Impact of dementia care courses on nursing students' filial piety and attitudes towards caring for family members with dementia: a cross-sectional questionnaire survey.

Support use in caregivers of persons with dementia of East Asian backgrounds: An integrative review.

Family functioning encompasses cultural values and behavioral patterns, with family dysfunction referring to pervasive and maladaptive interactions in the latter dimension. In Chinese culture, filial piety is a core familial value, comprising authoritarian filial piety (AFP), rooted in hierarchy and obedience, and reciprocal filial piety (RFP), based on mutual affection and care. This study examines the relationships between AFP, RFP, family dysfunction, and eating pathology among Chinese adults with anorexia nervosa (AN). We employed a two-part design that included a cross-sectional analysis of 144 female adults with AN in Chinese mainland and, within the same cohort, a longitudinal follow-up of 75 patients to examine how filial piety and family dysfunction predict changes in eating pathology over time. Correlation, hierarchical multiple regression, and generalized least squares were used for data analysis. Cross-sectionally, AFP was associated with greater eating pathology (β = 0.161, p < .05). While RFP and family dysfunction were not significantly associated with eating pathology after controlling psychological and biological factors. Longitudinally, AFP did not independently predict symptom progression after controlling for baseline pathology, suggesting that AFP may act not as a primary driver of worsening symptoms. AFP represents a stable cultural risk factor for eating pathology in Chinese adults with AN. These findings underscore the importance of integrating cultural values like AFP into therapeutic frameworks and developing culturally adapted interventions for Chinese populations.

This article analyses the unique challenges and issues Asian parties experience under the Property (Relationships) Act 1976 (PRA) in New Zealand. Drawing on demographic data, case law, and interviews with expert and experienced practitioners in property relationship issues, the article highlights how cultural practices, language barriers, and differing understandings of legal norms complicate relationship property disputes in court. Issues include the treatment of family transfers—whether a transfer is a gift or a loan, interpretation and translation of evidence, discovery and disclosure, limited documentation and lack of expert cultural and language evidence. The analysis emphasizes the need for cultural competence within the Family Court, when cultural issues may be relevant to adjudicative issues, and recommends changes to ensure equal access to justice as the PRA enters its 50th year. Keywords: Property (Relationships) Act; Asian parties; filial piety; cultural competence; family transfers; loans; gifts; language barriers; access to justice; superdiversity; contracting-out and compromise agreements; interpretation and translation; intergenerational support.

Filial piety has been shown to have a strong effect on the well-being of parents, but the findings have been inconsistent. This study aimed to clarify the mixed results by considering the role of parent-child discrepancies in filial piety. Specifically, we examined how congruence and incongruence in filial piety between parents and children are related to parental depressive symptoms. Data were obtained from 3922 eleven-year-old students and their fathers and mothers. Polynomial regression with response surface analysis was used to analyze the effects of parent-child discrepancies on depressive symptoms separately for reciprocal and authoritarian filial piety and separately for the four parent-child gender dyads. Approximately one-third of parents had congruent filial piety with their children, one-third had higher filial piety than their children did, and one-third had lower filial piety. When parent-child filial piety was congruent, greater reciprocal filial piety was associated with fewer parental depressive symptoms, while higher authoritarian filial piety was associated with more parental depressive symptoms. Moreover, parents with higher authoritarian filial piety than their children had more depressive symptoms than those with lower authoritarian filial piety. In addition, greater incongruence in authoritarian filial piety was associated with more parental depressive symptoms. The findings suggest that the type of filial piety, the level of congruent filial piety, and the direction and degree of incongruent filial piety between parents and children all influence parental depressive symptoms. The findings suggest focusing on the psychological needs of parents and reducing conflicts in filial relationships.

Unpacking the link between adverse childhood experiences and mental health disparities among Chinese men who have sex with men: The mediating role of filial piety and internalized homophobia.

