Psychological Well-Being of Older Chinese Immigrants in Canada Towards the End of the Covid-19 Pandemic: The Importance of Social Support and Resilience

This study examined the effects of loneliness, social support, and acculturation on psychological well-being, as indexed by general emotional well-being and life satisfaction, of older Chinese adults living in Canada during the COVID-19 pandemic. A total of 168 older Chinese adults, recruited via WeChat and the internet, completed an online study through a facilitated Zoom or phone meeting, or through a website link, individually or in a group. The testing package included demographic information, The UCLA Loneliness Scale, The Multidimensional Perceived Social Support Scale, Vancouver Index of Acculturation, The Satisfaction with Life Scale, and The World Health Organization’s Five Well-Being Index. The results showed that the psychological well-being (both general emotional well-being and cognitively perceived life satisfaction) was positively predicted by perceived social support but negatively predicted by loneliness. Acculturation was not predictive of both outcomes, and it did not moderate the predictive relationships of social support or loneliness. The results shed light on the importance of community services that target enhancing social support and reducing loneliness in promoting psychological well-being of older Chinese immigrants in Canada amidst and post the pandemic.

Purpose – The purpose of this paper is to review and discuss existing literature and available research findings related to understanding elder abuse and neglect in culturally diverse communities, particularly the Chinese immigrant community in Canada. The conceptual understandings of elder abuse are examined, based upon the socio-cultural context and challenges faced by aging Chinese immigrants. Design/methodology/approach – Previous literature and research publications related to elder abuse and neglect related to Chinese in Canada were reviewed and synthesized. Statistical information and research findings were summarized to illustrate the socio-cultural context that defines elder abuse and neglect experienced by aging Chinese immigrants in Canada. Findings – From a culturally diverse perspective, influence of race, ethnicity, immigrant status, and cultural norms on the recognition, identification, prevention and intervention of elder abuse and neglect are important to consider. A key message for professionals working with the aging population, particularly older immigrants from ethno-cultural minority background, is that understanding the social cultural context in which elder abuse or neglect emerges is critical. For many of the aging Chinese immigrants in Canada, the socio-cultural circumstances that they have experienced, their social environment, and various barriers and challenges further prevent them from being aware of this emerging concern. Cultural norms and practices have played a critical role in their access to preventive and intervention services. Research limitations/implications – Although this paper is not based upon a particularly empirical research study, the research and literature synthesized are both empirically and conceptually based. As indicated in the review of previous research publications on the subjective matter of elder abuse and neglect in aging Chinese immigrants in Canada is limited. Research on various issues related to elder abuse and neglect in ethno-cultural minority communities is also relatively scant. Evaluation research on prevention and intervention programs is desperately needed so as to facilitate the further establishment of best practice prevention and intervention models that are culturally appropriate and effective. While research engagement with minority groups such as the aging Chinese immigrants who do not speak English or are not familiar with the research culture in the western civilization could be challenging, academic researchers and service providers in both the mainstream and ethno-cultural minority communities should further align themselves in practice-research partnership endeavors to ensure the safety and wellbeing of the aging vulnerable individuals could be better maintained. Practical implications – In order to provide culturally competent services, service providers should be aware of cultural differences in attitudes towards elder mistreatment, including the ways in which specific types of abuse (e.g. financial abuse) are defined within ethno-cultural communities, and the cultural values and experiences that shape these understandings and determine attitudes or barriers towards reporting, intervention, and service use. Originality/value – This paper is a first attempt in the research community to synthesize a few critical issues related to elder abuse and neglect in the aging Chinese immigrant community in Canada. The paper has connected previous empirical findings related to Chinese older adults as well as other culturally diverse aging populations to the conceptualization of elder abuse and neglect by considering the unique socio-cultural context faced by the ethnocultural older adults.

