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“I should be doing more for my parent:” Chinese adult children's worry about performance in providing care for their oldest-old parents

Published online by Cambridge University Press:  22 October 2015

Jinyu Liu  and
Mercedes Bern-Klug
Jinyu Liu*
Affiliation:
School of Social Work, Columbia University, 1255 Amsterdam Ave, New York, USA
Mercedes Bern-Klug
Affiliation:
School of Social Work, The University of Iowa, Room 308 North Hall, Iowa City, Iowa, USA
*
Correspondence should be addressed to: Jinyu Liu, PhD, MSW, Assistant Professor, School of Social Work, Columbia University, 1255 Amsterdam Ave, New York, NY, USA10027. Phone: +(919) 1-212-851-2246. Email: jl4658@columbia.edu.
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Abstract

Background:

In China, as is the case in most of the world, family is the largest source of support for frail older adults. Confucian filial piety expectations hold children-in particular sons-responsible for the care of aging parents in China. During the course of caregiving, in addition to positive feelings, the caregiver may feel overwhelmed, entrapped, and worried about their performance, which can have negative health consequences. The purpose of this exploratory study is to examine one dimension of caregiver burden “worry about performance” (WaP) and investigate whether variables inspired by Pearlin's Stress Process Model help to explain the variation of WaP, so that at-risk caregivers can be identified and supported.

Methods:

Multiple regression was used to analyze CLHLS data from 895 Chinese adult children providing care for their oldest old parent in eight coastal provinces in China. WaP was measured by two items from the Zarit Burden Inventory. Independent variables representing concepts from Pearlin's Stress Process Model and control variables were included in the models.

Results:

Compared to a model of control variables only, using independent variables inspired by Pearlin's Stress Process Model increased the ability to explain the variation in WaP by three fold to 14%. The following variables increased WaP: parent's IADL level, the amount of time spent caregiving, being a daughter, reporting an emotionally close relationship with the parent, sharing a residence with the parent.

Conclusion:

Despite not being able to fully operationalize Pearlin's Model with this dataset, analyzing variables that represent concepts from the model was useful in increasing the ability to explain the variation in WaP. Results suggest that caregiver support directed at daughters may be particularly beneficial.

Keywords

filial pietycaregiver burdenoldest oldZarit Burden InventoryStress Process Model
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 2 , February 2016 , pp. 303 - 315
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