Vietnamese university students are experiencing profound moral and psychological challenges amid rapid urbanization, globalization, and digital transformation. While higher education institutions increasingly prioritize technical competencies and employability, moral education and character formation remain underdeveloped. In response, Buddhist institutions across Vietnam have expanded retreat programs designed specifically for young people, offering a form of non-formal moral education grounded in Buddhist ethical philosophy and contemplative practice. This study examines how Buddhist moral education delivered through retreat programs influences lifestyle awareness among university students in Hanoi. Using a mixed-methods design combining survey data (N = 200) and in-depth interviews, the research analyzes the relationships between core Buddhist ethical dimensions (mindfulness, compassion, non-harming, ethical reflection, and filial piety) and students’ lifestyle orientations, including self-discipline, emotional regulation, sustainable consumption, and social responsibility. Findings indicate that participation in retreats significantly enhances students’ ethical awareness and contributes to positive lifestyle transformation. Compassion is the strongest predictor of prosocial behavior, while mindfulness serves as a key regulatory mechanism shaping ethical decision-making. The study conceptualizes Buddhist retreats as an effective model of non-formal moral education and contributes empirical evidence to interdisciplinary scholarship on religion, education, and youth development in contemporary Vietnam.

Asian American women receive unique socialization messages about their race and gender, also known as gendered racial socialization (Ahn et al., 2022). Using an intersectional approach, we developed and validated the Gendered Racial Socialization Scale for Asian American Women. Our sample included 737 Asian American women who completed an online survey. Exploratory and confirmatory factor analyses suggested a seven-factor scale: filial piety socialization, preparation for bias and empowerment, beauty ideals, racialized dating socialization, traditional gender role socialization, disengagement with discrimination, and purity socialization. Convergent validity was demonstrated through associations with gender and racial socialization. Discriminant validity was established through weak or nonsignificant correlations with impression management. Most subscales were associated with self-esteem, depressive symptoms, and body shame, demonstrating criterion validity. Findings indicate that this scale can be used for researchers, clinicians, and families to better understand the gendered racial messages that Asian American women receive while growing up and their impact on psychological well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This study investigates the interplay between motivational orientations, learning climate, and student engagement within elite undergraduate dance programs in Guangdong, China. While Self-Determination Theory (SDT) typically frames controlled motivation as maladaptive, this research posits a “Guangdong–SDT Paradox,” where culturally embedded obligations support persistence. Using a cross-sectional design, data were collected from 509 dance students across six institutions and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results identify learning climate as the dominant predictor of multidimensional engagement, explaining over 70% of the variance. Consistent with SDT, autonomous motivation strongly predicted engagement and partially mediated the influence of the learning climate. However, contrary to Western-centric models, controlled motivation exhibited a significant positive effect on engagement, suggesting that collectivist values such as filial piety and institutional “face” function as adaptive mechanisms in high-performance contexts. These findings support a theory of “contextualized universality,” where basic psychological needs are universal but their expression is culturally modulated. The study concludes that instructor-led autonomy support is essential for internalizing both intrinsic and culturally sanctioned motivations, offering a framework for sustaining engagement in elite arts education.

China's current body donation landscape remains challenging, with traditional cultural factors such as values and religious beliefs widely regarded as significant influencers. However, the specific cultural factors at play remain unclear. This systematic review aims to comprehensively synthesize the factors within traditional Chinese culture that affect willingness to donate. Following the PRISMA guideline, two researchers systematically searched ten databases based on the predefined search strategy from the establishment to August 2025, including PubMed, Embase, Web of Science, Scopus, Medline, ScienceDirect, China Biology Medicine (CBM/Sinomed), VIP Full-text Database, Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure (CNKI). Sixteen relevant articles were retained for analysis after evaluating 2106 articles. The included studies encompassed 14,556 participants. Using content analysis based on the theory of cultural stratification, the study summarized 12 culturally related factors: spiritual culture (body perspective, death perspective, life perspective, values perspective, filial piety, social opinion); institutional culture (funeral rites, commemorative ceremonies, donation procedures, legal); and material culture (monuments and memorials, reception institutions). Overall, Chinese body donation was impeded by numerous obstacles that are not mutually independent. Measures should be taken including systematically integrating death education into the national curriculum, establishing a comprehensive donation system, advancing the development of material culture, and leveraging media and digital technologies to promote the sustainable and healthy development of modern medicine.