This scoping review aims to examine the extant literature and summarize findings related to barriers to accessing health care faced by older Chinese immigrants in Canada. We conducted a search of electronic databases for peer-reviewed articles using a comprehensive set of keywords without limiting the search to a specific time period. To be included in our review, articles had to meet the following criteria: (a) published in a peer-reviewed journal, (b) written in English, (c) provide a clear description of the methods used, and (d) respond to our research question, which focuses on identifying barriers to accessing healthcare for older Chinese immigrants living in Canada. Fifteen papers were selected based on the criteria, and five main barriers were identified, which are ranked in descending order according to the number of times they were mentioned: culture and health beliefs (N = 13), language and communication (N = 7), structural and circumstances (N = 2), health literacy and information (N = 2), and demographic, social, and economic factors (N = 2). The issue of accessing healthcare for older Chinese immigrants in Canada is complex, as it involves multiple aspects that are relevant to both patients and healthcare providers. Our research findings suggest that the culturally and linguistically sensitive education programs, inter-sectoral coordination, and social support should be improved for older Chinese immigrants and those of other ethnic backgrounds.

Using the Longitudinal Survey of Immigrants in Canada (LSIC) dataset, we explore the differences in remittance behaviour of Chinese and Indian immigrants in Canada in relation to their socio-economic characteristics. We apply logistic regressions on the likelihood to remit, and instrumental variable regressions to estimate the amount remitted. We find that age, income, level of education, and personal investment in the home country are important determinants of the remittance behaviour of Chinese immigrants in Canada. Marital status, having family members, and involvement with ethnic organizations in the host country are the major drivers of remittances sent by Indian immigrants in Canada. By analyzing the remittance behaviour of Canadian immigrants from two major sources, this study sheds light on potential motivations to remit which contribute to policy formulation in both home and host countries.

This study investigates the stress experiences and coping strategies among older Chinese immigrants in Canada during the COVID-19 pandemic. Data was collected through focus group interviews and analyzed using the Transactional Model of Stress and Coping (TMSC). The results showed that participants (N=25; 14 female, 11 male; age 65 and above) faced three main sources of stress during the pandemic: personal life disruption (e.g., hindered family reunions and financial pressure), emotional distress (e.g., fear, uncertainty, and distress), and structural obstacles (e.g., travel restrictions and anti-Chinese discrimination). In addition, participants reported generally three types of coping styles: cognitive coping (e.g., maintaining a positive mindset and redefining risks), behavioural coping (e.g., adhering to the pandemic prevention regulations and maintaining daily activities), and social coping (e.g., participating in online social activities and establishing mutual assistance networks). The results call for culturally sensitive policies and measures in future public health crises to address the specific stressors and coping resources of older immigrants.

Objectives: This study had three objectives. First, to determine the extent to which demographic factors, perceived social support, and Chinese cultural beliefs predict attitudes toward mental health help seeking; second, to assess mental health utilization; and third, to assess intentions to utilize mental health services among older Chinese immigrants in Canada aged 55 and above.Method: A total of 149 older Chinese adults (M = 73.92 years, SD = 9.99, range = 55–95 years) completed a semi-structured interview protocol in Cantonese or Mandarin. Demographic and health information were collected, and questionnaires assessing perceived social support, mental health help-seeking attitudes, and belief in Chinese culture and values were administered.Results: Demographic and health information, perceived social support, Chinese cultural beliefs and values accounted for 21.8% of the variance in help-seeking attitudes. Descriptive data related to mental health utilization and intentions are provided.Conclusion: Older Chinese participants exhibited less positive attitudes that were significantly associated with Chinese cultural beliefs and values. Implications for practice with older Chinese adults are also discussed.

The COVID-19 pandemic has profoundly impacted people’s lives globally; this is especially true for the older population. In this exploratory qualitative study 15 in-depth interviews were held to understand the unique experiences of older Chinese adults in Canada in the early stages of the COVID-19 pandemic. Participants’ narratives were shaped by their multiple and intersecting identities as immigrants, older adults, people of Chinese descent and as family members. In the face of challenges related to grief, loneliness, social isolation, ageism and racism, study participants demonstrated considerable resilience and strength, particularly with the adoption of technology in their daily lives. As the pandemic enters the second wave in Canada, study findings reinforce the need for anti-ageism, anti-racism and strength-based social work practice, research, and policies aimed at improving older immigrants’ lives during pandemics.

The authors examine the effects of service barriers on the health status of older Chinese immigrants in Canada. A survey was completed in seven Canadian cities by a random sample of 2,214 older Chinese immigrants age 55 years or older. Service barriers related to administrative problems, personal attitudes, and circumstantial difficulties were significant predictors of physical and mental health when controlling for the demographic factors. Empirically, the findings confirm that service barriers are detrimental to the health of older immigrants. The service barriers in the areas of ethnic, language, or cultural differences between the service providers or services themselves and the older Chinese clients also suggest that factors related to communication contribute to these older clients' perception of services or providers as culturally insensitive or unresponsive. Considering the individual, social, and economic costs incurred by adverse health consequences, barriers in service delivery must be addressed.