Ankri, J., Andrieu, S., Beaufils, B., Grand, A. and Henrard, J. C. (2005). Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. International Journal of Geriatric Psychiatry, 20, 254–260.CrossRefGoogle ScholarPubMed
Annesi, J. J. and Unruh, J. L. (2008). Relations of exercise, self-appraisal, mood changes and weight loss in obese women: testing propositions based on Baker and Brownell's (2000) model. The American Journal of the Medical Sciences, 335, 198–204.CrossRefGoogle ScholarPubMed
Bédard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A. and O’Donnell, M. (2001). The Zarit Burden Interview a new short version and screening version. The gerontologist, 41, 652–657.Google Scholar
Cheng, S. T. and Chan, A. C. (2006). Filial piety and psychological well-being in well older Chinese. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, P262–P269.Google Scholar
Chou, K.-R., Lin, J.-C. and Chu, H. (2002). The reliability and validity of the Chinese version of the caregiver burden inventory. Nursing Research, 51, 324–331.Google Scholar
Cohen, C. A., Colantonio, A. and Vernich, L. (2002). Positive aspects of caregiving: rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17, 184–188.Google Scholar
Cummings, J. L. (1993). Mini-mental state examination. JAMA, 269, 2420–2421.Google Scholar
Davis, A. et al. (1998). Informal caregivers for urban chronically ill elderly people at home in the People's Republic of China: a qualitative study. Health Care in Later Life, 3, 3–14.Google Scholar
Etters, L., Goodall, D. and Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 423–428.CrossRefGoogle ScholarPubMed
Gu, D. and Vlosky, D. (2008). Long-term care needs and related issues in China. In Garner, J. and Christiansen, T. C. (eds.), Social sciences in health care and medicine (pp. 52–84). New York: Nova Science Publishers.Google Scholar
Guo, Z. (1996). The living arrangement of the oldest old in China and its determinants. Population Research, 20, 45–53.Google Scholar
Guo, Z. and Zhang, K. (1996). Retesting the role of the number of children in family support for the elderly. Population Research, 20, 7–15.Google Scholar
Hébert, R., Bravo, G. and Préville, M. (2000). Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia. Canadian Journal on Aging/La Revue Canadienne du Vieillissement, 19, 494–507.CrossRefGoogle Scholar
Heru, A. M. and Ryan, C. E. (2006). Family functioning in the caregivers of patients with dementia: one-year follow-up. Bulletin of the Menninger Clinic, 70, 222–231. doi: DOI 10.1521/bumc.2006.70.3.222.Google Scholar
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, 533–537. doi: Doi 10.1002/Gps.1119.Google Scholar
Ikels, C. (ed.) (2004). Filial piety: Practice and discourse in contemporary East Asia. California: Stanford University Press.CrossRefGoogle Scholar
Kincannon, C., He, W. and West, L. (2005). Demography of aging in China and the United States and the economic well-being of their older populations. Journal of Cross-Cultural Gerontology, 20, 243–255.CrossRefGoogle Scholar
Ko, K. T., Yip, P. K., Liu, S. I. and Huang, C.-R. (2008). Chinese version of the Zarit caregiver Burden Interview: A validation study. American Journal of Geriatric Psychiatry, 16, 513–518.Google Scholar
Lai, D. W. (2007). Validation of the Zarit Burden Interview for Chinese Canadian caregivers. Social Work Research, 31, 45–53.CrossRefGoogle Scholar
Lawton, M. P., Kleban, M. H., Moss, M., Rovine, M. and Glicksman, A. (1989). Measuring caregiving appraisal. Journal of Gerontology, 44, P61–P71.Google Scholar
Lea Steadman, P., Tremont, G. and Duncan Davis, J. (2007). Premorbid relationship satisfaction and caregiver burden in dementia caregivers. Journal of Geriatric Psychiatry and Neurology, 20, 115–119. doi: 10.1177/0891988706298624.CrossRefGoogle Scholar
Leggett, A. N., Zarit, S., Taylor, A. and Galvin, J. E. (2010). Stress and burden among caregivers of patients with Lewy body dementia. The Gerontologist, 51, 76–85.Google Scholar
Lim, W. S., Cheah, W. K., Ali, N., Han, H. C., Anthony, P. V., Chan, M. and Chong, M. S. (2014). Worry about performance: a unique dimension of caregiver burden. International Psychogeriatrics, 26, 677—686.Google Scholar
Liu, J., Guo, M. and Bern-Klug, M. (2013). Economic stress among adult-child caregivers of the oldest old in China: the importance of contextual factors. Journal of Cross-Cultural Gerontology, 28, 465–479.CrossRefGoogle Scholar
Lu, L., Wang, L., Yang, X. and Feng, Q. (2009). Zarit Caregiver Burden Interview: Development, reliability and validity of the Chinese version. Psychiatry and Clinical Neurosciences, 63, 730–734.Google Scholar
