Social support resources in adolescents and young adults with advanced cancer: a qualitative analysis

PURPOSE

Adolescents and Young Adults (AYAs) with cancer are an at-risk group with unique palliative and supportive care needs. Social support in AYAs with cancer is associated with better coping, quality of life, and psychosocial well-being. Here, we extend existing research to examine the sources and types of support received by AYAs with advanced cancer.

METHODS

AYAs participated in a semi-structured, 1:1 interview on communication and psychosocial support needs. The present analysis focused on social support experiences for AYAs with advanced cancer. Directed content analysis was used to develop the codebook. Established social support constructs provided a coding framework. We presented our qualitative findings as a code frequency report with quantified frequency counts of all "source of support" and "type of support" codes. We assigned a global "sufficiency of support code" to each AYA.

RESULTS

We interviewed 32 AYAs with advanced cancer (Mage = 18, SDage = 3.2, 41% female). Most AYAs identified family (namely, caregivers) as their primary source of support and stated that family universally provided all types of support: emotional, informational, instrumental, and social companionship. They received informational and emotional support from clinicians, and received emotional support and social companionship from healthy peers, cancer peers, and their existing community. One-third of participants were coded as having "mixed support" and described a lack of support in some domains.

CONCLUSION

AYAs with advanced cancer described caregivers as their universal source of support, and that other support sources provided support for specific needs. Future research should continue to evaluate social support needs and family-based palliative and supportive care interventions to bolster social support resources in this high-risk group.

Facilitating international medical graduates' acculturation: From theory to practice

CONTEXT

International medical graduates (IMGs) are forming an ever-increasing proportion of the medical workforce. Much of the discourse around IMGs is about their performance at work and interventions to improve it. This discourse, however, is rarely situated in the wider context of the experiences of IMGs as migrants despite the wider context of migration and acculturation being likely to have a significant impact on IMGs' well-being and, ultimately, performance at work.

OBJECTIVES

The objectives of this article were to (1) raise awareness of the inextricable broader context within which IMGs are situated as migrants; (2) outline the impact this context might have on IMGs' performance; (3) discuss literature from the social sciences related to acculturation that could better inform the way we view IMG transition and performance; (4) highlight how acculturation theory can help inform the design, implementation and evaluation of interventions to facilitate the transition of IMGs into the host country and the workplace; (5) list some interventions that can provide support; and (6) suggest theory driven lines of enquiry to study acculturation in IMGs and the impact related issues might have on performance.

METHODS

This is a cross-cutting edge review drawing on selected theory and literature from the social sciences to explore its relevance to IMGs.

CONCLUSION

The broader context of migration and acculturation should not be ignored when discussing IMG performance in the workplace or when instigating interventions to improve it. There is an urgent need to further evaluate the impact this broader context has on IMGs' well-being and performance.

Medical outcomes study social support survey (MOS-SSS) in patients with chronic disease: A psychometric assessment

Purpose

Currently, information on the psychometric properties of the Medical outcomes study-social support survey (MOS-SSS) for patients with chronic disease in primary health care, suggests problems in the dimensionality, specifically predominant unidimensionality in a multidimensional measure. The aim of this study was to determine the internal structure (dimensionality, measurement invariance and reliability) and association with other variables.

Methods

A total of 470 patients with chronic disease from a Family Medicine Unit at the Instituto Mexicano del Seguro Social, IMSS, with a mean age of 51.51 years were included. Participants responded to the Questionnaire of Sociodemographic Variables (Q-SV), SF-36 Health-Related Quality of Life Scale-version 1.1, and MOS-SSS.

Results

Non-parametric (Mokken scaling analysis) and parametric (confirmatory factor analysis) analyses indicated unidimensionality, and three-factor model was not representative. A new 8-item version (MOS-S) was developed, where measurement invariance, equivalence with the long version, reliability, and relationship with the SF-36 were satisfactory.

Conclusion

The MOS-SSS scale is unidimensional, and the shortened version yields valid and reliable scores for measuring social support in patients with chronic disease at the primary health care.

Social Support and Loneliness among Chinese Rural-to-Urban Migrant Children: A Moderated Mediation Analysis of the Roles of Social Competence and Stress Mindset

Social support has been an important social-contextual protective factor against loneliness. However, how individual-level protective factors, such as social competence and a positive stress mindset, may jointly influence the relationship between social support and loneliness is less known. This study examined to what extent the link between social support and loneliness would be mediated by social competence and moderated by stress mindset among migrant children. In total, 198 rural-to-urban migrant children aged 10-14 years (56.1% girls) in Beijing, China, completed a set of self-reported questionnaires. A moderated mediation analysis was performed. We found that perceived social support was associated with a lower level of loneliness, and this association was significant only for migrant children holding a positive stress mindset (indicated by a high ratio of the stress-is-a-challenge mindset to the stress-is-a-threat mindset). Notably, across children with different stress mindsets, perceived social support was indirectly related to a lower level of loneliness through greater social competence. Our findings suggest that social competence and a stress-is-a-challenge mindset are important individual-level protective factors for migrant children to overcome loneliness. Social competence can carry the effect of social support, and a stress-is-a-challenge mindset can optimize the effect of environmental resources on mental health.

