The dyadic effects of family resilience and social support on quality of life among older adults with chronic illness and their primary caregivers in multigenerational families in China: A cross-sectional study

Older adults with chronic illness, as well as their primary caregivers in multigenerational families, may experience a complex interplay of factors that affect their quality of life (QOL). However, this interplay is not yet well-characterized for Chinese multigenerational families in particular. In this study, we analyzed how family resilience and social support affect the QOL of both older adults and caregivers in multigenerational Chinese families specifically. We enrolled 258 pairs of older adults with chronic illness and their primary caregivers in a multicenter cross-sectional study conducted in southern China in December 2021. Using the Actor-Partner Interdependence Model (APIM), we then examined the correlation between family resilience, social support, and QOL in dyadic analysis and found that QOL, family resilience, and social support for primary caregivers were better than those of older adults with chronic illness (t = 3.66-16.3, p＜0.01). These factors were found to be positively correlated (r = 0.22-0.60, p＜0.05), except for the family resilience of primary caregivers and the QOL of older adults with chronic illness (r = -0.14, p = 0.04). Additionally, actor effect results showed that when a dyadic member has high family resilience and objective social support, they tend to have a better QOL (β = 0.5-1.48, P < 0.01). However, partner effect results showed that when the primary caregiver has high family resilience, this is associated with a worse QOL for the older adult (β = -1.06, P < 0.01). Furthermore, we found that objective social support of dyads does not significantly influence their partner's QOL (β = 0.88/0.31, P＞0.05) for any pair. This suggests that medical staff should pay attention to the impact of family resilience on the QOL of older adult and caregiver dyads and explore health management plans that focus on binary coping in multigenerational families.

A Systematic Review: Risk and Protective Factors of Elder Abuse for Community-Dwelling Racial Minorities

Elder abuse is related to numerous adverse health and mental health conditions in older adults and some studies indicated higher rates of elder abuse in ethnic and racial minority populations than non-Hispanic Whites. This current study aims to summarize the risk and protective factors associated with elder abuse in community-dwelling racial minorities. A systematic review was conducted following Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. AgeLine, Medline, PsycINFO, and CINAHL were searched without limitation on time periods of publication. Two authors independently screened the search results and assessed the eligibility and quality of the retrieved articles. A total of 718 articles were screened and 25 articles were included in the review. The 25 included studies' publication dates range from 1989 to 2019. Five racial categories were generated: African Americans, Asian Americans, Native Americans, Hispanic Americans, and racial minorities in Canada. Risk and protective factors of elder abuse and its subtypes (e.g., physical and psychological abuse) for these racial groups were summarized. There are some common risk factors across racial minorities, such as dependence on caregivers and health issues. The review identified gaps and conflicting findings regarding culture and education that are worthy of further investigation. In particular, there is a lack of current research on elder abuse in racial minority older women, race minority subgroups, and protective factors of elder abuse. The results guide helping professionals to consider the role of traditional culture and identify warning signs of potential abuse among racial minority older adults.

A cross-sectional study: family communication, anxiety, and depression in adolescents: the mediating role of family violence and problematic internet use

OBJECTIVE

The objective of this study is to explore the relationship between family communication, family violence, problematic internet use, anxiety, and depression and validate their potential mediating role.

METHODS

The study population consisted of Chinese adolescents aged 12 to 18 years, and a cross-sectional survey was conducted in 2022. Structural equation models were constructed using AMOS 25.0 software to examine the factors that influence adolescent anxiety and depression and the mediating effects of problematic internet use and family violence.

RESULTS

The results indicate that family communication was significantly and negatively related to family violence (β = -.494, p < 0.001), problematic internet use (β = -.056, p < .05), depression (β = -.076, p < .01), and anxiety (β = -.071, p < .05). And the finds also indicate that family violence mediated the relationships between family communication and depression (β = -.143, CI: -.198 -.080), and between family communication and anxiety (β = -.141; CI: -.198 -.074). Chain indirect effects between family communication and depression (β = -.051; CI: -.081 -.030) or anxiety (β = -.046; CI: -.080 -.043) via family violence and then through problematic internet use were also found in the present study.

CONCLUSIONS

In conclusion, positive family communication is crucial in reducing anxiety and depression in adolescents. Moreover, problematic internet use and family violence mediate the effects of positive family communication on anxiety and depression. Therefore, improving family communication and promoting interventions aimed at reducing family violence and problematic internet use can help reduce anxiety and depression in adolescents, thus promoting their healthy development.

