Caregiving Obligations Research Articles

Ideals and realities: Chinese singleton daughters negotiating family size preferences and migrant motherhood in Spain

ABSTRACT Chinese young women’s fertility choices have attracted growing interest in the last years, however, the effects of women’s singleton status and transnational motherhood experience on their fertility behaviours remain understudied. Using 12 qualitative interviews with Chinese migrant mothers in Spain, we firstly examine how women’s family size preferences are constructed by their singleton status associated with changing gender norms and strong normative expectations of future family caregiving obligations; secondly, we explore the challenges faced by participants towards realizing their fertility expectations in transnational spaces from a gendered perspective. We find that although singleton status can contribute to women’s larger ideal family size, their gendered roles as only-daughters and migrant mothers increase care responsibilities, which negatively influence their childbearing decisions. By situating singleton daughters’ experiences within a broader institutional and sociocultural context, our study offers a unique opportunity to examine how changing gender norms, care, and responsibility structure fertility norms of one generation at the micro level.

Depressive symptoms among women in disaster-prone region in Bangladesh

Women are one of the crucial mental health victims of disaster but there is a lack of rigorous research in this area. This study, therefore, conducted a survey using a questionnaire among 350 randomly selected women from Khulna district (a disaster-prone region in Bangladesh) to explore the prevalence of depression and associated factors among women. 9-items Patient Health Questionnaire was used to measure the depressive symptoms and 63% were found to have the moderate to severe level of depression. Similarly, the ordered logistic regression model revealed that being married, having children, facing physical injury, job loss in disaster, damage of house, damage of crops, loss of domestic animals, worrying about future possible loss, family conflicts, and physical violence were the significant risk factors of depression among women in disaster-prone Bangladesh. This is because disasters increase caregiving obligations, financial instability, weak social support, and gender-based violence among women comparing men. Thus, it is crucial to prioritize mental health interventions for women including livelihood and emotional supports within disaster management policy framework. Likewise, future studies should use a longitudinal design with an extensive sample and study region since the current study employed a cross-sectional design with a small sample and study region.

ADRD CAREGIVERS’ ROLE PERCEPTION AND MENTAL HEALTH AFTER LTC-PLACEMENT OF FAMILY MEMBERS

Abstract The Chronic Grief Management Intervention-Video (CGMI-V) clinical trial tested the effects of an 8-week live online intervention for caregivers who placed their family members with ADRD in LTC on caregivers’ mental health outcomes (grief, depression and anxiety symptoms, positive states of mind). This cross-sectional study used baseline data (n=95) from the CGMI-V. We performed hierarchical linear regression to examine the main effects of caregiving role perceptions on caregivers’ levels of grief, depression, anxiety symptoms, and positive states of mind, controlling for potential covariates. At baseline, perceived caregiver role captivity was the most significant factor of outcome variables, followed by feelings of guilt and loss. Increased feelings of role captivity were linked to sum scores of grief as measured with the Marwit-Meuser Caregiver Grief Inventory. These findings indicate that increased feelings of role captivity were associated with increased feelings of loss and loss of interpersonal connections. Higher levels of perceived role captivity were associated with more depressive and anxiety symptoms. Caregivers with lower levels of perceived role captivity had higher levels of positive states of mind. The findings confirmed the need for interventions targeting caregivers’ feelings of role captivity, loss, and guilt related to caregiving obligations post-LTC placement of family members with ADRD to reduce caregivers’ grief, depression, and anxiety and to increase their positive states of mind. These baseline findings are preliminary. Future presentations will report the effects of the CGMI-V intervention on caregivers’ grief and mental health, including weeks 8 and 24 follow-up data.

Nurturing and Caring?

Abstract This essay examines Francis de Sales’s Introduction to the Devout Life through the framework of caregiving. It also uses de Sales’s correspondence with two elite women, Jeanne de Chantal and Marie Brûlart, to demonstrate how de Sales’s guidance for laity was put into practice. Exploring women that yearned for a richer spiritual yet also had extensive caregiving obligations that did not allow for complete withdrawal from the secular world, reveals the increased labor these women faced. Women could not neglect household and family to spend more time in prayer and devotional practices. Caregiving duties were ongoing for most women of Early Modern Europe and continue today. Exploring how caring was viewed as part of women’s obligations as Christians, highlights the often-hidden labor of women.