Chinese International Students' Face Concerns, Self-Stigma, Linguistic Factors, and Help-Seeking Intentions for Mental Health

Chinese international students (CIS) in American universities encounter serious mental health issues, and they also underutilize campus mental health care services. The current study examined several factors which result in this phenomenon, such as Chinese face concerns, self-stigma of seeking help for mental health services, as well as English proficiency and language discrimination. A survey with 433 CIS in multiple U.S. universities was conducted to analyze the relationships between these factors above, help-seeking intentions, and mental health problems (depression and anxiety). The SEM results suggested that face concerns increased the risk of mental health problems such as depression and anxiety and also increased self-stigma toward seeking mental health services. However, face concerns positively influenced help-seeking intentions. The self-stigma had a negative effect on help-seeking intentions. Perceived English discrimination increased mental health problems while English proficiency increased help-seeking intentions. Meanwhile, both linguistic factors above were significantly associated with face concerns. The theoretical and practical implications are discussed to investigate how to address mental health problems among Chinese international students.

The Impact of Social Support on Social Identity Development and Well-Being in International Exchange Students

International exchanges have become increasingly common. Although it is an explicit goal of exchange programs that exchange students immerse in another culture and learn to feel like a local, there is no systematic research on the development of one’s social identity during the exchange year. A longitudinal study with German high school students who spend an exchange year in the United States investigates the trajectories of social identification, identity integration of primary and secondary cultural identities, and well-being longitudinally at three measurement times (before departure, N = 556, 3 months, N = 210, and 6 months after arrival, N = 178). As social support is suggested to be an important resource, multilevel analyses tested the impact of three subcomponents of social support (i.e., emotional, instrumental, and compatibility-informational support) on the individual trajectories. It was found that social identification and identity integration increased over time, whereas well-being was high across all times. Identity integration mediated the positive effect of social identification on well-being. Moreover, emotional support was positively related to well-being and compatibility-informational support was positively related to identity integration. Instrumental support fostered early identity integration but diminished its slope when applied at later times. The present data demonstrate that an exchange year stimulates the development of the social self-concept, which is relevant for well-being. Moreover, it shows that the right kind of social support at the right time can foster this development.

Host country national support to expatriates: a motivated information processing perspective

Purpose

The support of host country nationals (HCNs) is a key determinant of expatriate adjustment and performance. The purpose of this paper is to explore underlying motivations for their support to expatriates. Previous research has shown that HCNs with pro-social motivation are more likely to help expatriates. Drawing upon motivated information processing in groups (MIP-G) theory, the authors test whether epistemic motivation moderates the observed relationship between pro-social motivation and HCNs’ support toward expatriates.

Design/methodology/approach

The authors ran two correlational studies (N = 267) in the USA (Study 1) and South Korea (Study 2). Across two studies, epistemic motivation and social motivation were measured using their multiple proxies validated in previous research. The authors also measured HCNs’ willingness to offer role information and social support to a hypothetical expatriate worker.

Findings

Results lend support to our hypotheses that pro-social HCNs are more willing than pro-self HCNs to provide role information and social support to the expatriates, but this occurs only when they have high rather than low epistemic motivation.

Originality/value

The current paper contributes the literature on HCNs helping expatriates by qualifying the prior results that a pro-social motivation (e.g. agreeableness and collectivism) increases the willingness of HCNs to help expatriates. As hypothesized, this study found that that case is only true when HCNs have high, rather than low, epistemic motivation. Also, previous research on MIP-G theory has mainly focused on the performance of small groups (e.g. negotiation, creativity and decision-making). To the best of the authors’ knowledge, this research is the first attempt to test MIP-G theory in the context of HCNs helping expatriates.

Association of Health Insurance and Documentation with Stigma and Social Support Among Myanmar Migrants with Tuberculosis Before and During Thailand's Policy on Border Closure Due to COVID-19: a Cross-Sectional Study

OBJECTIVE

The objective of this study was to assess the effect of health insurance and documentation status on tuberculosis (TB)-related stigma and social support before and during Thailand's policy on border closure.

METHODS

A cross-sectional study was conducted in two TB clinics in Mae Sot district, a border area of Thailand. Myanmar migrants with new TB were interviewed before (between September 2019 and March 2020) and during Thailand's policy (between April 2020 and January 2021). We used multiple linear regression models to assess the association of health insurance and documentation status with stigma and social support before and during the policy on border closure.

RESULTS

Of 229 migrants diagnosed new TB recruited, 117 and 112 were interviewed before and during Thailand's policy on border closure. The relationship of stigma with health insurance and documentation status was modified by the policy. Migrants with health insurance reported significantly lower stigma during the policy compared to those without health insurance, whereas documented migrants had lower stigma before the policy compared to undocumented migrants. No significant association of health insurance and documentation status with social support was observed. Ethnicity, perceived TB severity and education level were also independently associated with TB-related stigma.

CONCLUSION

The relationships between health insurance, documentation status and TB-related stigma were modified by Thailand's policy on border closure among Myanmar migrants with TB in a border area of Myanmar and Thailand. Promotion of health insurance and well-planned documentation for migrants should be more discussed and strengthened among stakeholders and policymakers.

Cultural distance and expatriates’ psychological adjustment: the moderating role of perceived social supports

Purpose

The purpose of this study is to investigate the relationship between cultural distance and psychological adjustment of expatriates in Nigeria and perceived social supports moderating the relationship.

Design/methodology/approach

The study used a cross-sectional survey research design. Data were collected through 236 validly filled questionnaires by expatriates working in different industries in Nigeria. The research variables were measured using appropriate validated scales developed by different experts. Data collected were analyzed using frequency, percentages, mean and standard deviation. Correlation and regression analyses were conducted to establish the relationships among the variables.