BackgroundSocial isolation is a key concern for immigrant older adults. We examined the effectiveness of a peer-based intervention in reducing loneliness, social isolation, and improving psychosocial well-being with a sample of aging Chinese immigrants.MethodsSixty community-dwelling older Chinese immigrants aged 65 and older were randomly assigned to an intervention group and a control group (n = 30 each) in a randomized control parallel trial design. Intervention group participants received an eight-week peer support intervention. Twenty-four volunteers aged 48 to 76 engaged in two-on-one peer support through home visits and telephone calls to provide emotional support, problem-solving support, and community resource sharing. Social workers who are not blinded to the group assignment measured the changes of both the intervention group and the control group participants in a range of psychosocial outcomes including three primary outcomes (loneliness, social support, barriers to social participation) and five secondary outcomes (depressive symptoms, anxiety, life satisfaction, happiness, and purpose in life).ResultsThe 30 intervention group participants showed a statistically significant decrease in loneliness and increase in resilience when compared to the 30 control group participants. They reported fewer barriers to social participation, fewer depressive symptoms, increased life satisfaction, and happiness while no such improvements were observed in the control group.ConclusionsThere is a need to further examine the use of peer-based interventions for both program effectiveness and delivery efficiency. In the era of population aging and increasing immigration, diverse aging adults can be trained to fill volunteer support roles via peer-based intervention approaches.Trial registrationISRCTN, ISRCTN14572069, Registered 23 December 2019 – Retrospectively registered.

Investigations of mental health literacy are important because the recognition of a mental health problem is the first step in seeking appropriate mental health care. Lack of recognition is a significant barrier to accessing mental health resources. Older Chinese immigrants are at increased risk for depression; however, there is no research investigating their depression literacy, including their beliefs about treatment, etiology, and prognosis. This study investigated depression literacy among 53 older Chinese immigrants in Canada (aged 55-87 years) and compared their literacy to Canadian-born participants of the same age who were part of a larger population-based survey. Depression literacy was assessed through interviews using a case vignette and included the following indices: rates of correct identification of depression; perceived efficacy of various people, professions and treatments; and perceptions of etiology and prognosis. In the Chinese sample, 11.3% correctly identified depression in the case vignette. In contrast, 74.0% of participants in the population-based survey correctly identified depression. Differences in the perceptions of helpful people and interventions, etiology, and prognosis were also noted between the samples. Both samples strongly endorsed physical activity as helpful in the treatment of depression. In light of these results, it is clear that older Chinese immigrants would benefit from information regarding the symptoms, etiology, and treatment of depression, and that this information may begin to address the serious underutilization of mental health services among this group. Our discussion highlights practice implications and promising interventions.

<p>Objection: The objective of this study was to assess attitudes towards the use of Traditional Chinese Medicine (TCM) for COVID-19 among Chinese immigrants in Canada during the early stage of the COVID-19 pandemic. </p> <p><strong>Methods</strong>: A cross-sectional study was conducted in April 2020 in Canada. Individuals aged 16 or older who were of Chinese origin and living in Canada at the time of the survey were invited to participate in an online survey. Descriptive and univariate statistics were performed to describe participant attitudes towards various preventive and treatment measures for COVID-19. Multiple logistic regression was used to identify independent associations with sociodemographic factors and attitudes. </p> <p><strong>Results: </strong>A total of 754 eligible respondents were included in the analysis. 65.8% of the participants were female, 77.2% had a university degree or higher and 28.6% were 55 years of age or older. Overall, 48.8% of the study participants believed that TCM was effective in preventing COVID-19% and 46.2% would use TCM if they had COVID-19-related symptoms. However, the corresponding numbers for western medicine were 20.8% and 39.9%, which were statistically lower (p<0.01). Older participants (55+vs <35, OR=3.55 (95% CI 2.05 to 6.14); 35–54 vs <35, OR=1.98 (95% CI 1.27 to 3.08)) and those who were dissatisfied with their income (OR=2.47(95% CI 1.56 to 3.92)) were more likely to believe TCM was effective against COVID-19. Similarly, older participants (55+vs <35, OR=3.13 (95% CI 1.79 to 5.46); 35–54 vs <35, OR=2.25 (95% CI 1.35 to 3.74)), females (OR=1.60 (95% CI 1.15 to 2.23)), and those born in mainland China (OR=10.49 (95% CI 2.32 to 47.39)) were more likely to use TCM if they had symptoms of COVID-19. </p> <p><strong>Conclusion</strong>: Despite the lack of scientific evidence to support its use, TCM was widely believed by Chinese immigrants in Canada to be an effective means of preventing COVID-19 and many also stated they would use it if they were experiencing symptoms of COVID-19. </p>

