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Kwong M, Pan CX. End-of-Life Considerations for Patients of East Asian Descent. J Palliat Med 2024. [PMID: 39180425 DOI: 10.1089/jpm.2024.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024] Open
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Peregrina HN, Bayog MLG, Pagdilao A, Bender MS, Doan T, Yoo GJ. Older Chinese and Filipino American Immigrants with Type 2 Diabetes and their Adult Child: A Qualitative Dyadic Exploration of Family Support. J Cross Cult Gerontol 2024; 39:151-172. [PMID: 38720112 PMCID: PMC11093813 DOI: 10.1007/s10823-024-09505-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
Abstract
Type 2 Diabetes (T2D) among older Asian American immigrants (AA) is a growing concern. Asian Americans represent 9% of diagnosed diabetes. Very little is known on how older Asian American immigrants with T2D navigate diabetes management, in particular the role of family support. This qualitative study examines Chinese and Filipino Americans, the two largest Asian subgroups in the US (4.2 million, and 3.6 million, respectively), and family support dynamics among adult children and their parents diagnosed with T2D. Ten dyads (n = 20) made up of adult children and aging parents participated in in-depth and dyadic interviews. Results indicate that family support occurs in a trajectory of stages. The following thematic patterns emerged in these dyads around support: independence, transitions, partnership, and stepping in. The findings point to various supportive stages that Asian American adult children and aging parents with T2D experience and the importance of developing supportive interventions for both adult children and aging parents at these various stages.
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Affiliation(s)
| | - Maria L G Bayog
- School of Nursing, University of California, San Francisco, San Francisco, USA
| | | | - Melinda S Bender
- School of Nursing, University of California, San Francisco, San Francisco, USA
| | - Therese Doan
- School of Nursing, San Francisco State University, San Francisco, USA
| | - Grace J Yoo
- Department of Asian American Studies, San Francisco State University, San Francisco, USA
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Ma C, Rajewski M, Bao S. Home Health Care to Asian Americans: a Systematic Review. J Racial Ethn Health Disparities 2024; 11:865-873. [PMID: 36940075 PMCID: PMC10026777 DOI: 10.1007/s40615-023-01568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE Despite being the fastest growing minority group in the USA, Asian Americans are among the least studied ones, particularly in the home and community-based services settings. This study aimed to review and synthesize extant evidence on Asian American's access, utilization, and outcomes of home health care. METHODS This is a systematic review study. A comprehensive literature search was conducted in PubMed and CINAHL as well as hand search. Each study was screened, reviewed, and evaluated for quality by at least two reviewers independently. RESULTS Twelve articles were determined eligible and included for review. Asian Americans were less likely to be discharged to home health care following hospitalization. At admission to home health care, Asian Americans had a high rate of inappropriate medication issues (28%) and they also had poorer functional status compared to White Americans. Asian Americans were also reported with less improvement in functional status at the end of home health care; however, there were some inconsistencies in the evidence on Asian Americans' utilization of formal/skilled home health care. Quality evaluation indicated that findings from some studies were limited by small sample size, single site/home health agency, analytic approaches, and other methodologic limitations. CONCLUSIONS Asian Americans often experience inequities in home health care access, utilization, and outcomes. Multilevel factors may contribute to such inequities, including structural racism. Robust research using population-based data and advanced methodology is needed to better understand home health care to Asian Americans.
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Affiliation(s)
- Chenjuan Ma
- New York University Rory Meyers College of Nursing, New York, NY 10010 USA
| | - Martha Rajewski
- New York University Rory Meyers College of Nursing, New York, NY 10010 USA
| | - Silin Bao
- Community Regional Medical Center, Fresno, CA USA
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Ng R, Indran N. #ProtectOurElders: Analysis of Tweets About Older Asian Americans and Anti-Asian Sentiments During the COVID-19 Pandemic. J Med Internet Res 2024; 26:e45864. [PMID: 38551624 PMCID: PMC10984343 DOI: 10.2196/45864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/12/2023] [Accepted: 09/14/2023] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND A silver lining to the COVID-19 pandemic is that it cast a spotlight on a long-underserved group. The barrage of attacks against older Asian Americans during the crisis galvanized society into assisting them in various ways. On Twitter, now known as X, support for them coalesced around the hashtag #ProtectOurElders. To date, discourse surrounding older Asian Americans has escaped the attention of gerontologists-a gap we seek to fill. Our study serves as a reflection of the level of support that has been extended to older Asian Americans, even as it provides timely insights that will ultimately advance equity for them. OBJECTIVE This study explores the kinds of discourse surrounding older Asian Americans during the COVID-19 crisis, specifically in relation to the surge in anti-Asian sentiments. The following questions guide this study: What types of discourse have emerged in relation to older adults in the Asian American community and the need to support them? How do age and race interact to shape these discourses? What are the implications of these discourses for older Asian Americans? METHODS We retrieved tweets (N=6099) through 2 search queries. For the first query, we collated tweets with the hashtag #ProtectOurElders. For the second query, we collected tweets with an age-based term, for example, "elderly" or "old(er) adults(s)" and either the hashtag #StopAAPIHate or #StopAsianHate. Tweets were posted from January 1, 2020, to August 1, 2023. After applying the exclusion criteria, the final data set contained 994 tweets. Inductive and deductive approaches informed our qualitative content analysis. RESULTS A total of 4 themes emerged, with 50.1% (498/994) of posts framing older Asian Americans as "vulnerable and in need of protection" (theme 1). Tweets in this theme either singled them out as a group in need of protection because of their vulnerable status or discussed initiatives aimed at safeguarding their well-being. Posts in theme 2 (309/994, 31%) positioned them as "heroic and resilient." Relevant tweets celebrated older Asian Americans for displaying tremendous strength in the face of attack or described them as individuals not to be trifled with. Tweets in theme 3 (102/994, 10.2%) depicted them as "immigrants who have made selfless contributions and sacrifices." Posts in this section referenced the immense sacrifices made by older Asian Americans as they migrated to the United States, as well as the systemic barriers they had to overcome. Posts in theme 4 (85/994, 8.5%) venerated older Asian Americans as "worthy of honor." CONCLUSIONS The COVID-19 crisis had the unintended effect of garnering greater support for older Asian Americans. It is consequential that support be extended to this group not so much by virtue of their perceived vulnerability but more so in view of their boundless contributions and sacrifices.