Intersections between the culture of Xiao (孝) and caring for older relatives in China: perspectives of United Kingdom-based Chinese students on future care for their parents

Emphasis placed on Xiao (孝; filial piety) in Chinese culture highlights parents' investment in their children with the expectation of being cared for when older. An increasing number of Chinese students come to the United Kingdom (UK) to study, with the majority returning home and likely to become future care-givers for their parents. Little attention has been paid to the implications of transnational mobility of Chinese students on the reciprocal aspects of future care responsibility. With the uniquely changing family structure due to consequences of the One-Child Policy, we conducted proactive research on the opportunities and challenges that Chinese transnational students anticipate they may face in future care-giving for elderly parents. Hence, this study's aim was to make a novel contribution to knowledge through exploration of the perspectives of Chinese students in England on intergenerational ties and filial obligations. Adopting a social constructivist philosophical position, we conducted three focus groups with 19 UK-based Chinese students, using a semi-structured topic guide with informed consent. Interviews were translated, transcribed and analysed using reflective thematic analysis, capturing semantic and latent meanings, and employed a descriptive and interpretative approach. Six themes were discovered, revealing a ‘culture of duty’ where familial obligation and societal expectations were prominent. Prospective care-givers anticipated a future dilemma between balancing work commitments and providing care as mandated by Xiao. Furthermore, it appeared that lack of preparedness might further exacerbate barriers faced when accessing support. We surmised that the changing demographics and absence of formal support could compound stressors over time, especially if cognitive dissonance arises as realities of life do not fit with societal expectations. Our findings imply that policy makers, practitioners and the government will need to adequately support prospective family care-givers who are returnees in caring for older generations.

Detecting Risk of Neglect in NSHAP Round 3 Using New Follow-Up Questions to Activities of Daily Living Measures

OBJECTIVES

Elder neglect is a type of elder abuse wherein an older adult's basic needs remain unmet through negligence. The risk of neglect and its harmful consequences coincides with the need for care that arises with difficulties completing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). In this paper, we describe how new questions included in Round 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP-R3) can help detect the risk of elder neglect.

METHODS

Based on the 2,340 respondents who indicated problems with at least one ADL or IADL, we categorized respondents as at a higher risk of neglect if they were either: (a) not getting wanted help (WANTHELP) or (b) getting help from an undependable caregiver (UNRELIABLE). We tested the external validity of these indicators by examining their association with NSHAP-R3 measures of physical and mental health, personal hygiene, home tidiness, social support, and elder mistreatment, using t tests and chi-square tests.

RESULTS

Those labeled higher neglect risk based on the WANTHELP variable showed significantly worse self-rated physical health, personal hygiene, room tidiness, mental health, partner support, family support, and elder mistreatment. The same correlates were significantly associated with higher neglect risk based on the UNRELIABLE variable, except for self-rated physical health, personal hygiene, and room tidiness.

DISCUSSION

Findings suggest that these new measures can be useful for identifying NSHAP respondents who are at risk of types of neglect that can be associated with having I/ADL limitations.

Financial Maltreatment of Chinese American Elders: An Inquiry through a Cultural Lens

This study examined financial maltreatment from the perspectives of Chinese American elders via a mixed method approach. Three focus groups of Chinese American elders and one group of service professionals recruited from Phoenix metropolitan areas shared their insights of financial maltreatment and contributed to the refinement of questions in the followed survey that included 325 elders (M_age = 75.6, SD = 7.00). Two types of financial maltreatment: Financial exploitation and financial neglect were identified from focus group discussions. About 9.2% experienced financial exploitation and 1.5% experienced financial neglect. Both financial exploitation and neglect were related to higher vulnerability scores for abuse assessed using the H-S/EAST elder abuse screening scale. Financial maltreatment needs to be understood in legal, cultural, and family contexts, incorporating the perspectives of older adults. Prevention of financial maltreatment hinges on increased awareness and knowledge of this issue among elders, families and service professionals, and the collaborative efforts of stakeholders from ethnic communities.

Perceptions of elder abuse and neglect by older Chinese immigrants in Canada

This study investigates how older adults perceive elder abuse and neglect in the context of migration and ageing. Based on a qualitative study of recent Chinese older immigrants in the Greater Toronto Area in Canada, it seeks to understand how migration and ageing processes, both of which engender cultural and contextual changes, shape and reshape views of elder abuse and neglect. The study argues that culture is important in older immigrants' perceptions of elder abuse and neglect, yet individuals with the same cultural roots may differ in their conceptualizations. Further, such perceptions could change through interactions with peers and non-peers in the host society, and these, in turn, can be influenced by both cultural and structural factors.