Service Utilization, Self-Efficacy, Positive Attitude and Well-Being Among Asian American Family Caregivers of Persons with Serious Mental Illnesses.

The well-being of the family caregivers of people with serious mental illnesses (SMIs) is a crucial success factor in the recovery of the afflicted family member. This cross-sectional quantitative study examined the associations between the use of formal mental health services, self-efficacy, and positive attitudes and their effects on the well-being of Asian American family caregivers of people with SMIs. Using convenience and snowball sampling, 116 Asian American family caregivers of people with SMIs in Northern California were recruited for this study. We found that formal mental health service utilization predicted an enhanced sense of self-efficacy. Higher levels of self-efficacy were related to attitudes being more positive, and these positive attitudes contributed to enhanced overall well-being. These findings suggest that mental health professionals should develop culturally competent and tailored services for Asian American family caregivers to support self-efficacy, which is fundamental to maintaining positive attitudes and promoting wellness.

Perinatal Experiences of Asian American Women During COVID-19.

PURPOSE: To explore the wellbeing, pregnancy, childbirth, and postpartum experiences of Asian American women who gave birth during the COVID-19 pandemic. STUDY DESIGN: Qualitative exploratory design. METHODS: Using convenience and snowball sampling, we recruited Asian American women who gave birth during the COVID-19 pandemic via social media. Participants completed sociodemographic and depressive symptom questionnaires and took part in a virtual semistructured interview where they were asked to describe their pregnancy, birth, and postpartum experiences in the midst of the COVID-19 pandemic. Qualitative content analysis methods were used to identify themes from participant narratives. RESULTS: Thirty-eight Asian American women representing several racial ethnic subgroups (Asian Indian, Chinese, Filipino, Hmong, Laotian, Vietnamese) participated in our study. Participants were on average 34 (SD = 3.5) years of age; the majority were married and lived in California. At the time of data collection, participants were 3.7 (SD = 2.07) months postpartum and 5.3 to 10.5 months into the COVID-19 pandemic. Qualitative content analysis revealed two main themes: 1) unexpected perinatal journey, and 2) the emotional and psychological consequences of COVID-19. CLINICAL IMPLICATIONS: Our findings are not unique to Asian American women, but they offer insight for nurses taking care of all childbearing women. Nurses can provide individually tailored anticipatory guidance to help women navigate perinatal changes and manage expectations during future public health crises. Nurses can also encourage and help perinatal women identify ways to increase their own social support networks during the pregnancy and postpartum period.

Korean Immigrant Women's Postpartum Experiences in the United States.

BACKGROUND: Postpartum depression (PPD) affects one in seven women in the United States. Korean Americans are one of the six largest Asian American (AA) subgroups, representing 9% of the AA population in the United States. Women of Asian descent have not always been represented in studies of PPD. PURPOSE: The purpose of this study was to understand postpartum experiences, perceptions of PPD, and mental health help-seeking among Korean women living in the United States. METHODS: Individual, face-to-face, semistructured interviews of Korean immigrant women, over age 18, who were able to read, write, and speak English or Korean, and who had given birth to a live infant within the past 12 months, were conducted using a qualitative exploratory design. Thematic analysis approach was used to analyze qualitative data The Edinburgh Postnatal Depression Screening Scale (EPDS) was used to assess frequency of depressive symptoms over the past week. RESULTS: Eleven women participated. Total EPDS scores ranged from 2 to 17 (mean 6.5, SD = 3.2); three women had scores indicating a high risk for developing PPD. Two overall themes, postpartum experiences and perceptions of PPD and professional help-seeking, along with several subthemes were identified. They included postpartum challenges, importance of keeping Korean postpartum traditions, desire for professional Korean postpartum care, "Sanhoo-Joeri" postpartum support and social networking, normalization of PPD symptoms, family first for health seeking attitude and behavior, and stigma attached to mental health care. CLINICAL IMPLICATIONS: Nurses working with Korean women during postpartum can provide culturally competent care by assessing postpartum care needs, respecting cultural practices, and providing resources such as Korean postpartum care centers Sanhoo-Joeriwon, which can be found in major U.S. cities with large Korean communities (e.g., Los Angeles), and in-home postpartum care providers, Sanhoo-Joerisa. Nurses should be comfortable educating women about normal signs and symptoms of PPD and those requiring immediate medical follow-up.

Exploring caregiving-related experiences among Chinese American and European American family caregivers of persons with mental illness.

Family caregivers (FCs) of people with mental illness (PMI) experience caregiving-related distress. These challenges tend to be greater for Asian American families due to acculturative stress and structural barriers to services. However, little is known about caregiving-related experiences among FCs of PMI within a cultural context. By using an exploratory approach, we examined the experience of caregiver distress and the influence of cultural values on caregiving in European American and Chinese American FCs. In collaboration with community-based agencies, a combination of convenience and snowball sampling methods were used to recruit Chinese American and European American caregivers who co-reside with PMIs. Two focus groups with each ethnic group with 57 participants (30 Chinese and 27 European American) were conducted. Thematic analysis indicates that FCs experience intense emotions, health/mental health problems, and a negative impact on their personal/social lives. Whereas Chinese American FCs reported shame, lack of knowledge, and over-protectiveness of PMIs, European American FCs reported the need for advocacy on behalf of the PMI. Findings indicate a need for: 1) greater awareness of the caregiving experience on wellbeing of FCs; 2) an understanding of how cultural values may influence caregiver experience; and 3) developing culturally relevant prevention and intervention services that can support FCs from diverse cultural contexts.

Vietnamese-American family caregivers of persons with mental illness: Exploring caregiving experience in cultural context.