Findings

The study found that the distance between expatriates’ home and Nigeria on each of the dimensions of cultural values: power distance, individualism, masculinity, uncertainty avoidance cultural value, long-term orientation and indulgence negatively influence the psychological adjustment of the expatriates in Nigeria. The study demonstrated that the larger the distance between expatriates’ home and Nigeria's cultural values, the larger the difficulties in the psychological adjustment of expatriates in the country.

Practical implications

This study provides useful insights and a better understanding to both present and future global human resource practitioners, multinational organizations, international institutions and local organizations operating in Nigeria with a global mindset on the cultural profiles of expatriates that are critical to adjust to working, social interactions and living environments in Nigeria.

Originality/value

It provides practical guidance to global human resource practitioners and employers on dimensions of cultural values distance between Nigeria and the home countries of expatriates that should be considered when deciding on, searching for, selecting, recruiting and relocating expatriates to work and live in Nigeria.

A Scoping Review of the Experiences of Violence and Abuse Among Sexual and Gender Minority Migrants Across the Migration Trajectory

Violence against sexual and gender minority (SGM) individuals has continued to proliferate globally. Yet, less is known about victimization among subgroups of SGM individuals, especially SGM immigrants, refugees, and asylum seekers. There has been a steady increase in this vulnerable group of migrants over the years, and emerging evidence has pointed to their heightened risk of victimization. We conducted a scoping review of the peer-reviewed literature that examined violence, abuse, and mental health among SGM individuals who migrate internationally. One hundred ninety-nine articles were identified by searching five scholarly databases and hand searching. Twenty-six articles met inclusion criteria. We first used the migration framework, which outlines the distinct phases of the migration trajectory (predeparture, travel, interception, destination, and return), to categorize findings and then identified four overarching themes to capture SGM migrants' experiences at each phase: severe and prolonged violence and abuse related to sexual orientation or gender identity (predeparture); continued victimization and high-risk for sexual violence (travel); detainment- and deportation-related violence and abuse (interception and return); and new manifestations of violence and abuse while living with past trauma (destination). Violence and abuse began in childhood and continued in the host country, where they faced discrimination while managing posttraumatic stress disorder and depression. Findings indicate that SGM migrants are extremely vulnerable to victimization. There is an immediate need for policies to protect SGM individuals worldwide and for affirmative, culturally informed practices to help SGM migrants manage trauma and the structural barriers impeding recovery.

Relative Deprivation and Prosocial Tendencies in Chinese Migrant Children: Testing an Integrated Model of Perceived Social Support and Group Identity

As a particularly vulnerable group, children from rural areas in China whose families migrate to urban areas often encounter social exclusion, prejudice, and discrimination as they adjust to city life. Hence, migrant children may experience a sense of relative deprivation when they feel they are treated unjustly when compared to their urban counterparts. Although previous research has demonstrated that relative deprivation is a risk factor for prosocial tendencies, this association has not yet been examined in the population of migrant children in China. Further, few studies have revealed the mediating and moderating mechanisms between relative deprivation and prosocial tendencies. Therefore, this study constructed an integrated model examining the possible mediating role of perceived social support and moderating role of in-group identity on the association between relative deprivation and prosocial tendencies. A large sample of 1,630 Chinese rural-to-urban migrant children (845 girls; M _age = 12.30, SD = 1.74) completed a battery of self-report questionnaires regarding relative deprivation, prosocial tendencies, perceived social support, in-group identity, and demographic variables. The results indicated that relative deprivation was negatively correlated with migrant children's prosocial tendencies and this connection was partially mediated by perceived social support. Moderated mediation analysis further indicated that in-group identity moderated the effect of perceived social support on prosocial tendencies, with a high level of in-group identity strengthening the positive association between perceived social support and prosocial tendencies. Parents, educators, and other members of society concerned about migrant children's psychosocial adaptation should provide adequate social support resources and help them foster positive in-group identity to migrant populations to mitigate the adverse effects of relative deprivation and promote their prosocial tendencies.

Perceived Discrimination and Aggression Among Chinese Migrant Adolescents: A Moderated Mediation Model

Previous research has showed that Chinese rural-to-urban migrant adolescents are at high risk for discrimination, negative emotions, and aggression. However, little is known about how discrimination, negative emotions, and aggression are interrelated and whether social support addressing the emotional needs of the adolescents would moderate the relationship of discrimination to aggression. This study attempts to fill these gaps. Based on prior research, it is proposed that perceived discrimination relates to reactive aggression by increasing negative emotions that foster aggressive responses to stressful events. Considering the central role that negative emotions may play, it is also hypothesized that socioemotional support provided by family, friends, and community mitigates the impact of perceived discrimination on reactive aggression by reducing negative emotions. The results obtained from the analysis of two-wave survey data collected from a probability sample of 470 migrant students aged 11-17 (46.17% female; mean age = 13.49) in China supported these hypotheses. The findings indicate that perceived discrimination fosters negative emotions, which in turn increase reactive aggression. Additionally, socioemotional support reduces the adverse impact of perceived discrimination on reactive aggression by weakening the link between perceived discrimination and negative emotions. Practical and policy implications of these findings are discussed.