When Change and Stability in Work Location Matter for Psychological Distress: A Study of Workers Before and During the COVID-19 Pandemic

Prior research has explored the consequences of the sudden transition to remote work during the pandemic. Less is known, however, about how the mental distress of individuals who changed work locations during the pandemic differed from that of those who consistently worked from home or consistently worked on-site, nor to what extent these differences varied across worker characteristics, such as gender and caregiving obligations. This study addresses these gaps using data from the Pew Research Center’s American Trends Panel survey and a Stress Process Model framework. Results show that those who transitioned into working from home during the pandemic reported greater mental distress than those who consistently worked from home or on-site. This association was larger among women with school-aged children. These findings suggest that structural changes in work location during the pandemic were more strongly related to mental distress. Moreover, the finding that this distress was unevenly distributed by gender and caregiving obligations has important implications.

Caregivers' Burden in Patients With Bipolar Disorder and Schizophrenia and Its Relationship With Anxiety and Depression in Caregivers: A Narrative Review.

Mental disorders affect a person's thinking, mood, and/or behaviour and can range in severity from minor to severe. Nearly one in five persons have a mental disease as stated by the National Institute of Mental Health. A serious mental illness called bipolar disorder causes extreme mood swings that can range from manic to depressive states.Schizophrenia is abrain condition that leads individuals to perceive reality differently. They cannot distinguish between what they are actually experiencing and what they are just imagining. Both illnesses have a variety of negative effects on the patient as well as the primary caregiver, who may be the patient's family or other relatives. In the case of a patient with mental illness, the family's role is crucial. Family members' long-term caregiving obligations may result in a caregiving burden that negatively impacts the caregivers' quality of life, career and personal relationships. Depression generally undermines carers' ability to fulfil their crucial supportive role towards their relative with a mental illness while contributing to their distress and handicap. Given the high prevalence of caregiver depression, it is critical to address this issue not just by creating therapies to treat caregiver depression once it has started, but also by preventing caregiver depression.

Remote Technologies and Filial Obligations at a Distance: New Opportunities and Ethical Challenges

The coupled growth of population aging and international migration warrants attention on the methods and solutions available to adult children living overseas to provide distance caregiving for their aging parents. Despite living apart from their parents, the transnational informal care literature has indicated that first-generation immigrants remain committed to carry out their filial caregiving obligations in extensive and creative ways. With functions to remotely access health information enabled by emergency, wearable, motion, and video sensors, remote monitoring technologies (RMTs) may thus also allow these international migrants to be alerted in sudden changes and remain informed of their parent’s state of health. As technological solutions for caregiving, RMTs could allow independent living for older persons while any unusual deviations from normal health patterns are detected and appropriately supported. With a vignette of a distance care arrangement, we engage with concepts such as filial piety, in-absentia caregiving distress, and the social exchange theory, as well as the upholding of shifting cultural ideals to illustrate the complex dynamic of the satisfaction and quality of the informal caregiving relationship. This paper extends the traditional ethical issues in technology-aided caregiving, such as autonomy, privacy, and justice, to be considered within the context of distance care. We also posit newer ethical considerations such as consent in power imbalances, harm to caregivers, and stigma. These known and new ethical issues aim to encourage further ethically conscious design and use of RMTs to support distance care for older persons.

Mitigating Caregiver Distress in South Western Ontario: Perspectives on Role, Community, and Care.

The former South West Local Health Integration Network (SW LHIN) of Ontario, which is in a predominantly rural region, regularly reports the lowest rates of caregiver distress in the province.Caregivers from rural communities regularly face challenges related to the access, applicability, and availability of supports and services, This qualitative case study describes perspectives of caregiving from the region, and explores how role construction and expectations of caregivers might both mitigate distress and influence service support use. Thematic analysis identified five themes: anticipated care, gendered caring, service support assumptions, confidence in community, and the "line in the sand": care decisions for evolving needs. Using the lens of caregiver identity theory, the findings suggest that these caregivers conceptualize identity as an extension of their primary role, to include caregiving obligations and responsibilities. We also noted a steadfast confidence in community and perceived service support assumptions across the region, with no notable rural-urban divide.

“I’m Not Back to Where I Was”: COVID-19 and Gendered Mental Health Outcomes among Working Parents in the U.S.

