of Nursing, Seattle University, Seattle, Washington, USA
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Kim J, Heo J, Park SH. The Exploration of Acculturation and Health Among Immigrants From Non-Eastern Cultures. QUALITATIVE HEALTH RESEARCH 2014; 24:1138-1149. [PMID: 25023220 DOI: 10.1177/1049732314543195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Literature on acculturation has been mainly focused on how acculturation influences the perception of health and well-being among immigrants from non-Western cultures. Conversely, we sought to explore immigration experiences associated with health and well-being among immigrants from non-Eastern cultures during their acculturation process. With a sample of 9 participants, we identified two major themes as outcomes of acculturation: psychological well-being and social benefits. We found that during acculturation, Western immigrants improved their sense of happiness, experienced reduced stress, and discovered meaning through activities, and that overall, acculturation facilitated personal growth. In addition, they developed a sense of cross-group friendships with Korean people and facilitated group cohesion within their own ethnic group. Further implications and future research avenues are discussed.
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Affiliation(s)
- Junhyoung Kim
- Central Michigan University, Mount Pleasant, Michigan, USA
| | - Jinmoo Heo
- Texas A & M University, College Station, Texas, USA
| | - Se-Hyuk Park
- Seoul National University of Science and Technology, Seoul, South Korea
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Connor JB, Miller AM. Occupational stress and adaptation of immigrant nurses from the Philippines. J Res Nurs 2014. [DOI: 10.1177/1744987114536570] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Immigrant nurses face multiple challenges that create vulnerability to stress. The purpose of this study was to explore the stresses and work experiences of Filipino immigrant nurses. Specific aims were to identify the perceived sources of work-related and non-work-related stress and describe the factors that influence stress. A cross-sectional qualitative research design was used to gain a holistic understanding of the participants’ experiences. Twenty women, 28–48 years old, working as registered nurses in the Chicago metropolitan area were interviewed. The findings showed that participants faced resettlement demands because of unexpected social and living environments. They also experienced communication problems, discrimination and alienation, which interacted with and intensified work-related stressors. In addition, challenges arose from encountering cultural differences. Overall, this study illustrated that stress is dynamic, multidimensional and highly influenced by culture. These findings increase awareness of the types of stressors encountered by immigrant health care providers and urge health care administrators to develop and implement programmes to improve their quality of life. Recommendations for future studies include focusing on the outcomes of cumulative stress among immigrant health care providers.
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Affiliation(s)
- Jorgia Briones Connor
- Assistant Professor, Marcella Niehoff School of Nursing, Loyola University Chicago, USA
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Chae SM, Park JW, Kang HS. Relationships of acculturative stress, depression, and social support to health-related quality of life in Vietnamese immigrant women in South Korea. J Transcult Nurs 2014; 25:137-44. [PMID: 24518058 DOI: 10.1177/1043659613515714] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Promoting the health-related quality of life (HRQOL) is an important aim of nursing care for immigrant women. The aim of this study was to evaluate the level of HRQOL and its relationships with social support, acculturative stress, and depression among Vietnamese immigrant women. METHOD A total of 216 Vietnamese immigrant women residing in South Korea participated in the study. Participants completed a series of questionnaires, including measures of social support, acculturative stress, depression, and HRQOL. For statistical analyses, a path analysis was applied. RESULTS Social support, acculturative stress, depression, and HRQOL were interrelated. Acculturative stress and depression directly influenced the mental health component of HRQOL, whereas social support indirectly influenced HRQOL through acculturative stress and depression. Only depression directly influenced the physical health component of HRQOL. CONCLUSION Results suggest that social support and acculturative stress are related factors in preventing depression and promoting HRQOL, especially mental health, among Vietnamese immigrant women.