Moderating Roles of Social Support in the Association between Hope and Life Satisfaction among Ethnic Minority College Students in China

Ethnic minority college students in China are Chinese students who migrate from ethnic minority-dominant areas to Han-dominant areas to attend college. Acculturative stress would lead to maladjustments for ethnic minority college students in China, such as low levels of life satisfaction. To help improve the life satisfaction of these students, this study adopted resilience theory to explore the beneficial effects of hope and social support and their influencing mechanisms. The participants included 362 ethnic minority college students in Beijing, China, and a questionnaire method was used. The results indicated that Han social support had a promotive effect on life satisfaction, while hope did not have a promotive effect on life satisfaction. Moreover, Han social support moderated the relationship between hope and life satisfaction. Specifically, the effect of hope on life satisfaction was stronger under the condition of a higher level of Han social support compared with those under a lower level of Han social support. In conclusion, Han social support can play a promotive effect individually, while hope only affected life satisfaction when a high level of Han social support existed. Han social support should be strengthened to improve the life satisfaction among ethnic minority college students in China.

Expatriate demographic characteristics and host country national support: an empirical investigation in Central/South America

Purpose

The support of host country nationals (HCNs) is critical for expatriate adjustment and performance. Drawing from social identity theory and self-categorization theory, this study investigates the antecedents of HCNs' support toward expatriates in Central/South America, focusing on cultural similarities and expatriate race.

Design/methodology/approach

We conducted a quasi-experimental study to understand the antecedents that promote the willingness of HCNs to offer required support to expatriates. Data were gathered from 117 Latin American participants, who were asked to respond to questions about their perceptions of expatriates from the USA and their willingness to offer support to those expatriates.

Findings

Overall, our findings suggest that HCNs are likely to provide support to expatriates when they perceive the expatriates as similar in terms of culture and race. Specifically, African Americans received more positive attitudes and support than White Americans in South/Central America. The effect of cultural similarity on HCN willingness to support expatriates was mediated by perceived trustworthiness.

Originality/value

The present study extends the research on HCN support to expatriates, to Central/South America, an important region that has been under-studied in the expatriate–HCN context. Another novel feature of our study is that we investigate the role of expatriate race and cultural similarity and illuminate the underlying mechanism of the relationship between expatriate race and HCN support.

Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis

Background

To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people.

Objectives

The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives.

Data sources

Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants.

Review methods

Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness.

Results

The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal levels increase risk of loneliness, and undermine access to, and the impact of, interventions. Racism operates in various ways throughout the system to increase risk of loneliness.

Limitations

There was a lack of high-quality quantitative studies, and there were no studies with longer-term follow-up. UK evidence was very limited. Studies addressing upstream determinants operating at the community and societal levels did not link through to individual outcome measures. Some elements of the search approach may mean that relevant literature was overlooked.

Conclusions

Theory regarding the causes of loneliness, and functioning of interventions, among migrant and ethnic minority populations was usefully developed. Evidence of positive impact on loneliness was strongest for shared-identity social support groups. Quantitative evidence was inadequate. The UK evidence base was extremely limited.

Future work

UK research in this area is desperately needed. Co-production of interventional approaches with migrant and ethnic minority people and evaluation of existing community-based initiatives are priorities.

Study registration

This study is registered as PROSPERO CRD42017077378.

Funding

This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.

Social Support and Other Factors Associated with HIV Testing by Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex with Men in the U.S. South

Cognitive-psychosocial and other factors may affect participation in HIV testing, particularly by Hispanic/Latino gay, bisexual, and other men who have sex with men (MSM) in the U.S. South, a region hard-hit by HIV. We used univariate and multivariable logistic regression analyses to examine the association between social support and other cognitive-psychosocial factors; sociodemographic characteristics; risk behaviors; and self-reported HIV testing in a sample of 304 Hispanic/Latino MSM in North Carolina. In the multivariable logistic regression analysis, general and HIV-related social support and HIV-related knowledge were associated with greater odds of testing; speaking only Spanish was associated with reduced odds of testing. Social support and aspects of social connectedness may constitute community-based resources for use in HIV prevention efforts with Hispanic/Latino MSM. However, harnessing these resources for HIV prevention will require a better understanding of how social support relationships and processes shape HIV risks and protective actions by these vulnerable MSM.

The diplomatic spouse

Purpose

The purpose of this paper is to investigate the relationship between adjustment, social support and satisfaction with life for expatriate spouses. The sample consists of European diplomatic spouses, residing all over the world.

Design/methodology/approach

This is a quantitative study. The sample consists of European diplomatic spouses, residing all over the world. The sample consists of 268 participants: 231 females and 44 males.

Findings

The findings of this study reveal that there was a significant relationship between adjustment and emotional and instrumental support as well as satisfaction with life. Furthermore, a multiple regression was performed to predict the level of satisfaction with life. Both adjustment and emotional support were statistically significant and they explained nearly 50 percent of the variability in participant’s satisfaction with life.

Research limitations/implications

The limitations of the paper include, for example, method bias, language and geographic location.

Practical implications

Foreign Ministries within the European Union (EU) will be in a better position to improve their expatriate programs and policies. Furthermore, this study indicated that the well-being of diplomatic spouses can be enhanced by considering how social support is provided, the level of adjustment and satisfaction with life.

Social implications

This study highlights the importance for diplomatic spouses to belonging to various groups, and group membership serves as a means to gain access to social networks. Therefore, being part of support groups of other expatriate spouses can aid cross-cultural adjustment.

Originality/value

Little is known about diplomatic spouses. This paper will be an important first step in examining the relationship between adjustment, social support and satisfaction with life for the spouses of diplomats working for the Foreign Ministries within the EU and European Economic Area.

