Grace J. Yoo

Examining the Types of Social Support and the Actual Sources of Support in Older Chinese and Korean Immigrants

This study explored social support domains and actual sources of support for older Chinese and Korean immigrants and compared them to the traditional domains based on mainly White, middle class populations. Fifty-two older Cantonese and Korean speaking immigrants participated in one of eight focus groups. We identified four similar domains: tangible, information/advice, emotional support, and companionship. We also identified needing language support which is relevant for non-English speaking minority populations. Participants discussed not needing emotional support. These Chinese and Korean immigrants had a small number of actual sources of support, relying mainly on adult children for help with personal situations (e.g., carrying heavy groceries, communicating with physicians) and friends for general information/advice (e.g., learning how to speak English, applying for citizenship) and companionship. Immigrant Asians are caught between two different traditions; one that is strongly kinship oriented where needs and desires are subordinated to the interests of the family and one that values independence and celebrates individuality. Despite their reticence in asking for help outside the family, elders are seeking help from other sources, such as ethnic churches and the government.

An Empirical Evaluation of Social Support and Psychological Well-being in Older Chinese and Korean Immigrants

Objectives. To examine, among older Chinese and Korean immigrants: (1) the concept and measurement of perceived social support; (2) levels of social support and psychological well-being by living arrangement; and (3) whether social support is positively related to psychological well-being. Design. A convenience sample of 200 self-identified Chinese and Koreans, aged 65 years and older, were interviewed. Psychometric analysis was conducted to examine the reliability and validity of a new social support measure. Bivariate and multivariate analyses were used to examine the relationship between social support and psychological well-being. Results. Factor analysis revealed a four-factor solution of social support and adequate psychometrics of all social support scales was found. Multivariate results suggest that Koreans have more depression than Chinese (p < 0.01). Those who lived with their spouse and adult children had lower overall psychological well-being (p < 0.05) and lower positive affect (p < 0.05) compared to those who lived alone. Having more emotional/companionship support significantly (p < 0.001) contributed to better overall psychological well-being, having less depression and higher positive affect. Conclusions. A new multidimensional social support measure for use with older Chinese and Koreans could be useful upon further validation. These results suggest that older Chinese and Koreans’ psychological well-being may be negatively affected when they live with their adult children. More depression in Koreans may be related to difficulties in expanding their social network beyond Korean-speaking people.

Ethnicity and spirituality in breast cancer survivors.

IntroductionMany women are incorporating spirituality as a way of coping with cancer. However, few studies have examined the role of spirituality in mood and quality of life among breast cancer survivors from different ethnic groups.MethodsOne hundred and seventy-five women who had completed treatment for breast cancer participated in in-depth interviews about their experiences. Transcripts were available for 161 women.ResultsThe majority (83%) of the women talked about their spirituality. The main themes were: (1) God as a Comforting Presence; (2) Questioning Faith; (3) Anger at God; (4) Spiritual Transformation of Self and Attitude Towards Others/Recognition of Own Mortality; (5) Deepening of Faith; (6) Acceptance; and (7) Prayer by Self. A higher percentage of African-Americans, Latinas, and Christians felt comforted by God than the other groups.ConclusionsThese results are consistent with the common assumption that more African-American and Latinas engage in spiritual activities and that African-Americans are more fatalistic than the other groups. Implications for Cancer Survivors: The present findings suggest that there are several dimensions of spirituality experienced among cancer survivors. For many the trauma of a cancer diagnosis might deepen their faith and appreciation of life as well as changing the way they view at themselves, their lives, and how they relate to those around them, including God.

The benefits of prayer on mood and well-being of breast cancer survivors

ObjectivesPrayer is becoming more widely acknowledged as a way to cope with cancer. The goal of this study was to compare differences in use of prayer between breast cancer survivors from different ethnic groups and examine how use of prayer is related to mood and quality of life.MethodsThis study used a mixed methods design. One hundred and seventy-five breast cancer survivors participated in a longitudinal study of survivorship. Women completed in-depth qualitative interviews and a battery of measures including quality of life, spirituality, social support, and mood.ResultsEighty-one percent of the women prayed. There were no significant differences between the groups for any of the psychological, social support, or quality of life variables with the exception of higher benefit finding and spiritual well-being among those who prayed. The data did show that women who prayed were able to find more positive contributions from their cancer experience than women who did not pray. The interviews showed that those who prayed tended to be African American or Asian, Catholic or Protestant. The prayers were for petitioning, comfort, or praise. Some of the women stated that they had difficulty praying for themselves.ConclusionsWhile there seems to be few differences in terms of standardized measures of quality of life, social support, and mood between those who prayed and those who did not, the interviews showed that certain ethnic minority groups seem to find more comfort in prayer, felt closer to God, and felt more compassion and forgiveness than Caucasian women.

Remembering Sacrifices: Attitude and Beliefs Among Second-generation Korean Americans Regarding Family Support

Korean immigration peaked in the mid-1980s, so that large cohorts of post-1965 immigrants are now approaching or entering retirement. As the baby boomer generation ages, few studies have examined how the lack of retirement savings and eldercare plans combined with cultural expectations such as filial piety may pose challenges for aging Korean immigrants and their adult children. This exploratory study examines attitudes and beliefs among 1.5 and 2nd generation Korean American adults regarding filial expectations and support for aging immigrant parents. In-depth interviews conducted with 124 adult children of immigrants show that their attitudes and beliefs around filial care were primarily motivated by feelings of gratitude and a strong sense of responsibility toward their parents. In addition, because Korean immigrant parents often face language and financial barriers, adult children were preparing themselves for future support of their parents’ finances, health care and long-term care needs. Although both adult sons and daughters expressed a desire to care for their parents, adult daughters often discussed in detail their concerns and worries about future care of their parents. The findings of this paper illustrate how the intersections of gender, culture, and class inform attitudes and beliefs regarding aging and family support among Korean American families.

