Patricia S. Jones

An Adaptation of Brislin’s Translation Model for Cross-cultural Research

BackgroundThe number of nurse scientists pursuing cross-cultural research using quantitative designs is increasing. Preparation of instruments that are conceptually and functionally appropriate in the language of the participants is a complex process that needs examination. ObjectivesBrislin’s classic model for translation and validation of instruments for cross-cultural research is critiqued. Adaptations and extensions of that model are recommended. MethodsBrislin’s model guided tool preparation in a cross-cultural investigation. The process is described and lessons learned are outlined and discussed. ConclusionsSteps toward a more efficient and valid approach to the preparation of instruments are suggested.

Health is empowerment

A consideration of health in relation to global and diverse social and economic contexts forces nurses to reexamine the centrality of health in the discipline of nursing and to confront the issue of whether health is a personal matter. In this article, the authors review development of the concept of health in nursing science, discuss the limitations of some current definitions in addressing diverse clients, and challenge members of the discipline to develop a contextualized definition of health congruent with societal needs and the mission of nursing.

Caregiving between two cultures: an integrative experience.

In 1995, more than half of elderly immigrants to the United States were born in Asia or the Pacific region. The purpose of this study was to describe the process of caring for elderly parents by Asian American women. Forty-one women (22 Chinese American and 19 Filipino American) caring for elderly parents were interviewed in a study based on Strauss and Corbin’s grounded theory methodology (1990). Although the women were moderately acculturated, indications of being in transition were evident. Analysis of interview data led to development of a substantive theory of caregiving between two cultures, reflecting the paradox of living and caregiving by two sets of standards and worldviews. The primary strategies used to manage the caregiving challenges were connecting and calibrating. Through personal growth and finding meaning, the caregivers integrated the caregiver role into their lives and became more connected with their families and within themselves.

Assessing Cross-Cultural Differences Through Use of Multiple-Group Invariance Analyses

The use of structural equation modeling in cross-cultural personality research has become a popular method for testing measurement invariance. In this report, we present an example of testing measurement invariance using the Sense of Coherence Scale of Antonovsky (1993) in 3 ethnic groups: Chinese, Japanese, and Whites. In a series of increasingly restrictive constraints on the measurement models of the 3 groups, we demonstrate how to assess differences among the groups. We also provide an example of construct validation.

Development of a Caregiver Empowerment Model to Promote Positive Outcomes

Family members caring for aging parents experience both negative and positive outcomes from providing care. Theoretical explanations for negative outcomes have been developed. There is need for models that explain and predict positive outcomes. This article describes the evolution of the Caregiver Empowerment Model (CEM) to explain and predict positive outcomes of family caregiving. Although empirical findings support positive outcomes of family caregiving, less attention has been given to theoretical rationale for positive effects. The CEM predicts that, in the presence of filial values and certain background variables, caregiving demands are appraised as challenges instead of stressors. Appraising caregiving demands as a challenge, finding meaning, and using certain types of coping strategies are posited to be associated with growth and well-being. The CEM extends our understanding of the complexity of the caregiving experience, and can serve as a framework to guide in developing and testing theory-based interventions to promote positive outcomes.

Clarifying and measuring filial concepts across five cultural groups.

Literature on responsibility of adult children for aging parents reflects lack of conceptual clarity. We examined filial concepts across five cultural groups: African-, Asian-, Euro-, Latino-, and Native Americans. Data were randomly divided for scale development (n = 285) and cross-validation (n = 284). Exploratory factor analysis on 59 items identified three filial concepts: Responsibility, Respect, and Care. Confirmatory factor analysis on a 12-item final scale showed data fit the three-factor model better than a single factor solution despite substantial correlations between the factors (.82, .82 for Care with Responsibility and Respect, and .74 for Responsibility with Respect). The scale can be used in cross-cultural research to test hypotheses that predict associations among filial values, filial caregiving, and caregiver health outcomes.

