Fei Sun

Arizona State University, Phoenix, Arizona, United States

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Publications (34)31.51 Total impact

  • Jana Wardian, Fei Sun
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    ABSTRACT: The purpose of this study is to understand changes in thinking in patients with diabetes and factors related to the health care providers and significant others that would mediate changes in thinking. Cross-sectional data were collected from three sites. Adults age 21 and older with type 2 diabetes were asked about their thinking regarding diabetes at diagnosis and the present time. In addition, respondents were asked questions about their perceptions of health care providers (that is, physicians, nurses, diabetes educators), significant others, and manage- ment of diabetes. Significant other blame and self-efficacy were found to be partial mediators in thinking about diabetes; the model explained 29 percent of the variance. Social workers are uniquely trained in the person-in-environment framework, which allows flexibility in creating interventions to provide patients with diabetes the support necessary to have a more positive orientation toward diabetes self-management, increase self-efficacy, and reduce feelings of blame from significant others. Improving the support of significant others and the patients' level of self-efficacy can provide mediation of negative thinking, which may result in an environment that supports improved diabetes self-management behaviors.
    Social work 04/2015; 60(2):175-82. DOI:10.1093/sw/swv001 · 1.15 Impact Factor
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    Clinical Gerontologist 06/2014; 37(4):386-405. DOI:10.1080/07317115.2014.907593 · 0.66 Impact Factor
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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; DOI:10.1007/s10823-014-9229-6
  • 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. DOI:10.1080/00981389.2014.884038 · 0.62 Impact Factor
  • 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.
    04/2014; 33(3):291-315. DOI:10.1177/0733464812444462
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    ABSTRACT: Background and Purpose: The use of spirituality among African Americans, and older African Americans in particular, to cope with stressful situations is almost universal. Yet, in spite of the importance of spirituality to African Americans, the extant research suggests that African Americans are less likely to be asked about their spiritual needs during hospitalization, relative to European Americans. In other words, racial disparities in health care may also include disparities in the administration of spiritual care in hospitals. To assist practitioners address the spiritual needs of older African Americans, this poster reports findings from a study designed to develop and test a model of spiritual care for use in hospitals. Toward this end, the study hypothesized that 1) addressing older African Americans’ spiritual needs will be directly related to higher levels of overall satisfaction with service provision and 2) that this relationship will be mediated by satisfaction with certain dimensions of service provision (e.g., physicians, the discharge process). Methods: The study design was cross-sectional. The sample consisted of 2,227 African Americans, aged 65 and older, who were consecutively discharged over a 12 month period from hospitals across the United States. Approximately 61 percent (n = 1,357) of respondents were female. De-identified hospital inpatient satisfaction data were supplied by Press Ganey, the largest healthcare organization in the nation specializing in the measurement of patient satisfaction. Surveys are administered to former inpatients soon after discharge in the privacy of their homes. Cronbach’s alphas across measures were acceptable (α = ranged from .78 to .94). After imputing missing data with the EM (Expectation-Maximization) algorithm procedure, and transforming variables to improve their normality, structural equation modeling (SEM) was used to test the study hypotheses. Results: Consistent with the study’s first hypothesis—addressing older African Americans spiritual needs was associated with higher levels of overall satisfaction with service provision. The model fit the data well [χ2 = 85.840 (df = 12, p > .001), CFI = .990, RMSEA = .053 (90% CI, .042 - .063), and SRMR = .012]. Spiritual needs accounted for 32% of the variance in overall satisfaction. Consistent with the study’s second hypothesis, the relationship between spiritual needs and overall satisfaction was fully mediated by five variables. The resulting model fit the data well [χ2 = 2048.115 (df = 346, p < .001), CFI = .967, RMSEA = .047 (90% CI, .045 - .049), and SRMR = .023] and accounted for 72% of the variance in overall satisfaction. In declining order of magnitude these mediators were satisfaction with: nursing staff, the discharge process, physicians, visitors, and room quality. Conclusions and Implications: The results shed light on the variables that may help reduce disparities in the administration of spiritual care among hospitalized African Americans. Specifically, the results underscore the importance of nursing staff, the discharge process, physicians, visitors, and room quality in addressing African Americans’ spiritual needs. By focusing on these variables, it may be possible to provide more effective, culturally relevant services to older African Americans.
    The Society for Social Work and Research 2014 Annual Conference; 01/2014
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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; 26(3). DOI:10.1177/0898264313516995 · 1.56 Impact Factor