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Affiliation(s)
- Sun-Mi Chae
- Seoul National University & The Research Institute of Nursing Science, Seoul, Korea
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Nielsen SS, Hempler NF, Krasnik A. Issues to consider when measuring and applying socioeconomic position quantitatively in immigrant health research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:6354-65. [PMID: 24287857 PMCID: PMC3881118 DOI: 10.3390/ijerph10126354] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/04/2013] [Accepted: 11/08/2013] [Indexed: 01/02/2023]
Abstract
The relationship between migration and health is complex, yet, immigrant-related inequalities in health are largely influenced by socioeconomic position. Drawing upon previous findings, this paper discusses issues to consider when measuring and applying socioeconomic position in quantitative immigrant health research. When measuring socioeconomic position, it is important to be aware of four aspects: (1) there is a lack of clarity about how socioeconomic position should be measured; (2) different types of socioeconomic position may be relevant to immigrants compared with the native-born population; (3) choices of measures of socioeconomic position in quantitative analyses often rely on data availability; and (4) different measures of socioeconomic position have different effects in population groups. Therefore, caution should be used in the collection, presentation, analyses, and interpretation of data and researchers need to display their proposed conceptual models and data limitations as well as apply different approaches for analyses.
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Affiliation(s)
- Signe Smith Nielsen
- Danish Research Centre for Migration, Ethnicity and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014 Copenhagen K, Denmark; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +45-3532-7991; Fax: +45-3532-7629
| | - Nana Folmann Hempler
- Steno Diabetes Center, Steno Health Promotion Center, Niels Steensensvej 8, 2820 Gentofte, Denmark; E-Mail:
| | - Allan Krasnik
- Danish Research Centre for Migration, Ethnicity and Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014 Copenhagen K, Denmark; E-Mail:
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20
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Wong YJ, Kim BSK, Nguyen CP, Cheng JKY, Saw A. The interpersonal shame inventory for Asian Americans: scale development and psychometric properties. J Couns Psychol 2013; 61:119-32. [PMID: 24188650 DOI: 10.1037/a0034681] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article reports the development and psychometric properties of the Interpersonal Shame Inventory (ISI), a culturally salient and clinically relevant measure of interpersonal shame for Asian Americans. Across 4 studies involving Asian American college students, the authors provided evidence for this new measure's validity and reliability. Exploratory factor analyses and confirmatory factor analyses provided support for a model with 2 correlated factors: external shame (arising from concerns about others' negative evaluations) and family shame (arising from perceptions that one has brought shame to one's family), corresponding to 2 subscales: ISI-E and ISI-F, respectively. Evidence for criterion-related, concurrent, discriminant, and incremental validity was demonstrated by testing the associations between external shame and family shame and immigration/international status, generic state shame, face concerns, thwarted belongingness, perceived burdensomeness, self-esteem, depressive symptoms, and suicide ideation. External shame and family shame also exhibited differential relations with other variables. Mediation findings were consistent with a model in which family shame mediated the effects of thwarted belongingness on suicide ideation. Further, the ISI subscales demonstrated high alpha coefficients and test-retest reliability. These findings are discussed in light of the conceptual, methodological, and clinical contributions of the ISI.
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Affiliation(s)
- Y Joel Wong
- Department of Counseling and Educational Psychology, Indiana University Bloomington
| | - Bryan S K Kim
- Kim, Department of Psychology, University of Hawai'i at Hilo
| | - Chi P Nguyen
- Department of Counseling and Educational Psychology, Indiana University Bloomington
| | | | - Anne Saw
- Department of Internal Medicine, University of California
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21
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Lee S, Chen L, He X, Miller MJ, Juon HS. A cluster analytic examination of acculturation and health status among Asian Americans in the Washington DC metropolitan area, United States. Soc Sci Med 2013; 96:17-23. [PMID: 24034947 DOI: 10.1016/j.socscimed.2013.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 07/01/2013] [Accepted: 07/05/2013] [Indexed: 11/28/2022]
Abstract
Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups. A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range:-1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score. Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the multifaceted acculturation process.
