Clarifying and measuring filial concepts across five cultural groups (original) (raw)
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BMC Nursing, 2024
Background The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. Purpose To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. Methods A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. Findings Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene' , (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. Conclusion Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study. Highlights • Filial piety attributes are aging-related material and physical support from family and society. • Filial piety is associated with burden on family caregivers, psychological and physical well-being, quality of life, and health equity. • Culturally-sensitive healthcare services for aging Chinese and Chinese American individuals and families in the U.S. are hindered by lack of awareness of filial piety's effect. • Operationalizing filial piety contributes to bridging the gap in nursing knowledge and understanding of the aging needs of Chinese and Chinese Americans in the U.S.
Family Matters: Cross-Cultural Differences in Familism and Caregiving Outcomes
The Journals of Gerontology: Series B, 2021
Objectives The increasing number of minority older adults, and the subsequent increase in family members providing care to these individuals, highlights the need to understand how cultural values contribute to differential caregiving outcomes. Using the sociocultural stress and coping model as a guiding framework, the current study examined cross-cultural relationships among familism, social support, self-efficacy, and caregiving outcomes and examines how these relationships vary as a function of caregiver background characteristics. Methods Baseline data were collected from 243 participants in the Caring for the Caregiver Network randomized controlled intervention trial. Participants completed measures assessing familism, social support, self-efficacy, positive aspects of caregiving, depression, and burden. Results African American and Hispanic participants exhibited higher levels of familism compared to Whites. Compared to White participants, African Americans’ endorsement of fami...
Cultural implications of filial obligation and the Asian Indian American family caregiver
Qualitative Research in Medicine & Healthcare
Family caregivers in young adulthood from different racial/ethnic groups represent an understudied population. Of this group, Asian Indians are a diverse and fast-growing immigrant population in the US and present unique challenges for health care providers. To illustrate factors influencing a young family caregiver from an under-represented racial/ethnic population, we report on the case of a 33 year-old American from an Asian Indian background who was a caregiver for his father with Normal Pressure Hydrocephalus (NPH). With this case report, we illustrate that medical providers should attend to cultural norms of the family system, including family communication patterns, filial obligation, and decision-making.
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2013
Objectives. Race has been found to predict justi cations for caregiving in family caregivers for older adults. However, little is known about this relationship in another type of family caregiver, Grandparents Raising Grandchildren (GRG). This study examined relationships between race and justi cations for caregiving in Asian American, Native Hawaiian, and White GRG. Method. A sample of 259 GRG registered as students' primary caregivers with a public school system completed a modi ed version of the 10-item Cultural Justi cations for Caregiving (CJCG) scale. Results. CJCG items did not load onto a single analytic factor. Two factors, custom and responsibility, emerged. Race was predictive of custom, with Native Hawaiian GRG having signi cantly higher scores than White or Asian American GRG. Native Hawaiian GRG also scored higher than Asian American, but not White, GRG on responsibility. Discussion. Justi cations for raising grandchildren appear to differ among groups based on racial identi cation. Findings elucidate cultural justi cation for caregiving in understudied GRG populations and suggest that justi cations for caregiving are con gured differently in GRG and family caregivers for older adults. Future studies should examine justi cations for caregiving in GRG of other races.
Culture, Caregiving, and Health: Exploring the Influence of Culture on Family Caregiver Experiences
ISRN Public Health, 2014
Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups Thirty-five caregivers participated in this study. We found commonalities among all of the cultural/ethnic groups in their experiences of the difficulties of caregiving. However, there were some significant differences in the cultural values and norms that shaped the caregiving experience. We categorized these differences as: (a) cultural embeddedness of caregiving, (b) cultural determinants of caregiving responsibilities or taxonomy of caregiving, and (c) cultural values and norms underlying the decision to provide care. The significance of this study is that it highlights the culturally perceived mandate to provide care in the African, Asian, and Hispanic American cultures.
