Family caregiving experience and health status among Chinese in the United States

Abstract

It is estimated that by 2025 the Asian population in the United States will be over 40 million; it will represent nearly 10% of the total U.S. population. Currently Chinese immigrants are the largest Asian group and constitute 22.6% of all Asian immigrants. With the Chinese immigrant population growing steadily, the Chinese elderly population will increase in the future. Historically, "Hsiao" (filial piety in English), rooted in Confucianism, teaches Chinese people to pay respect to living parents and provides rules for culturally defined intergenerational relationships and family caregiving, and putting family needs above individual interests. Among the Chinese, family caregiving is perceived as a duty, obligation, responsibility, and cultural virtue. The purpose of the study was to test a theoretical model specifying how factors including subjective beliefs of traditional filial obligation, subjective feelings about role requirements, perceived burdens, perceived rewards and use of coping affect Chinese caregivers' health in the United States. The aim of this study was to understand how caregivers' cultural background and the appraisal of family caregiving affect caregivers' well-being. Data from 137 caregivers were used to describe sample profile and for model testing. The original model failed to explain the data adequately. Two revised models were developed. Results suggest that data fit better with physical health, as indicated by CFI = .91 and the χ²/df ratio = 2.9, than mental health model, as indicated by CFI = .90 and the χ²/df ratio = 3.5. Findings suggest caregivers' beliefs of traditional filial obligation is a primary predictor for caregivers' physical health. Caregivers' subjective beliefs of traditional filial obligation affect caregivers' physical health not only directly but also indirectly. Implications for nursing research, practice, education and theory construction, and policy making were addressed. Limitations and recommendations for research design and interpretation of model fit were described. Further studies are needed to compare differences in cultural influences among different ethnic groups, identify effective coping style and test the effect of intervention caregivers' health.