Magai, C. and Cohen, C. I. (1997). Attachment style and emotion regulation in dementia patients and their relation to caregiver burden. Journal of Gerontology, 53B, 147–154.Google Scholar
Pearlin, L. I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30, 241–256.CrossRefGoogle ScholarPubMed
Pearlin, L. I. (1999). The stress process revisited. In Aneshensel, C. S. and Phelan, J. C. (eds.), Handbook of the Sociology of Mental Health (pp. 395–415). New York: Springer.Google Scholar
Pearlin, L. I. and Bierman, A. (2013). Current issues and future directions in research into the stress process. In Handbook of the sociology of mental health (pp. 325–340). Netherlands: Springer.CrossRefGoogle Scholar
Pearlin, L. I., Mullan, J. T., Semple, S. J. and Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30, 583–594.Google Scholar
Pinquart, M. and Sörensen, S. (2007). Correlates of physical health of informal caregivers: a meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62, P126–P137.Google Scholar
Qiu, Y. and Li, S. (2008). Stroke: coping strategies and depression among Chinese caregivers of survivors during hospitalisation. Journal of Clinical Nursing, 17, 1563–1573.Google Scholar
Schreiner, A. S., Morimoto, T., Arai, Y. and Zarit, S. (2006). Assessing family caregiver's mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging and Mental Health, 10, 107–111.Google Scholar
Schulz, R. and Beach, S. R. (1999). Caregiving as a risk factor for mortality. JAMA, 282, 2215–2219.Google Scholar
Sherwood, P. R., Given, C. W., Given, B. A. and von Eye, A. (2005). Caregiver burden and depressive symptoms: analysis of common outcomes in caregivers of elderly patients. Journal of Aging and Health, 17, 125–147. doi: 10.1177/0898264304274179.Google Scholar
Song, L., Li, S. and Feldman, M. W. (2012). Out-migration of young adults and gender division of intergenerational support in rural China. Research on Aging, 34, 399–424.Google Scholar
Spaid, W. M. and Barusch, A. (1994). Emotional closeness and caregiver burden in the marital relationship. Journal of Gerontological Social Work, 21, 197–212.Google Scholar
Swann, W. B. Jr, Chang-Schneider, C. and Larsen McClarty, K. (2007). Do people's self-views matter? Self-concept and self-esteem in everyday life. American Psychologist, 62, 84.CrossRefGoogle ScholarPubMed
Tang, Y. (2006). Obligation of Filial Piety, Adult Child Caregiver Burden, Received Social Support, and Psychological Wellbeing of Adult Child Caregiversfor Frail Elderly People in Guangzhou, China. ProQuest Dissertations & Theses (0819161) database.Google Scholar
Tsai, J. H. C. (1999). Meaning of filial piety in the Chinese parent-child relationship: Implications for culturally competent health care. Journal of Cultural Diversity, 6, 26–34.Google ScholarPubMed
The National People's Congress of the People's Republic of China. (2004, March 14). The Constitution of the People's Republic of China. Retrieved March 15, 2014 from http://www.npc.gov.cn/englishnpc/Constitution/node_2824.htm.Google Scholar
United Nations. (2011). World Population Prospects: 2010 Revision Population Database. Retrieved March 15, 2012 from http://esa.un.org/UNPP/.Google Scholar
Wang, L. and Schneider, W. J. (2000). Discussion on the familial types in caring for the aged and relationships in it. Sociological Research, 88, 27–41.Google Scholar
Yue, X. and Ng, S. H. (1999). Filial obligations and expectations in China: current views from young and old people in Beijing. Asian Journal of Social Psychology, 2, 215–226.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649–655.Google Scholar
Zeng, Y., Liu, Y. and George, L. K. (2003). Gender differentials of the oldest old in China. Research on Aging, 25, 65–80.Google Scholar
Zhan, H. J. (2005). Social-economic context of parent care: explaining chinese caregivers’ psychological and emotional well-being. Journal of Gerontological Social Work, 45, 83–100.Google Scholar
Zhan, H. J. (2006). Joy and sorrow: explaining Chinese caregivers’ reward and stress. Journal of Aging Studies, 20, 27–38.Google Scholar
Zhan, H. J. and Montgomery, R. J. (2003). Gender and elder care in China the influence of filial piety and structural constraints. Gender & Society, 17, 209–229.CrossRefGoogle Scholar
Zhang, Z. (2008). The effects of adult children's caregiving on the health status of their elderly parents: protection or selection? In Zeng, Y., Poston, D. L., Vlosky, D. A. and Gu, D. (eds.), Healthy Longevity in China: Demographic Methods and Population Analysis (pp. 251–268). New York: Springer.CrossRefGoogle Scholar
Zhu, C. and Xu, Q. (1992). Family care of the elderly in China. In Kosberg, J. (ed.), Family Care of the Elderly: Social and Cultural Changes (pp. 67–81). California: Sage Publications, Inc.Google Scholar