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A Qualitative Study of Filial Piety Among Community Dwelling, Chinese, Older Adults: Changing Meaning and Impact on Health and Well-Being

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Abstract

This study investigates the construct of filial piety and its impact on the health and well-being of U.S. Chinese older adults. Based on semistructured interview data with 39 community-dwelling, Chinese older adults in Chicago's Chinatown, this community-based participatory research study suggests existing disconnections between older adults' conceptualizations of filial piety and the receipt of filial care. Our data suggest older adults mitigate tension by prioritizing immigrant families' socioeconomic mobility. However, filial care discrepancy may be detrimental to their health and well-being. This study has implications for the provision of culturally appropriate health care services.

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... The present study found an even larger proportion of Chinese older adults who identified kin-centered networks (95%). Kin relationships often are the source most likely to provide unconditional support during health crises [23] . Besides the needs of reaching out to kin members during health crises, what is more consequential for Chinese older adults may be the cultural indoctrination of family-oriented filial piety values. ...
... Besides the needs of reaching out to kin members during health crises, what is more consequential for Chinese older adults may be the cultural indoctrination of family-oriented filial piety values. Family cohesiveness remains a deeply valued social norm for Chinese older adults, both in China and overseas, expressed in the form of high filial expectations of adult children [23] in addition to serving as a robust protective factor against psychological distress [24] . Previous social network analyses in Hong Kong have indicated that kin-based networks can be further divided into immediate kin and distant kin, both of which are associated with older adults' subjective wellbeing [25] . ...
... Second, from focus groups and field interview experience, older adults have expressed sentiments of voluntarily reducing their expectations of adult children, fearing that they may be overburdening their immigrant adult children who may be equally challenged by the cultural and linguistic barriers in the USA [23] . Traditionally, Chinese culture prioritizes the collective welfare of the family over individual attainment. ...
Article
Background: Social network research has become central to studies of health and aging. Its results may yield public health insights that are actionable and improve the quality of life of older adults. However, little is known about the social networks of older immigrant adults, whose social relationships often develop in the context of migration, compounded by cultural and linguistic barriers. Objectives: This report aims to describe the structure, composition, and emotional components of social networks in the Chinese aging population of the USA, and to explore ways in which their social networks may be critical to their health decision-making. Methods: Our data come from the PINE study, a population-based epidemiological study of community-dwelling older Chinese American adults, aged 60 years and above, in the greater Chicago area. We conducted individual interviews in participants' homes from 2011 until 2013. Based on sociodemographic and socioeconomic characteristics, this study computed descriptive statistics and trend tests for the social network measures adapted from the National Social Life, Health, and Aging Project study. Results: The findings show that older Chinese adults have a relatively small social network in comparison with their counterparts from other ethnic and racial backgrounds. Only 29.6% of the participants could name 5 close network members, and 2.2% could name 0 members. Their network composition was more heavily kin oriented (95.0%). Relationships with network members differed according to the older adults' sociodemographic and socioeconomic characteristics. Subgroup variations included the likelihood of discussing health-related issues with network members. Conclusion: This study highlights the dynamic nature of social networks in later-life Chinese immigrants. For healthcare practitioners, developing cost-effective strategies that can mobilize social network support remains a critical undertaking in health intervention. Longitudinal studies are needed to examine the causal impact of social networks on various domains of health.
... Yet, modernization and industrialization in recent years may change the cultural values of younger generations and erode the practice of filial piety in Chinese societies. In addition, changes in the expectation and receipt of filial piety are likely to take place in the context of immigration (14). A prior qualitative study found that Chinese immigrant older adults have shifted their expectations of filial piety away from children and towards friends and neighbors (15). ...
... A prior qualitative study found that Chinese immigrant older adults have shifted their expectations of filial piety away from children and towards friends and neighbors (15). Another qualitative study found that U.S. Chinese older adults' expectations of filial piety were different from what they actually received, which may affect their wellbeing (14). However, our understanding of the expectations and receipt of filial piety among U.S. older adults are mainly based on qualitative analyses. ...
... Internal consistency reliability was 0.88 for the filial piety measures in our study sample. Filial piety receipts were divided into three groups based on the score: low receipts (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), medium receipts (21)(22)(23)(24), and high receipts (25)(26)(27)(28)(29)(30). ...
Article
Background: Suicidal ideation is a public health issue that has a significant impact at the individual, family, community, and societal levels. This study aimed to examine the association between filial piety and suicidal ideation among U.S. Chinese older adults. Methods: Guided by a community-based participatory research approach, 3,159 community-dwelling Chinese older adults in the Greater Chicago area were interviewed in person between 2011 and 2013. Independent variables were expectations and receipt of filial piety from the older adult's perspective. Dependent variables were suicidal ideation in the last 2 weeks and last 12 months. Logistic regression analyses were performed. Results: Of the 3,159 participants interviewed, 58.9% were female and the mean age was 72.8 years. After adjusting for age, sex, education, income, medical comorbidities, and depressive symptoms, lower receipt of filial piety was associated with increased risk for 2-week suicidal ideation (odds ratio: 1.07, 95% confidence interval: 1.03-1.11) and 12-month suicidal ideation (odds ratio: 1.07, 95% confidence interval: 1.04-1.11). The lowest tertiles of filial piety receipt was associated with greater risk for 2-week suicidal ideation (odds ratio: 1.95, 95% confidence interval: 1.12-3.38) and 12-month suicidal ideation (odds ratio: 2.17, 95% confidence interval: 1.35-3.48). However, no statistically significant associations were found between overall filial piety expectations and suicidal ideation in the last 2 weeks or in the last 12 months. Discussion: This study suggests that filial piety receipt is an important risk factor for suicidal ideation among U.S. Chinese older adults. Future longitudinal studies are needed to quantify the temporal association between filial piety and suicidal ideation.
... However, recent studies suggested that traditional Confucian filial piety may be undergoing modification, perhaps erosion, implying ongoing changes in inter-generational relations in this modernizing Asian society [10]. A qualitative study noted that there are existing disconnections between older adults' conceptualizations of filial piety and the receipt of filial care in U.S. Chinese community [11]. What the older adults are expecting in contemporary society might be different from what their adult children would like to offer. ...
... Because of cultural and linguistic barriers, acculturation, and social isolation, Chinese older immigrants are found having a higher risk of neglect and elder abuse [26][27][28][29]. Meanwhile, they expected overall high level of filial piety, especially respect from their children [11,[30][31][32][33]. For their children, caregiving is challenging when they struggle among unfamiliar systems of elder support and try to balance back and forth between western and eastern values. ...
... It is daunting for Chinese younger generation to support the elder population along with China's developing economy and its fragmented old-age support system [34]. In order to meet the challenges, and mitigate conflicts between westernization and traditional values expected from the older generation [11,[35][36][37][38], we need national and international studies for in-depth information of the concept and perception of filial piety. The purpose of this systematic review is to enhance our understanding of the epidemiology of filial piety from the perspectives of adult children among global Chinese populations. ...
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Objective: This review aims to explore the perception of filial piety among the global Chinese adult children with respect to its endorsement level, risk factors and consequences as well as the perceptions of filial piety. Methods:Theauthor searchedthegloballiteratureinPubMed,EBSCO, JSTOR, ProQuest and PsycINFO. Search terms included adult children/ young/ student ANDfilial piety/ Xiao/ filial obligations/ respect/ attitudes/ beliefs/ practice/ behaviors AND Chinese/ Taiwan/ Hong Kong/ ChineseAmerican/ Chinese Immigrants. The author excluded studies that existed only as abstracts, case series, or case reports and non-English publications. Results: Evidence revealed that filial piety is common among the global Chinese adult children. Being only-child, married, with older age, higher education level, and more income are associated with higher endorsement of filial piety and more filial practice.Mixed findings are found regarding gender, grade, living arrangements, place of origin as risk factors of filial piety.Theadverseoutcomesoffilialpiety included caregiving stress, worse self-rated health, and role strain. Beneficial outcomes were found such as healthier family functioning, higher academic achievement, and less caregiving burden. Conclusion: Filial piety is commonly endorsed among the global Chinese adult children. This review highlighted important knowledge gaps, such as a lack of standardized assessing instruments, insufficient longitudinal research in regards to risk factors, consequences of endorsing filial piety, intervention and education programs unified and coordinated efforts at global level should continue to be promoted in understanding and encouraging the value of filial piety.
... 24 Focus groups soliciting Chinese immigrant women's opinions about women's health and experiences with medical care in the United States were conducted as part of formative work for a parent study, an intervention implementation study of cancer patient navigation among adult women (age 21+) residing in Chicago's Chinatown. Guided by our previous work and the existing body of literature on factors influencing Chinese and other minority and immigrant women's health practices, 23,25,26 we constructed focus group questions to elicit women's attitudes and beliefs about involvement of their immediate family members (i.e., spouse, children) in women's health and healthcare, as rooted in cultural beliefs, values, and life experiences. 27 Questions were translated into Chinese and arranged in three topic areas within the semi-structured moderator's guide: (1) perceived family members' (spouse and children's) involvement in medical care and health; (2) perceived family members' opinions on health-related matters; and (3) women's preferences and perceived constraints to family involvement. ...
... Unlike more rigid notions of filial piety, whereby adult children must provide care for elderly parents or else cause shame, 31 our findings suggest that Chinese immigrant women accepted that adult children offered what available support they could. Much of the literature attributed decline in filial piety to migration and exposure to Western values, 13,25 our findings also speak of systemic issues regarding financial hardship, work environments, and economic policies that limit time and resources for caregiving. We found that one aspect of filial piety-emotional support-was largely missing, and only mentioned in the context of serious illness. ...
... We found that one aspect of filial piety-emotional support-was largely missing, and only mentioned in the context of serious illness. Prior studies suggest that emotional support may be more important than instrumental (e.g., financial and practical) support, 25,32 so perceived dearth of emotional support may have troubling implications. ...
Article
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Purpose: Healthcare utilization and health-seeking behaviors of Chinese American immigrant women may be influenced by longstanding cultural perspectives of family roles and relationships. An understanding of Chinese immigrant women's perceptions of family social support in health and how these beliefs manifest in healthcare utilization and help-seeking behaviors is critical to the development of culturally appropriate health interventions. Focusing on a sample of Chinese women in Chicago's Chinatown, this qualitative study seeks to describe women's attitudes and beliefs about spouse and adult children's involvement in women's health and healthcare. Methods: We conducted six focus groups among 56 Chinese-speaking adult women in Chicago's Chinatown between July and August 2014. Focus groups were transcribed, coded, and analyzed for emergent themes. Results: Women reported that their adult children supported their health and healthcare utilization by helping them overcome language and transportation barriers, making and supporting decisions, and providing informational and instrumental support related to diet and nutrition. Women viewed these supports with mixed expectations of filial piety, alongside preferences to limit dependency and help-seeking because of concern and emotional distress regarding burdening adult children. Women's expectations of the spouse involvement in their healthcare were low and were shaped by avoidance of family conflict. Conclusion: Findings inform opportunities for the development of culturally appropriate interventions to enhance Chinese immigrant women's health and healthcare. These include patient navigation/community health worker programs to promote self-management of healthcare and family-centered strategies for enhancing family social support structures and reducing family conflict.