A diary study of expatriate adjustment: Collaborative mechanisms of social support

Understanding the antecedents of expatriate adjustment is vital for the success of international assignments. Social support is one of the most critical predictors of cross-cultural adjustment. Nevertheless, the nuances and interaction of diverse sources and types of support in the expatriates’ social networks need further scrutiny. This study examines the distinct and collaborative role of four different social groups in the expatriates’ social network, specifically host country nationals, home country nationals, compatriots, and foreign expatriates, on expatriate adjustment. For that purpose, an exploratory qualitative approach was adopted by using a diary study. The study was conducted with 42 single expatriates working in 21 different countries. The results showed that the nature of support provided by each social group was distinct, contributing to expatriate adjustment via different mechanisms. Moreover, it was found that these mechanisms worked collaboratively toward facilitating the expatriate adjustment.

Help Wanted: Mental Health and Social Stressors Among Latino Day Laborers

Latino day laborers may be especially vulnerable to poor mental health due to stressful life experiences, yet few studies have described patterns of mental health outcomes and their correlates in this population. Patterns of depression (PHQ-9) and anxiety (GAD-7), and associations with demographic characteristics, social stressors, and substance use in a recruited sample of male Latino day laborers ( n = 101) are described. High rates of depression and anxiety were identified. Specifically, 39% screened positive for moderate or severe depression and 25% for moderate or severe anxiety. Higher levels of depression and anxiety symptoms were associated with being single, being homeless or in temporary housing, experiencing discrimination, acculturation stress, and marijuana use. While tobacco and unhealthy alcohol use were common in this sample (39% and 66%, respectively), they were not associated with depression and anxiety. These findings suggest that depression and anxiety are common among Latino day laborers and associated with stressful life experiences. Future research should further assess ways to ameliorate social stressors and reduce risk for poor mental health.

Social Support, Adjustment, and Psychological Distress of Help-Seeking Expatriates

The present study aimed to explore the interrelations between support processes, adjustment, and psychological distress within a sample of help-seeking expatriates. Specifically, we examined (1) the association between expatriates’ cross-cultural adjustment (i.e., work, interaction and general adjustment) and levels of psychological distress (i.e., depression, anxiety and stress), (2) the association between expatriates’ perceptions of socioemotional and instrumental support availability and their level of cross-cultural adjustment, and (3) the moderating role of expatriates’ socioemotional and instrumental support needs in the latter association. Findings showed that lower levels of expatriates’ work adjustment were associated with higher levels of psychological distress. Further, perceived availability of socioemotional support was positively linked to expatriates’ interaction and work adjustment. Finally, instrumental support needs moderated the relationship between instrumental support availability and general adjustment such that higher levels of instrumental support availability were associated with better general adjustment, but only for expatriates reporting high needs for instrumental support. Our study represents a novel contribution to the expatriate literature by shedding light on expatriates’ vulnerability for psychological distress and understanding the type of social support that is considered most beneficial for help-seeking expatriates. Suggestions are made for clinical interventions for expatriates in need of support.

Percepções de brasileiros acerca do processo de adaptação cultural ao Japão

Resumo Esta pesquisa objetivou investigar as formas de aculturação dos brasileiros ao Japão e as variáveis que auxiliam na compreensão da adaptação cultural. Foram realizadas entrevistas com 15 imigrantes brasileiros residentes no Japão. Os resultados indicaram uma separação social entre brasileiros e japoneses e apontaram para a importância do suporte social e do engajamento na cultura japonesa na adaptação ao país. Concluiu-se com as contribuições teóricas, metodológicas e práticas deste estudo e com a apresentação das limitações e sugestões para pesquisas futuras.

Rehabilitation for Cancer Patients

Rehabilitation for cancer patients aims at reducing the impact of disabling and limiting conditions resulting from cancer and its treatment in order to enable patients to regain social integration and participation. Given current trends in cancer incidence and survival along with progress in medical treatment, cancer rehabilitation is becoming increasingly important in contemporary health care. Although not without limitations, the International Classification of Functioning, Disability and Health (ICF) provides a valuable perspective for cancer rehabilitation in understanding impairments in functioning and activity as the result of an interaction between a health condition and contextual factors. The structure of cancer rehabilitation varies across countries as a function of their healthcare systems and social security legislations, although there is a broad consensus with respect to its principal goals. Cancer rehabilitation requires a careful assessment of the individual patient's rehabilitation needs and a multidisciplinary team of health professionals. A variety of rehabilitation interventions exist, including psycho-oncological and psycho-educational approaches. Research on the effectiveness of cancer rehabilitation provides evidence of improvements in relevant outcome parameters, but faces some methodological challenges as well.

Embeddedness and social support of self-initiated and assigned expatriates

Purpose

The purpose of this paper is to investigate expatriates social networks and their role in delivering social support resources. Self-initiated expatriates (SIEs) and assigned expatriates (AEs) are compared in order to investigate similarities and differences between both groups.

Design/methodology/approach

Methodologically a mixed-methods study is conducted, using qualitative interviews and social network analysis (SNA) to investigate the structure of the respondent’s social support ego networks; and to gain an understanding of the use of those networks as well as the network embeddedness of the individuals.

Findings

The findings show that there are differences in structural terms as well as in the composition of the networks. While the networks of self-initiated individuals tend to be bigger in size, AEs networks tend to be denser. In terms of the composition traditional expatriates do have more ties with colleagues that are in the same company while the self-initiated group is more closely embedded within their occupation, with ties to colleagues worldwide.

