Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-24T14:04:28.914Z Has data issue: false hasContentIssue false
  • English
  • Français

Coping strategies and social support-seeking behaviour among Chinese caring for older people with dementia

Published online by Cambridge University Press:  26 July 2012

ALMA AU ,
STEVEN M. SHARDLOW ,
YUE TENG ,
TERESA TSIEN  and
CHARLES CHAN
ALMA AU*
Affiliation:
Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China.
STEVEN M. SHARDLOW
Affiliation:
Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China. School of Nursing, Midwifery & Social Work, The University of Salford, UK.
YUE TENG
Affiliation:
Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China.
TERESA TSIEN
Affiliation:
Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China.
CHARLES CHAN
Affiliation:
Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China.
*
Address for correspondence: Alma Au, Department of Applied Social Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong, China. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The study reviewed coping and help-seeking behaviour among Hong Kong Chinese family care-givers of older people diagnosed with dementia. A convenience sample of those caring for family members with dementia (N=11) was recruited in Hong Kong. Semi-structured interviews were conducted, transcribed and analysed using NVivo. The study found evidence of distinct Chinese coping strategies that focused upon internal self-regulation, forbearance and family obligations. In terms of help-seeking behaviour, these care-givers expressed great concern about bothering their family members. When there is a desperate need for help, they turn to community services. Results are discussed in the context of both traditional Chinese cultural values as well as the modern transformations of the Chinese society. In particular, Eastern philosophical teachings tend to focus on changing personal inner perception and thoughts rather than attempting to change the environment. Although family obligations have been traditionally upheld, many modern Chinese societies are undergoing social and demographic changes, resulting in marked decline in multi-generational households. Our findings can have applications not only for Chinese cities but also may have implications to the West as strong well-established Chinese communities are widespread.