... Family relations comprise a large proportion of social networks of older Chinese immigrants (Dong and Chang, 2017). Filial piety is deeply valued in Eastern culture (Lo and Russell, 2007), and adult children generally have responsibilities outside the home and they frequently play core roles in providing informal care to their parents, including financial, instrumental and emotional support (Wong et al., 2005;Wu et al., 2011;Dong et al., 2012b). Five articles critically explored family relationships among older Chinese immigrants (Pei-Chia, 2002;Wong et al. 2006;Lo and Russell, 2007;Dong et al. 2012b;Lin et al., 2017). ...
... Filial piety is deeply valued in Eastern culture (Lo and Russell, 2007), and adult children generally have responsibilities outside the home and they frequently play core roles in providing informal care to their parents, including financial, instrumental and emotional support (Wong et al., 2005;Wu et al., 2011;Dong et al., 2012b). Five articles critically explored family relationships among older Chinese immigrants (Pei-Chia, 2002;Wong et al. 2006;Lo and Russell, 2007;Dong et al. 2012b;Lin et al., 2017). The most frequently cited reasons for the migration of older Chinese people include family and domestic responsibilities, such as taking care of grandchildren and assisting in household work (Da and Garcia, 2015). ...
... As a result, older Chinese immigrants are more likely to want to live independently, since they are reluctant to live in someone else's home (Wong et al., 2007;Da and Garcia, 2015). This lack of satisfying intergenerational relationships is the main factor influencing the wellbeing of older immigrants (Dong et al., 2012b;Luo and Menec, 2018). ...
Article
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Neighbourhood environment has a significant impact on the health and wellbeing of older people. In recent years, the increase in older Chinese immigrants globally has attracted a growing amount of research which has investigated the health and wellbeing of these elderly residents. The aim of this study is to provide a systematic literature review of empirical findings on the health and wellbeing of older Chinese immigrants and the ways in which the neighbourhood environment impacts them. A systematic search was conducted using online databases where 52 articles met specific criteria and were subsequently reviewed critically. An inductive approach was undertaken to analyse the data extracted from the selected articles. The review was categorised according to the following themes: neighbourhood social environment, neighbourhood physical environment and place attachment. The findings show that the majority of research has investigated the health status of older immigrants, and in particular, the impacts related to the social environments in which they live. The literature review indicated that there is scope for future studies to investigate the impact of the physical neighbourhood environment on this group of people.
... Recent studies with Chinese elderly investigated whether older adults would still hold strong expectations or willingly reduce their expectations of filial behaviors from younger generation (Chong & Liu, 2016;Dong, Chang, Wong, & Simon, 2012;Luo & Zhan, 2012). A qualitative study with middle-aged and older Chinese adults in Hong Kong reported that all respondents pledge to the traditional value of filial piety, but had willingly reduced their filial expectations of their younger generation (Chong & Liu, 2016). ...
... A qualitative study with middle-aged and older Chinese adults in Hong Kong reported that all respondents pledge to the traditional value of filial piety, but had willingly reduced their filial expectations of their younger generation (Chong & Liu, 2016). Another research with Chinese older adults in Chicago reported the disconnections between older adults' perspectives of filial piety and the receipt of filial care (Dong et al., 2012). Elderly parents in rural China still highly expected their children's filial piety, even from migrated sons (Luo & Zhan, 2012). ...
Article
Changing filial piety expectations have been examined from the viewpoint of younger generations. However, research on older adults’ perspective of this cultural phenomenon is virtually absent from the empirical literature. In an effort to address the changing family life circumstances of Korean and Korean-American families, this study explores older adults’ filial expectations from their own children and correlated factors associated with the expectation. The cross-sectional survey study with 449 older adults found that the majority of respondents still believe that adult children should assume responsibility for the care of their parents. Several factors such as age, education, income, living arrangements, self-rated health, year of immigration, and social support were significantly correlated with filial expectations among older Korean-Americans. Only satisfaction with social support received from family and friends was significantly related to older Koreans’ expectations. Implications for social work practice are discussed and further research directions are suggested.
... (S. T. Wong, Yoo, & Stewart, 2006), the perceptions and impacts of filial piety discrepancy among Chinese older adults' (Dong, Chang, Wong, & Simon, 2012), and the stresses experienced by Bangladeshi immigrant women and men in living in the United States who had caregiving responsibilities for older parents living in Bangladesh (Amin & Ingman, 2014). Two additional studies explored the broader context of relationships in older age, including the social networks of Korean elderly immigrants (Yoo & Zippay, 2012) and the impacts of loneliness among a sample of Chinese older adults (Dong et al., 2012). ...
... (S. T. Wong, Yoo, & Stewart, 2006), the perceptions and impacts of filial piety discrepancy among Chinese older adults' (Dong, Chang, Wong, & Simon, 2012), and the stresses experienced by Bangladeshi immigrant women and men in living in the United States who had caregiving responsibilities for older parents living in Bangladesh (Amin & Ingman, 2014). Two additional studies explored the broader context of relationships in older age, including the social networks of Korean elderly immigrants (Yoo & Zippay, 2012) and the impacts of loneliness among a sample of Chinese older adults (Dong et al., 2012). Four articles focused on death and end-of-life issues. ...
Article
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Qualitative methods have made important contributions to Asian American psychology. To date, annual reviews of research in the Asian American Journal of Psychology have not focused on the nature and status of qualitative studies in the field. To address this gap, the present study provides a content review of 12 years of qualitative research related to Asian American psychological well-being, published between 2003 and 2014. Using PsycINFO, 487 relevant articles were identified and coded for publication journal, study sample and qualitative research method characteristics, and topical focus. The most frequently studied populations in the 12-year span were Korean and Chinese, immigrants, community adults, heterogeneous samples including women and men, and individuals living in the western and northeastern regions of the United States. Grounded theory emerged as the predominant qualitative method approach, and individual interviews were the most prevalent form of data collection. Nearly half of the reviewed studies lacked identification of a specific qualitative approach, and a similar percentage lacked a description of trustworthiness/credibility checks. The most frequently studied topic was mental health, followed by physical health. Additional topics covered in this review include self and identity, family dynamics, acculturation, interpersonal violence, aging, education, racism, religion, and work. Descriptive summaries of studies within topic areas are provided as well as a discussion of broader themes, methodological patterns, and future recommendations.
... Filial piety may be associated with perceived stress as it affects both stressors and stress coping. Children who do not perform filial duties are often deemed as the tragedy of the entire family and the misfortune of the older parents [32]. Thus, perceiving children not filial may serve as an intrinsic stressor. ...
... Second, our study distinguished the expectation and the receipt of filial piety, and assessed their associations with perceived stress separately. Our results revealed that filial piety expectation and receipt are not congruent in terms of their associations with perceived stress [32]. Further research is needed to explain the reason why only the filial piety receipt is associated with perceived stress. ...
Article
Background: Perceived stress influences the health and well-being of older adults. This study aims to examine the association between the expectation and the receipt of filial piety and perceived stress among U.S Chinese older adults. Methods: Data were drawn from the PINE study, a population-based study of Chinese older adults aged 60 and above in the greater Chicago area. Perceived stress was assessed by the PSS-10 and was the dependent variable. Independent variables were the expectation and the receipt of filial piety examined in six domains. Negative Binomial Regression and Multivariable Logistic Regression analyses were conducted. Results: Of the 3,159 Chinese older adults interviewed, the mean age was 72.8 (SD=8.3) and 58.9% were female. Compared with older adults who received a high level of filial piety, older adults who received a medium level of filial piety were 1.57 (1.29-1.93) times more likely to perceive stress as high, and older adults who received a low level of filial piety were 2.74 (2.26-3.33) times more likely to perceive stress as high, after controlling for the potential confounding variables. The expectation of filial piety was not significantly associated with perceived stress. Conclusion: A low level of filial piety receipt may be a risk factor for perceived stress. Our findings suggest incorporating cultural contributors into the analyses of perceived stress.
... Parents may refrain from asking for help because they do not want their children to be overwhelmed by the multiple demands of paid work and caregiving, and parents may only ask for help when serious health problems occur or when they think children have the ability to help (Sun, 2014a;Wong et al., 2005). Even when parents do ask for help, adult children's negative response (e.g., scolding parents for requesting money) may also discourage them from asking for help next time; instead, they may turn to neighbors and aging service professionals for help (Dong et al., 2012;Wong et al., 2005). Therefore, it is worth looking into how older immigrants mobilize support from different adult children, under what conditions do they seek help and accept help, which adult children they turn to for help and why, and what prevents them from asking for or accepting help from adult children. ...
... Many also question the feasibility of traditional family-based eldercare because they witness how adult children experience severe time pressure due to work, family, and caregiving responsibilities in midlife, along with stress about surviving, succeeding, and "fitting in" to US society as first, 1.5-or second-generation immigrants (Menjívar, 2000). Empathizing with the younger generation makes older parents believe that pushing children to provide more care would only cause family conflict and jeopardize their intergenerational intimacy with their children (Dong et al., 2012;Sun, 2014a). Last, many older immigrants also attribute the discrepancies to broader social changes, rather than specifically to their children's failure to provide care. ...
Article
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The rapid aging of the immigrant population in the United States has drawn increasing scholarly attention to studying the kinship support networks of older immigrants. Despite the common stereotype of older immigrants as passive dependents of their families and the receiving society, this review highlights their active negotiations of ties to adult children as they manage family relations and secure old‐age support. After a brief description of the demographic profiles of the older immigrant population in contemporary United States, this article shows how international migration challenges the patterns and power dynamics of two major aspects of intergenerational relationships in adulthood—intergenerational exchanges and intergenerational conflicts. By presenting the diversity and variations of intergenerational relations in aging immigrant families, the author argues that research on older immigrants' family relations holds great potentials to contribute to the literature on immigration, family, and aging studies.
... However, given the trend of older Filipinos' recent migration, there has been limited empirical evidence generated on how filial responsibilities transcend this migration phenomenon. Evidence indicates there is a need to explore culturally familial expectations, which has great relevance to both healthcare and social service delivery systems that target ageing immigrants, (Dong, Chang, Wong, & Simon, 2012;Kristiansen, Razum, Tezcan-Güntekin, & Krasnik, 2016). Therefore this study addresses the gap in knowledge related to culturally-based family living and caregiving obligations and the ways in which these might be informed by filial piety among older Filipinos immigrants within the New Zealand context. ...
... Contrary to older Chinese' experiences on filial care within a New Zealand context (Mingsheng, 2013), this cohort of older Filipinos did not consider their changing views of filial responsibility as constituting weakened ties to their adult children. However, reconfiguration of filial expectations was seen to be an expression of sacrificing traditions for a greater good, which is a consistent pattern among older immigrants' ways of mitigating family tensions by prioritising adult children's socioeconomic mobility (Dong et al., 2012). ...