This study examines how dual-earner parents in the U.S. experienced mental health in relation to their caregiving and work obligations during the COVID-19 pandemic. Current research shows that parents experienced heightened negative mental health outcomes during the pandemic yet does not analyze how parents understood their mental health while balancing multiple ongoing priorities. Research on parental mental health during COVID-19 largely remains quantitative. I analyze 48 semi-structured interviews with dual-earner parents in the U.S. between January 2021 and August 2022 to understand how parents interpreted their mental health during the pandemic, and how their work and caregiving obligations directly affected their mental health outcomes. Findings indicate that during the COVID-19 pandemic: (1) parents experienced an increase in negative mental health outcomes; (2) mothers attributed negative mental health outcomes to both work and childcare obligations, while fathers attributed negative mental health outcomes only to work obligations; and (3) parents, but more frequently mothers, stressed the need for a more flexible work environment in a post-COVID-19 world.

Employment and leave while parenting children with medical complexity.

Children with medical complexity (CMC) require frequent medical care and are at risk of recurrent hospitalizations. The Family Medical Leave Act (FMLA) allows some workers to take unpaid leave from work to care for family members. This study examines caregiving obligations of parents of CMC, the availability and appropriateness of FMLA in facilitating their roles as caregivers and employees, and how these challenges affect employment and financial security. Parents of CMC were recruited from a primary care pediatric care management program for semistructured interviews. An integrated approach, using both deductive and inductive codes, was used to conduct a thematic analysis. All 16 respondents were female, with half working full-time, five working part-time, and three not employed at the time of participation. On average, their CMC experienced 1.8 hospitalizations in the prior 12 months. Parents described that caring for CMC required ongoing and unpredictable time commitments that conflicted with job duties and schedules. This conflict led to frequent employment changes that negatively impacted parents' eligibility for FMLA, their financial health, and their own well-being. Parents often described not having access to FMLA due to exhausting the allotted time, part-time status, insufficient tenure at their job, or the inability to take unpaid leave. Parents depended on informal workplace policies and relationships with supervisors to maintain employment, as well as personal and formal supports to care for CMC and their families' financial stability. Parents want and need to work in order to support their families and pay for the added expenses related to care for their CMC. Remaining active in the workforce requires that they have flexible schedules that accommodate their unpredictable and ongoing caregiving responsibilities. The eligibility criteria and unpaid nature of FMLA, however, make employment and financial stability elusive for caregivers of CMC. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Family Norms and Declining First-Marriage Rates: The Role of Sibship Position in the Japanese Marriage Market

This study explores how changes in sibship composition associated with fertility decline may, in conjunction with entrenched family norms and expectations associated with specific sibship positions, impact marriage rates and further reduce fertility. We evaluate this possibility by focusing on Japan, a society characterized by half a century of below-replacement fertility and widely shared family norms that associate eldest (male) children with specific family obligations. Harmonic mean models allow us to quantify the contribution of changes in both marriage market composition with respect to sibship position and sibship-specific pairing propensities to the observed decline in marriage rates between 1980 and 2010. One important finding is that marriage propensities are lower for those pairings involving men and women whose sibship position signals a higher potential of caregiving obligations, especially only-children. Another is that changes in marriage propensities, rather than changing sibship composition, explain most of the observed decline in marriage rates. We also found that marriage propensity changes mitigate the impact of the changing sibship composition to some extent. However, the limited contribution of changing sibship composition to the decline in first-marriage rates provides little support for a self-reinforcing fertility decline via the relationship between changing sibship composition and marriage behavior.

Workplace flexibility, work-family interface, and psychological distress: differences by family caregiving obligations and gender.

Drawing on data from the 2008 U.S. National Study of the Changing Workforce, this study (1) examines the associations between access to three types of flexible working arrangements-flextime, flexplace, and culture of flexibility-and psychological distress, (2) tests the mediating roles of work-family conflict and work-family enrichment, and (3) investigates whether these relationships differ by workers' childcare or elder-care obligations as they intersect with gender. Results show that a flexible workplace culture, but not access to flextime or flexplace, is associated with lower psychological distress. Work-family conflict and work-family enrichment partially mediate the relationship between culture of flexibility and psychological distress. In addition, the negative effect of culture of flexibility on psychological distress is stronger among workers sandwiched between preschool childcare and elder-care compared with those with neither caregiving obligations, a pattern especially pronounced among women. We discuss these results and their implications for organizational practices and worker well-being.