Keywords

Chinesedementiacare-giverscopingsocial supportHong Kong
Type
Articles
Information
Ageing & Society , Volume 33 , Issue 8 , November 2013 , pp. 1422 - 1441
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Disease International 2009. World Alzheimer Report 2009. Available online at http://www.alz.co.uk/research/files/World%20Alzheimer%20Report.pdf [Accessed 9 May 2011].Google Scholar
Alzheimer's Society 2008. The Later Stages of Dementia. Available online at http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200173&documentID=101 [Accessed 9 May 2011].Google Scholar
Au, A., Lai, M. K., Lau, K. M., Pan, P. C., Lam, L., Thompson, L. and Gallagher-Thompson, D. 2009 a. Social support and well-being in dementia family caregivers: the mediating role of self-efficacy. Aging and Mental Health, 13, 5, 761–68.CrossRefGoogle ScholarPubMed
Au, A., Lau, K. M., Koo, S., Cheung, G., Pan, P. C. and Wong, M. K. 2009 b. The effects of informal social support on depressive symptoms and life satisfaction in dementia caregivers in Hong Kong. Hong Kong Journal of Psychiatry, 19, 2, 92–9.Google Scholar
Au, A., Li, S., Lee, K., Leung, P., Pan, P. C., Thompson, L. and Gallagher-Thompson, D. 2010. The coping with caregiving group program for Chinese caregivers of patients with Alzheimer's disease in Hong Kong. Patient Education and Counseling, 78, 256–60.CrossRefGoogle ScholarPubMed
Benson, P., Fisher, G. and Tessler, R. C. 1996. A state network of family support services: the Massachusetts family support demonstration project. Evaluation and Program Planning, 19, 1, 27–39.CrossRefGoogle Scholar
Boey, K. W. 1999. Help-seeking preference of college students in urban China after the implementation of the ‘open-door’ policy. International Journal of Social Psychiatry, 45, 2, 104–16.CrossRefGoogle ScholarPubMed
Chen, L. L. 1987. A study of the process of psychological help-seeking among college students in Taiwan. Chinese Journal of Mental Health, 3, 125–35. (In Chinese)Google Scholar
Cheng, C. and Cheung, M. W. L. 2005. Cognitive processes underlying coping flexibility: differentiation and integration. Journal of Personality, 73, 4, 859–86.CrossRefGoogle ScholarPubMed
Cheng, C., Lo, B. C. Y. and Chio, J. H. M. 2010. The Tao (way) of Chinese coping. In Bond, M. H. (ed.), Oxford Handbook of Chinese Psychology. Oxford University Press, Hong Kong, 399–439.Google Scholar
Cheung, F. M. 1984. Preferences in help-seeking among Chinese students. Culture, Medicine and Psychiatry, 8, 4, 371–80.CrossRefGoogle ScholarPubMed
Cheung, F. M. and Lau, B. W. K. 1982. Situational variations of help-seeking behavior among Chinese patients. Comprehensive Psychiatry, 23, 3, 252–62.CrossRefGoogle ScholarPubMed
Department of Health 2005. Carers and Disabled Children Act 2000 and Carers (Equal Opportunities) Act 2004 Combined Policy Guidance. Available online at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4117866.pdf [Accessed 9 May 2011].Google Scholar
Donaldson, C., Tarrier, N. and Burns, A. 1998. Determinants of carer stress in Alzheimer's disease. International Journal of Geriatric Psychiatry, 13, 4, 248–56.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
Elliott, K. S., Di Minno, M., Lam, D. and Tu, A. M. 1996. Working with Chinese families in the context of dementia. In Yeo, G. and Gallagher-Thompson, D. (eds), Ethnicity and the Dementias. Taylor & Francis, New York, 89–108.Google Scholar
Fingerman, K. L., Gallagher-Thompson, D., Lovett, S. and Rose, J. 1996. Internal resourcefulness, task demands, coping, and dysphoric affect among caregivers of the frail elderly. International Journal of Aging and Human Development, 42, 3, 229–48.CrossRefGoogle ScholarPubMed
Fung, H. H. and Cheng, S. T. 2010. Psychology and aging in the land of the panda. In Bond, M. H. (ed.), Oxford Handbook of Chinese Psychology. Oxford University Press, Hong Kong, 309–26.Google Scholar
Gaugler, J. E., Linder, J., Given, C. W., Kataria, R., Tucker, G. and Regine, W. F. 2008. The proliferation of primary cancer caregiving stress to secondary stress. Cancer Nursing, 31, 2, 116.CrossRefGoogle ScholarPubMed
Granvold, D. K. 1996. Constructivist psychotherapy. Families in Society, 77, 6, 345–59.CrossRefGoogle Scholar
Haley, W. E., Gitlin, L. N., Wisniewski, S. R., Mahoney, D. F., Coon, D. W., Winter, L., Corcoran, M., Schinfeld, S. and Ory, M. 2004. Well-being, appraisal, and coping in African-American and Caucasian dementia caregivers: findings from the REACH study. Aging & Mental Health, 8, 4, 316–29.CrossRefGoogle ScholarPubMed
Haley, W. E., Levine, E. G., Brown, S. L. and Bartolucci, A. A. 1987. Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging, 2, 4, 323–30.CrossRefGoogle ScholarPubMed
Heru, A. M., Ryan, C. E. and Iqbal, A. 2004. Family functioning in the caregivers of patients with dementia. International Journal of Geriatric Psychiatry, 19, 6, 533–7.CrossRefGoogle ScholarPubMed
Ho, D. Y. F. 1994. Face dynamics: from conceptualization to measurement. In Ting-Toomey, S. (ed.), The Challenge of Facework: Cross-cultural and Interpersonal Issues. State University of New York, New York, 269–86.Google Scholar
Hong Kong Government Census and Population Department 2010. Hong Kong Statistics. Available online at http://www.censtatd.gov.hk/hong_kong_statistics/statistics_by_subject/index.jsp [Accessed 9 May 2011].Google Scholar
Hwang, K. K. and Han, K. H. 2010. Face and morality in Confucian society. In Bond, M. H. (ed.), Oxford Handbook of Chinese Psychology. Oxford University Press, Hong Kong, 479–98.Google Scholar
Jolley, D. and Moniz-Cook, E. 2009. Memory clinics are all about stigma, not screening. British Medical Journal, 338, b860.CrossRefGoogle Scholar