Article
Background: One of the many socio-cultural issues impacting older immigrants in host countries is the cultural expectations of filial piety from their adult children. Objective: To understand older Filipino immigrants’ beliefs and cultural values towards filial expectations within a New Zealand context Design: Focused ethnography. Results: Two major themes were identified. The first theme ‘moving away from filial expectations’ drew out older Filipino's changing views of cultural expectations from their adult children in terms of considering non familial caregiving arrangements and not being a burden to their adult children. The second theme ‘maintaining cultural values through good family relationships’ highlighted the importance of acknowledging the cultural values considered to be most important by older Filipinos, which was having harmonious family relationships and avoiding conflicts with family members even if this meant moving away from the traditional and cultural norms of filial piety. Conclusion: The reconfigured expectation was salient with participants’ who identified ‘not being a burden’ to their adult children and the ardent desire to maintain positive family relationships. The findings of the study contend a newly formed culturally-oriented understanding of changing traditional views in older Filipinos Impact Statement: Nurses need to be aware of changes to our current understanding of filial piety when providing care to older Filipinos.
... A study conducted in Hong Kong also found respect was a significant predictor for depressive symptoms of older adults and financial support was the least expectation of aging parents (Cheng & Chan, 2006). The different levels of expectation on the instrumental and emotional domains of filial piety have been observed in early qualitative study among Chinese older adults in the United States (Dong, Chang, Wong, & Simon, 2012b). ...
Article
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Background: Depressive symptoms are detrimental to the overall health and well-being of older adults. This study aimed to examine the association between filial piety and depressive symptoms among U.S. Chinese older adults. Method: Data were derived from the Population Study of Chinese Elderly in Chicago (PINE), a community-engaged, population-based epidemiological study of U.S. Chinese older adults aged 60 years and above in the Greater Chicago area. The Patient Health Questionnaire-9 (PHQ-9) was adopted to measure depressive symptoms. Six domains of filial piety were evaluated, involving respect, happiness, care, greeting, obedience, and financial support. Regression analyses were performed. Results: After adjusting for age, sex, education, annual personal income, marital status, living arrangement, number of children, years in the United States, years in the community and medical comorbidities, every one point lower in filial piety expectation score was associated with increased risk of depressive symptoms (RR [rate ratio] = .96, .95-.98). And every one point lower in filial piety receipt score was associated with increased risk of depressive symptoms (RR = .94, .93-.95). Discussion: This study provides insights to research on filial piety and depressive symptoms by examining expectation and perceived receipt of filial piety. Future studies are needed to investigate the association between filial discrepancy and depressive symptoms.
... Moreover, kin-centered social networks among Chinese Americans tend to be larger and more instrumental than those of other Asian Americans (Wen, Fang, and Ma 2014). In fact, Chinese American social networks seem to be primarily kin-centered, even more so than Hispanic social networks that are well known to be kin-centered (Dong et al. 2012). Nuclear and extended family members, especially those in close neighborhood proximity, are the 'most likely sources of unconditional support in health crises' (Dong and Chang 2017, 246). ...
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Objective: Like the barrio advantage theory related to Mexican Americans, a theory about the protective effects of Chinese American enclaves is developing. Such protections were examined among socioeconomically vulnerable people with colon cancer. Design: A colon cancer cohort established in California between 1995 and 2000, and followed until the enactment of the Affordable Care Act was utilized in this study. Secondary analysis was conducted on the 5-year survival among 127 Chinese Americans and 4524 other Americans (3810 non-Hispanic white and 714 Hispanic people). A third of the original cohort was selected from high poverty neighborhoods. Chinese American enclaves were neighborhoods where typically 25% or more of the residents were Chinese Americans. Effects were tested with Cox regressions and group differences described with age and stage-standardized survival rate ratios (RR). Results: Though they were less adequately insured, Chinese American women residing in Chinese American enclaves (63%) were more likely to survive than were other Americans (50%, RR = 1.26). The protective effect of being married was also larger for Chinese Americans (RR = 1.31) than for others (RR = 1.17). Chinese American women (61%) were more likely than men (46%) to live in such enclaves and a large enclave survival advantage was observed among Chinese American women only (RR = 1.59). Conclusions: There is consistent evidence of the relatively protected status of Chinese American women, particularly those who were married and resided in Chinese American enclaves. Mechanisms that explain their apparent advantages are not yet well understood, though relatively large, kin-based social networks seem instrumental. Research on the influence of social networks as well as the possible effects of acculturation is needed. This study also exposed structural inequities related to the institutions of marriage, health care and communities that disadvantage others. Policy makers ought to be aware of them as future reforms of American health care are considered.
... Social norms in Bhutan mandates respect for older adults. However, with rapid socio-economic modernization, change in the family structure and function, education, force of materialism Bhutan continues to face, the seemingly deterioration in respect for older adults and its influence on their QOL remain obvious [27,28]. ...
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A considerable amount of international research into Quality of Life (QOL) seeks to explain the determinants of health and well-being as we age. Many older adults in Bhutan continue to live traditionally in socially integrated Buddhist communities. Popular understanding of health and QOL to some extent could be different from western populations. This qualitative study employed in-depth interviews with 30 older adults (aged 60 to 83 years). Content analysis generated key themes. Finding indicated most older participants experience good QOL. Close family integration and interpersonal harmony, respect for the older people, spirituality, chronic health conditions and adverse childhood experiences, lack of education, insufficient income, and changes in the sources of practical help in the community influenced QOL. Further research is needed to systematically examine the relative contribution of various factors to health and QOL among elderly people in Bhutan and similar communities.
... For example, it has been found that Chinese adult children are increasingly using the financial aid to compensate for the inadequacy of emotional support (Lee & Kok, 2005). However, studies investigating Chinese elderly people's perception of filial piety revealed that financial support from children is least expected and the significance of adult children's emotional support outweighs that of material support (Dong, Chang, Wong, & Simon, 2012). If we simply combine the different types of support together, both the elderly who do not provide any support for their adult children but receive financial support and the elderly who do not provide any support but receive emotional support would be treated identically as being over-benefited, but their levels of subjective well-being could be very different. ...
Article
Objectives:This study examines in what exchange patterns that three types of intergenerational support are associated with elderly parents' life satisfaction, and whether elderly parents' evaluation on parent-child relationship plays a mediation role on those associations. Method: Data were drawn from Hong Kong Panel Survey for Poverty Alleviation. Respondents aged 65 and over were included ( N=504). Three types of support, namely, daily-living, financial, and emotional support were examined in four patterns-the over-benefited , under-benefited , reciprocal and no flow of exchange. A multivariable linear regression was applied to investigate the association between pattern of intergenerational exchange and life satisfaction, and mediation analysis was employed to examine the mediating role of satisfaction with parent-child relationship on their associations. Results: Elderly parents were less satisfied with their lives when they had no flow of exchange in daily-living support, and more satisfied when they were under-benefited in financial support, and over-benefited or reciprocal in emotional support. Elderly parents’ satisfaction with parent–child relationship mediated the association between exchange of emotional support and life satisfaction; but not the association between daily-living or financial support and life satisfaction. Conclusion: Different types of intergenerational support are associated with elderly parents’ life satisfaction in different patterns.
... The results may reflect the effect of familism culture in China (Chen, 2019). For Chinese people, kin relationships seem to be the source that is most likely to provide unconditional support when a person is in a health crisis (Dong, Chang, Wong, & Simon, 2012). Chinese Shidu parents seem to largely rely on their kin-centred networks when going through the psychological crisis of losing an only child. ...
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Background: In China, bereaved parents who have lost their only child are known as Shidu parents, and they tend to present high levels of prolonged grief reactions. To date, a widespread focus has been placed on positive social support, while potential negative experiences have been relatively neglected. Additionally, the role of social support from different sources (i.e. close family members [partner, siblings, grandchildren], peers, and others [relatives, friends, colleagues]) has not been examined thoroughly. Objective: The present study investigated whether social support from different sources has a differential impact on postloss adaptation (i.e. prolonged grief and growth). The loss-orientated and restoration-orientated coping strategies of the dual process model were also tested for their mediating roles. Methods: A total of 277 Chinese Shidu parents were recruited to complete a series of questionnaires including social support from different sources, prolonged grief symptoms, posttraumatic growth, and dual process coping strategies. Correlation analyses, paired sample t tests and structural equation modelling were conducted. Results: More positive support were related to less prolonged grief symptoms and more posttraumatic growth, while more negative support was only related to more prolonged grief. Positive support from close family members and others was significantly related to prolonged grief/growth, and negative support from these sources was significantly positively associated with prolonged grief. Positive or negative support from people who shared a similar experience was unrelated to prolonged grief/growth. Positive and negative support were related to prolonged grief and growth through loss-oriented coping strategies. Conclusion: Overall, the present study indicated that positive and negative support experiences from different sources functioned differently in the recovery of Chinese Shidu parents and that loss-oriented coping played a mediating role. These findings highlight the importance of differentiating social support by traits in coping with grief and the crucial mediating role of loss-oriented coping. Highlights: More positive support correlated with less prolonged grief and more growth, while more negative support correlated with more prolonged grief.Support from family members and friends was more potent than that from peers.Social Support correlated with prolonged grief/growth through loss-oriented coping.
... This study also informs policy practice in the delivery of social services. Cultural relevancy of health interventions is important in the context of Chinese communities (44)(45)(46)(47)(48). Given the vital role of filial piety in the psychological well-being of U.S. Chinese older adults, more policies and services are needed to support adult children to take care of their aging parents, particular for U.S. Chinese families. ...
Article
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Background The relationship between filial piety and depressive symptoms has been widely discussed, but limited research focused on the gap between filial expectations and filial receipt. This study aims to investigate the association between filial discrepancy and depressive symptoms. Methods Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of U.S. Chinese older adults aged 60 and older in the greater Chicago area. Depressive symptoms were measured by the Patient Health Questionnaire-9. Overall filial discrepancy was evaluated by filial receipt minus expectations. Levels of overall filial discrepancy divided older adults into four groups based on the medium value of filial expectations and receipt. Logistic regression analyses were performed. Results Older adults with greater filial receipt than expectations were more likely to have lower risk of depressive symptoms (odds ratio [OR], 0.95 [0.92–0.97]). The group with high expectations and low receipt has the highest risk of depressive symptoms among the four groups (OR, 1.51 [1.07–2.13]). Greater receipt than expectations in care (OR, 0.83 [0.76–0.92]), make happy (OR, 0.77 [0.69–0.86]), greet (OR, 0.88 [0.79–0.97]), obey (OR, 0.76 [0.68–0.86]), and financial support (OR, 0.80 [0.71–0.89]) was associated with lower risk of depressive symptoms. Conclusions This study goes beyond previous research by examining the association between filial discrepancy domains and depressive symptoms. Cultural relevancy of health interventions is important in the context of Chinese communities. Health care professionals are suggested to be aware of the depressive symptoms of U.S. Chinese older adults with high filial expectations and low receipt.
