Asian American Journal of Psychology最新文献

The present study aimed to understand the reasons for early and prolonged parent-child separation and its impacts among separated-reunited Chinese immigrant families. Chinese dual-earner immigrant parents, especially low-income families, are likely to send their newborns back to China to be raised by their extended families. Prior research has not yet sufficiently investigated the reasons for separation and how affected families perceive the benefits and costs, especially among those who have reunited years after separation. Based on one-on-one qualitative interviews (N = 48 in 24 parent-child dyads) and supplemental screening survey data (N = 142), we identified common reasons for separation, including involuntary reasons (e.g., financial difficulties and lack of child-rearing time) and voluntary reasons (e.g., building bonds with Chinese culture). In addition, we used thematic analysis for the 24 parent-child dyad interviews and explored the impact of early and prolonged parent-child separation (i.e., benefits and costs) perceived by the youth and their primary caregivers. Benefits of separation included improved financial and living situations and enhanced bonding with cultural origins. Costs they perceived included impaired relationships within nuclear families, substitute caregivers spoiling children, and introducing language barriers. These findings shed light on the development of policies and initiatives aiming to support Chinese immigrant families pre- and postseparation.

Burmese refugees, constituting one of the largest group of refugees admitted to the United States, accounting for 21% of total admissions in the past decade. Using a multi-informed perspective, this research study sought to understand the help-seeking experiences of Burmese American refugee families regarding the diagnosis and treatment of autism spectrum disorder. In this study, we conducted semi-structured qualitative interviews with 16 individuals, including primary caregivers (n=6), Burmese community leaders (n=4), and healthcare workers (n=6). Caregiver interviews were conducted in Burmese Chin languages by native speakers on the research team. Our results indicated systematic barriers and access to health care, health literacy, cultural stigma and perception surrounding families and community, professional and family interaction with multicultural consideration, and caregiver burnout collectively shape the complex landscape of help-seeking experiences among Burmese American families with children with ASD. We provided clinical recommendations for providers and community leaders to address the barriers found in our study.

Cultural values influence health beliefs, attitudes, and behaviors. Given the history of pre-colonial Philippines and under Spanish, American, and Japanese colonization, Filipinos have unique cultural values that are understudied in relation to health outcomes. The objectives of this study are to (1) create and validate measurement scales of surface level Filipino cultural values and (2) examine its associations with depressive symptoms and substance use in a sample of Filipino Americans. We analyzed data from the Midwest Longitudinal Studies of Asian American Families (MLSAAF) collected in 2013 of Filipino American parents (n=376). We implemented factor analyses to create and validate the scales and ordinary least squares and logistic regressions to examine the associations between Filipino cultural values and depressive symptoms and substance use. Factor analyses produced five scales: hiya (dignity or shame) from parent, hiya in general, utang na loob (gratitude or solidarity), pakikisama (companionship), and bahala na (determination). Hiya from parent was positively associated with depressive symptoms and hiya in general was negatively associated with depressive symptoms and alcohol use until passing out. The findings demonstrate the nuanced and complex means that Filipino cultural values have influenced health outcomes in Filipino Americans. This study is the first of its kind to quantitatively measure surface level Filipino cultural values. Future studies should consider using the measurement scales to better understand how intergenerational trauma and resilience through cultural values influence other health beliefs, behaviors, and outcomes in Filipinos in the Philippines and in the diaspora.

The supportive care needs of people with metastatic cancer, particularly Asian Americans, are understudied. Distinct psychosocial support needs may exist across ethnocultural groups with Confucian-heritage values and norms. Cultural factors may shape how adults approach their oncologic care. This qualitative study represents the perspectives of 15 experienced healthcare professionals about the supportive care needs of Chinese-, Korean-, and Vietnamese-heritage (CKV) adults with metastatic solid cancers. Reflexive thematic analysis was conducted with transcripts from three semi-structured focus groups and five parallel-format individual interviews. Inductive coding and iterative theme development resulted in four themes describing the types of needs (basic, care-related, mental health, relational trust) that should be met for CKV patients with metastatic cancer, which may fall through the gaps when the healthcare system and patient's differing cultural contexts collide. In conclusion, greater involvement of psychosocial care specialists with cultural expertise is essential to promote patients' and families' well-being, prevent care disparities, and better support the healthcare team. Systemic changes that increase workforce diversity, reduce language and insurance barriers, and allow healthcare professionals to build relational trust with patients, are needed to improve quality of life for CKV patients with metastatic cancer.

Sleep-related issues may be one significant pathway through which socioeconomic disadvantages are associated with worse self-reported states in cancer. The present study examined the relationships between SES (income and education level) and two important biobehavioral factors (cancer-related fatigue and perceived stress), as well as mediation through sleep-related problems (sleep medication use, daytime dysfunction, and sleep quality) among a sample of Chinese American breast cancer survivors. 136 Chinese American breast cancer survivors completed a self-reported questionnaire. We found that relative to those with the lowest annual household income, those with the highest income have lower perceived stress. This relationship was mediated by lower sleep quality. Relative to those with a high school degree or less, those with graduate degrees have lower daytime dysfunction, and in turn lower cancer-related fatigue. Our findings point to the importance of addressing sleep-related issues, perceived stress, and cancer-related fatigue among Chinese American breast cancer survivors with low SES backgrounds.

