Chinese American Caregivers Research Articles

Effectiveness of a psychoeducational skill training DVD program to reduce stress in Chinese American dementia caregivers: Results of a preliminary study

Prior research (Gallagher-Thompson, D., Gray, H., Tang, P., Pu, C.-Y., Tse, C., Hsu, S., et al. (2007). Impact of in-home intervention versus telephone support in reducing depression and stress of Chinese caregivers: Results of a pilot study. American Journal of Geriatric Psychiatry, 15, 425–434.) found that an in-home behavioral management program, derived conceptually from cognitive behavioral theories (CBT), was effective in reducing caregiver related stress and depressive symptoms in Chinese American dementia caregivers (CGs). Results were promising, but a more cost-effective intervention is needed to serve this growing population. Past work also found that a psychoeducational videotaped training program based on CBT was effective in reducing stress due to caregiving in Caucasian and African American dementia family CGs (Steffen, 2000, Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy, 31, 281–299.). To date no research has been conducted using a technological medium to deliver a similar kind of intervention to Chinese American caregivers. The present study evaluated the effectiveness of a similar but culturally “tailored” program in which 70 CGs were randomly assigned to a 12-week CBT skill training program delivered on a DVD, or to a general educational DVD program on dementia. Both were available in Mandarin Chinese or English as preferred. Pre post change analyses indicated that CGs did not differ on change in level of negative depressive symptoms, but positive affect was higher, and patient behaviors were appraised as less stressful and bothersome, for CGs in the CBT skill training program. They were also more satisfied with the program overall and reported that they believed they were able to give care more effectively. Results encourage further development of theoretically based interventions, delivered using modern technology, for this ever increasing group of CGs.

Impact of In-Home Behavioral Management Versus Telephone Support to Reduce Depressive Symptoms and Perceived Stress in Chinese Caregivers: Results of a Pilot Study

Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs). Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms. CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments. This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.

Recruiting Chinese Americans for Dementia Caregiver Intervention Research: Suggestions for Success

The purpose of this study was to compare the relative effectiveness of three recruitment modalities for enrolling Chinese-American and white family caregivers into research studies to evaluate intervention strategies. A total of 116 Chinese Americans and 134 whites were screened for eligibility to participate in one of two clinical intervention trials. Participants were recruited using: 1) media sources; 2) nonprofessional referral sources; or 3) professional referrals. Each participant was asked an open-ended question about how they became aware of the programs offered. A smaller proportion of Chinese Americans (39%) than whites (50%) who responded to recruiting strategies actually enrolled as subjects. There was a significant interaction between ethnicity and recruitment strategy. Chinese-American caregivers who were recruited by nonprofessional sources were less likely to enroll in the intervention studies than those who were recruited through media sources or professional referrals. Whites, on the other hand, were more likely to be recruited through nonprofessional sources than the other two. A consumer-oriented approach, which included direct face-to-face contact with key community leaders, generated the highest number of Chinese-American participants. Culture-specific factors such as trust-building with social service agencies, demonstrating genuine commitment to the well-being of the target community, and linguistic and ethnic matching between research staff and potential participants appear helpful to successful research recruitment in this rapidly increasing segment of dementia caregivers.

Caring for family members with Alzheimer's disease: perspectives from Chinese American caregivers.

The purpose of this study was to examine the experiences of Chinese American caregivers who provide care for family members with Alzheimer's disease (AD). Individual interviews were conducted with four family caregivers. Results revealed ethnocultural and structural barriers that Chinese family caregivers experienced, including stigmatization of AD in the Chinese community, a lack of knowledge about AD, a lack of culturally and linguistically appropriate AD services, nega tive interactions with health-care providers, and difficulty with English. This study vides cultural knowledge and insights nurses who care for AD clients and their fam ilies. Overcoming barriers and working with Chinese American families and their community are needed to improve access and dementia services for Chinese American patients and their families.

Causal Attributions of Schizophrenia by Chinese American Caregivers

Causal attributions of schizophrenia by 30 Chinese American caregivers in the Los Angeles area are investigated. Stress-related and biological explanations are most highly endorsed. Interpersonal and familial stress attributions reflect the sociocentric culture and centrality of family. A better match in causal attributions is key to improving interactions between mental health service providers and Chinese American patients and their caregivers. To this end, a stress-vulnerability model is suggested. Higher acculturation is also found to be positively associated with biological attributions of the illness, and supernatural attributions significantly relate to caregivers' objective and total burden. Implications of the findings are discussed.

The Illness, Stigma, Culture, or Immigration? Burdens on Chinese American Caregivers of Patients with Schizophrenia

In this study, the author investigates the burden of 30 Chinese American caregivers of patients with schizophrenia using both quantitative and qualitative data. The relatives experienced enormous burden because of being intensely involved in patient care. Burdens were strongly positively related to family conflicts. In the literature, conflicts among caregivers have rarely been examined, but these conflicts seem particularly important to Chinese families because of the intense involvement of more than 1 member in caregiving. The significant relationship between length of stay in the United States and burden is perhaps related to caregivers' sense of mastery in language and knowledge of community resources in coping with stress.

A social cognitive examination of responses to family conflicts by Arfican-American and Chinese-American carrgivers

Conflict between caregivers and their family members has been examined in relation to caregiver burden. However, specific theoretical models have not been applied to analyses of caregiver family conflicts. Nor has there been much research on the family conflicts of ethnic minority caregivers. Using Selman's1 interpersonal conflict strategies and their related levels of social perspective coordination as our framework, we content analyzed conflict reports of African-American and Chinese-American caregivers. Overall, there were more similarities in the strategies and social perspective coordination levels of the two groups than differences. In narratives where conflict was present (78 percent), about half of caregivers in both groups reported higherlevel conflict strategies, and half reported lower-level strategies. More advanced social perspective coordination seemed associated with greater satisfaction with family sharing of responsibilities in both groups. If these data patterns bear up under further testing, training in conflict resolution and social perspective coordination skills may prove an effective means of fostering better social relationships and sharing arrangements between caregivers and family members, and be a worthwhile complement to existing stress reduction interventions for caregivers.