Acculturation in Filial Practices Among U.S. Chinese Caregivers
Qualitative Health Research, 2008
In this article, we explore the phenomenon of acculturation in filial practices among 21 Chinese immigrants in a suburban city in the Midwestern United States using focus groups and individual interviews. All participants were situational reciprocal-filial caregivers who had acculturated into mainstream filial practices while preserving their heritage to deal with the challenges of parental care. Factors that influenced participants' acceptance of new filial practices included comfort in accepting new practices, financial status, and past relationship with the care receiver. Their motivations to acculturate included being overwhelmed, a multitude of situational constraints from being an immigrant, access to and utilization of resources, and the need for a coordinated approach to filial responsibilities. Their filial motivations included love, honoring traditions, meeting personal values, and meeting social expectations. These findings provide insight for designing culturally competent training and immigrant caregiver education. Keywords: caregiving; caregiving, community-based (home care); caregiving, immigrants; caregiving, informal; Chinese culture; cultural competence; families Article: For immigrants acculturation is a resocialization process that involves adjusting to the host culture while maintaining their own heritage (Berry, 1997, 2003). Since the 1930s acculturation has been widely explored in the social and behavioral sciences (Redfield, Linton, & Herskovits, 1936). Existing research has shown that acculturation is stressful for immigrants, especially for the first generation, because it requires changes in social skills, beliefs, and behavioral values (Rosenthal & Feldman, 1990; Sodowsky, Lai, & Plake, 1991). Although some studies have examined U.S. immigrants' caregiving experiences, no research has addressed the acculturation experience from sociohistorical and situational-psychological perspectives (Dilworth-Anderson, Williams, & Gibson, 2002; Janevic & Connell, 2001). The ways in which immigrant caregivers' original filial beliefs melt into the mainstream of the host society are unknown, and the ways in which their situational status influences or is influenced by their acculturation practices are unclear. In this article we report on a qualitative inquiry into the changes in filial practices resulting from acculturation among first-generation Chinese immigrants who provided care or informal support-such as custodial services for their parents or parents-in-law-in a suburban city in the Midwestern United States. We chose the Chinese because they represent nearly one fourth (23.4%) of all Asian immigrants (U.S. Census Bureau, 2007) and they share similar values of collectivism that stress conventional, lifelong, reciprocal obligations for parental care (Berger & Huntington, 2003). We focused only on immigrants who left their home countries voluntarily. We excluded refugees because they left their home countries involuntarily and therefore represent a Authors' Note: We would like to express special thanks to our participants, two research assistants, and gatekeepers in the Chinese community. They made the success of this research possible. This research was supported by the University of Missouri-St. Louis through two awards-one from the Research Board and the other from the Center for International Studies. special subgroup with different social-political backgrounds (U.S. Department of Justice, 2005). Parental Care in Collectivistic and Individualistic Cultures Collectivistic and individualistic cultures vary in their views of who should provide parental care and how it should be provided. People living in a collectivistic culture such as a Confucian society have historically accepted that children have a lifelong responsibility to their parents to reciprocate for their gift of life and upbringing (Sung, 2001; Waley, 1938). Confucianism mandates collectivism-based filial values (CBFV) that reinforce interdependence; unconditional loyalty and devotion to parents and family; the ability to endure existential difficulties; a lifelong commitment to self-sacrifice for family needs; and filial responsibility governed by rules of primogeniture and gender roles (Chen, 1908; Schorr, 1960). By tradition, Chinese adult children are morally and socially bound to care for their parents (Schorr, 1960). Married sons are expected to reside with and take care of their elderly parents, especially oldest sons, who often inherit the largest portion of the family property and are responsible for passing on their heritage to the next generation (Waley, 1938). Unmarried daughters live with and provide affective support and personal care for their parents, but when they marry they become daughters-in-law and are obligated to care for their parents-in-law instead of their own parents (Ikels, 1983). Thus, married sons provide living arrangements and assume financial responsibility for their parents, and daughters-in-law customarily provide personal care and affective support for parents-in-law (Hsu & Shyu, 2003). Parental care is based on a sense of gratitude and moral obligation that goes beyond social pressure or economic force or benefit (Ho, 1996; Ikels, 1983). In contrast, people living in an individualistic culture such as the United States generally agree that children are not obligated to take care of their parents, though they may choose to do so (Collingridge & Miller, 1997). In the United States the government provides health care and support for its citizens through a welfare system to ensure that all individuals are free from poverty, disability, and illness (Axinn & Stern, 2005; Triandis, 1995). The emphasis on individuals' rights and control over their own choices is expressed as individualism-based filial values (Collingridge & Miller, 1997). As a result, adult children may or may not provide care or support for parents (Lee, Peek, & Coward, 1998). Parental care is usually focused on financial support or assistance with daily tasks and/or affective support by visits or phone calls
Association between filial responsibility when caring for parents and the caregivers overload
Revista Brasileira de Enfermagem, 2017
Objective: To analyze the association between filial responsibility and the overload of the children when caring for their older parents. Method: Cross-sectional study with 100 caregiver children of older adults. Filial liability was assessed by the attitudes of the responsible child (scale of expectation and filial duty) and by care behaviors (assistance in activities of daily living, emotional and financial support, and keeping company). The overload was assessed by the Caregiver Burden Inventory. To assess the associations, the correlation coefficients of Pearson and Spearman, Kruskal-Wallis Test, and Mann-Whitney were employed. Variables that presented p-value<0.20 in the bivariate analysis were inserted in a multivariate linear regression model. Results: The factors associated with overload were: formal employment (p=0.002), feelings regarding family life (p<0.001), financial support (p=0.027), and assistance with Activities of Daily Living (ADLs) (p<0.001). Conclusion...
Adult Caregiving Among American Indians: The Role of Cultural Factors
The Gerontologist, 2011
With a sample of American Indian adults, we estimated the prevalence of adult caregiving, assessed the demographic and cultural profile of caregivers, and examined the association between cultural factors and being a caregiver. This is the first such study conducted with American Indians. Design and Methods: Data came from a crosssectional study of 5,207 American Indian adults residing on 2 closely related Lakota Sioux reservations in the Northern Plains and one American Indian community in the Southwest. Cultural factors included measures of cultural identity and traditional healing practices. Results: Seventeen percent of our sample reported being caregivers. In both the Northern Plains and Southwest, caregiving was positively correlated with younger age, being a woman, larger household size, attending and participating in Native events, and endorsement of traditional healing practices. In both regions, attendance and participation in Native events and engagement in traditional healing practices were associated with increased odds of caregiving after adjusting for covariates. Only in the Northern Plains did we find that speaking some Native language at home was associated with increased odds of being a caregiver. Examination of interaction terms indicated some sex differences in the association between cultural factors and caregiving in the Northern Plains but not in the Southwest. Implications: Our findings indicate that greater cultural identity and engagement in traditional healing practices are related to caregiving in American Indian populations. Caregiving research, intervention efforts, and caregiving programs and services in Native communities should pay special attention to the dynamics of culture and caregiving.