Abstract
Filial piety is a Confucian concept derived from Chinese culture, which advocates a set of moral norms, values, and practices of respect and caring for one’s parents. According to the dual-factor model of filial piety, reciprocal and authoritarian filial piety are two dimensions of filial piety. Reciprocal filial piety is concerned with sincere affection toward one’s parent and a longstanding positive parent-child relationship, while authoritarian filial piety is about obedience to social obligations to one’s parent, often by suppressing one’s own wishes to conform the demands of the parent. The primary aim of this study is to investigate the moderating effect of culture on the relationships between filial piety and palliative care knowledge. The secondary aim is to investigate whether filial piety is a universal construct across Singaporean and Australian cultures. A total of 508 participants living in Singapore and Australia were surveyed between May and October 2020. The final sample comprised of 406 participants, with 224 Singaporeans and 182 Australians. There were 289 females (71.1%), 115 males (28.3%), and two unspecified gender (0.6%) in the sample, with an average age of 27.27 years (SD = 9.79, range = 18–73). Results indicated a significant effect of culture on authoritarian filial piety and palliative care knowledge. Singaporeans showed higher authoritarian filial piety and higher palliative care knowledge than Australians. However, no effect of culture was found on reciprocal filial piety. Overall, no significant correlation existed between palliative care knowledge and reciprocal filial piety and authoritarian filial piety. For Singaporeans, a weak negative correlation was found between palliative care knowledge and authoritarian filial piety. In contrast, Australians and Singaporeans indicated a positive, moderate correlation between reciprocal and authoritarian filial piety. Further, culture moderated the relationship between authoritarian filial piety and palliative care knowledge. High authoritarian filial piety was associated with increased palliative care knowledge among Australians, while high authoritarian filial piety was associated with decreased palliative care knowledge among Singaporeans. The results support the conceptualization of filial piety as a possible psychological universal construct. In addition, the results point out an important implication that public health programs should target the appropriate filial piety types to enhance palliative care knowledge among Singaporeans and Australians.
Highlights
BackgroundAccording to World Health Organization [WHO] (2018), palliative care is person- and family-centered care that focuses on the improvement of the quality of life for both patients with a life-threatening illness and their families, through preventing and relieving suffering by the early identification, correct assessment, and treatment of pain and other physical, psychosocial, or spiritual problems
The hypothesized model for the Singaporean participants generated an adequate model according to the fit indices: χ2(103) = 233.853, p < 0.001, PCMIN/DF = 2.270, comparative fit index (CFI) = 0.907, Tucker-Lewis index (TLI) = 0.891, root mean square error of approximation (RMSEA) = 0.075, 90% CI [0.071, 0.088], standardized root meansquare residual (SRMR) = 0.087; while the hypothesized model for the Australian participants was found to be of poor fit: χ2(103) = 251.390, p < 0.001, PCMIN/DF = 2.441, CFI = 0.851, TLI = 0.826, RMSEA = 0.089, 90% CI [0.075, 0.103], SRMR = 0.095
The modified Singaporean baseline model resulted in better model fits: χ2(101) = 222.595, p < 0.001, PCMIN/DF = 2.270, CFI = 0.913, TLI = 0.897, RMSEA = 0.073, 90% CI [0.060, 0.087], SRMR = 0.086
Summary
BackgroundAccording to World Health Organization [WHO] (2018), palliative care is person- and family-centered care that focuses on the improvement of the quality of life for both patients with a life-threatening illness and their families, through preventing and relieving suffering by the early identification, correct assessment, and treatment of pain and other physical, psychosocial, or spiritual problems. The provision of high-quality palliative care is a way to improve the quality of death, and many countries have continuously made progress in improving affordable access to palliative care (The Economist Intelligence Unit [EIU], 2015), including Australia and Singapore. The 2015 Quality of Death Index (The Economist Intelligence Unit [EIU], 2015), which ranks palliative care worldwide, revealed that Australia and Singapore are at the top of the Index at positions two and 12, respectively. These two countries are coping with a rapidly aging population.
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