Fei Sun

Arizona State University, Phoenix, Arizona, United States

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Publications (25)29.58 Total impact

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    ABSTRACT: Objective: This study examined knowledge of Alzheimer's disease (AD) and correlates of AD knowledge in a sample of Chinese American older adults living in the Phoenix metropolitan area of the United States. Methods: Survey data were collected from 385 Chinese Americans age 55 or older (M = 72.43, SD = 8.67) recruited from various settings not limited to senior housing facilities, senior clubs, senior centers and church groups. Results: Participants responded to a 24-item true/false AD knowledge scale with 73 % accuracy. Multivariate regression analyses found that participants who held more traditional Chinese cultural beliefs of AD tended to have less AD knowledge. Older women had more knowledge of AD than men when educational differences were controlled. Participants who used media to acquire AD information had more AD knowledge than those did not. Conclusions: AD educational programs should target domains (e.g., risk factors, symptoms, and caregiving) about which Chinese American elders tend to have less knowledge; AD information should be disseminated through appropriate media to outreach Chinese American elders more effectively. Addressing the biases in elders' cultural beliefs of AD should be incorporated in AD educational programs.
    Journal of Cross-Cultural Gerontology 04/2014;
  • Fei Sun, David R Hodge
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    ABSTRACT: This study used stress coping theory to examine the effects of spirituality and religion on depression among a sample of Latino family members caring for a person with Alzheimer's disease (AD) in the United States. Participants consisted of 209 Latino caregivers (CGs) drawn from baseline data from the Resource for Enhancing Alzheimer's Caregivers Health (REACH) II clinical trial. The findings indicate that church attendance moderates the relationship between subjective forms of stress and depression in tandem with exhibiting direct effects on depression. Consistent with the central role religion plays in Latino culture, the results imply that religious involvement may play an important role in mitigating depression through indirect and direct pathways.
    Journal of applied gerontology : the official journal of the Southern Gerontological Society. 04/2014; 33(3):291-315.
  • Jana Wardian, Fei Sun
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    ABSTRACT: As 7.8% of the U.S. population is affected by diabetes, health care providers are tasked with providing resources to assist patients toward self-management. Psychosocial issues have an effect on diabetes self-care. Diabetes-related distress is associated with self-management and lower A1C. This cross-sectional study seeks to understand how demographic factors, psychological orientations, support, and diabetes management behaviors predict diabetes-related distress. This study uses data from 267 adults with Type 2 diabetes. The Diabetes Distress Scale (DDS) is a 17-item scale measuring diabetes-related distress including emotional distress, physician-related distress, regimen distress, and interpersonal distress. Hierarchical regression was conducted in four stages. The final model explains 48% of the variance in DDS. Significant factors related to lower DDS were older age, lower body mass index, higher self-efficacy, higher levels of health care provider support, and a healthy diet. Findings of this study help health care providers know where to focus to reduce diabetes-related distress. Health care provider support is significant in reducing DDS. Diabetes education may want to include strategies that increase self-efficacy and assist people with diabetes to obtain a healthy weight through a more healthful diet.
    Social Work in Health Care 04/2014; 53(4):364-81. · 0.62 Impact Factor
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    ABSTRACT: A paucity of research has examined the relationship between addressing the spiritual needs of hospitalized Asians and their overall satisfaction with service provision. This study examined this relationship, in tandem with the effects of eight potential mediators, to develop a model of spiritual care for older hospitalized Asians. Structural equation modeling was used with a national sample of Asians (N = 805), age 50 and above, who were consecutively discharged from hospitals over a 12-month period. The relationship between spiritual needs and satisfaction was fully mediated by five variables: nurses, physicians, the discharge process, visitors, and the admissions process. As the first study to develop and test a model of spiritual care for older hospitalized Asians, the findings provide practitioners with the information to target their efforts on the most important organizational areas that facilitate more effective, culturally relevant service delivery to members of this population.
    Journal of Aging and Health 01/2014; · 1.56 Impact Factor
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    ABSTRACT: This study focuses on the identification of multiple latent trajectories of pain intensity, and it examines how religiousness is related to different classes of pain trajectory. Participants were 720 community-dwelling older adults who were interviewed at four time points over a 3-year period. Overall, intensity of pain decreased over 3 years. Analysis using latent growth mixture modeling (GMM) identified three classes of pain: (1) increasing (n = 47); (2) consistently unchanging (n = 292); and (3) decreasing (n = 381). Higher levels of intrinsic religiousness (IR) at baseline were associated with higher levels of pain at baseline, although it attenuated the slope of pain trajectories in the increasing pain group. Higher service attendance at baseline was associated with a higher probability of being in the decreasing pain group. The increasing pain group and the consistently unchanging group reported more negative physical and mental health outcomes than the decreasing pain group.