Originality/value

This is one of the first studies to address social network embeddedness and social support systems of globally mobile employees by using SNA. As a mixed-methods design as well as psychological and sociological theories are applied, a contribution to linking disciplines as well as methodologies is undertaken.

Subjective well-being amongst migrant children in China: unravelling the roles of social support and identity integration

BACKGROUND

Migrant children refer to rural children who accompany one or both parents to urban area. Empirical evidence showed that compared with their urban counterparts, migrant children had poorer developmental, emotional and psychological health.

METHOD

A sample of 1306 migrant children were recruited to examine the characteristics of migrant children and investigate the effects of identity integration, support and socioeconomic factors (e.g. age, gender, type of school, family socioeconomic status, city type) on their subjective wellbeing.

RESULTS

Children with higher levels of identity integration, social support, family socioeconomic status, who attended public school and who lived in the third-tiered city of Weihai demonstrated better subjective wellbeing. Social support remained a strong predictor for subjective wellbeing, despite a significant mediating effect of identity integration.

CONCLUSIONS

These results highlight the need for policymakers and practitioners alike to address individual factors pertaining to psychological adjustments, as well as social determinants of subjective wellbeing in the context of migration.

Cultural humility and low ethnocentrism as facilitators of expatriate performance

Purpose

– For decades, expatriate scholars have understood that the individual factors of cultural humility and ethnocentrism and the contextual factors of feedback and support affect expatriates’ outcomes. The study, rooted in the observation that great advice and support are often ignored by expatriates, seeks to uncover why. Based in the humility literature, the authors test whether individual differences interact with support to affect expatriate performance. The paper aims to discuss these issues.

Design/methodology/approach

– The authors surveyed a matched sample of 62 expatriates and their supervisors from one multinational organization.

Findings

– The study found that expatriates higher in cultural humility benefit more from the support and feedback offered in the host national work environment which, in turn, facilitates better supervisor ratings of performance. The authors also found that expatriates’ ethnocentrism has a direct negative influence on their ratings of performance.

Research limitations/implications

– The findings in the study are focussed and robust, but tested within a single organization. That said, the authors believe the results have implications for expatriate selection and for ways to manage the host national environment to improve expatriate performance.

Originality/value

– The study joins the research conversation on how expatriates’ individual differences interact with the environments in which they are placed to affect their success. This study also underscores the importance of humility in the global professional context.

The categorization of expatriates and the support offered by host country nationals

Purpose

– Although several authors have suggested that host country nationals (HCNs) play an important role in the management of expatriates (e.g. Toh and DeNisi, 2003; Farhet al., 2010), research has also suggested that this relationship is not always good, and the flow of critical information to expatriates can be limited. This is especially true when HCNs categorize the expatriates as “out-group” members. The purpose of this paper is to examine potential determinants of categorization decisions as well as potential outcomes related to expatriate socialization.

Design/methodology/approach

– The paper employs a dyadic survey approach to determine the antecedents to expatriate categorization and HCN socialization behaviors from the perspective of both the expatriate and HCN.

Findings

– The results of survey data from 65 expatriate-HCN dyads indicated that expatriate ethnocentrism and the salience of the expatriates’ nationality were important predictors of categorization, but that categorization was related to only one dimension of socialization. However, affect was found to play a role in predicting socialization behaviors.

Research limitations/implications

– There is potential selection bias since expatriates chose HCNs as respondents, but results suggested this was not a serious problem. Other limitations include a relatively small sample size and the fact that a number of contextual issues such as national stereotypes and MNC strategy, are not controlled for.

Practical implications

– Implications of these findings for the successful management of expatriate assignments include sending over expatriates with the right relational skills, and those low in ethnocentrism, rather than just the right technical skills.

Originality/value

– The present study was one of the first to empirically test the potential role of categorization in the process of socialization.

Depressive Symptoms among Latino Sexual Minority Men and Latina Transgender Women in a New Settlement State: The Role of Perceived Discrimination

Background. Little is known about the role of discrimination on depression among Latino sexual and gender identity minorities. This manuscript examined the relationship between ethnic/racial discrimination and sexual discrimination on clinically significant depressive symptoms among Latino sexual minority men (i.e., gay and bisexual men and other men who have sex with men) and Latina transgender women. Methods. A community-based participatory research partnership recruited participants (N = 186; 80.6% cisgender men) in North Carolina to a social network-based HIV intervention. Using baseline data, we quantified the amount of perceived discrimination and conducted mixed-effects logistic regression analyses to examine correlates of clinically significant depressive symptoms. Results. A high percentage of participants reported ethnic/racial discrimination (73.7%) and sexual discrimination (53.8%). In the multivariable models, ethnic/racial discrimination, sexual discrimination, masculinity, fatalism, and social support were significantly associated with clinically significant depressive symptoms. Discussion. Improving mental health requires multilevel interventions that address pertinent individual, interpersonal, and system level factors.

The HIV Risk Profiles of Latino Sexual Minorities and Transgender Persons Who Use Websites or Apps Designed for Social and Sexual Networking

The use of websites and GPS-based mobile applications ("apps") designed for social and sexual networking has been associated with increased HIV risk; however, little is known about Latino sexual minorities' and transgender persons' use of these websites and apps and the risk profiles of those who use them compared with those who do not. Data from 167 participants who completed the baseline survey of a community-level HIV prevention intervention, which harnesses the social networks of Latino sexual minorities and transgender persons, were analyzed. One quarter of participants (28.74%, n = 48) reported using websites or apps designed for social and sexual networking, and 119 (71.26%) reported not using websites or apps designed for social and sexual networking. Those who used websites or apps were younger and reported more male sex partners, a sexually transmitted disease diagnosis, and illicit drug use other than marijuana. HIV prevention interventions for those who use websites or apps should consider addressing these risks for HIV.