... One option is that encouraging cancer screening through social support includes education programs and peer support provided by community center. Then, given the significant role of family support, future programs and interventions targeting Chinese older adults should focus more on the unique cultural values, such as filial piety value of their children (40). Education programs which integrate the education for both older adults and adult children can help all realize the importance of cancer screening and encourage adult children to take their aging parents to undergo cancer screenings. ...
Article
Background Social support is a key indicator of utilization of preventive health care among older adults, but we have limited knowledge on these associations in U.S. Chinese older adults. This study aims to examine the association between sources of social support and cancer screening behaviors among Chinese older adults in the greater Chicago area. Methods Data were drawn from the Population Study of Chinese Elderly in Chicago. Social supports were measured by asking the frequency of receipt of support from spouse, non-spouse family members, and friends. Use of cancer screenings were evaluated by asking the history of utilization of colon, breast, cervical, and prostate cancer screenings. Results After adjusting for covariates, results indicated significant association between higher social support and higher utilization of cancer screenings. Regarding to different sources of social support, higher levels of social supports from family members (odds ratio [OR], 1.15 [1.07, 1.25]) and friends (OR, 1.14 [1.06, 1.23]) were associated with higher utilization of breast cancer screening. However, higher levels of social support from family members (OR, 0.94 [0.88, 0.99]) and friends (OR, 0.94 [0.88, 1.00]) were associated with lower utilization of colon cancer screening. No associations were found between social support and prostate cancer screening. Conclusions This study provides evidence that different types of social support were associated with variations in the utilization of cancer screenings. Future longitudinal studies are needed to explore the causal relationship between social support and cancer screening use.
... In particular, family violence and its perpetuation are growing global health issues, with wide implications for health and wellbeing (15). With the Chinese population in particular, there are cultural beliefs and practices, like filial piety, which previous research has shown are related to health outcomes among Chinese (16)(17)(18). As many Chinese adult children provide instrumental, emotional, and financial support for their aging parents, particular issues pertaining to these intergenerational relationships may influence the health and wellbeing of multiple generations of U.S. Chinese. ...
... Providing financial support, adequate health care, and other formal support programs are essential to help elders with self-neglect (29). Second, it is important for professionals who work with self-neglecting elders to understand differences in perception by culture and cohort (30). Professionals who work with elder self-neglect are supposed to be culturally sensitive and have good understanding of the targeted population. ...
Article
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Background Self-neglect and suicidal ideations are important public health issues among the aging population. This study aims to examine the association between self-neglect, its phenotypes, and suicidal ideation among U.S. Chinese older adults. Methods Guided by a community-based participatory research approach, the Population Study of Chinese Elderly in Chicago (PINE) study is a population-based epidemiological study conducted from 2011 to 2013 among 3,159 Chinese older adults aged 60 years and older in the Greater Chicago area. Self-neglect was assessed by a 27-item instrument, describing five phenotypes with hoarding, poor personal hygiene, unsanitary condition, lack of utilities, and need of home repair. Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Logistic regression is utilized to analyze the association. Results Higher level of self-neglect was found significantly associated with increased risk of self-reported suicidal ideation within 2 weeks (odds ratio 2.97 [1.54–5.72]); 12 months (odds ratio 2.82 [1.77–4.51]); and lifetime (odds ratio 2.74 [1.89–3.95]). For phenotypes, the study found that poorer personal hygiene and severer level of unsanitary conditions were associated with increased risk of suicidal ideation at all three time periods. Conclusion This study suggests that self-neglect and its phenotypes are significantly associated with suicidal ideation among Chinese older adults. Longitudinal studies are needed to explore the mechanisms through which self-neglect links with suicidal ideation.
... Another interesting finding of this study is that older adults who perceived children as more filial were less likely to report both family and marital conflict. A sense of children being filial may be reflective of close intergenerational relations, possibly reducing disagreement, argument, and criticism between the parent and the children (23). Such satisfying and supportive parent-child relationships may have the spillover effect, transferring to positive mood, affect, or behavior in spousal interactions. ...
Article
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Background Conflict in the family is a major risk factor for the well-being of older immigrants, whose lives are centered around their families. This study examined the potential linkage between personal coping resources and family and marital conflict among U.S. Chinese older adults. Methods Data were derived from the PINE study, a population-based study of Chinese elders in Chicago (N = 3,157). Logistic regressions were carried out to predict the likelihood of having conflict with family members and with the spouse, respectively, using indicators of personal coping resources (ie, socioeconomic status, physical health, acculturation level, perceived children’s filial piety, number of friends, and sense of mastery). Results The results showed that older adults with higher education (odds ratio [OR] = 1.03, confidence interval [CI] = 1.01–1.06; OR = 1.09, CI = 1.06–1.11, respectively), lower perception of children being filial (OR = 0.95, CI = 0.93–0.97; OR = 0.96, CI = 0.94–0.98], respectively), and lower sense of mastery (OR = 0.95, CI = 0.94–0.96; OR = 0.98, CI = 0.97–0.99, respectively) were more likely to report both family and marital conflict. Older adults who had more friends were less likely to report marital conflict (OR = 0.61, CI = 0.43–0.86). Conclusions Overall, older immigrants with greater coping resources seemed to have less family and marital conflict. Particularly important are their own sense of control and available support from children and friends in the new society. Higher education could be a risk factor for these conflicts. Future studies are needed to distinguish everyday life conflict from acculturation-related conflict in this population.
... Our study found that 59.8% of participants self-disclosed the risk of having committed abuse towards their older parents; adult children were more likely Depending on the years living in the U.S., the adult children have become acculturated to Western culture's emphasis on individualism. Compared with their older parents, the adult children are likely to have a different perspective on filial piety [44,45], that is, children being respectful, obedient, and obligated to provide support and care for older parents both emotionally and financially [46].Take the younger generation in Hong Kong as an example, "love and care" has been perceived as paying for parents' institutional care [47]. A recent study indicated that more than half of the Chinese older adults placed high expectations on filial piety [29]. ...
Article
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Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse.
... The experiences and insights of immigrant populations are imperative to our understanding of a given phenomenon in order to develop culturally supported interventions [28]. CBPR has been viewed as particularly useful with immigrants because the approach aims to address the complex health disparities affecting their communities while maintaining respect for their cultural identities and values [29][30][31][32]. Active participation of the population of study at the start of the research project helps to ensure that the data collected are culturally grounded and reflective of the lived experiences of that population [33,34]. ...
Article
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Community-based participatory research (CBPR) is uniquely suited to engage immigrants in all aspects of research, from research question development to data collection to interpretation and dissemination of results. An increasing number of research studies have utilized the methodology for exploring complex health issues for immigrants. In the current manuscript, we present a review of peer-reviewed articles in health-related research where CBPR was conducted in partnership with immigrants. We examined the role of immigrants in the CBPR process and how immigrant involvement improved/enhanced the research rigor. A total of 161 articles met the inclusion criteria. The results of this literature review enhance our understanding of how CBPR can be used in direct collaboration with immigrants and highlights the many potential benefits for both researchers and immigrant communities.
... [20] An increasing body of literature indicates that filial piety influences the physical and psychological well-being of U.S. Chinese older adults, despite the association between filial piety and loneliness has not been well established. [21,22] The Chinese community represents the largest and oldest Asian population in the U.S., with an estimated population of 4 million. [23] Considering that over 80% of Chinese older adults were foreign-born and that 30% of them immigrated to the U.S. after the age of 60, [23] their conceptualization of health and intergenerational relationships is likely to adhere to traditional values. ...
Article
Background: Loneliness is an important health indicator for psychological well-being. This study aims to examine the association between filial piety and loneliness among Chinese older adults in the U.S. Methods: Data were drawn from the PINE study, a population-based study of 3,159 Chinese older adults aged 60 and above in the greater Chicago area. Severity of loneliness was the dependent variable. Independent variables were the expectation and perceived receipt of filial piety, examined in six domains. Negative Binomial Regression analyses were conducted. Results: Lower levels of perceived filial piety receipt were associated with greater severity of loneliness (Ratio of Expected Severity: 0.92, 0.91-0.94) after adjusting for socio-demographics and medical co-morbidities. Expectation of filial piety was not associated with severity of loneliness. Conclusion: Our findings indicate higher perceived receipt of filial piety may protect older adults from loneliness. Our study suggests that cultural sensitivity need to be considered in the detection and intervention of loneliness.
... Women expressed that language and transportation barriers contribute to their reliance on their adult children. This reliance on their adult children, in combination with recent literature describing the effects of informal caregiving as a chronic stressor (27), suggests that support mechanisms beyond family-based interventions may be needed, such as evolving roles for physicians, community organizations, and health delivery systems (28). Improving patient-provider interactions is one possible area of intervention, as providers were noted during our focus groups as among the most influential to Chinese women. ...
Article
Background Chicago’s Chinatown is home to a sizeable community of first-generation Chinese American immigrants. This qualitative study seeks to describe the attitudes toward, and barriers and facilitators of, breast cancer screening among Chinese women in Chicago’s Chinatown to inform strategies for future interventions. Methods We conducted six focus groups among Chinese-speaking adult women aged 45 and older. Focus groups were transcribed, coded, and analyzed for emergent themes. Results Forty-seven women participated in focus groups; 10 (21%) had received a breast cancer diagnosis in their lifetime, all participants were foreign-born, and 80% have resided in the United States for over 10 years. Participants expressed a range of breast cancer beliefs, attitudes toward screening, barriers encountered, and facilitators. Some differences were noted between women with cancer and those without. Barriers described include language, time, not wanting to burden their adult children, and transportation. Navigation services and physician recommendation were suggested facilitators to screening. Conclusions Our findings have important implications for development of interventions and policies to bolster breast cancer screening among Chinese women. We highlight the need to connect Chinese older adults with resources to navigate the health care system and present opportunities for community stakeholders, researchers, health professionals, and policy makers to improve the health of Chinese Americans.
... However, the vast intragroup diversity in language, education level, socioeconomic status, and degree of acculturation among U.S. Chinese older adults have resulted in limited evidencebased research targeting this group (12). To build upon the social and health issues documented in previous research with U.S Chinese older adults (13)(14)(15) and paint their overall health burden, there is a need to assess the presence of clinical symptoms experienced by this population. ...
Article
Background: Cardiovascular and pulmonary symptoms influence health and well-being among older adults. However, minority aging populations are often underrepresented in most studies on cardiovascular and pulmonary symptoms. This study aims to examine the prevalence of cardiovascular and pulmonary symptoms among U.S. Chinese older adults. Methods: Data were drawn from the Population Study of Chinese Elderly study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. Clinical Review of Systems was used to assess participants' perceptions of their cardiovascular and pulmonary symptoms. Results: Cardiovascular symptoms (31.6%) and pulmonary symptoms (42.2%) were commonly experienced by U.S. Chinese older adults. Symptoms such as cough (27.4%), sputum production (22.7%), chest pain or discomfort (16.3%), shortness of breath at rest (15.1%), and shortness of breath with activity (12.9%) were commonly reported. Older age, lower income, fewer years residing in the community, poorer self-perceived health status and quality of life, and worsened health over the last year were associated with report of any cardiovascular or pulmonary symptom. Conclusions: Cardiovascular and pulmonary symptoms are common among Chinese older adults in the U.S. Future longitudinal research is needed to examine changes in Chinese older adults' burden of cardiopulmonary symptoms and their health and well-being.