Jones, P. S. 1995. Paying respect: care of elderly parents by Chinese and Filipino American women. Health Care for Women International, 16, 5, 385–98.CrossRefGoogle ScholarPubMed
Jose, P. E. and Huntsinger, C. S. 2005. Moderation and mediation effects of coping by Chinese American and European American adolescents. The Journal of Genetic Psychology, 166, 1, 16–44.CrossRefGoogle ScholarPubMed
Lazarus, R. S. and Folkman, S. 1984. Stress, Appraisal, and Coping. Springer, New York.Google Scholar
Losada, A., Marquez-Gonzalez, M., Knight, B. G., Yanguas, J., Sayegh, P. and Romero-Moreno, R. 2010. Psychosocial factors and caregivers’ distress: effects of familism and dysfunctional thoughts. Aging & Mental Health, 14, 2, 193–202.CrossRefGoogle ScholarPubMed
Lu, L., Gilmour, R., Kao, S. F., Eng, T. H., Hu, C. H., Chern, J. G., Huang, S. W. and Shih, J. B. 2001. Two ways to achieve happiness: when the East meets the West. Personality and Individual Differences, 30, 1161–74.CrossRefGoogle Scholar
Mak, W. W. S. and Chen, S. X. 2010. Illness behaviors among the Chinese. In Bond, M. H. (ed.), Oxford Handbook of Chinese Psychology. Oxford University Press, Hong Kong, 309–26.Google Scholar
Meng, Q., Xiao, S. and Liu, Y. 2006. Burden on caregivers of at-home dementia patients and its relevant factors. Chinese Nursing Research, 20, 7, 1721–3.Google Scholar
Mitrani, V. B., Lewis, J. E., Feaster, D. J., Czaja, S. J., Eisdorfer, C., Schulz, R. and Szapocznik, J. 2006. The role of family functioning in the stress process of dementia caregivers: a structural family framework. The Gerontologist, 46, 1, 97–105.CrossRefGoogle ScholarPubMed
Mjelde-Mossey, L. A., Barak, M. E. M. and Knight, B. G. 2004. Coping behaviors as predictors of drinking practices among primary in-home dementia caregivers. Journal of Applied Gerontology, 23, 3, 295–308.CrossRefGoogle Scholar
Ow, R. and Katz, D. 1999. Family secrets and the disclosure of distressful information in Chinese families. Families in Society, 80, 6, 620–8.CrossRefGoogle Scholar
Pines, A. M., Zaidman, N., Wang, Y., Chengbing, H. and Ping, L. 2003. The influence of cultural background on students’ feelings about and use of social support. School Psychology International, 24, 1, 33–53.CrossRefGoogle Scholar
Pinquart, M. and Sörensen, S. 2003. Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. Journals of Gerontology: Psychological Sciences and Social Sciences, 58B, 2, 112–28.CrossRefGoogle Scholar
Powers, D. V., Gallagher-Thompson, D. and Kraemer, H. C. 2002. Coping and depression in Alzheimer's caregivers: longitudinal evidence of stability. Journals of Gerontology: Psychological Sciences and Social Sciences, 57B, 3, 205–11.CrossRefGoogle Scholar
Pruchno, R. A. and Resch, N. L. 1989. Mental health of caregiving spouses: coping as mediator, moderator, or main effect? Psychology and Aging, 4, 4, 454–63.CrossRefGoogle ScholarPubMed
QSR International 2009. NVivo Version 8.0 [computer software]. QSR International, Melbourne.Google Scholar
Sörensen, S. and Pinquart, M. 2005. Racial and ethnic differences in the relationship of caregiving stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health. Aging & Mental Health, 9, 5, 482–95.CrossRefGoogle ScholarPubMed
Sue, S. 1976. Clients’ demographic characteristics and therapeutic treatment: differences that make a difference. Journal of Consulting and Clinical Psychology, 44, 5, 864.CrossRefGoogle Scholar
Tang, Y. 2006. Female caregiver burden and coping: the case study in Shenzhen. Journal of Social Work, 12, 2, 20–3. (In Chinese)Google Scholar
Tremont, G., Davis, J. D. and Bishop, D. S. 2006. Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. Dementia and Geriatric Cognitive Disorders, 32, 3, 170–4.CrossRefGoogle Scholar
Triandis, H. C., Bontempo, R., Villareal, M. J., Asai, M. and Lucca, N. 1988. Individualism and collectivism: cross-cultural perspectives on self and in-group relationships. Journal of Personality and Social Psychology, 54, 2, 323–38.CrossRefGoogle Scholar
Tseng, W. S. 1973. The concept of personality in Confucian thought. Psychiatry, 36, 191–202.CrossRefGoogle ScholarPubMed
Vitaliano, P. P., Russo, J., Carr, J. E., Maiuro, R. D. and Becker, J. 1985. The ways of coping checklist: revision and psychometric properties. Multivariate Behavioral Research, 20, 1, 3–26.CrossRefGoogle ScholarPubMed
Vitaliano, P. P., Zhang, J. and Scanlan, J. M. 2003. Is caregiving hazardous to one's physical health? A meta-analysis. Psychological Bulletin, 129, 6, 946–72.CrossRefGoogle ScholarPubMed
Wang, P., Tong, H., Liu, W., Long, S., Leung, L. Y. L., Yau, E. and Gallagher-Thompson, D. 2006. Working with Chinese American families. In Yeo, G. and Gallagher-Thompson, D. (eds), Ethnicity and the Dementias. Taylor & Francis, New York, 173–88.Google Scholar
Werner, P. 2008. Discriminatory behavior towards a person with Alzheimer's disease: examining the effects of being in a nursing home. Aging & Mental Health, 12, 6, 786–94.CrossRefGoogle ScholarPubMed
Wilksa, S. E. and Croomb, B. 2008. Perceived stress and resilience in Alzheimer's disease caregivers: testing moderation and mediation models of social support. Aging & Mental Health, 12, 3, 357–65.CrossRefGoogle Scholar
Williamson, G. M. and Schulz, R. 1993. Coping with specific stressors in Alzheimer's disease caregiving. The Gerontologist, 33, 6, 747–55.CrossRefGoogle ScholarPubMed
Wimo, A., Winblad, B. and Jonsson, L. 2007. An estimate of the total worldwide societal costs of dementia in 2005. Alzheimer's and Dementia, 3, 2, 81–91.CrossRefGoogle ScholarPubMed
Yang, K. 1981. Social orientation and individual modernity among Chinese students in Taiwan. Journal of Social Psychology, 113, 2, 159–70.CrossRefGoogle Scholar
Zhan, H. J. 2006. Joy and sorrow: explaining Chinese caregivers’ reward and stress. Journal of Aging Studies, 20, 27–38.CrossRefGoogle Scholar