Asian American Women Caring for Elderly Parents

In Asian Amerncan families, women caringfor elderly parents are at risk when family and cultural obligations conflict with acculturation factors and employment. This descriptive correlational study investigated the relationships between resources and strategies used and perceived health in Chinese and Filipino American women caringfor elderly parents. Meleiss theory of role integration, Lazarus and Folkmans theory of cognitive appraisal, and Antonovskys healthgenerating theory of stress were integrated with Pearlins model of caregiver stress to examine the relationships between stressors, resources, and outcomes of caregiving. Twenty Asian American women, 10 Chinese and 10 Filipino, participated in the study. Instruments included The Jalowiec Coping Scale, The Lewis Coherency Scale, Total Role Investment Scale, Stress and Satisfaction Scales, Affect Balance Scale, and the Cantril Ladder. Findings support the possibility that satisfaction from caregiving can help to balance caregiver stress and that a sense of coherence may contribute to positive health outcomes in family caregivers.

The Relationship Between Mutuality, Filial Piety, and Depression in Family Caregivers in China.

Purpose. Caregiving to parent stroke survivors in China is increasing and adult child–parent relationships are being challenged. The purpose of this study was to explore whether mutuality and filial piety have a protective role against caregiver depression. Design. A cross-sectional correlational study was conducted with a nonproportional quota sample of 126 caregivers. Surveys were conducted at hospitals or in homes using structured questionnaires: the 15-item Mutuality Scale, the 4-item Filial Attitude Scale, the 9-item Filial Behavior Scale, and the 10-item Center for Epidemiological Studies Depression Scale. Results. Higher mutuality and stronger filial attitudes were significantly associated with less caregiver depression after the covariates were controlled. Mutuality explained 5.5% (p < .01) and filial attitude explained 4.6% (p < .01) of the variance in caregiver depression. Conclusion. Mutuality and filial attitude may be protective factors against caregiver depression. Implications for Practice. Supportive strategies can be implemented to enhance mutuality and filial attitude.

The Relationship Between Mutuality and Health-Related Quality of Life in Adult Child Caregivers in China

The strain inherent in caregiving relationships between adult children and aging parents is a prominent issue in contemporary China due to a combination of demographic and socioeconomic changes. The purpose of this study was to explore how mutuality, a positive quality of caregiving relationships, contributes to the physical health and mental health (health-related quality of life [HRQoL]) of adult child caregivers [ACCs] of parent stroke survivors. A cross-sectional correlational study was conducted on a nonproportional quota sample of 126 ACCs, using questionnaires of demographics, the 15-item Mutuality Scale, and the Second Version of the Standard 12-Item Health Survey (SF-12v2). Higher mutuality was found to be correlated with better caregiver physical health and mental health. However, after adjusting for the covariates, mutuality significantly explained 4.6% of the variance of caregiver physical health (β = .22, ΔR2 = .046, p < .01) but it did not significantly explain the variance of caregiver mental health. Although multiple factors correlate with Chinese family caregivers’ HRQoL, this was the first study exploring the impact of caregiver–care receiver dyadic relationships on caregiver HRQoL in mainland China by using a mutuality scale with SF-12v2. Despite the fact that the Chinese tradition of filial piety can facilitate mutuality, socioeconomic changes and legislation that require adult children to care for aging parents appear to create high stress among family caregivers. Higher levels of mutuality contribute to better physical health in Chinese family caregivers. Therefore, culturally appropriate family nursing strategies and social policies in China could enhance caregiver mutuality and potentially promote their HRQoL, in particular physical health.

Influence of Religion on Later Burden and Health of New Black and White Caregivers

Objective: We assessed the relationship between positive aspects of religiosity and reduced stress in caregivers, and negative aspects of religiosity and increased caregiver burden. Method: Using data from the Biopsychosocial Religion and Health Study, we performed multiple linear regression analysis on 584 caregivers. Results: Mental health, but not physical health, was predicted by caregiver burden. Caregivers who viewed God as loving and not controlling and felt a sense of community with their church family had less burden. Caregivers who engaged in negative religious coping had a greater decline in mental health than those who saw God as loving and not controlling and who gave emotional support to others. Discussion: Some aspects of religion appear to play an important role in alleviating the mental stresses of being a caregiver.