... Despite that the diaspora regards Confucian values as important, these values are prone to modification, if not erosion, in diasporic communities in Western societies (Dong et al., 2012b;Hsueh & Clarke-Ekong, 2008;Lan, 2002;Liu et al., 2000;Lo & Russell, 2007). Therefore, the Chinese diaspora can be considered as a social construct, meaning its integration in Western society leads to the formation of a hybrid identity and a diasporic culture that diversifies the contemporary Chinese culture (McKeown, 1999). ...
Article
Background and Objectives: Loneliness is prevalent among older adults and known to be detrimental to mental health. The objective of this study was to determine the psychometric properties of the Chinese 6-item De Jong Gierveld Loneliness Scale (DJGLS) in the older native and diasporic Chinese community. Research Design and Methods: Participants were recruited from a local community in urban Tianjin, China and urban Chinese communities of older adults in the Netherlands. Scale properties, including reliability, were calculated with Cronbach‟s alpha and multiple- group confirmatory factor analysis to examine the two-dimensional structure of the scale and the cross-cultural equivalence between both countries. Item response analysis was employed to plot the relationships between the item response and expected total scale score. Results: A total of 193 older adults from China and 135 older adults from the Netherlands were included. The Cronbach‟s alphas were and 0.68 (China) and 0.71 (the Netherlands). The DJGLS‟s two-dimensional structure was validated by the goodness of fit and the factor loadings. Cross-cultural equivalence was demonstrated with the multiple-group confirmatory analysis. In addition, sufficient discriminative power of the individual items was demonstrated by item response analysis in both countries. Discussion and Implications: This study is the first to provide a detailed item behavior analysis with an item response analysis of the DJGLS. In conclusion, the findings of this study suggest that the DJGLS has adequate and similar item and scalar equivalence for use in Chinese populations.
... For example, previous research shows that Chinese adult children are compensating for the inadequacy of emotional support by increasingly using financial support (Lee & Kwok, 2005). However, studies also show that elderly Chinese least expect financial support from their children but ascribe more importance to emotional support than material support (Dong, Chang, Wong, & Simon, 2012). Different types of support also have different impacts on the well-being of older people. ...
Thesis
This thesis aims to investigate the factors associated with health and well-being of older people in the Philippines, by focusing on the role of different types of resources, including socioeconomic resources and various forms of social support. This thesis extends the literature on the health and well-being of older people in several ways. First, it goes beyond the individualistic approach of studying determinants of health by also looking at how socioeconomic resources of children also influence parental health. Second, it does not only examine how social support such as living arrangement is associated with the well-being of older people, but it also examines whether living arrangement concordance - the fit between actual and preferred living arrangement - is also related to their well-being. Third, unlike previous research that tends to aggregate different types of intergenerational support into one indicator, this research distinguishes these different forms of support and assesses how each type have different implications for the well-being of older people. Fourth, it provides evidence of variations of healthy ageing at the sub-national level, thus addressing the paucity of research on this topic, particularly in developing countries. Finally, this research is set in the Philippines, a developing country in Southeast Asia that shares the culture and values of its Asian neighbors, but is also heavily influenced by Western values because of its long history of colonization. This unique culture of the Philippines provides a rich contrast to existing research that was mostly set in either Western or other Eastern societies, hence contributing to a more nuanced understanding of health and well-being of older people in a diverse cultural, socio-economic and environmental setting. Data are drawn from the 2007 Philippine Study on Ageing (PSOA) and the 2010 Philippine Census of Population and Housing (CPH).
... Perceived filial piety is also important to the well-being of the elderly (e.g. Dong et al. 2012;Mao and Chi 2011;Wang et al. 2009). For example, seniors in Hong Kong feel the failing of filial piety most acutely when they are in times of need (such as when they are suffering illness or distress), and lack of filial respect predicted lower levels of psychological well-being (Cheng and Chan 2006). ...
Preprint
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In a number of papers, Liu Qingping has critiqued Confucianism's commitment to 'consanguineous affection' or filial values, claiming it to be excessive and indefensible. Many have taken issue with his textual readings and interpretive claims, but these responses do little to undermine the force of his central claim that filial values cause widespread corruption in Chinese society. This is not an interpretive claim but an empirical one. If true, it merits serious consideration. But is it true? How can we know? I survey the empirical evidence and argue that there is no stable or direct relationship between filial values and corruption. Instead, other cultural dimensions (such as high power distance and assertive materialism) are more robust predictors of corruption. As it happens, China ranks very high in these other cultural dimensions. I conclude that if the empirical research is correct, then Liu's claims lack direct empirical support. †Forthcoming in Dao: A Journal of Comparative Philosophy. Please cite the published version of the article.
... intensify the anxiety about aging in Chinese societies [5,8,34]. Additionally, with a strong sense of filial piety expectation in Chinese culture, older adults would expect their adult children to take care of them when they were [35]. With regard to U.S. Chinese older adults, their traditional social support system broke down [36], and the culture and language barriers inhibited their access to health care services [37][38][39]. ...
... The PRFPS also demonstrated criterion validity, suggested by a moderate and positive relationship between perceived filial receipt and life satisfaction, as measured by the QOLS. Consistent with previous findings indicating a deleterious effect of low filial piety receipt on well-being measures (Cheng and Chan 2006;Dong et al. 2017;Dong et al. 2012;Dong and Zhang 2016), the present results suggest the perception of more frequent levels of perceived receipt of filial piety behaviours is associated with better quality of life. Moreover, studies have demonstrated that Chinese older adults who receive familial support having higher life satisfaction (Yeung and Fung 2007). ...
Article
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Filial piety plays an important role in the parent-child relationship in Chinese culture. To date, the majority of studies have focused on filial piety attitudes and expectations from the perspectives of the adult child. With only a few studies examining filial piety from the parent’s perspectives, there is a paucity of studies that examines the dimensionality of filial piety receipt. The objective of this study was to validate the Perceived Receipt of Filial Piety Scale (PRFPS), a 10-item questionnaire designed to measure how often Chinese parents perceive their child(ren) engage in filial pious behaviours. A total of 222 middle-aged and older adult Chinese parents (Mage = 67.91, SD = 13.20) completed the PRFPS, MultidimensionalScale of Perceived Social Support (MSPSS) and the Quality of Life Scale (QOLS). A single-factor structure emerged from the developed PRFPS, which demonstrated excellent internal consistency (α = .95). The scale was also significantly associated with the MSPSS (r = .50) and QOLS (r = .42), supporting convergent and criterion validity. In conclusion, the PRFPS is found to be a reliable and valid measure of perceived filial piety receipt among Chinese parents. Theoretical implications and suggestions for further scale development and research is discussed.
... Studies show that filial piety has remained stable as a cultural value, especially among the educated (e.g., Cheung, Kwan, and Ng 2006;Hu and Scott 2016;Xie 2013), even while it has come under tremendous amounts of pressure owing to challenges arising from the single child policy and attendant economic constraints (Chou 2011;Zhan and Montgomery 2003;Zimmer and Kwong 2003). Perceived filial piety is also important to the well-being of the elderly (e.g., Dong, Chang, Wong, and Simon 2012;Mao and Chi 2011;D. Wang, Laidlaw, Power, and Shen 2009). ...
Article
Full-text available
In a number of papers, Liu Qingping has critiqued Confucianism’s commitment to “consanguineous affection” or filial values, claiming it to be excessive and indefensible. Many have taken issue with his textual readings and interpretive claims, but these responses do little to undermine the force of his central claim that filial values cause widespread corruption in Chinese society. This is not an interpretive claim but an empirical one. If true, it merits serious consideration. But is it true? How can we know? I survey the empirical evidence and argue that there is no stable or direct relationship between filial values and corruption. Instead, other cultural dimensions (such as high power distance and assertive materialism) are more robust predictors of corruption. As it happens, China ranks very high in these other cultural dimensions. I conclude that if the empirical research is correct then Liu’s claims lack support.
... This finding may also can apply to some countries or regions where Confucianism were influenced. However, with the recent socioeconomic and demographic changes over the last ten years in China, the role of filial piety as well as its significance and content are being challenged (Dong et al., 2012). Such changes are in danger of having a negative influence of family caregivers' capability and availability to look after their older parents (Zhang et al, 2018). ...
Article
Background and aims Globally, two thirds of people with dementia are cared for by their families or friends. Family caregivers’ coping strategies of managing the caregiving burden of dementia have been studied widely in western literature. However, few attempts have been made to explore the experience of family caregivers’ coping strategies in China. The aim of this study was to explore the family caregivers’ coping strategies when caring for people with dementia in one city in the province of Shandong, China. Methods Fourteen family caregivers were individually interviewed, and interpretative phenomenological analysis was used to identify themes within different family members. Results Four key themes were found: (a) being filial; (b) changing self and self-care; (c) seeking help; and (d) having hope and continuing life. Conclusion The study illustrates the different strategies developed by family members in order to cope with their new roles when caring for a relative who has dementia. It shows that cultural belief of filial piety plays a large role across these various coping strategies. It highlights how responsibility has been maintained and influenced by the specific sociocultural context. The results provide a useful foundation for developing interventions that support family caregivers cope with the burden of caring in this population.
... While T3′s home is over 300 km away from Yellow River, the four other teachers' original homes are within 80 km only. Since family-centeredness remains a salient characteristic of the Chinese society today (Dong et al., 2012), the four teachers felt drawn by their homes when deciding where to teach. For instance, T5 said, After I graduated, I went to work in a company in Taiyuan [the capital city]. ...
Article
This study aims to understand the reportedly high retention rates of teachers recruited through Special Teaching Position (STP)-an alternative teacher hiring policy in China. Drawing on ethnographic data, this study examines how five STP teachers make career decisions in their sociocultural contexts. The findings demonstrate how a new phenomenon emerges, which I refer to as "weekday rural teachers, weekend urban spouses and parents." Two factors contribute to its emergence: (1) improvement of transportation conditions, and (2) skip-generation parenting, that grandparents or older relatives raise children on behalf of the parents. The findings suggest implications for researching alternative hiring policy.
... Despite that the diaspora regards Confucian values as important, these values are prone to modification, if not erosion, in diasporic communities in Western societies (Dong et al., 2012b;Hsueh & Clarke-Ekong, 2008;Lan, 2002;Liu et al., 2000;Lo & Russell, 2007). Therefore, the Chinese diaspora can be considered as a social construct, meaning its integration in Western society leads to the formation of a hybrid identity and a diasporic culture that diversifies the contemporary Chinese culture (McKeown, 1999). ...