Social stressors and alcohol use among immigrant sexual and gender minority Latinos in a nontraditional settlement state

We sought to quantify the association of social stressors with alcohol use among immigrant sexual and gender minority Latinos in North Carolina (n = 190). We modeled any drinking in past year using logistic regression and heavy episodic drinking in past 30 days using Poisson regression. Despite a large proportion of abstainers, there were indications of hazardous drinking. Among current drinkers, 63% reported at least one heavy drinking episode in past 30 days. Ethnic discrimination increased, and social support decreased, odds of any drinking in past year. Social support moderated the associations of English use and ethnic discrimination with heavy episodic drinking.

Health promotion and related factors among korean goose mothers

PURPOSE

The purpose of this study was to further understand the health promotion behaviors of Korean goose mothers in the North America area. Health promotion behaviors measured in this study were self-actualization, health responsibility, physical activity, nutrition, interpersonal relations, and stress management.

METHODS

The study is part of a larger study which used surveys (N=140) and in-person interviews (n=18). In this study, analysis of survey results is presented. Advertisements and snowballing technique were used to recruit study participants. Pearson's correlation was used to explore the relationships between health promotion and social support, acculturation attitudes, and perceived family health. Multiple regressions were used to examine the predictors of health promotion behaviors.

RESULTS

Women in the study were most frequently engaging in self-actualization and least in physical activity. Physical activity did not correlate with any of the study variables. When multiple regressions were performed, the model for each health promotion behavior was found to be statistically significant except for that of physical activity. Overall, study variables worked differently across models. Social support predicted self-actualization, health responsibility, interpersonal relations, and stress management. None of the acculturation attitudes predicted health promotion behaviors. The subdimensions of perceived family health predicted health promotion behaviors except physical activity.

CONCLUSIONS

The findings of this study contributed to the body of knowledge of health promotion among international migrant populations by identifying the differential effects of social support, acculturation attitudes, and perceived family health for six areas of health promotion.

Predictors of Heavy Episodic Drinking and Weekly Drunkenness Among Immigrant Latinos in North Carolina

Few studies have examined correlates of heavy drinking among rural immigrant Latino men. This analysis identified correlates of typical week drunkenness and past 30-day heavy episodic drinking, within a sample of immigrant Latino men in rural North Carolina (n = 258). In the bivariate analyses, Mexican birth, entering the United States as an adult, and year-round employment were associated with increased odds of typical week drunkenness, and higher acculturation and affiliation with a religion with strict prohibitions against drinking alcohol were associated with lower odds of typical week drunkenness. Being older, Mexican birth, entering the United States as an adult, and lower acculturation were associated with increased odds of heavy episodic drinking, and affiliation with a religion with strict prohibitions against drinking alcohol and completing high school were associated with decreased odds of heavy episodic drinking. In multivariable modeling, only religious affiliation was associated with typical week drunkenness. Mexican birth, entering the United States as an adult, and lower acculturation were associated with increased odds of heavy episodic drinking, and affiliation with a religion with strict prohibitions against drinking alcohol and completing high school were associated with lower odds of heavy episodic drinking. The health of minority men in the United States has been neglected, and immigrant Latino men comprise a particularly vulnerable population. This analysis provides initial data on some factors associated with heavy drinking within a population about which little is known. Future studies should examine moderating or mediating factors between age, acculturation, religiosity, and heavy drinking that might be targets for behavioral interventions.

Immigrant sexual minority Latino men in rural North Carolina: an exploration of social context, social behaviors, and sexual outcomes

Immigrant sexual minority Latino men-who may or may not self-identify as gay-constitute a minority within a minority. Often labeled "hidden" and "hard-to-reach," and marginalized along multiple dimensions, it is a subgroup about whom little is known. Informed by a social ecological framework, we sought to describe key social variables for 190 such men in rural North Carolina and to test associations with three sexual outcomes: consistent condom use, number of sex partners, and sexual compulsivity. Participants reported limited English-language use, predominantly Latino close friends, middle levels of social support despite numerous social ties, and frequent experiences of discrimination. There were unique sets of correlates for each sexual outcome. Findings may inform health promotion interventions and guide future research.

HIV testing among immigrant sexual and gender minority Latinos in a US region with little historical Latino presence

Immigrant sexual and gender minority Latinos constitute a vulnerable subgroup about which little is known. We examined HIV testing among 190 such Latinos recruited via respondent-driven sampling in North Carolina, a state with little historical Latino presence but recent, rapid growth of this population. Sixty-eight percent reported an HIV test in the past year, and nearly half reported multiple HIV tests. Concern for their health was the most frequent reason for seeking an HIV test. Reasons not to get tested included fear of a positive test, previous HIV tests, worry that test results might be reported to the government, and concerns that others might treat the person differently if found to be HIV positive. In a multiple variable model, correlates of HIV testing included age, educational attainment, HIV stigma, comfort with sexual orientation, and previous STD diagnoses. Among participants reporting anal sex, consistent condom use was associated with HIV testing, suggesting that protective behaviors may co-occur. These findings may inform the development of more efficacious interventions to increase HIV testing among this subgroup.