The Preservation of the Separate Spheres Doctrine in Congress and the Federal Courts

In Bradwell v. State, an 1872 decision upholding an Illinois law prohibiting women from practicing law, the United States Supreme Court reasoned that the law was justified because women belonged in the “domestic sphere.” While today’s sex-based workplace exclusions are not as explicit as they once were, women still face barriers to remaining in the workforce and advancing in the workplace despite the existence of major federal legislation in the areas of pregnancy discrimination and family leave policy. Congress passed the Pregnancy Discrimination Act (PDA) in 1978 to stop pregnancy discrimination, but the PDA has not come close to eliminating pregnancy discrimination. Similarly, despite Congress’s passing of the Family and Medical Leave Act (FMLA) in 1993, ineffective family leave policy continues to hinder women’s ability to balance work and their disproportionate family caregiving obligations. After tracing the development of sex-based workplace exclusions from the 1870s through the 1970s, this Note argues that the PDA and FMLA prohibited explicit sex-based workplace exclusions while preserving other forms of sex-based workplace exclusions. This Note then analyzes proposed work-family legislation and argues that policies aimed at eliminating sex-based workplace exclusions must account for the specific experiences of women while promoting anti-stereotyping principles.

Between predictability and perplexity

Abstract This article focuses on the relationship between academia, the gendered division of labor, and the pandemic. After briefly canvassing preliminary research about the effects of the pandemic on academic women, it discusses the gendered division of caregiving responsibilities, both inside the family and in academic institutions. Through the lens of feminist theory, the article aims to understand what can be perceived as a kind of paradox or contradiction: on the one hand, there is something deeply predictable about the fact that women have shouldered relatively disproportionate caregiving responsibilities during the pandemic. On the other hand, and because these gendered effects are so predictable, there is something somewhat perplexing in the lack of institutional response. This article explains what is predictable about the phenomenon as an instantiation of misogyny and the gendered division of labor—a reproduction of already existing issues. The somewhat perplexing nature of the phenomenon comes from the lack of institutional response to deeply predictable effects, but it is also related to how resilient the gendered nature of caregiving obligations has proven to be, even during the extraordinary circumstances of a pandemic. This resilience, the article suggests, might be explained by the intersection of misogyny and economic exploitation.

Informal caregiver motivations, values, challenges and gains: A photovoice and interpretative phenomenological analysis of interrelationships.

The adoption of a caregiving role in the context of illness and disability is often taken for granted. This study explores caregivers' motivations to provide care and how these relate to values, and to the challenges and gains of caregiving. Eight semi-structured interviews were conducted with caregivers and photographs were taken by caregivers to exemplify their caregiving experiences. This photo-elicitation method complemented the use of Interpretative Phenomenological Analysis when applied to verbatim transcripts. Superordinate themes included: caregiver's life story; significance of family; caregiving obligations; caring relationship; challenges and gains associated with caregiver motivations. Intrinsic and extrinsic motivations were less distinct in caregivers' lived experiences than previously suggested, and were influenced by family values and specific challenges and gains of caregiving. The coexistence of different motivations and the nature of single complex motivations is discussed. The importance of caregiver assessment and support planning, and regular breaks from caregiving are highlighted.

Family Care-Work Interference and Mid/Late-Career Motivation and Intentions: Mediating Role of Occupational Future Time Perspective

The combination of work and family obligations can lead to two-way interference, resulting in Family Care Interference with Work (FCIW) and Work Interference with Family Care (WIFC). Both can impact late career motivation and intentions to continue working or retire and reduce their occupational time perspective (OFTP). Through two studies, this paper shows how OFTP mediates the relationship between FCIW/WIFC and mid and late career indicators such as early retirement intentions and motivation to continue working beyond the retirement age. Our findings contribute to increasing knowledge of how increasing family caregiving obligations may impact the career intentions of working carers in their mid and late career stages.

Factors affecting timely breast cancer treatment among black women in a high-risk urban community: a qualitative study

BackgroundBlack women diagnosed with breast cancer in the U.S. tend to experience significantly longer waits to begin treatment than do their white counterparts, and such treatment delay has been associated with poorer survival. We sought to identify the factors driving or mitigating treatment delay among Black women in an urban community where treatment delay is common.MethodsApplying the SaTScan method to data from Ohio’s state cancer registry, we identified the community within Cuyahoga County, Ohio (home to Cleveland) with the highest degree of breast cancer treatment delay from 2010 through 2015. We then recruited breast cancer survivors living in the target community, their family caregivers, and professionals serving breast cancer patients in this community. Participants completed semi-structured interviews focused on identifying barriers to and facilitators of timely breast cancer treatment initiation after diagnosis.ResultsFactors reported to impact timely treatment fell into three primary themes: informational, intrapersonal, and logistical. Informational barriers included erroneous beliefs and lack of information about processes of care; intrapersonal barriers centered on mistrust, fear, and denial; while logistical barriers involved transportation and financial access, as well as patients’ own caregiving obligations. An informational facilitator was the provision of objective and understandable disease information, and a common intrapersonal facilitator was faith. Logistical facilitators included financial counseling and mechanisms to assist with Medicaid enrollment. Crosscutting these themes, and mentioned frequently, was the centrality of both patient navigators and support networks (formal and, especially, informal) as critical lifelines for overcoming barriers and leveraging facilitating factors.ConclusionsThe present study describes the numerous hurdles to timely breast cancer treatment faced by Black women in a high-risk urban community. These hurdles, as well as corresponding facilitators, can be classified as informational, intrapersonal, and logistical. Observing similar results on a larger scale could inform the design of interventions and policies to reduce race-based disparities in processes of cancer care.