Article
Full-text available
Background and Objectives Loneliness is prevalent among older adults and known to be detrimental to mental health. The objective of this study was to determine the psychometric properties of the Chinese 6-item De Jong Gierveld Loneliness Scale (DJGLS) in the older native and diasporic Chinese community. Research Design and Methods Participants were recruited from a local community in urban Tianjin, China and urban Chinese communities of older adults in the Netherlands. Scale properties, including reliability, were calculated with Cronbach’s alpha and multiple-group confirmatory factor analysis to examine the two-dimensional structure of the scale and the cross-cultural equivalence between both countries. Item response analysis was employed to plot the relationships between the item response and expected total scale score. Results A total of 193 older adults from China and 135 older adults from the Netherlands were included. The Cronbach’s alphas were and 0.68 (China) and 0.71 (the Netherlands). The DJGLS’s two-dimensional structure was validated by the goodness of fit and the factor loadings. Cross-cultural equivalence was demonstrated with the multiple-group confirmatory analysis. In addition, sufficient discriminative power of the individual items was demonstrated by item response analysis in both countries. Discussion and Implications This study is the first to provide a detailed item behavior analysis with an item response analysis of the DJGLS. In conclusion, the findings of this study suggest that the DJGLS has adequate and similar item and scalar equivalence for use in Chinese populations.
... With regard to the combination of three types of support, our results manifest that receiving only financial support is negatively related to life satisfaction, while receiving other two types reverse the relationship to positive one. Study on Chinese older people's perception of filial piety reveals that they expect least on financial support from children while the significance of receiving emotional support outweighs that of material support [34]. According to the contextual Turkish example, older women do not wish to burden their children but enjoy being thought of and valued [26]. ...
Article
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Backgrounds The oldest-old population is increasing sharply in China, and intergenerational support has been their primary source of caregiving. Although intergenerational support has been found to be associated with wellbeing of older people in previous study, most analysis were from the perspective of children’s characteristics and exchange patterns. This study aims to investigate the impact of different types of intergenerational support on subjective wellbeing among Chinese oldest-old and the variation across groups of different economic status, based on their five-tier of needs (physiological needs, safety needs, love/belonging needs, esteem needs, and self-actualization needs). Methods We included older adults aged ≥ 80 years from the 2018 Chinese longitudinal Healthy Longevity Survey (CLHLS). We assessed older people’s subjective wellbeing by their life satisfaction and psychological health. We evaluated four types of intergenerational support: parents provide financial support, receive financial, instrumental and emotional support. We applied binary logistic regression analysis to analyze the association between different intergenerational support and older people’s subjective wellbeing and the moderating effect of self-rated economic status on this relationship. Results A total of 8.794 participants were included, with a mean age of 91,46 years (standard deviation:7.60). Older adults who provide financial support (OR: 1.37, 95% CI: 1.01, 1.85) and receive emotional support (OR: 1.99, 95% CI: 1.40, 2.83) report better subjective wellbeing. However, receiving instrumental support depressed psychological health (OR: 0.67, 95% CI: 0.56, 0.79) while improved life satisfaction (OR: 1.42, 95% CI: 1.04, 1.55). Receiving emotional support promoted parents’ psychological health among all combinations of support, and receiving all the three types together raised their subjective wellbeing most. Conclusions Our study recognizes that higher level of subjective wellbeing for oldest-old is related to providing financial support, receiving emotional and certain instrumental support. In addition, higher economic status can moderate these associations.
Article
Against the background of population ageing and increasing cultural diversity in many Western countries, the study examined differences and similarities between Australian-born people and Chinese immigrants in their relationships with adult children. The specific research questions were: (a) are there differences between these groups in the nature of parent–child relationships; and (b) if there were differences, did these differences reflect the Confucian concept of filial piety among older Chinese immigrants. The solidarity–conflict model and the concept of ambivalence were used to quantify parent–child relationships. Data from 122 community-dwelling people aged 65 and over (60 Australian-born and 62 Chinese-born people) were collected using standardised interviews. There were significant differences between the two groups for all relationship dimensions except associative solidarity. Compared to Australian participants, Chinese participants were more likely to live with their children. However, when they did not live with their children, they lived further away. They were also more likely to receive, but less likely to provide, instrumental help. Finally, they reported higher levels of normative solidarity, conflict and ambivalence, and lower levels of affectual and consensual solidarity. The differences in solidarity dimensions persisted when socio-demographic variables were controlled for. The study revealed complex differences in the nature of older parent–child relationships between Australian-born people and Chinese immigrants. Some of these differences, such as more prevalent multigenerational living among older Chinese immigrants, likely reflect the strong influence of filial piety among this group. However, differences in other dimensions, such as lower levels of consensual solidarity, might be associated with the Chinese participants’ experience as immigrants. This study also highlights the usefulness of the solidarity–conflict model as a theoretical framework to understand the nature of parent–child relationships among older Chinese immigrants.
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Filial piety is important to Chinese adults and is associated with mental health among older Chinese immigrants in the United States. However, it is unclear whether filial piety is linked to the mental health of Chinese immigrants in European countries. Therefore, this study aims to gain insights into the association between mental health and filial piety of first-generation Chinese immigrants in the Netherlands. A random sample of 143 participants took part in the study. A cross-sectional design was used. Data were collected through a postal survey conducted in the Chinese language between January 2021 and March 2021. The survey included a Mental Health Continuum-Short Form (MHC), and expected and perceived filial piety scale. The results indicated that in general, perceived filial piety exceeded expected filial piety (‘filial piety sufficient’). Regression analysis revealed that ‘filial piety sufficient’ is associated with a higher emotional MHC (B =.498, p =.035). This study provided new insights into the wellbeing of older Chinese immigrants in the Netherlands and showed accordance with the literature that filial piety remains an important factor for mental health.
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Immigration disrupts the bonding process in families. Maintaining close relationships with adult children can be an important protective factor for older immigrants’ health and wellbeing. Quantitative research explaining such close relationships is rare. This study examined factors associated with close parent–child relationships in a purposive sample of 236 older Chinese immigrants in Los Angeles who provided information regarding 365 children. Two-level regression models were estimated to investigate factors contributing to cohesive parent–child relationships among these older adults. The findings showed that co-residence, a characteristic that distinguishes immigrant families from most non-immigrant families, was associated with lower parent–child relationship quality. Frequent contact was associated with closer relationships. While receiving instrumental and monetary support from children was associated with favourable ratings of relationships with children, providing such support to children was not related to parents’ assessment of relationship quality. Parental perceptions of children being respectful was also associated with better relationship quality ratings. Overall, the findings demonstrate how family-related changes in the immigration context shape parent–child relationships in later life. Implications for future research and practice are provided.
Article
Purpose – The purpose of this paper is to explore US Chinese older adults’ views regarding elder abuse interventions in order to understand barriers and facilitators of help-seeking behaviors. Design/methodology/approach – The study design was qualitative, using a grounded theory approach to data collection and analysis. Community-based participatory research approach was implemented to partner with the Chicago Chinese community. A total of 37 community-dwelling Chinese older adults (age 60+) participated in focus group discussions. Findings – Participants viewed many benefits of intervention programs. Perceived barriers were categorized under cultural, social, and structural barriers. Facilitators to implement interventions included increasing education and public health awareness, integrating social support with existing community social services, as well as setting an interdisciplinary team. Perpetrators intervention strategies were also discussed. Originality/value – This study has wide policy and practice implications for designing and deploying interventions with respect to elder abuse outcome. Modifying the cultural, social, and structural barriers that affect health behavior of Chinese older adults contribute to the salience of elder abuse interventions in this under-served.
Article
Objective: Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women. Design: With data from the Study of Women's Health Across the Nation (SWAN; N = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group. Results: Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]). Conclusions: These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.
Article
This study focuses on the ageing experiences of older Chinese immigrants in Australia. The life course perspective provides a framework to investigate the main aspects relating to a sense of home and to analyse how family, relational, and societal factors influence older Chinese immigrants' construction of a sense of home in a transnational context. This paper is based on qualitative data from 30 in-depth interviews with older Chinese immigrants living on the Gold Coast, Australia. This study reveals that family relationships, independence, and social interactions contribute to constructing a sense of home among older Chinese immigrants. Findings elucidate the interrelations between personal adaptive actions and mindsets, Chinese organisations, and social policies in the life experiences of older Chinese immigrants in Australia. This study suggests that policymakers need to be more sensitive to the significance of culture; it also highlights the need to further support existing cultural services that contribute to developing a sense of home for older Chinese immigrants.
Purpose This qualitative study explores how Chinese senior outbound tourists perceive support from their adult children and what kinds of support they desire. Design/methodology/approach Qualitative data were collected from semi-structured interviews with 26 participants. Transcribed interviews were analysed via thematic analysis. Findings This study captured the contradictory feelings of different types of Chinese senior outbound tourists (i.e. independent, neutral, and dependent) according to the degree of desire for support from their adult children. The results further identified the real desires among Chinese senior outbound tourists for children's attitudinal support, caring support, appropriate financial support, companionship, and timing support. Research limitations/implications Since this qualitative research is based on small samples with typical social and cultural characteristics, our research results only describe an existence. Our findings provide insight into the existence of the phenomenon, rather than allowing the results to be generalized to the wider population (Gram et al. , 2019). Practical implications The tourism industry could develop products to alleviate such feelings. Integrating the concept of filial piety into adult children's support for their parents' overseas travel can not only meet parents' expectations but also relieve parents' ambivalence. Destination operators and travel agencies could thus design mixed products targeting Chinese elderly parents and their adult children by providing activities for both generations. Purchasing behaviour represents a type of emotional and instrumental support for the elderly. Destination operators and travel agencies can also launch products suitable for in-depth outbound travel that cater to adult children's leisure travel while meeting the elderly's travel needs. Originality/value This study also extends both intergenerational support theory and intergenerational ambivalence theory regarding Chinese senior outbound tourists.
Article
While a large body of evidence suggests potential cultural variations in the experiences of subjective aging, very little is known about how members of Asian cultures feel about their aging. This study aims to acquire an in-depth understanding of subjective aging and its cultural/societal contexts among older Korean adults. In-depth face-to-face interviews were conducted with 20 community-dwelling Korean adults over age 65. Guided by the Stereotype Embodiment Theory, open-ended questions were asked to address how exposure to cultural/societal views about older adults relate to individuals' subjective aging. Data were analyzed using the constant comparative method. Seven categories were identified, which were grouped into three primary themes: 1) exposure to negative views on aging/older persons; 2) salience gain from self-relevance; and 3) influence on older adults' subjective aging. Most participants were generally not satisfied with their aging, felt they were a burden, and were prone to experience intergenerational conflicts. This may be attributed in part to their exposure to widespread negative age stereotypes and disrespect for older adults. Awareness of age-related changes and experience of age discrimination appear to be triggers through which the negative cultural/societal views on aging/older persons influence one's subjective perceptions and experience of aging. This in-depth data from an understudied population contributes to the existing literature by suggesting that the dominant-negative experience of aging among older Koreans may be better understood from socio-cultural contexts. Our findings can inform culture-specific intervention strategies to promote positive subjective aging.