Beyond Culture Learning Theory

The meta-analytic study examined correlates of cultural competence as assessed by the Sociocultural Adaptation Scale. A total of 17 variables were analyzed from 66 independent studies ( N = 10,672). In line with culture learning theory, situational factors such as length of residence ( r = .16), cultural knowledge ( r = .34), previous cross-cultural experience ( r = .17), cultural distance ( r = −.33), language proficiency ( r = .35), and contact with host nationals ( r = .29) were associated with better sociocultural adaptation. The meta-analysis was extended to personality variables, with small to medium effect sizes found for the “Big Five” traits of agreeableness ( r = .16), conscientiousness ( r = .22), openness/flexibility ( r = .29), extraversion ( r = .29), and neuroticism ( r = −.32), and large effect sizes found for more narrowly defined, culture-relevant factors such as cultural empathy ( r = .49) and cross-cultural self-efficacy ( r = .45). The findings indicate that both personal and situational factors relate to cultural competence and that personality variables deserve greater attention in future studies of sociocultural adaptation.

Perceived Social Support among International Students at a U.S. University

This study investigated the extent and sources of perceived social support among international students attending a northeastern university in the United States. Using the Index of Sojourner Social Support Scale, international students reported perceiving greater socioemotional and instrumental support from other international people than from Americans. Results also indicated that younger international students perceived more socioemotional and instrumental support from others than did older international students. The findings point to sources of social support available to international students in the host culture and the important role such types of social support may play in helping international students make adjustments to living and studying in a new cultural context.

Correlates of HAART adherence among immigrant Latinos in the Southeastern United States

We explored the relationships between sociocultural and psychological constructs and adherence to antiretroviral therapy among predominantly Spanish-speaking immigrant Latinos in the southeastern United States. A cross-sectional clinic-based sample of immigrant Latino men and women participated in an interviewer-administered assessment. Self-reported prevalence of adherence was assessed along with demographic characteristics, acculturation, physician trust, social support, and theory of planned behavior (TPB) constructs: attitude, subjective norm (SN), and perceived behavioral control (PBC). A total of 66 respondents met inclusion criteria. Average age was 38 years old, 74% of respondents were male, 71% heterosexual, and 86% reported being from Mexico or Central America. Prevalence of "complete" adherence (i.e., not missing a single dose) in the past 30 days was 71%. Social support was significantly and inversely associated with adherence, PBC, and attitude. Positive correlates of adherence included attitude, PBC, and employment status. In multivariable analysis, SN and PBC were significantly associated with social support, controlling for acculturation, physician trust, and number of behavioral referents. TPB constructs have utility in explaining ART adherence among immigrant Latinos in the "Deep South." Further research is necessary to understand the complex relationships between social support, attribution processes, and ART adherence outcomes.

Assessing the Role of Culture in Korean Goose Mothers’ Lives

Korean women who migrate to a foreign country with their children for the latter’s education while their husbands stay in Korea as breadwinners are referred to as “goose mothers.” The cultural beliefs that have contributed to the formation of this family form and the experiences of these women need to be explored within their cultural context. To understand this population, Confucianism as a cultural background and its influence on goose mothers’ value systems, family systems, and view of self were explored. Based on the learning, their potential health issues are described and implications for culturally competent care are suggested.

Psychometric Performance of a Novel Measure of Social Support Among Spanish-Speaking Immigrant Latino Gay Men

Social support is protective for a variety of health outcomes, and individuals living outside their country of origin ("sojourners") might use social support in distinctive ways. The authors performed a confirmatory factor analysis of the 18-item Index of Sojourner Social Support (ISSS) using data obtained from 190 Spanish-speaking immigrant Latino gay men and men who have sex with men (MSM) in North Carolina, a marginalized group for whom social support might be especially salient. The authors failed to replicate the original distinction between socioemotional and instrumental support; however, a reduced set of 11 ISSS items appeared to be a very good measure of a single latent factor, with high factor loadings (λ ≥ .87) and excellent internal consistency reliability (α = .97). The authors encourage further research to understand the psychometric properties of the ISSS, to further elaborate the most meaningful dimensions of social support among immigrant populations, and to establish whether associations exist between ISSS scores and health-related behaviors.

Family social support during the predeparture period: the experience of British migrants

This study explored the stress, wellbeing and social support of predeparture British migrants to New Zealand. The main research questions addressed the relationship between family support and psychological outcomes, differences in migration desire between couples, and the impact of extended family support. A survey recruited 95 participants from online forums for migrants to New Zealand and results indicated that support from immediate family was related to better wellbeing and lower stress. Migrants who considered themselves the driving force behind the move reported significantly more stress and less family support than migrants who had partners who were equally enthusiastic about the move abroad. Sojourners perceived more support from extended family than did migrants who intended to leave permanently. The most difficult parts of the migration process were leaving loved ones, logistical demands, and uncertainty. The most positive parts of the process were adventure and becoming closer as a family. Overall, migration stress and coping began well before departure from the country of origin. This work was supported by a Victoria University of Wellington Faculty Strategic Research Grant.

Social support concepts and measures

Distinctions among concepts and approaches to assessing social support are made, and published generic and specialized measures of social support are reviewed. Depending on study aims, investigators may be interested in assessing perceived or received support from the perspective of the provider, the recipient, or both. Whereas some measures inquire about the availability or mobilization of several kinds of supportive resources, others seek supplemental information about the membership and structural properties of the social network as well. Observational and self-reported measures of support are presented, along with brief and extensive measures. A final set of three support measures is highlighted, including their psychometric properties.