Beyond role strain: Work–family sacrifice among underrepresented minority faculty

AbstractObjectiveThis study describes the perceived work demands and family caregiving obligations associated with work–family life among URM faculty and the coping strategies used to negotiate the integration of roles.BackgroundPast research on families focuses primarily on professional majority‐culture families and often fails to include traditionally and historically underrepresented minority (URM) families. The study of how URM professionals negotiate work and family obligations and economic and institutional constraints remains relatively absent in the family science discourse.MethodIn‐depth individual and group interviews (N = 58) were conducted with US‐born African American, Mexican American, and Puerto Rican faculty at research universities.ResultsThe overarching theorizing anchor that grounded the themes was sacrifice. Three themes emerged: excessive work demands/role strain; commitments and caregiving obligations to family of origin and nuclear family; and few coping strategies and resources to maintain a balanced life.ConclusionThis analysis offers insight into the multiple factors that affect the experiences of URM academics in their workplaces that deeply influence work roles and self‐care and its impact on family roles. These data fill a gap by applying alternative frameworks to explore the work–family nexus among racialized groups.ImplicationsNew research frontiers are offered to study the work–family nexus for URM faculty and how higher education can respond to alleviate excessive work demands and work–family life conflicts.

Why do they care? A qualitative systematic review and meta-synthesis of personal and relational motivations for providing informal care

ABSTRACT Informal caregiving is crucial to the sustainability of health and social care systems globally. With ageing populations and a rising prevalence of acute and chronic health conditions, the need for informal care is growing, making it important to understand what motivates individuals to care and to continue caring. This paper reports findings of a systematic review which examined determinants of motivations and willingness to provide informal care. A systematic search was conducted using six electronic databases and a wide range of additional sources. 105 qualitative studies published before August 2019 were included with 103 of them reporting on personal and relational motivations, and the contextual factors underpinning these. Grounded theory-based, thematic synthesis was applied to synthesise the literature. This meta-synthesis reports on findings from across the world spanning three decades, with data from over 2500 caregivers across a range of health conditions. This paper presents the relational, personal and contextual themes. It highlights the significance of reciprocity, affection, family values and caregiving obligations. Personal characteristics, finding meaning, illness perceptions, situational and temporal aspects of caregiving are also identified as important in shaping motivations and willingness to care and to continue caring. Implications for theory, research, policy and practice are discussed.

Access to Health Services Among Low-Income Women in the Philippines: A Review

Healthcare access is the availability of medical services to prevent, identify, diagnose, and manage illnesses, diseases, disorders, and other problems that influence one's health (MU School of Medicine, 2022). Where it must provide convenience and optimal health outcomes for everyone. However, despite the attempts of the Philippine Government to provide Universal healthcare, low-income households still have a hard time accessing the coverage and using it. Low-income women have it more difficult to access healthcare due to various reasons such as inequalities, norms, age, and socioeconomic status. This article was influenced by the study of Luu, K. et al. (2022), entitled “Exploring the Role of Social Networks in Facilitating Health Service Access Among Low-Income Women in the Philippines”. With the use of available published materials from various journal databases, specifically Sage Journals, Google Scholar, and EBSCO, this review article managed to obtain literature that could support the aim of this review article. Furthermore, demographic characteristics of participants such as Approachability and the ability to perceive; Acceptability and the ability to seek; Availability, accommodation, and the ability to reach; Affordability and the ability to pay and; Appropriateness and the ability to engage — were used to gather information on why low-income women put off seeking medical attention. As a result, based on the findings of various research articles, certain women's access to health treatment hindered timely treatment, with younger women more prone than older women to put off seeking medical attention. For they prioritize their children's health, have caregiving obligations, have a hard time finding childcare, and are discouraged by the financial burden of medical expenses on their families as caregivers