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Affiliation(s)
- Sunmin Lee
- 2234C School of Public Health Building, College Park, MD 20742, USA.
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22
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Gupta A, Leong F, Valentine JC, Canada DD. A meta-analytic study: the relationship between acculturation and depression among Asian Americans. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2013; 83:372-385. [PMID: 23889028 DOI: 10.1111/ajop.12018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Acculturation is an important and popular cultural research variable among specific ethnic populations that is used to explain the process of assimilating into the host culture. Acculturation has often been used to account for psychosocial changes and health outcomes and has been used to explain health disparities among ethnic groups. Using Asian Americans as an illustrative ethnic group, the authors see that researchers have highlighted the influence of acculturation on health outcomes. Some researchers suggest that this relationship is positive, whereas others postulate that the opposite is true. Because of the highly complex and divergent findings in the literature, this meta-analysis addresses the question of how acculturation (as measured by acculturation scales) is related to depression (a specific mental health outcome) among the Asian American population living in North America. Analyses were based on 38 studies. The meta-analyses reveal that when acculturation is measured as assimilation to the American culture, there is a small but statistically significant negative relationship between acculturation and depression scores. When acculturation is measured as orientation to the Asian culture, the relationship between acculturation and depression scores is also negative, but not statistically significant.
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Affiliation(s)
- Arpana Gupta
- Semel Institute, University of California Los Angeles, Psychiatry and Bio-Behavioral Sciences, 760 Westwood Plaza, #28-261, Los Angeles, CA 90024, USA.
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23
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Do Korean Immigrant Adolescents Experience Stress-Related Growth During Stressful Intergroup Contact and Acculturation? JOURNAL OF HUMANISTIC PSYCHOLOGY 2012. [DOI: 10.1177/0022167812468614] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Asian immigrant adolescents have a difficult time adapting to unfamiliar customs and cultural values as well as interacting with other ethnic groups. During intergroup contacts and acculturation, Asian immigrant adolescents have negative experiences such as discrimination experiences, intergroup anxiety, interracial tension, and limited social support. In spite of such stressful and negative life experiences, some research has shown that individuals may develop the ability to thrive or grow from stressful life events. Using grounded theory, we explored the characteristics of positive psychological changes that occurred as the result of stressful intergroup contacts and acculturation from the perspective of Korean immigrant adolescents. We captured three main themes related to stress-related growth: (a) psychological thriving, (b) cultural and ethnic understandings, and (c) culturally attuned relationships. This finding implies that stressful intergroup contacts and acculturation provide an opportunity in which Korean immigrant adolescents develop coping abilities and enhance a sense of personal growth.
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24
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Kim J, Suh W, Kim S, Gopalan H. Coping strategies to manage acculturative stress: meaningful activity participation, social support, and positive emotion among Korean immigrant adolescents in the USA. Int J Qual Stud Health Well-being 2012. [PMID: 23195747 PMCID: PMC3503268 DOI: 10.3402/qhw.v7i0.18870] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
During acculturation, Asian immigrant adolescents have numerous challenges such as language barriers, cultural and ethnic differences, different school environments, discrimination experiences, and intergroup conflicts and tension. These challenges generate acculturative stress, which negatively affects the perception of health and well-being among Asian immigrant adolescents. This article explored how Asian immigrant adolescents perceive and cope with acculturative stress. In particular, this study examined the stress-coping strategies in the adaptation process as experienced by Korean immigrant adolescents. Three main themes associated with the stress-coping strategies were captured: (a) engagement in meaningful activities; (b) social support; and (c) positive emotion. This finding implies that Asian immigrant adolescents create and develop their own strategies to deal with acculturative stress, which results in a sense of happiness and psychological well-being. This study discuss the future implications on how to improve the perception of health and well-being among Asian immigrant adolescents.