Immigrants and Welfare: Policy Constructions of Deservingness

ABSTRACT The passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, H.R. 3734, ended eligibility for all immigrants to federal means tested entitlements including federal cash assistance, food stamps, and Medicaid. Underprivileged elderly immigrants were specifically targeted. This article examines how older immigrants are constructed as “undeserving” of federal means-tested entitlements such as Supplemental Security Income (SSI). In particular, it focuses on the frames used in various congressional policy hearings leading up to the passage of the welfare reform law and examines how older immigrants become unworthy of receiving SSI. The sample consisted of the 1994–1996 U.S. Congressional hearing transcripts on SSI and immigrants. Through a content analysis of these transcripts, themes and frames were identified. The findings demonstrate that immigrants were constructed as fraudulent and immigrating to the U.S. to receive public assistance. Their families were portrayed as irresponsible and negligent and these elders were portrayed as “noncontributing” members of society whose number were increasing and becoming a burden to U.S. tax payers. These constructions of “undeservingness” evolved to make both young and old immigrants ineligible from federal safety nets such as SSI. This study has implications for how immigrants are construed in policy circles in times of cutbacks. The finding of this study demonstrates that the notions of deservingness are constructed through dialogue and discussion that happens in policy hearings.

Older women, breast cancer, and social support

IntroductionOne in ten women over the age of 65 will develop breast cancer. Despite this high incidence of breast cancer among older women, social support for them is often inadequate. This paper describes a qualitative study of the impact of a breast cancer diagnosis on older women from racially/ethnically diverse populations and their subsequent need for social support.MethodsForty-seven older African American, Asian American, Caucasian and Latina women between the ages of 65 to 83 participated in a larger study examining the impact of breast cancer on women from racially/ethnically diverse populations and the meaning and nature of social support. The women completed an in-depth qualitative interview on the psychosocial impact of breast cancer and the meaning and nature of social support.Results and ConclusionThe results indicate that there are variations in reactions to a breast cancer diagnosis among older women, and that these reactions impact their experiences with seeking social support at diagnosis and during treatment. Respondents were concerned about their aging bodies, potential dependency on others, and loss of autonomy. At the same time, the severity of cancer treatment and existing co-morbidities often meant they needed to learn to receive support, and to reach out if they had no support. The implications of these findings underscore the older cancer patient’s need to strengthen her supportive networks at the time of diagnosis, during treatment, and post-treatment.

Breast cancer and coping among women of color: A systematic review of the literature

Breast cancer is the most commonly diagnosed form of cancer for women regardless of race/ethnicity. Women of color are diagnosed at later stages and experience greater mortality than their White counterparts. However, there has been comparatively little research on coping with breast among racial/ethnic minorities at time of diagnosis, during treatment, or in the course of survivorship. This is despite the fact that research has repeatedly shown that distress can impact disease progression and survival. The questions asked of this systematic literature review include: (1) What is known about coping with breast cancer among major racial/ethnic groups? (2) What are the strengths and gaps in research to date? Over 120 peer-reviewed published studies (1980–2012) were reviewed. A total of 33 met criteria for inclusion including 15 quantitative, 17 qualitative, and 1 mixed methods study. The majority of studies were small sample cross-sectional studies. Only five studies were longitudinal, and two randomized-controlled intervention trials sought to improve coping among survivors. The most common topic in both quantitative and qualitative studies was spirituality and coping among African American breast cancer patients. Thirteen studies included Latinas only or in combination with other groups. Only one quantitative and one qualitative study solely addressed the Asian American population exploring coping and adjustment. In the course of this systematic literature review, we elucidate what is known about coping with breast cancer among racial/ethnic minority women and identify priorities for future research.

Cervical Cancer Screening: Attitudes and Behaviors of Young Asian American Women

Compared to other racial/ethnic groups, Korean, Filipino, and Vietnamese American women experience high incidence rates of cervical cancer but low rates of cervical cancer screenings. This study examines the behaviors and attitudes towards screening in young Korean, Filipino, and Vietnamese American women (n = 304) in the San Francisco Bay Area. Results indicated Vietnamese American (OR = 2.51) and Filipino American (OR = 2.31) women had greater odds of ever having a Pap test than Korean American women. Those older (OR = 1.55), born in the USA (OR = 2.64), and those comfortable with the test (OR = 3.41) also had greater odds of ever having a Pap test. Correct knowledge of cervical cancer and the human papillomavirus did not significantly affect the odds of having a Pap test. Interventions to increase Pap testing in these populations should focus on increasing levels of comfort and should target those younger and foreign born.

Destigmatizing hepatitis B in the Asian American community: lessons learned from the San Francisco Hep B Free Campaign.

Compared to any other racial/ethnic group, Asian Americans represent a population disproportionately affected by hepatitis B virus (HBV) infection, a leading cause of liver cancer. Since 2007, the San Francisco Hep B Free (SFHBF) Campaign has been actively creating awareness and education on the importance of screening, testing, and vaccination of HBV among Asian Americans. In order to understand what messages resonated with Asian Americans in San Francisco, key informant interviews with 23 (n = 23) individuals involved in community outreach were conducted. A key finding was the ability of the SFHBF campaign to utilize unique health communication strategies to break the silence and normalize discussions of HBV. In addition, the campaign’s approach to using public disclosures and motivating action by emphasizing solutions towards ending HBV proved to resonate with Asian Americans. The findings and lessons learned have implications for not only HBV but other stigmatized health issues in the Asian American community.