    Research on Aging 11/2013; 35(6). · 1.23 Impact Factor
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    ABSTRACT: The purpose of this study was to develop empirically based typologies of religiousness/spirituality (R/S) and to determine whether the typologies were related to health and well-being. The study used a nationally representative sample of adults (N = 1,431). Using latent profile analysis, typologies were derived based on religious service attendance, prayer, positive religious coping, and daily spiritual experiences. Multivariate statistical tests were used to examine cluster differences in health and well-being. A four-class model was identified: highly religious, moderately religious, somewhat religious, and minimally religious or non-religious. The four classes were distinctively different in psychological well-being, in that the highly religious class was most likely to be happy and satisfied with finances and least likely to be psychologically distressed.
    Journal of Religion and Health 09/2013; 52(3):828-839. · 1.02 Impact Factor
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    ABSTRACT: PURPOSE: Literature on institutionalization of patients with dementia has not considered the role of caregivers' quality of care, which encompasses caregivers' exemplary care (EC) behaviors and caregivers' potentially harmful behaviors (PHBs) toward care recipients. This study sought to understand the role of quality of care in mediating between caregiving stressors and caregiver desire to institutionalize (DTI) a patient with dementia. DESIGN AND METHODS: A sample of 612 family caregivers from diverse racial/ethnic backgrounds was drawn from the baseline data of the Resources for Enhancing Alzheimer's Caregiver Heath (REACH II) project. Multiple mediator models were run using Preacher and Hayes asymptotic and resampling strategies to assess direct and indirect effects of caregiver stressors (daily care bother, behavioral bother, and burden) on caregiver desire to institutionalize a patient with dementia. RESULTS: Overall, PHB was positively related to caregiver desire to institutionalize their care recipients. Specifically, PHB was found to mediate the relationship between caregiving stressors and DTI in the Caucasian and Latino groups, whereas only the mediation effect of EC was significant in the African American group. IMPLICATIONS: Caregivers' perceptions of quality of care helped explain their desire to institutionalize their care recipients with dementia. Including assessment of EC and PHB in clinical and social service settings is recommended for all ethnic groups. Interventions should facilitate EC behaviors among African American caregivers and address concerns of PHBs in Caucasian and Latino caregivers.
    The Gerontologist 09/2012; · 2.48 Impact Factor
  • David R Hodge, Fei Sun
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    ABSTRACT: This study used structural equation modeling to examine the effects of spirituality on positive aspects of caregiving (PAC) among a sample of American Latino family members caring for a relative with Alzheimer's disease (AD). Participants consisted of 209 Latino caregivers (CGs) drawn from baseline data from the Resources for Enhancing Alzheimer's Caregivers Health II study. The findings indicate that spirituality is positively related to PAC and may partially mediate the effect of subjective stress on PAC. AD CGs typically provide better care when they perceive the caregiving experience to be satisfying and rewarding. Toward this end, gerontological practitioners should adopt a proactive stance to ensure Latino AD CGs can operationalize their spiritual strengths.
    Aging and Mental Health 04/2012; 16(6):689-98. · 1.68 Impact Factor
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    ABSTRACT: Given world aging, social workers will be involved in assisting older persons in their home-country and/or abroad in various types of governmental or nongovernmental agencies. This paper identifies potential opportunities for social workers with gerontological backgrounds interested in working in international and cross-cultural settings. Discussed are the role of social work education in assisting the development of student interest and competence in working with and for older persons in an aging world. Also discussed are international opportunities in field placements for work with older people.
    Educational Gerontology 03/2012; 38(3):166-178. · 0.39 Impact Factor
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    ABSTRACT: This study examined the effects of religiosity on the trajectories of depressive symptoms in a sample of community-dwelling older adults over a four-year period in a Southern state in the U.S. Data from the University of Alabama at Birmingham (UAB) Study of Aging were analyzed using a hierarchical linear modeling (HLM) method. This study involved 1000 participants aged 65 and above (M age = 75 at baseline, SD = 5.97) and data were collected annually from 1999 to 2003. The Geriatric Depression Scale measured depressive symptoms; the Duke University Religion Index measured religious service attendance, prayer, and intrinsic religiosity; and control variables included sociodemographics, health, and social and economic factors. The HLM analysis indicated a curvilinear trajectory of depressive symptoms over time. At baseline, participants who attended religious services more frequently tended to report fewer depressive symptoms. Participants with the highest levels of intrinsic religiosity at baseline experienced a steady decline in the number of depressive symptoms over the four-year period, while those with lower levels of intrinsic religiosity experienced a short-term decline followed by an increase in the number of depressive symptoms. In addition to facilitating access to health, social support and financial resources for older adults, service professionals might consider culturally appropriate, patient-centered interventions that boost the salutary effects of intrinsic religiosity on depressive symptoms.