Article
Studies of family relations have not kept pace with the acceleration of international migration. To address this gap, this study relied on a survey of 545 Chinese immigrants in Chicago who reported information of 869 older parents to examine the sources of intergenerational conflict in five domains: norms/values, relationship itself, money, health, and parenting. The results of logistic regression showed that maintaining one’s traditional culture, in the form of endorsing a sense of filial obligation, was a significant protective factor against all types of conflict. Immigrants with a higher level of acculturation were more likely to report conflict regarding norms/values and relationship itself, but not more so regarding practical issues such as health, money, and parenting. Helping parents with ADLs, not IADLs, was associated with more conflict regarding monetary and health issues. Immigrants’ greater sense of mastery was associated with a lower chance of reporting norm/value-related intergenerational conflict.
Article
Much of the literature discusses filial piety in general and ambiguous terms. This study, in contrast, investigates specific perceptions of filial piety and parental expectations of filial duty among older Chinese immigrants in Canada. The study is based on thematic analysis of 46 Chinese immigrants in seven focus groups conducted in the Greater Toronto Area. Findings show the perceptions of filial piety varied, but almost all participants had reduced expectations of their children. Nevertheless, they still valued and expected emotional care from their children. The study argues that changes in institutional settings, social policies and welfare systems define parents’ support needs and affect their expectations in the host society, while norms and institutional settings in the place of origin influence their perceptions of filial piety.
Article
Objective: To develop a predictive index that estimates the individual risk of incident self-neglect onset among the US Chinese older adults. Methods: The study used two waves of longitudinal data from 2713 participants of the Population Study of Chinese Elderly (PINE). Data were collected during 2011–2015 in Chicago, Illinois, with approximately 2-year follow-up intervals. The main outcomes are incident self-neglect cases. Variables in 14 potential predictive domains were considered, which are (1) sociodemographic/socioeconomic, (2) neighborhood/community, (3) immigration and acculturation, (4) adverse events, (5) culture, (6) general wellbeing, (7) health behavior, (8) medical health, (9) health care, (10) physical function, (11) cognitive function, (12) social wellbeing, (13) violence, and (14) psychological wellbeing. Stepwise selection in multivariable logistical regression models and bootstrapping were used to develop and validate the predictive index. Results: The 2-year self-neglect incidence rate was 237 (8.7%). A 19-item predictive model (with a c-statistic of 0.74) was developed. After correcting for overfitting by validating in 100 bootstrapping samples, the model demonstrated moderate predictive accuracy by a c-statistic of 0.68. A point-based risk index was developed and has an area under the receiver operating characteristic curve of 0.73. Discussion: The study developed an efficient index with a moderate-to-good predictive ability of self-neglect. With further external validation, modification, and impact studies, the index could be a culturally relevant tool for practitioners to quantify the risk of self-neglect among the US Chinese older population.
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This paper explores the intergenerational dynamics of “giving back” among immigrants in an Asian American community in the southern region of the United States. The paper is guided by the intergenerational ambivalence paradigm to explore dynamics between first and second generations in their community involvement. The study used the qualitative method of phenomenological approach to identify emerging themes that include (a) importance of ethnic organizations; (b) defined roles and responsibilities within the ethnic organizations that exist between first and second generations; and (c) the second generation wanting to give back and manage ethnic organizations differently from the first generation.
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Older Chinese immigrants are one of the largest and fastest growing groups of older immigrants in many Western countries. This study examined their relationships with children using multiple dimensions drawn from the solidarity–conflict model and the ambivalence perspective. A convenience sample of 62 older Chinese immigrants was recruited and data were collected through standardized interviews. The majority of participants lived independently from their children and had at least weekly contact with them. Most were involved in some kind of intergenerational exchange with their children and had relatively high expectations about filial obligations. Despite half considering that their parent–child relationships were good, three-quarters reported conflict and ambivalence in these relationships, and half reported generational differences in values. The results highlight the complexity of parent–child relationships among older Chinese immigrants and suggest that although filial piety continues to influence parent–child relationships in this group, many changes have occurred in its practice.
Article
In this study, we aimed to examine the relationship of social support with hospitalizations and emergency department (ED) visits among older Chinese adults in the United States and its possible mechanism. This was a secondary analysis of data from the Population Study of Chinese Elderly (July 2011-June 2013; N = 3,157). After adjusting for demographic, clinical, and functional covariates in logistic regression analyses, significant interaction between social support from spouse and the number of functional limitations in (instrumental) activities of daily living was related to lower odds of hospitalization (odds ratio [OR] = 0.97 [0.95-0.99]) and ED visits (OR = 0.98 [0.96-0.99]). This finding suggests that among older Chinese American adults with functional limitations, more spousal support was related to lower odds of hospitalizations and ED visits. Future studies should comprehensively measure social support (e.g., content, amount) from other sources and investigate how unnecessary acute health service utilization in this population may be reduced by social support interventions.
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This paper discusses the concept of filial piety and whether older generations of Chinese people have reduced their expectations of these behaviors from younger generations. The paper describes two studies (conducted in mainland China) that examine expectations for filial piety. The first study looks at the demographic variance on older adults' expectation of filial piety and finds no differences in the effects of age, gender, living area, educational level, etc., on levels of expectation. Close correlation exists, however, between well-being and levels of filial piety expectation. The second study introduces a modified version of filial piety expectation scale (FPE) and describes a dual model of filial piety that characterizes this concept in terms of two separate factors. The FPE is compared with attitudes to aging using a new standardized measure (the Attitudes toward Aging Questionnaire [AAQ]), and a strong positive relationship is evident. Data are discussed regarding the traditional value of filial piety, and its modifications, in current Mainland China.
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This study examines how 90 university students and 77 old people in Beijing view filial piety in Chinese society now. The results show that old people continue to hold high filial expectations for young people and that young people still endorse strongly filial obligations for old people. Obedience received the lowest rating while respect received the highest rating. “Looking after the aged parents” and “assisting them financially” are the top filial concerns for young males whereas “retaining contact with the elders” is the top filial concern for young females. “Respecting elders but necessarily obeying them” appears to be a new cultural protocol for fulfilling filial obligations in Chinese societies now.
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Responding to growing impatience with the limited application of research findings to health practices and policies, both funding bodies and communities are demanding that research show greater sensitivity to communities' perceptions, needs, and unique circumstances. One way to assure this is to employ participatory research-to engage communities at least in formulating research questions and interpreting and applying research findings and possibly also in selecting methods and analyzing data. "Community" should be interpreted broadly as all who will be affected by the research results, including lay residents of a local area, practitioners, service agencies, and policymakers. Participatory research should not be required of every project, but when results are to be used for, in, and by communities, those communities should collaborate not only in applying findings but also in determining the ways in which the findings are produced and interpreted.
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Community-based participatory research (CBPR) increasingly is being recognized by health scholars and funders as a potent approach to collaboratively studying and acting to address health disparities. Emphasizing action as a critical part of the research process, CBPR is particularly consistent with the goals of "results oriented philanthropy" and of government funders who have become discouraged by the often modest to disappointing results of more traditional research and intervention efforts in many low income communities of color. Supporters of CBPR face challenging issues in the areas of partnership capacity and readiness, time requirements, funding flexibility, and evaluation. The authors suggest strategies for addressing such issues and make a case for increasing support of CBPR as an important tool for action-oriented and community-driven public health research.
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This study examined the relationship between adherence to tradition and depression in a large sample (N = 1502) of Chinese elders living in the People's Republic of China. In Chinese traditional culture, an elder's purpose, meaning and self-worth are derived, in large, from their social roles within the family and community. As the traditional culture declines so do these familiar roles, supports, and ways of coping. This constitutes a major loss which can have a variety of psychosocial consequences, one of which could be depression. The elders in our study responded to a nine-item measure of traditional mutual aid and intergenerational exchange. Depression was measured by the Center for Epidemiological Studies Depression Scale. Regression analysis found a significant and negative relationship between tradition and depression which suggests that adherence to tradition may have protective benefits. These findings have application with elders in China as well as with those who are immigrants to other societies.
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Chinese older persons (N = 164) recruited from social centers responded to a survey instrument tapping the perceived filial behaviors of children (close vs not close), and the degree to which these behaviors matched personal expectations (filial discrepancy). Across all kinds of filial behaviors, providing attention when the parent was ill or distressed was perceived to be the least performed and was most discrepant with expectations. Whether the children were paying respect and whether they were providing care in times of illness or distress were most important in determining a sense of filial discrepancy in the parent. However, after functional limitations and financial strain were controlled for, only respect emerged as a consistent predictor of psychological well-being. These findings were similar whether the target was the closest child(ren) or less close children. There was no evidence that a child's overdoing his or her filial role was detrimental to the parents' well-being among the Chinese individuals in this study.
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Based on in-depth interviews with middle-class Taiwanese and Hong Kong immigrant families in California, the author examines how the cultural meaning and social practice of filial care for aging parents have been transformed in the U.S. context. The author analyzes the commodification of elder care from three dimensions—where care takes places, who gives care, and who pays for care—and examines its impacts on Chinese family relations. Although three-generational cohabitation may have declined on foreign soil, the family remains the nexus of care networks and economic ties among Chinese immigrants. Through recruiting home care workers as fictive kin, immigrant adult children are able to maintain the cultural ideal of filial care. The receipt of public care among immigrant elders does not necessarily indicate the diminishment of family bonds, but it reinforces kin connections as channels for circulating economic resources.
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This study examined the profiles of 147 Chinese elderly immigrants by living arrangement and the role that stress and coping resources played in explaining depressive symptoms in the volunter sample group who were recruited at senior centers and meal sites. Elderly Chinese Americans who lived alone, had higher levels of education, reported poorer health, experienced more stressful life events, and were dissatisfied with help received from family members were more likely to be depressed. The impact of these factors on the quality of life of elderly Chinese immigrants can be understood within the Chinese cultural context and the implications of these findings for service providers are discussed.
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assess the current status of psychological research on filial piety [in Chinese culture] / review the research literature and endeavor to integrate findings into a coherent body of knowledge, paying particular attention to the influence of filial piety on parental attitudes, child training, personality formation, and cognitive functioning / the wider implications for socio-political processes are also explored a central theme is that internal psychological and external socio-political processes, both rooted in filial piety, are mutually reinforcing / 2 theoretical constructs, authoritarian moralism and cognitive conservatism, serve as conceptual linkages between cultural values and psychological functioning / discuss the cross-cultural significance of research on filial piety (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This paper is a contribution to the debate on how to make health-care services in the United Kingdom more responsive to the needs of older people who are members of recent immigrant groups. The focus is on the Chinese-origin elders, and the objective is to demonstrate their diverse migrant histories, cultural backgrounds and attitudes to both ‘traditional’ and Western health-care practices. The underlying argument is that if National Health Service staff had a better understanding of the diversity of Chinese older people, this would make an important contribution to making the service more sensitive to their needs. To develop this argument, this paper carries out three main analytical tasks. The first is to discuss the range of strategies adopted by Chinese people in general and Chinese older people in particular to improve their health. The second is to study Chinese people's heritage of exploring different methods to organise health in response to foreign culture. The third considers the ways in which the sensitivity of British health-care services to the needs of ethnic-minority groups can be improved, with a focus on the culturagram instrument and procedure. Three contrasting examples are presented.