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Affiliation(s)
- Junhyoung Kim
- Department of Human Performance and Sport Sciences, Winston-Salem State University, Winston-Salem, NC, USA
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25
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Abstract
The objective of this study is to examine the association between acculturation and BMI among Asian Americans using multiple measures of acculturation. Data of 847 Chinese, Korean and Vietnamese recruited for a health education program in Maryland during 2009 to 2010 were used. Acculturation was measured by the short version of Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and its individual components. Height and weight were measured by trained staff. Multiple linear regressions were used to estimate the association between acculturation and BMI. After adjusting for age, gender, education, income, marital status, and ethnicity, SL-ASIA (β = 0.71, SE = 0.28), having education in the US (β = 0.56, SE = 0.28), younger age of arrival (0-5 years: β = 3.32, SE = 0.76, 6-10 years: β = 1.55, SE = 0.78), self identified as Americans (β = 1.51, SE = 0.77) and equal preference of Asian/American food in restaurants (β = 0.92, SE = 0.28) were significantly associated with increased BMI. The association between acculturation and BMI was stronger among men than women, strongest among Chinese and weakest among Vietnamese. Acculturation was moderately associated with increased BMI among Asian Americans and this association varied by measures of acculturation. The association of acculturation and BMI was moderated by sex and ethnicity groups.
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26
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Hung CH, Wang HH, Chang SH, Jian SY, Yang YM. The health status of postpartum immigrant women in Taiwan. J Clin Nurs 2012; 21:1544-53. [DOI: 10.1111/j.1365-2702.2011.03999.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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27
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Norris AE, Aroian KJ, Nickerson DM. Premigration persecution, postmigration stressors and resources, and postmigration mental health: a study of severely traumatized U.S. Arab immigrant women. J Am Psychiatr Nurses Assoc 2011; 17:283-93; discussion 294-6. [PMID: 21835819 PMCID: PMC4464810 DOI: 10.1177/1078390311408900] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Competing theories exist regarding the importance of premigration trauma as compared with postmigration stressors and resources with respect to the risk to immigrant mental health. OBJECTIVE To examine how type of premigration trauma, postmigration stressors, and postmigration resources differentially predict posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) symptomatology in Arab immigrant women who have been exposed to premigration trauma. DESIGN Descriptive, using multinomial logistic regression to explain membership in one of four groups: (a) PTSD only (n = 14), (b) MDD (n = 162), (c) comorbid PTSD-MDD (n = 148), and (d) subclinical symptoms (n = 209). RESULTS Parameter estimates for postimmigration-related stressors (as measured by the Demands of Immigration [DI]) indicated that a unit increase in DI scores was associated with a nearly 16-fold increase in the likelihood of being in the comorbid relative to the subclinical group, and a nearly 2.5-fold increase in the likelihood of being in the comorbid relative to the MDD-only group (p < .05). Odds ratios for social support, age, and type of premigration trauma ranged between 0.95 and 1.95 and only differentiated between subclinical and comorbid PTSD-MDD groups (p < .05). CONCLUSION Postmigration stressors exert substantive effects on immigrant mental health outcomes. Nursing interventions are needed to reduce immigration-related stressors. Screening Arab immigrant women for depression and PTSD is important, given the high levels observed in this community-based sample.
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Affiliation(s)
- Anne E Norris
- University of Central Florida, Orlando, FL 32816-2210, USA.