ABSTRACT Sexual and gender minority youth in China endure elevated mental health risks within a collectivistic culture that prioritises familial harmony and heteronormative continuity, positioning family acceptance as a critical yet underexplored protective factor. Grounded in minority stress theory adapted to the Chinese context, this study tested a serial mediation model positing that family acceptance enhances psychological well-being through sequential pathways involving self-esteem and sexual identity acceptance among 316 LGBT college students. Serial mediation analysis revealed that family acceptance robustly predicted psychological well-being (total effect b = 0.69), with significant independent mediation by self-esteem and sexual identity acceptance, and a notable serial indirect effect (b = 0.08, 95% BC CI [0.05, 0.11]). All hypothesised paths were supported, illuminating a hierarchical mechanism amplified by cultural norms of filial piety and normative conformity. These findings extend minority stress theory by delineating culturally contingent sequential processes in collectivistic societies, where self-esteem serves as a foundational gateway to identity affirmation. They underscore the transformative potential of family-inclusive interventions tailored to Chinese cultural realities, offering actionable pathways to foster resilience and reduce disparities among this vulnerable population.

Abstract Background During the Ming and Qing dynasties, as a mature period of traditional Chinese society, the education system dominated by the imperial examination system deeply penetrated the social fabric. Existing research mostly focuses on explicit issues such as the evolution of the education system and cheating in the imperial examination system, with insufficient empirical research on its value shaping and psychological impact, and a lack of quantitative support. The study focuses on the Ming and Qing imperial examination archives, local chronicles, and literati diaries as core historical materials, combined with quantitative statistics and text analysis methods, to explore the mechanism of the impact of educational content and form on social core values and group psychology, aiming to provide a new perspective for exploring the modern value of traditional education. Methods The study selected local chronicles from 286 counties in 13 provinces during the Ming and Qing dynasties, 432 imperial examination answer sheets, 156 literary diaries, and 307 family education records as research samples, including different educational levels and regions. Using content analysis method to encode core textbooks and answer texts such as "Annotations to the Four Books, Chapters and Sentences," and extract values keywords; Use historical demographic methods to analyze the correlation data between sample education level, occupation, and social behavior. The study first uses bibliometric methods to screen representative historical materials, removing non first-hand materials with a credibility of less than 85%; Then use Nvivo software to encode the values dimension of the text; Finally, correlation analysis was conducted using SPSS to explore the correlation between education years, scores of various values, and psychological representations. Results Data shows that among those who receive systematic Confucian education, 83% of respondents list "loyalty to the monarch and filial piety" as their core values, which is much higher than the 21% of those who have not received formal education; There is a significant positive correlation (r = 0.76, p&amp;lt;.01) between the length of education and the value of valuing righteousness over profit. The score of this dimension is 2.3 times higher for the Jinshi group than for the Tongsheng group. On a psychological level, the frequency of scholars and above mentioning adversity and striving in their diaries is 3.1 times higher than that of young students per year, and the frequency of expressing anxiety about fame and achievements in the juren class is 1.8 times higher than that of the Jinshi group. Discussion The research results indicate that traditional education has a strong shaping power on social values, and the cultivation model of both morality and talent has reference significance for contemporary moral education. Psychological phenomena such as fame anxiety provide a historical mirror for modern education pressure relief. The limitation of this study lies in the insufficient attention paid to folk education forms such as private schools, free schools, and clan education in the Ming and Qing dynasties. Future research can explore the value transmission path of grassroots education by sorting out first-hand materials such as local clan account books and private school teaching logs.

This study focuses on the important visual text "A Mirror for the Emperor", exploring how it transforms Confucian "rites" into social norms through visual mechanisms. Unlike previous studies that mainly remained within the fields of textual analysis or political history, this paper approaches it from the perspective of visual culture and etiquette dissemination, analyzing its unique value as a "visual etiquette mechanism". Methodologically, this study combines Panofsky's three-level analysis method of iconography, visual semiotics, and political etiquette theory to conduct in-depth interpretations of the three core images: "Appointing Talents for Governance", "Warning Stelae and Criticism Boards", and "Filial Piety Ascending to Heaven". At the same time, this study pays attention to its regional reconfiguration in Shandong, Henan, and Shaanxi, revealing the recontextualization process of these images in local academies, temples, and families. Additionally, this study draws on Cosmological Ethics and normative social psychology to examine how these visual symbols construct the paradigm of normative compliance. The research on Ming Dynasty etiquette images also confirms that the visual presentation of natural symbols reinforces society's understanding of "the harmony between heaven and man", thereby extending the political admonition consciousness to a widespread reverence for cosmic order and social order. The research results indicate that the visual mechanism of "A Mirror for the Emperor" mainly manifests in four aspects: Firstly, through elements such as postures, objects, and spaces, it constructs a stable visual grammar, making "rites" have systematic expressibility; Secondly, the images align with the political tensions of the Wanli period and become symbols of admonition; Thirdly, the regional re-production realizes the cycle of "central generation - local adaptation", promoting the diffusion of the ritual system in grassroots society; Fourthly, the visual medium transforms ethical norms into daily learnable postures, strengthening social integration. The academic contributions of this study can be summarized as four points: expanding the artistic history perspective beyond textual studies; emphasizing the cultural function of etiquette in visual communication; integrating iconography and etiquette theory to reveal the interaction mechanism between visual and power; and placing Chinese etiquette images within the academic discourse of global visual culture and cross-cultural comparison.