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This study examines self-perceived physical and mental health among 213Chinese elderly who visited the Geriatric Outpatient Clinic of BeijingHospital, the Peoples Republic of China. The study hypothesizes thatcultural factors, specified by family relations, along with demographicfactors, number of diseases, economic well-being, and living conditionshave a significant impact on subjects self-perceived health status.Pearson correlation, linear and logistic regression analyses areperformed. Results indicate that age, number of diseases, perceived familyrespect, neighborhood relations, and percentage of income spent on rentare significant predictors of self-perceived physical health. These samefactors plus preference to live with a son and personal monthly income aresignificant predictors of self-perceived mental health. Socio-culturalimplications of these findings are examined.
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Informal care provided by family has been the cornerstone for older persons in Hong Kong. Changes in the structure of Hong Kong family alter this supportive function, and changes in traditional filial piety values affect the nature of the care and support provided. This proposition was investigated by a quantitative study involving structural survey interviews of 390 older persons in Hong Kong. The findings show that there are discrepancies between expected and actual caring functions. Living arrangements and geographical proximity affect the needs for and provision of informal support. Financial support has compensated for inadequate personal care by adult children. There is evidence to show that informal support for the older persons is changing. Traditional Confucian filial piety is undergoing modification, perhaps erosion, implying ongoing changes in intergenerational relations in this modernized Asian society.
Article
Social support networks, consisting principally of family members, neighbors, and friends, can provide various support functions to older persons. As societies modernize, changes in family structure might alter this supportive ability, and changes in traditional values affect the nature of the network and support provided. This may especially be so in rapidly modernizing societies as in the Asia–Pacific region where the traditional role of the family and especially children's duty of care for parents (“filial piety”) may be weakening. This proposition was investigated by a qualitative study in a modern new town (Tuen Mun) in Hong Kong. In-depth interviews with 50 older persons in public housing estates were triangulated with data from focus groups and key informants. Living arrangements, geographical proximity, and the quality of relationships between potential caregivers and receivers affected needs for and provision of support, and there were interactions between various components of informal support. An important finding, which also has policy implications, is that traditional Confucian filial piety may be undergoing modification, perhaps erosion, implying ongoing changes in intergenerational relations in this modernizing Asian society.
Article
China has the largest aging population in the world today. Despite the Chinese tradition of filial piety, economic, social, cultural, and familial changes have made it increasingly difficult for older Chinese to receive support from adult children. To ensure parental support, the Family Support Agreement (FSA) emerged from a local community in the mid-1980s. Since then, the FSA has been promoted and monitored by the government. By the end of 2005, FSAs had been signed by more than 13 million rural families across China and is now finding its way into cities. A voluntary contract between older parents and adult children concerning parental provisions, the FSA represents an innovation to help meet the challenge of providing elder support. Although the FSA’s moral persuasion is based on filial piety, violations of the FSA are subject to penalties by law. As the first systematic and comprehensive exploratory study on the FSA, this article examines (a) the FSA’s emergence, content, legal foundation, and implementation; (b) the role of the government and the legal system in promoting or monitoring FSAs; (c) the FSA’s strengths, limitations, and challenges; (d) the FSA’s implications in light of Chinese history, intergenerational contract, filial piety, and intergenerational relations; and (e) the future of the FSA as a social policy.
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How has rapid economic development and the aging of the population affected the expression of filial piety in East Asia? Eleven experienced fieldworkers take a fresh look at an old idea, analyzing contemporary behavior, not norms, among both rural and urban families in China, Korea, Japan, and Taiwan. ---------- Charlotte Ikels is Professor of Anthropology at Case Western Reserve University. ---------- How have rapid industrial development and the aging of the population affected the expression of filial piety in East Asia? Eleven experienced fieldworkers take a fresh look at an old idea, analyzing contemporary behavior, not norms, among both rural and urban families in China, Japan, Korea, and Taiwan. Each chapter presents rich ethnographic data on how filial piety shapes the decisions and daily lives of adult children and their elderly parents. The authors’ ability to speak the local languages and their long-term, direct contact with the villagers and city dwellers they studied lend an immediacy and authenticity lacking in more abstract treatments of the topic. This book is an ideal text for social science and humanities courses on East Asia because it focuses on shared cultural practices while analyzing the ways these practices vary with local circumstances of history, economics, social organization, and demography and with personal circumstances of income, gender, and family configuration. ---------- Table of Contents for Filial Piety List of Tables and Figures List of Contributors Introduction, by Charlotte Ikels 1. Ritualistic Coresidence and the Weakening of Filial Practice in Rural China, by Danyu Wang 2. Filial Daughters, Filial Sons: Comparisons from Rural North China, by Eric T. Miller 3. Meal Rotation and Filial Piety, by Jun Jing 4. “Living Alone� and the Rural Elderly: Strategy and Agency in Post-Mao Rural China, by Hong Zhang 5. Serving the Ancestors, Serving the State: Filial Piety and Death Ritual in Contemporary Guangzhou, by Charlotte Ikels 6. Filial Obligations in Chinese Families: Paradoxes of Modernization, by Martin King Whyte 7. The Transformation of Filial Piety in Contemporary South Korea, by Roger L. Janelli and Dawnhee Yim 8. Filial Piety in Contemporary Urban Southeast Korea: Practices and Discourses, by Clark Sorensen and Sung-Chul Kim 9. Culture, Power, and the Discourse of Filial Piety in Japan: The Disempowerment of Youth and Its Social Consequences, by Akiko Hashimoto 10. Curse of the Successor: Filial Piety vs. Marriage Among Rural Japanese, by John W. Traphagan 11. Alone in the Family: Great-grandparenthood in Urban Japan, by Brenda Robb Jenike Glossary Notes References Index
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Contemporary Chinese America is the most comprehensive sociological investigation of the experiences of Chinese immigrants to the United States-and of their offspring-in the late twentieth and early twenty-first centuries. The author, Min Zhou, is a well-known sociologist of the Chinese American experience. In this volume she collects her original research on a range of subjects, including the causes and consequences of emigration from China, demographic trends of Chinese Americans, patterns of residential mobility in the U.S., Chinese American "ethnoburbs," immigrant entrepreneurship, ethnic enclave economies, gender and work, Chinese language media, Chinese schools, and intergenerational relations. The concluding chapter, "Rethinking Assimilation," ponders the future for Chinese Americans. Also included are an extensive bibliography and a list of recommended documentary films. While the book is particularly well-suited for college courses in Chinese American studies, ethnic studies, Asian studies, and immigration studies, it will interest anyone who wants to more fully understand the lived experience of contemporary Chinese Americans.
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Using survey data on 1,227 adult and pre-adult children in Korea, we identified some specific measures and dimensions of filial piety, a traditional East Asian value to respect and care for parents. Factor analysis and cross-validation of measures of affection, repayment, family harmony, respect, obligation, and sacrifice revealed two important factors--behaviorally oriented and emotionally oriented filial piety. These findings suggest that filial piety is two-dimensional, and that multiple indicators should be used to separately assess the behavioral and emotional components of modern-day filial piety.
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To work with Chinese/Chinese-American clients more effectively, health care providers must know how to work with them within their value system of filial piety. This paper focuses on Chinese parent-child relationships with respect to this value system from the perspective of young adult Chinese immigrants in the United States. Using an ethnographic approach, in-depth interviews were conducted with six immigrants from Taiwan. Domain analysis and content analysis revealed ten domains, five of which are reported in this paper. The findings suggest that filial piety continues to operate in Chinese immigrant families. Implications for cross-cultural health care and research are addressed.
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This study examines the current status of older Korean immigrants and their changing roles in their families. Interviews were conducted with fifty elderly and forty adult children from Korean-American families residing in the Philadelphia area. The results suggest that a decrease in power and resources placed the elderly Koreans in an unfavorable position to remain valued members of their family. Older Korean immigrants have experienced many unexpected changing, and often less prestigious, roles in their old age. However, their modified beliefs on "filial piety" and a relative financial independence supported by the United States government may have been of significant influence to prevent intergenerational conflicts in Korean-American families.
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This study reported a qualitative analysis of health-seeking behaviors of community-dwelling elderly Chinese Americans on the influences of family network, cultural values, and immigrant experience in their use of health resources. Barriers to health care, pathway of health care, and adaptation of health care by use of self-treatment and Eastern and Western medicines were also examined. The investigators used content analysis to obtain themes and key points of focus group interview data (N = 25) to explore the elderly participants' attitudes, values, and practices in their use of health resources. Survey questionnaires in Chinese were used to compile demographic data. Findings suggested a shift from traditional expectations of filial piety to more dependence on neighbors and friends, and a genuine adaptability to combining Eastern and Western health care modalities. Immigration was not proposed by these Chinese elders as an explanation of shifts in expectations for family support or values. This study has implications for research, service delivery, and policy making for health care of ethnic elderly persons, particularly in addressing structural and cultural issues in access and compliance.
Article
The complexity of many urban health problems often makes them ill suited to traditional research approaches and interventions. The resultant frustration, together with community calls for genuine partnership in the research process, has highlighted the importance of an alternative paradigm. Community-based participatory research (CBPR) is presented as a promising collaborative approach that combines systematic inquiry, participation, and action to address urban health problems. Following a brief review of its basic tenets and historical roots, key ways in which CBPR adds value to urban health research are introduced and illustrated. Case study examples from diverse international settings are used to illustrate some of the difficult ethical challenges that may arise in the course of CBPR partnership approaches. The concepts of partnership synergy and cultural humility, together with protocols such as Green et al.'s guidelines for appraising CBPR projects, are highlighted as useful tools for urban health researchers seeking to apply this collaborative approach and to deal effectively with the difficult ethical challenges it can present.
Community-based participatory research for health Relationship between adherence to tradition and depression in Chinese elders in China
  • M Minkler
  • N Wallerstein
Minkler, M., & Wallerstein, N. (2003). Community-based participatory research for health. San Francisco: Jossey Bass. Mjelde-Mosse, L. A., Chi, I., & Lou, V. W. Q. (2006). Relationship between adherence to tradition and depression in Chinese elders in China. Aging & Mental Health, 10, 19–26.
Qualitative research methods for health professionals
  • J M Morse
  • P A Field
Morse, J. M., & Field, P. A. (1995). Qualitative research methods for health professionals. Thousand Oaks, CA: Sage.