This qualitative study analyzed how Chinese American (CA) and non-Hispanic White (NHW) breast cancer patients and their oncologists communicated about patients' emotional concerns. Data included twenty-four recordings of clinical encounters between oncologists and four CA and eight NHW women with a new breast cancer diagnosis between 2013 and 2015. Using an interactional sociolinguistics approach to discourse analysis, we examined how CA and NHW patients and their oncologists initiated conversations about patients' emotions. We also categorized oncologists' responses by whether oncologists turned toward, turned away, or remained neutral to patients' emotions. When bringing up emotions with oncologists, NHW patients brought up social and personal life topics, whereas CA patients only brought up biomedical topics. We also observed that oncologists initiated discussions about emotions with only English-speaking patients of both racial groups. There were no observed differences in how oncologists remained neutral to or turned away from both CA and NHW patients' emotional expressions. When oncologists turned away from patients' emotions, they did so to solve administrative or biomedical problems. In conclusion, the findings suggest that CA patients' racial backgrounds and the language spoken during the encounters may influence how patients and oncologists initiate discussion about patients' emotions. Furthermore, the findings suggest that oncologists remain neutral and turn away from CA and NHW patients' emotions in similar ways. This study provides preliminary data for more comprehensive investigations of Asian American cancer patients' actual communication with their providers regarding emotions and treatment decisions to facilitate patient-provider communication quality.

Many Asian American cancer patients face barriers to cancer care but little is known about their navigational needs. We designed and implemented a pilot study to provide culturally- and linguistically-appropriate navigation for Asian American cancer patients. We recruited Asian American adults age 21+ years, who spoke English, Cantonese, Mandarin, or Vietnamese, with newly diagnosed, stage I-III colorectal, liver, or lung cancer in the Northern California Bay Area. Participants were assigned a language-concordant patient navigator, who provided support and resources over 6 months. Surveys were administered at baseline, 3-, and 6-months to assess sociodemographic characteristics, healthcare access, quality of life (FACT-G), and cancer care needs. Participants' mean age was 65 years (range 38-81); 62% were men, 67% spoke Chinese, and 75% reported limited English proficiency. Forty-two percent of participants had lung, 38% colorectal, and 21% liver cancer. Of 24 participants who enrolled, 67% completed the program and 75% completed standard of care cancer treatment. The average total FACT-G score was 72.6 (SD 17) at baseline, 68.0 (SD 20) at 3 months, and 69.9 (SD 22) at 6 months. All participants reported that the program was culturally appropriate and would recommend it. Asian American cancer patients in a patient navigation program reported lower quality of life compared to the general adult cancer population. Even with navigation, 75% of participants reported completing standard of care treatment. While participants were satisfied with the program, more research is needed to address the quality of cancer care Asian American cancer patients receive.

In the United States (US), rates of cervical cancer screening among Asian American women (notably Korean American women) lag far behind other populations. Thus, guided by the Health Belief Model, we developed a multi-component intervention to enhance Korean American women's knowledge and beliefs about screening and to increase screening uptake. The intervention group (N=341) received a culturally-relevant cancer education program and navigation services. The control group (N=335) received a similar program on cervical cancer risk and screening, along with information about free/low-cost screening sites. Women's knowledge and beliefs were measured at baseline and post-program, and screening behavior was assessed at 12-months post-program. It was hypothesized that the intervention would lead to positive changes in health beliefs and knowledge about cervical cancer and screening, which were then evaluated as potential mediators of the intervention on screening behavior. From pre- to post-program, the intervention group reported significantly greater increases in knowledge (p<0.01) and perceived risk (p=0.02) and significantly greater decreases in perceived barriers (p<0.001) compared to the control group. However, changes in knowledge and health beliefs did not mediate intervention effects on screening behavior. Use of navigation services was associated with greater odds of obtaining screening (OR=3.15, 95% CI=2.28-4.01, p<0.001) and attenuated the significant effect of group assignment (intervention vs. control) on screening behavior to non-significance. In conclusion, although our intervention program was effective in improving women's knowledge and beliefs about screening, delivery of navigation services was the critical component in increasing cervical cancer screening rates in this underserved population.

Asian Americans have surpassed Hispanics as the fastest-growing racial/ethnic group in the United States and Chinese Americans are the largest Asian American subgroup. Cancer is the leading cause of death among Chinese Americans while heart disease remains the leading cause of death in the U.S. overall. Foreign-born immigrants are more likely to be diagnosed with advanced stage cancers than their native-born counterparts. Patients with advanced cancer have specific psychosocial needs, such as end-of-life concerns and existential distress. Meaning-Centered Psychotherapy (MCP), which enhances a sense of meaning in life to increase QOL, is among the most promising psychosocial treatments for advanced cancer patients, having demonstrated efficacy in several randomized controlled trials. Our preliminary qualitative work suggested a meaning-centered intervention was acceptable but required adaptation to ensure ecological validity among Chinese cancer patients. This paper presents the cultural and linguistic adaptation of Meaning-Centered Program for Chinese Americans with advanced cancer (MCP-Ch), which was informed by the Ecological Validity Model (EVM) and Psychotherapy Adaptation and Modification Framework (PAMF) for cultural adaptation of evidence-based interventions. Implementation considerations, which will be assessed in the next phase of the project, are also discussed. MCP-Ch is used as a case example to illustrate how to adapt culturally syntonic and sustainable evidence-based psychosocial interventions for racial/ethnic minority cancer populations.