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    ABSTRACT: This presentation will describe a unique community development partnership between the owners, managers, and tenants of a large urban subsidized housing property and a local university. The findings of a mixed-methods assets and needs assessment, designed and implemented by university faculty and students, provided an in-depth portrayal of the health and social status, service utilization and quality of life among a representative sampling of the subsidized housing property tenants. Archival data provided by local police and fire departments supplemented the tenant-reported high rates of 911 calls and elevated utilization of crisis and emergency services. While tenants reported good access to routine health care, they also reported elevated chronic health risks (including mental illness, cardiopulmonary disease, and diabetes), as well as social isolation and community disconnectedness. Consistent with the principles of participatory action research, tenants, property management, and community stakeholders have been engaged with the university in designing and implementing a student-staffed, faculty-supervised onsite program that provides psychosocial rehabilitation and health promotion support and services. Embedding the university within the community in this manner provides an opportunity to revitalize a sense of community among property tenants, involves the local philanthropic community in addressing the needs of an often-marginalized population, and expands service learning and research opportunities for university faculty and students.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
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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). DOI:10.1177/0164027512456402 · 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. DOI:10.1007/s10943-011-9520-6 · 1.02 Impact Factor
  • Fei Sun
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    ABSTRACT: Purpose: This study aims to identify caregiving stressors and coping strategies in a sample of family caregivers of persons with dementia living in Shanghai, China.Methods: A sample of 18 family caregivers participated in semi-structured face-to-face interviews. Information regarding caregiver appraisal of caregiving situations, difficulties with care provision, and ways of dealing with stressors were obtained. Thematic analysis was used to assess the interview data.Results: In addition to stressors directly related to caregiving demands (i.e., burden due to care recipient limitations in physical, cognitive, or behavioral functions), other salient stressors that emerged were role strains, family conflicts, and pressure from the social environment. Yet, caregivers demonstrated resilience by drawing on their coping resources from a variety of sources, including personal experience, family, technology and information, religion, and governmental support.Implications: Specific attention needs to be given to help family caregivers alleviate stress due to family conflicts and pressure from the social environment. Policy formulation and program design needs to build on caregiver strengths to support and empower Chinese families caring for relatives with dementia patients.
    Dementia 04/2013; 13(6). DOI:10.1177/1471301213485593
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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; 53(3). DOI:10.1093/geront/gns110 · 2.48 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 07/2012; 55(4):538-553. DOI:10.1177/0020872811417474 · 0.48 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. DOI:10.1080/13607863.2012.678481 · 1.78 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. DOI:10.1080/13607863.2011.602959 · 1.78 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(1-3-3):166-178. DOI:10.1080/03601277.2010.515913 · 0.39 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. DOI:10.1177/1533317512438224 · 1.43 Impact Factor
  • Fei Sun, David R. Hodge
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    ABSTRACT: Background: Caring for an Alzheimer's relative can engender physical, emotional, and psychosocial stress. More recently, an emerging body of research has began to examine the positive aspects of caregiving (PAC), which can be defined as the rewards or gains caregivers derive from the caregiving experience. Differences in caregiving appraisal and resources are posited to help account for different levels of PAC among ethnic groups. Spirituality, for example, may engender higher levels of PAC by embedding caregiving in transcendent narrative. The purpose of this study is twofold. First, to test Pearlin et al.'s stress process model in explaining PAC among Caucasian (n=220), African-American (n=211) and Latino (n=209) Alzheimer's family caregivers; and second, to identify the role of spirituality in predicting PAC for each of these groups. Methods: A secondary data analysis was performed using baseline data from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) II project (Belle et al., 2006). Latent constructs included in the model included, objective stress, subjective stress, social support, spirituality, and PAC. Demographic variables included caregiver age, gender, education, and household income. Structural equation modeling (SEM) was performed using LISREL 8.80. First, we tested the measurement model fit for each ethnic group. Second, we tested the structural model for each ethnic group controlling for the effects of demographics. We used commonly recommended cut-off values for model fit indices, namely the comparative fit index (CFI ≥ .95), the standardized root mean square residual (SRMR≤ .08), and the Root Mean Square Error of Approximation (RMSEA .05) and both a direct (B=.26, p Conclusions and Implications: This study suggests: 1) the constructs in Pearlin et al.'s model are useful in explaining PAC for Caucasian, African American, and Latino caregivers and 2) spirituality plays a positive role in facilitating PAC among Caucasian and Latino caregivers, but not among African American caregivers. Although further research is needed with African American caregivers, the results suggest that spirituality is a strength that can be utilized to help frame the caregiving experience more positively. Social work practitioners might be trained in the process of conducting spiritual assessments. Such assessments can, for example, help identify barriers that inhibit caregivers from operationalizing their spiritual strengths.
    Society for Social Work and Research Sixteenth Annual Conference Research That Makes A Difference: Advancing Practice and Shaping Public Policy; 01/2012
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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. DOI:10.1080/01634372.2010.496823
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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 06/2010; 29(3):290-307. DOI:10.1177/0733464809343205 · 0.97 Impact Factor

Publication Stats

140 Citations
31.51 Total Impact Points

Institutions

  • 2008–2014
    • Arizona State University
      • School of Social Work
      Phoenix, Arizona, United States
  • 2007–2010
    • University of Alabama
      • Center for Mental Health and Aging
      Tuscaloosa, Alabama, United States