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28
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Ding D, Hofstetter CR, Norman GJ, Irvin VL, Chhay D, Hovell MF. Measuring immigration stress of first-generation female Korean immigrants in California: psychometric evaluation of Demand of Immigration Scale. ETHNICITY & HEALTH 2011; 16:11-24. [PMID: 21213157 PMCID: PMC3057536 DOI: 10.1080/13557858.2010.523107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Immigration involves challenges and distress, which affect health and well-being of immigrants. Koreans are a recent, fast-growing, but understudied group of immigrants in the USA, and no study has established or evaluated any immigration stress measure among this population. This study explores psychometric properties of Korean-translated Demands of Immigration (DI) Scale among first-generation female Korean immigrants in California. Analyses included evaluation of factor structure, reliability, validity, and descriptive statistics of subscales. DESIGN A surname-driven sampling strategy was applied to randomly select a representative sample of adult female Korean immigrants in California. Telephone interviews were conducted by trained bilingual interviewers. Study sample included 555 first-generation female Korean immigrants who were interviewed in Korean language. The 22-item DI Scale was used to assess immigration stress in the study sample. RESULTS Exploratory factor analysis suggested six correlated factors in the DI Scale: language barriers; sense of loss; not feeling at home; perceived discrimination; novelty; and occupation. Confirmatory factor analysis validated the factor structure. Language barriers accounted for the most variance of the DI Scale (29.11%). The DI Scale demonstrated good internal consistency reliability and construct validity. CONCLUSION Evidence has been offered that the Korean-translated DI Scale is a reliable and valid measurement tool to examine immigration stress among Korean immigrants. The Korean-translated DI Scale has replicated factor structure obtained in other ethnicities, but addition of cultural-specific items is suggested for Korean immigrants. High levels of language and occupation-related stress warrant attention from researchers, social workers, and policy-makers. Findings from this study will inform future interventions to alleviate stress due to demands of immigration.
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Affiliation(s)
- Ding Ding
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
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29
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Abstract
Despite its high prevalence, depression is often unrecognized and untreated in minority immigrants. Culture and environment influence perceptions of depression. The purpose of this study was to understand perceptions of depression (knowledge and coping mechanisms) in Korean American immigrants using focus group discussions. A convenience sample (n = 28) was recruited from Korean communities in the Puget Sound region of Washington State. Participants lacked an understanding of depression. Difficulties from immigration-related environmental changes were the main sources of stress. Immigration-related environmental changes resulted in changes in coping resources. Culture-friendly education and coping resources might benefit this minority group.
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Affiliation(s)
- Mo-Kyung Sin
- Seattle University, College of Nursing, Seattle, Washington, USA.
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Ayers JW, Hofstetter CR, Hughes SC, Park HR, Paik HY, Song YJ, Irvin V, Hovell MF. Gender modifies the relationship between social networks and smoking among adults in Seoul, South Korea. Int J Public Health 2010; 55:609-17. [PMID: 20217178 PMCID: PMC2992131 DOI: 10.1007/s00038-010-0126-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 10/19/2009] [Accepted: 01/20/2010] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To evaluate the interaction of gender with social network mechanisms and smoking behaviors in Seoul, South Korea, where smoking is common among men but not women. METHODS During 2002, telephone surveys were completed with 500 adults drawn from a probability sample in Seoul. Respondents described their smoking status, smoking rate (number of cigarettes smoked per day) and social networks by assessing who discouraged or encouraged smoking (smoking support) or smoked (smoking models). Multivariable regressions were used for analyses. RESULTS Women encountered significantly less smoking support than men, 88% (95% confidence interval [95% CI], 85-91) versus 70% (95% CI 66-73) net discouragement of smoking in their network. A difference in smoking support from 25 to 75% net discouragement was associated with a 27% (95% CI 9-49) lower probability of smoking among women, significantly stronger (z = 3.18, p < 0.01) than among men who had a 19% (95% CI 8-27) lower probability of smoking. A similar difference in smoking support was associated with male smokers smoking 6.38 (95% CI 0.86-12.30) fewer cigarettes per day, or 2,329 (95% CI 314-4,490) fewer cigarettes per year. The later association could not be observed among women due to the small proportion of female smokers. Smoking models were not significantly associated with any smoking behaviors across genders. CONCLUSIONS Social network mechanisms were differentially associated with the high smoking prevalence among men and low prevalence among women and should be targeted by interventions tailored to these differences.
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Affiliation(s)
- John W Ayers
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
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