    Aging and Mental Health 03/2012; 16(2):189-98. · 1.68 Impact Factor
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    ABSTRACT: The purpose of this article is to pinpoint the cultural and ethnic influences on dementia caregiving in Chinese American families through a systemic review and analysis of published research findings. Eighteen publications on Chinese American dementia family caregivers published in peer-reviewed journals between 1990 and early 2011 were identified. Based on a systematic database search and review process, we found that caregivers' beliefs concerning dementia and the concept of family harmony as evidenced through the practice of filial piety are permeating cultural values, which together affect attitudes toward research and help-seeking behaviors (ie, seeking information on diagnosis and using formal services). There is also evidence to suggest that these cultural beliefs impinge on key elements of the caregiving process, including caregivers' appraisal of stress, coping strategies, and informal and formal support. The study concludes with recommendations for future research and practice with the Chinese American population.
    American Journal of Alzheimer s Disease and Other Dementias 02/2012; 27(1):13-22. · 1.52 Impact Factor
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    ABSTRACT: After years in Nepali refugee camps, over 100,000 Bhutanese refugees are being resettled around the world by the United Nations High Commissioner for Refugees (UNHCR). This study examines the relationship between religious coping and acculturation stress among newly-resettled Hindu Bhutanese refugees in the United States (US), the projected home of most Bhutanese refugees.
    International Social Work 01/2012; 55(4):538-553. · 0.48 Impact Factor
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    ABSTRACT: We studied the coping styles by which family caregivers living in rural areas of Alabama deal with the demands of caring for an older relative with dementia. Data were obtained from a sample of 141 caregivers through the random-digit dialing telephone survey. Two coping styles were identified: deliberate coping and avoidance coping. Deliberate coping was related to higher life satisfaction scores and, avoidance coping was related to lower life satisfaction scores and higher caregiver burden scores. Avoidance coping appeared to moderate the effects of caregiver health on caregiver burden. Social workers should pay greater attention to caregivers with dysfunctional coping styles.
    Journal of Gerontological Social Work 08/2010; 53(6):547-67.
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    ABSTRACT: Antisocial behavior among youth remains a serious personal and social problem in the United States. The purposes of this study were to (1) identify the shape and number of developmental trajectories of antisocial behavior in a sample of poor, inner-city African American youth, and (2) test predictors of group membership and the developmental course of antisocial behaviors. Using growth mixture modeling, we examined predictors of antisocial behavior pathways and the likelihood of arrest in a sample of 566 poor, urban African American adolescents (ages 11 to 16). Three distinct trajectory classes of antisocial behavior were identified over a period of six years: one low-risk group (low steady) and two high-risk groups (incremental and high starter). The conditional probabilities for being arrested during ages 14-16 were 0.18 for the low steady class, 0.68 for the incremental class, and 0.31 for high starter class. Prevention strategies for adolescents at high risk are discussed.
    Children and Youth Services Review 03/2010; 32(3):409-415. · 1.27 Impact Factor
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    ABSTRACT: The purpose of this study was to understand self-reported transportation difficulty among rural older adults. We used data from the UAB Study of Aging (255 Black and 259 White), community-dwelling participants residing in rural areas. We examined the relationship of predisposing characteristics, enabling resources, and measures of need for care with self-reports of transportation difficulty. Blacks reported having more transportation difficulty than Whites (24.7% vs. 11.6%; p ≤ .05). When we introduced other variables, race differences disappeared, but there was a race by income interaction with transportation difficulty. Whites with lower incomes were more likely to have transportation difficulty than Whites with higher incomes. When data from Blacks and Whites were analyzed separately, income was the only variable associated with transportation difficulty among Whites. Among Blacks, income was not related to transportation difficulty but several variables other than income (age, gender, marital status, MMSE scores and depression) were.