While involvement of family caregivers can play an important role in the recovery process of persons with serious mental illness (SMI), family caregivers often endure poor health and mental health issues due to caregiving-related distress. These challenges may be exacerbated for Vietnamese American families due to cultural values (e.g., familism and stigma). This qualitative exploratory study examined how Vietnamese American family caregivers of persons with SMI describe their caregiving experience. Using convenience and snowball sampling, the study recruited 21 participants who took part in two Vietnamese-language focus groups. Key findings of the study addressed three themes: (1) the influence of cultural and religious values on caregiving and mental health; (2) the negative impact of caregiving on caregivers' wellbeing; and (3) the stigma attached to mental illness. The study offers useful insights to assist mental health practitioners in tailoring culturally appropriate and effective services for Vietnamese caregivers.

Exploring the role of ethnic media and the community readiness to combat stigma attached to mental illness among Vietnamese immigrants: the pilot project Tam An (Inner Peace in Vietnamese).

Vietnamese Americans are at high risk for developing mental health disorders due to multiple risk factors such as trauma and acculturative stress. However, the utilization of mental health services has been low. The pilot project Tam An was implemented to raise mental health awareness by engaging community resources in the Vietnamese population. Informed by the Community Readiness Model and through local ethnic media sources, messages to destigmatize mental health and promote the willingness to initiate mental health treatment were presented. Using an exploratory perspective, findings from focus group data suggest that the project improved the community's stage of readiness.

Latino families with a child with Prader-Willi syndrome: exploring needs for support.

Prader-Willi syndrome (PWS) is a complex, genetically based disorder; caring for a family member with a disability such as PWS brings significant challenges to the whole family. However, no research has been conducted focusing on the impact of PWS in the dynamics of Latino families. This qualitative study explored the challenges and need for support services among Latino families of children with PWS. Findings of the study suggest the need for support services geared toward the whole family unit to help members cope with daily challenges at home.

Acculturation and Post-Migration Stress in Middle-Aged Chinese Immigrant Women in Philadelphia: Variation between the Fujianese and the non-Fujianese women.

The experience of acculturation in Chinese immigrant women from the rural coastal province of Fujian has not been well studied despite of their growing numbers in American cities. This exploratory study is an attempt to examine the experience of acculturation and post-migration stress in Fujianese immigrant women as compared to those from other parts of China. The study is based on a convenience sample 240 Fujianese and 162 non-Fujianese Chinese immigrant women living in Philadelphia.Results from bivariate analyses showed that the variation in demographic characteristics between Fujianese and non-Fujianese women was marginal; that all Chinese women in this study reported experiencing a unidimensional process of acculturation and a domain-generic model of acculturation; and that the Fujianese women showed a higher level of post-migration stress than the non-Fujianese women. In multiple regression controlling for demographic characteristics and including all the women in our sample, more acculturated women reported a higher level of post-migration stress. However, separate multiple regression analyses for Fujianese and non-Fujianese women revealed a different pattern of post-migration stress models. The findings suggest the importance of further research to understand acculturation and post-migration stress among Fujianese immigrant women.

Mental health stigma about serious mental illness among MSW students: social contact and attitude.

In this study, the attitudes toward and beliefs about serious mental illness (SMI) held by a group of graduate social work students in the northwestern United States were examined. Mental health stigma was examined with relation to the following factors:participants'level of social contact with SMI populations, adherence to stereotypes about SMI populations, belief in the ability to recover from SMI, and the belief that SMI defines an individual's identity. Measures used to identify mental health stigma included the desire for social distance and restrictions with relation to the SMI population. Survey results from 71 graduate social work students found that a significant number of participants who engaged in friendships with SMI-diagnosed individuals had less desire for social distance from and restrictions toward SMI populations. Participants who indicated that they believed in stereotypes of dangerousness and believed that SMI defines an individual's identity were more likely to express desire for both social distance and restrictions. Implications for social work and further research on the matter are discussed.

Cultural orientation in Southeast Asian American young adults.

The study assessed cultural orientation in a group of 188 Southeast Asian American American-born and early-arriving (by age 5) young adults using the General Ethnicity Questionnaire--Southeast Asian and American versions. The sample included 98 Vietnamese, 45 Cambodian, and 45 Hmong college students in California. As hypothesized and in support of the bidimensional model, overall orientation to ethnic and American cultures were independent of each other, and predicted, respectively, by ethnic and American cultural domains. The three ethnic groups did not vary on level of cultural orientation, but their endorsement of ethnic and American cultures differed across domains. Specifically, they enjoyed American mass media and cultural activities more than ethnic media and activities, and were more fluent in English than their ethnic language. However, they expressed greater ethnic pride and a stronger overall Southeast Asian orientation than American pride and orientation.

The longitudinal effect of intergenerational gap in acculturation on conflict and mental health in Southeast Asian American adolescents.

This longitudinal study examined the intergenerational gap in acculturation, subsequent conflict, and their mental health consequences in Southeast Asian American adolescents. It was hypothesized that perceived intergenerational discrepancy in acculturation during early adolescence would predict intergenerational conflict in late adolescence, which, in turn, would increase depressive symptomatology in late adolescence. Using data from the Children of Immigrants Longitudinal Study (A. Portes & R. G. Rumbaut, 2001; R. G. Rumbaut, 1994), 490 Southeast Asian American adolescents in 8th and 9th grades completed surveys and again 3 years later. The results supported the hypothesis and showed that intergenerational/intercultural conflict fully mediated the longitudinal effect of perceived intergenerational discrepancy in acculturation on depressive symptomatology. Recommendations for community-based interventions for both parents and youth are offered.