Death in Chinese culture is a multifaceted phenomenon shaped by centuries of philosophical and religious thought. This study explores the complementary conceptions of death in Chinese tradition through the lenses of Taoism, Buddhism, and Confucianism, highlighting their unique contributions and interconnected perspectives. Taoism views death as a natural part of the cosmic cycle, emphasizing harmony with nature, the flow of life energy (Qi), and the continuity of existence beyond physical life. Confucianism, in contrast, frames death within ethical, social, and familial dimensions, stressing filial piety, ancestral reverence, and the cultivation of moral relationships that extend beyond the individual. Buddhism adds a spiritual and soteriological dimension, interpreting death as a transition in the cycle of samsara, governed by karma, impermanence, and the potential for liberation (nirvana). Together, these traditions provide a holistic framework in which death is not merely an end but a transformation that balances natural, moral, and spiritual concerns. Historical examples, such as the philosophy of Wang Yangming, illustrate the integration of these traditions, showing how Confucian, Taoist, and Buddhist ideas were synthesized to guide ethical living, spiritual cultivation, and the understanding of mortality. In repetition, Chinese funeral rites and ancestral rituals reflect this synthesis, blending ethical duties, cosmological awareness, and spiritual aspirations. Understanding these complementary conceptions provides valuable insights for scholars in religious studies, philosophy, anthropology, and cross-cultural healthcare, particularly in contexts where death intersects with ethical decision-making, bereavement practices, and cultural sensitivity.

Hong Kong’s ageing population, with over 20% of residents aged 65 and older by 2024, has intensified the demand for robust caregiver support policies and services to sustain “ageing in place”. This policy review examines the evolution of informal caregiver policies and practices for frail older adults in Hong Kong, analyzing historical, current, and future dimensions through Bronfenbrenner’s (1983) ecological systems theory. Pre-2020 services were fragmented across microsystem (family strain), mesosystem (service gaps), and macrosystem (residual funding) levels, rooted in filial piety norms with limited accessibility. Post-2020 reforms, informed by the 2022 Consultancy Study, have solidified support through regularized caregiver allowances, expanded respite services and community care vouchers, with social workers fostering stakeholder collaboration and bridging ecological levels. The review reveals Hong Kong’s first systematic ecological analysis of policy evolution, identifying cross-level causal pathways (e.g., pre-2020 macrosystem funding failures due to mesosystem deficits) and international LTC financing gaps (Japan, Germany, Singapore). Future directions propose integrated strategies: assistive technologies, caregiver-friendly workplaces, longitudinal research databases, workforce upskilling, and medical-health-social data platforms. By highlighting social work’s pivotal role in bridging micro-, meso-, and macro-level systems, this review offers insights for policymakers and practitioners a roadmap for a sustainable, equitable caregiving aligned with Hong Kong’s ageing society.

Filial piety and fertility decisions, Thailand.

The purpose of this study was to develop a Music Curriculum-Based Character Education Program utilizing School-Designed Autonomous Time for fifth- and sixth-grade elementary school students. To this end, first, the theoretical foundation of School-Designed Autonomous Time was established, and and its current operational status was analyzed to derive implications for the necessity of music curriculum-based character education. Second, the theoretical basis for program development was established by examining the policy basis of Character Education and exploring its linkage with music education. Through an analysis of prior research, music activities and teaching methods were identified to cultivate the eight core values and virtues designated in the Character Education Promotion Act: Etiquette, Filial Piety, Honesty, Responsibility, Respect, Consideration, Communication, and Cooperation. Third, the program, titled &lt;Character Growing through Music&gt; was developed according to systematic procedures and was refined through expert validity verification. As a result, the final proposal of the program—consisting of ‘Characteristics and Objectives,’ ‘Content System and Achievement Standards,’ and ‘Teaching, Learning and Assessment’—along with thematic activities, was presented based on the eight core values and virtues of Character Education. This study is significant in that it supports the intended purpose of School-Designed Autonomous Time, complements the limitations of bias toward specific subjects, and provides practical and actionable strategies to foster students’ character cultivation and holistic growth.