    Journal of Applied Gerontology 02/2010; 29(1):70-88. · 0.97 Impact Factor
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    ABSTRACT: This study explores whether religiosity explains racial differences in caregiving burden for a rural sample of dementia family caregivers. Data are from a probability sample of 74 non-Hispanic White and 67 African American dementia caregivers in rural Alabama. SPSS macros for estimating indirect effects in multiple mediator models are used to test the mediation effects of religiosity. White caregivers report higher burden, are less likely to use religious coping, and less likely to engage in organized religion than do African American caregivers. Church attendance is found to significantly (B = —.57, p < .05) mediate the racial differences on caregiving burden (R2 = .07). Religious involvement in general, and church attendance in particular, seem to provide both spiritual and social psychological benefits to dementia caregivers. Thus, supplementing formal services with the services provided by religious organizations may be important in rural areas where formal resources are scarce.
    Journal of Applied Gerontology 01/2010; 29(3):290-307. · 0.97 Impact Factor
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    ABSTRACT: It is the purpose of this paper to provide an overview of the problems faced by rural men and the challenges faced by those mental health professionals seeking to prevent and intervene in the mental health problems of rural men. To be discussed is the fact that men, in general, and rural men, in particular, are greatly affected by their gender role socialization which influences both their life styles and their attitudes and behavior in seeking needed mental health assistance. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
    Journal of Rural Mental Health. 01/2010; 34(1):5.
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    ABSTRACT: The paper explores the longitudinal changes of emotional well‐being of Chinese oldest old adults (80 years or older) and discloses significant factors that influence the trajectories, with a focus on the differences between those residing in rural and urban settings. Data were derived from three waves (1998, 2000, and 2002) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which was carried out in 22 of the 31 provinces in China. We used hierarchical linear modelling to examine how the well‐being of 2490 older adults changed over the three waves of the survey. Results indicate that urban residence and greater involvement in social activities predicted an increase in well‐being over time. Participants with lower cognitive functioning and poorer self‐rated health at baseline tended to show improvements in well‐being over time. Rural oldest old adults were found to report decreases in well‐being, in contrast to an increasing trend found for urban oldest old adults. This finding lends itself to an important conclusion that more social services or formal support should be provided for older adults in rural areas in China.本文探讨了中国的老年人((80岁或以上))跨时间的情绪变化,并揭示当中具有影响力的重要因素,尤其是农村和城市之间的差异。数据主要来自三次((1998年,2000年和2002年))对中国22个省份进行的中国高龄老人健康长寿基础调查((CLHLS)。作者用了分层线性模型去研究2490名老年人在三次调查之间的情绪变化。结果发现,居住在城市和积极参与小区活动对老人的情绪有正面的影响。认知功能较低和对自我健康评分较低的研究对象往往随时间的推移表现出有所改善。报告发现农村的老年人认为幸福的愈来愈少,相反,在城市的老年人中则有上升的趋势。这一发现本身的一个重要结论就是应该为中国农村地区的老年人提供更多的社会服务。
    China Journal of Social Work 04/2009; 2(1):20-33.
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    ABSTRACT: The authors examined perceived income inadequacy as a predictor of self-reported depressive symptomatology and anxiety in the original sites of the Resources for Enhancing Alzheimer's Caregiver Health I project. Perceived income inadequacy, self-reported household income, and control factors (e.g., subjective health) were entered into hierarchical regression analyses predicting psychological distress. Findings suggest that perceived income inadequacy and not household income significantly predicted more self-reported depressive symptomatology and greater self-reported anxiety. This supports previous findings that objective income measures alone are not adequate indicators of socioeconomic status in older adults.
    Psychology and Aging 04/2009; 24(1):177-83. · 2.73 Impact Factor
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    ABSTRACT: The primary aim of this study was to test the stress process model (SPM; Pearlin, Mullan, Semple, & Skaff, 1990) in a racially diverse sample of Alzheimer's caregivers (CGs) using structural equation modeling (SEM) and regression techniques. A secondary aim was to examine race or ethnicity as a moderator of the relation between latent constructs (e.g., subjective stressors and role strain) in the SPM. Participants included White or Caucasian (n = 212), Black or African American (n = 201), and Hispanic or Latino (n = 196) Alzheimer's CGs from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) II clinical trial. SEM revealed that the Pearlin model obtains a satisfactory fit across race or ethnicity in the REACH II data, despite significant racial differences in each of the latent constructs. Race or ethnicity moderated the impact of resources on intrapsychic strain, such that CGs reported similar intrapsychic strain across race at lower levels of resources, but White or Caucasian CGs reported more intrapsychic strain than Black or African American or Hispanic or Latino CGs when resources are higher. Strengths and weaknesses for each race or ethnicity vary considerably, suggesting that interventions must target different aspects of the stress process to provide optimal benefit for individuals of different cultural or ethnic backgrounds.
    The Gerontologist 04/2009; 49(2):248-61. · 2.48 Impact Factor