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Affiliation(s)
- Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
- Lloyd's Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore
| | - Nicole Indran
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
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Ng WI, Che SL, Li X, Zhu M. Association of filial attitude, filial behavior and death literacy: implications for development of death system in Guangdong-Hong Kong-Macao Greater Bay Area of China. BMC Public Health 2024; 24:721. [PMID: 38448863 PMCID: PMC10916039 DOI: 10.1186/s12889-024-18197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Filial piety, as a major traditional norm in Chinese culture and in Chinese families, affects the attitudes and behaviors of adult children toward their parents and impacts their end-of-life decision-making and the quality of death of their parents. Death literacy is a novel concept aimed at promoting palliative care in the context of public health. AIMS To understand attitudes and behaviors related to filial piety and to examine the role of death literacy in filial behaviors toward dying parents among residents in the Guangdong-Hong Kong-Macao Greater Bay Area of China. METHODS A cross-sectional online survey that employed the convenient and snowball sampling methods was adopted. Filial Piety Representations at Parents' End of Life Scale and Death Literacy Index were used. RESULTS This study identified a significant gap between the filial piety attitudes and behaviors of Chinese adult children. Gender, caregiving experience and death literacy were predictors of filial behaviors in an end-of-life context. CONCLUSION Providing truth disclosure support, offering guidance to young adult children and caregivers of terminally ill fathers, and strengthening factual and community knowledge of death are necessary to enhance the reciprocal comfort of both adult children and dying parents in the context of Chinese filiality.
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Affiliation(s)
- Wai I Ng
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Sok Leng Che
- Nursing and Health Education Research Centre, Kiang Wu Nursing College of Macau, Macao SAR, China.
| | - Xiang Li
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Mingxia Zhu
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China
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Xiao C, Patrician PA, Montgomery AP, Wang Y, Jablonski R, Markaki A. Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis. BMC Nurs 2024; 23:115. [PMID: 38347512 PMCID: PMC10863110 DOI: 10.1186/s12912-024-01789-0] [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: 07/20/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. PURPOSE To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. METHODS A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. FINDINGS Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. CONCLUSION Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study.
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Affiliation(s)
- Chunhong Xiao
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA.
| | - Patricia A Patrician
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Aoyjai P Montgomery
- University of Alabama at Birmingham School of Public Health, 1665, 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Youhua Wang
- College of State Governance, Southwest University, No. 2 Tianshen Road, Chongqing, 400715, Beibei District, China
| | - Rita Jablonski
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
| | - Adelais Markaki
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, Birmingham, AL, 35294-1210, USA
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Zhylkybekova A, Turlayev A, Grjibovski AM, Koshmaganbetova GK. Measures to support informal care for the older adults in Kazakhstan: a review of the current status. Front Public Health 2023; 11:1247684. [PMID: 37670833 PMCID: PMC10475596 DOI: 10.3389/fpubh.2023.1247684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023] Open
Abstract
The demand for informal caregivers to support the older adults has grown worldwide in recent decades. However, informal caregivers themselves require support. This article aims to examine existing support measures for caregivers of the older adults in the Republic of Kazakhstan. Relevant articles and grey literature were identified through manual searches on Google and Google Scholar, as well as electronic searches using indexed databases like PubMed, Web of Science, and Scopus. Moreover, the reference lists of identified sources and government ministry websites were meticulously scrutinized. This review highlights the scarcity of research on caregiver support measures in Kazakhstan, supported by the lack of peer-reviewed articles on this subject. A comprehensive analysis of the literature shows that in Kazakhstan's legislative framework, "caregivers" exclusively refers to individuals providing care for a first-degree disability. The responsibility of caring for older adults parents lies with able-bodied children. However, there is a lack of registration and assessment procedures to evaluate the burden and quality of life of caregivers. As a result, the medical and social support provided to caregivers is standardized, failing to adequately address their unique needs and requirements. The analysis of current support measures for informal caregivers highlights the need to develop support mechanisms and recognize individuals providing informal care as key figures in the long-term care system.