<p>Objection: The objective of this study was to assess attitudes towards the use of Traditional Chinese Medicine (TCM) for COVID-19 among Chinese immigrants in Canada during the early stage of the COVID-19 pandemic. </p> <p><strong>Methods</strong>: A cross-sectional study was conducted in April 2020 in Canada. Individuals aged 16 or older who were of Chinese origin and living in Canada at the time of the survey were invited to participate in an online survey. Descriptive and univariate statistics were performed to describe participant attitudes towards various preventive and treatment measures for COVID-19. Multiple logistic regression was used to identify independent associations with sociodemographic factors and attitudes. </p> <p><strong>Results: </strong>A total of 754 eligible respondents were included in the analysis. 65.8% of the participants were female, 77.2% had a university degree or higher and 28.6% were 55 years of age or older. Overall, 48.8% of the study participants believed that TCM was effective in preventing COVID-19% and 46.2% would use TCM if they had COVID-19-related symptoms. However, the corresponding numbers for western medicine were 20.8% and 39.9%, which were statistically lower (p<0.01). Older participants (55+vs <35, OR=3.55 (95% CI 2.05 to 6.14); 35–54 vs <35, OR=1.98 (95% CI 1.27 to 3.08)) and those who were dissatisfied with their income (OR=2.47(95% CI 1.56 to 3.92)) were more likely to believe TCM was effective against COVID-19. Similarly, older participants (55+vs <35, OR=3.13 (95% CI 1.79 to 5.46); 35–54 vs <35, OR=2.25 (95% CI 1.35 to 3.74)), females (OR=1.60 (95% CI 1.15 to 2.23)), and those born in mainland China (OR=10.49 (95% CI 2.32 to 47.39)) were more likely to use TCM if they had symptoms of COVID-19. </p> <p><strong>Conclusion</strong>: Despite the lack of scientific evidence to support its use, TCM was widely believed by Chinese immigrants in Canada to be an effective means of preventing COVID-19 and many also stated they would use it if they were experiencing symptoms of COVID-19. </p>

ABSTRACTThis study investigates how older adults perceive elder abuse and neglect in the context of migration and ageing. Based on a qualitative study of recent Chinese older immigrants in the Greater Toronto Area in Canada, it seeks to understand how migration and ageing processes, both of which engender cultural and contextual changes, shape and reshape views of elder abuse and neglect. The study argues that culture is important in older immigrants’ perceptions of elder abuse and neglect, yet individuals with the same cultural roots may differ in their conceptualizations. Further, such perceptions could change through interactions with peers and non-peers in the host society, and these, in turn, can be influenced by both cultural and structural factors.

ObjectionThe objective of this study was to assess attitudes towards the use of Traditional Chinese Medicine (TCM) for COVID-19 among Chinese immigrants in Canada during the early stage of the...

Elderly people from ethnic minority groups often experience different barriers in accessing health services. Earlier studies on access usually focused on types and frequency but failed to address the predictors of service barriers. This study examined access barriers to health services faced by older Chinese immigrants in Canada. Factor analysis results indicated that service barriers were related to administrative problems in delivery, cultural incompatibility, personal attitudes, and circumstantial challenges. Stepwise multiple regression showed that predictors of barriers include female gender, being single, being an immigrant from Hong Kong, shorter length of residency in Canada, less adequate financial status, not having someone to trust and confide in, stronger identification with Chinese health beliefs, and not self-identified as Canadian. Social work interventions should strengthen support and resources for the vulnerable groups identified in the findings. Service providers should adjust service delivery to better serve elderly immigrants who still maintain strong Chinese cultural values and beliefs.