This study examines how Chinese international students balance career and romantic relationship in emerging adulthood using in-depth interview data from 20 participants in the UK. This study adopts thematic analysis to identify two role prioritization strategies: Synchronized Integrators , who leverage stable relationships for parallel growth in career and relational domains and Asynchronous Navigators , who sequence or suspend domains to adapt to uncertainty. Gendered logics underpin these patterns: men delay intimacy to meet provider roles, women defer commitment for autonomy, while cultural factors like filial piety and gender norms exert influence. By reconceptualizing identity exploration as a calibration of personal-familial expectations and feeling-in-between as a structural negotiation, this study frames emerging adulthood as a culturally shaped role negotiation. This extends acculturative stress theory beyond Western paradigms by highlighting familial obligations, suggesting new support pathways.

This study aimed to explore the end-of-life decision-making experiences of bereaved family caregivers of Alzheimer's disease (AD) patients, focusing on do-not-resuscitate orders. Given the high emotional and ethical burden on caregivers, understanding their challenges and needs is crucial to enhancing palliative care for AD patients. A qualitative, exploratory study was conducted using semi-structured interviews with 22 family caregivers recruited through purposive sampling in central Taiwan. Participants were primary caregivers for AD patients who had been bedridden for at least a year before death. Analysis employed inductive thematic coding to identify key themes, with rigor ensured through multiple coding, member checking, and reflective journaling. Three major themes emerged: (1) Decision-making difficulties, where caregivers felt pressure and conflict when making urgent decisions; (2) Willingness to let go, which involved accepting the inevitability of death when recovery was no longer possible; and (3) Embracing the consequences of the decision, reflecting caregivers' sense of relief and acceptance post-decision. Cultural factors, such as filial piety, were found to influence decision-making processes, often intensifying emotional conflicts. Findings underscore the importance of early, culturally sensitive discussions around end-of-life care in palliative settings for AD patients. Healthcare providers are encouraged to initiate these discussions, offering clear explanations and emotional support to assist caregivers through decision-making. This study highlights the need for a family-centered approach that respects cultural nuances, helping to reduce caregiver stress and enhance the quality of palliative care in AD contexts.

Adolescents exposed to secondhand smoke (SHS) and those living with parents who smoke are at higher risk for tobacco use and adverse health outcomes. School nurses are expected to support smoke-free policies on campuses and play a prominent role in health promotion. However, few nursing studies on SHS exposure prevention have included recommended strategies for advising family smokers (AFS). This study was developed to examine the prevalence of SHS exposure among adolescents in rural areas and assess the impact of implementing a pilot program that incorporates innovative strategies for AFS. A school-based, educational intervention study was conducted in four middle schools in western coastal Yunlin County between March and September 2023. Innovative strategies for AFS were integrated into the school's health education curricula using a 6-hour secondhand smoke prevention program. Data were collected using self-administered, anonymous questionnaires. Descriptive and inferential statistical analyses were employed to examine the factors and barriers associated with AFS. Of the 1,202 adolescents who participated at baseline, 806 (51.4% boys; mean age=13.5 years) reported living with a smoker at home (67%). Among these 806, 91.4% reported family members smoked indoors, and, after completing the AFS program, 46.9% reported having attempted to advise their family members to quit smoking or smoke outdoors. The factors identified as significantly associated with AFS included being female, practicing avoidance behaviors, and witnessing smoking on campus. Only 8.1% felt their advice was successful, with common challenges including parental refusal, being scolded, and feelings of hopelessness. Also, many of the participants reported experiencing moral dilemmas, particularly with regard to cultural values such as filial piety, when advising parents. Exposure to secondhand smoke among adolescents living in rural areas is a serious issue. Teaching them strategies on how to advise family smokers may help reduce home exposure, particularly among boys. However, in Eastern cultures, advising parents about smoking presents moral challenges due to cultural values. Regulatory changes are needed to protect youths from secondhand smoke at home.