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Affiliation(s)
- Aliya Zhylkybekova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Andrey Turlayev
- Department of Law, Buketov Karaganda University, Karaganda, Kazakhstan
| | - Andrej M. Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
- Department of Health Policy and Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Gulbakit K. Koshmaganbetova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Zong X, Ingoglia S, Lo Coco A, Tan JP, Inguglia C, Liga F, Cheah CSL. Evaluating the filial behaviour scale across three cultural groups using exploratory structural equation modelling. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2023; 58:42-51. [PMID: 36181306 DOI: 10.1002/ijop.12880] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 09/06/2022] [Indexed: 01/11/2023]
Abstract
Filial piety is a Confucian concept that guides how children treat and take care of their parents. The Filial Behaviour Scale (FBS) is a 25-item instrument developed in the Chinese context measuring behavioural manifestations of filial piety. Although the components of filial piety have been found to be relevant across cultures, little research has investigated the psychometric properties of the FBS in other cultural contexts. The present study evaluated the factor structure, internal consistency, measurement invariance and construct validity of the FBS across three cultural groups: the United States, Italy and Malaysia. Participants were 1090 emerging adults (67% females; Mage = 21.29 years, SD = 1.97; White Americans: n = 455, White Italians: n = 428, Malays: n = 328). A two-factor structure emerged across groups: Obedience/Obligation (behaviours showing obedience and obligation towards parents) and Relationship (behaviours expressing affection and promoting positive parent-child relationships). The two factors demonstrated adequate internal consistency, full configural, partial metric and partial scalar invariance, as well as unique associations with depressive symptoms and parent-child relationships across groups. These findings yielded a more nuanced understanding of filial behaviour and supported the utility of a two-factor FBS among emerging adults in various cultural contexts.
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Affiliation(s)
- Xiaoli Zong
- Department of Psychology, University of Maryland, Baltimore County, MD, USA
| | - Sonia Ingoglia
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Alida Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Jo-Pei Tan
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - Cristiano Inguglia
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Francesca Liga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Charissa S L Cheah
- Department of Psychology, University of Maryland, Baltimore County, MD, USA
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Yeh KH. Constructing Indigenous Psychological Theories From A Global Perspective: Taking Filial Piety Model As An Example. REVIEW OF GENERAL PSYCHOLOGY 2023. [DOI: 10.1177/10892680231152191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Most nonwestern researchers regard the field of indigenous psychology as an intellectual movement across the globe to resist the hegemony of Western psychology in representation of the human mind, and in investigations of local mentality. Other than avoiding the hegemony of Western psychology, scholars may still wonder why they need to construct indigenous theories or conduct indigenous research. The answer usually is that existing theories and constructs (especially Western mainstream ones) cannot explain or clarify the local phenomena that they observe or want to talk about. They have to find a new way to describe the local phenomenon they want to describe. An indigenous (new) theory or construct is the solution; the local phenomenon is the basis of reality and needs to be explored and clarified, rather than applying existing theories and constructs. There are several ways to construct indigenous theories or conduct indigenous research. One of the most common ways is the emic approach. However, this paper wants to go a step further to distinguish two different approaches: reflective emic and reflexive etic approach. This paper elaborates on application of these two approaches and advocates a multiple paradigm perspective for constructing an indigenous psychological theory from a global perspective.
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Affiliation(s)
- Kuang-Hui Yeh
- Institute of Ethnology, Academia Sinica & Department of Psychology, National Taiwan University, Taipei, Taiwan
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Chou S, Han C, Ouyang JX, Yan Li AS. East Asian Population. Child Adolesc Psychiatr Clin N Am 2022; 31:745-763. [PMID: 36182222 DOI: 10.1016/j.chc.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This article explores the ways East Asian American (EAA) children and adolescents have experienced disparities in the United States throughout the COVID-19 pandemic. The history of racism toward Asian American and Pacific Islanders (AAPI) and the complexities of acculturation are reflected through this contemporary lens. Traditional East Asian (EA) values were disrupted during this period. Implications for children and families are discussed. Persistent underlying xenophobia and racism, such as the model minority myth or perpetual foreigner stereotype, rose to new prominence, furthering emotional distress in EA and EAA youths beyond those already experienced universally by AAPI families during the pandemic.
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Affiliation(s)
- Shinnyi Chou
- University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Crystal Han
- University of Maryland Medical Center, 701 West Pratt Street, Baltimore, MD 21201, USA
| | - Jessica Xiaoxi Ouyang
- Georgetown University School of Medicine, MedStar Georgetown University Hospital, 2115 Wisconsin Avenue Northeast, Suite 200, Washington, DC 20002, USA
| | - Annie Sze Yan Li
- NYU Grossman School of Medicine, NYU Langone Health, NYC Health + Hospital-Bellevue Medical Center, NYU Child Study Center, One Park Avenue, 7th Floor, New York, NY 10016, USA
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