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Proquest Dissertations Family caregiving experience and health status among Chinese in the United States Item Type text; Dissertation-Reproduction (electronic) Authors Hsueh, Kuei-Hsiang Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 03/10/2021 20:50:45 Link to Item http://hdl.handle.net/10150/279876 INFORMATION TO USERS This manuscript has been reproduced fix)m the microfilm master UMI films the text directly f^ the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author dkl not send UMI a complete manuscript and there are missing pages, these will be noted. Also, unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sectk>ns with small overiaps. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6' x 9' black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. ProQuest Infbrmatkm and Learning 300 North Zeeb Road. Ann Arbor. Ml 48106-1346 USA 800-521-0600 FAJVOLY CAREGIVING EXPERIENCE AND HEALTH STATUS AMONG CHINESE IN THE UNITED STATES By Kuei-Hsiang Hsueh Copyright © Kuei-Hsiang Hsueh 2001 A Dissertation Submitted to the Faculty of the COLLEGE OF NURSING In Partial ftilfillment of the Requirements For the Degree of DOCTOR OF PHILOSOPHY In the Graduate College THE UNIVERSITY OF ARIZONA 200 t UMI Number: 3031388 Copyright2001 by Hsueh, Kuet-Hsiang All rights reserved. UMI(ft UMI Microform 3031388 Copyright 2002 by Bell & Howell Informatfon and Leamfng Company. All rights reserved. This microfonm edition is protected against unauthorized copying under Title 17, United States Code. Bell & Howell Information and Learning Company 300 North Zeeb Road P.O. Box 1346 Ann Arbor, MI48106-1346 2 THE UNIVERSITY OF ARIZONA ® GRADUATE COLLEGE As nembers of the Final Examination Committee, we certify that we have read the dissertation prepared by Kuet-Hstanq Hsueh entitled Famfly caregiving experience and health status amonn Chinese caregivers in the United States and recoDBend that it be accepted as fulfilling the dissertation requirement for the Degree of Doctor of Philosophy 9^z/<= ?^Linda R.. PhilJ4PS^Phil^ps^ ^ DrTsandra ^SiTwel^ ^ 0_v D?t/^^^ if 27/01 Dr. Lee Sechrest Date f/C/ 7 /0 / Dr. mne V/oodtli Date Date Final approval and acceptance of this dissertation, is contingent upon the candidate's submission of the final copy of the dissertation to the Graduate College. I hereby certify that I have read this dissertation prepared under ny direction and reconmend that it be accepted as fulfilling the dissertation requirement. V_»igsertation Director Dr. Linda R. Phillips Date 3 STATEMENT BY AUTHOR This dissertation has been subniitted in partial Mfillment of requffements for an advance degree at The University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library. Brief quotations from, this dissertation are allowable without special permission, provided the accurate acknowledgement of sources is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by the copyright holder. Signed: ^ 4 ACKNOWLEDGEMNTS With sincere appreciation, I acknowledge the support, understanding, encouragement, patience, and guidance of Dr. Linda PhilUps, my comnoittee chairperson. She has been very generous with her time and assistance during this doctoral scholarship. With special thanks, I acknowledge the encouragement, support and contribution of my committee members. Dr. Anne Woodtii, Dr. Sandra Cromwell and Dr. Lee B. Sechrest. Dr. Sechrest was the centered source providing guidance and consultation in advance statistics - structural equation modeling. His support and encouragement strengthened my beliefs that I could handle the EQS program mdependently, which I did it. There are a number of people I need to thank: Dr. Pamela Reed and Dr. Ruth Eskesen granted me general scholarships that financially supported this project; Dr. Beverly Rosenthal who was always the first person to read and edit my dissertation draft; finends, who helped me to validate the translation of instruments and referred qualified recruiting representatives for this study; recruiting representatives, who so willingly assisted in identifying and recruiting available subjects for this study; and specially to the subjects who agreed to participate in this study. Finally, I offer special gratitude to my family back in Taiwan, espedally my parentSr BQng-Po Hsueh and Mei-Tai Chen, for theur unconditional love, encouragement and endless financial support that sustained me during this long journey of learning here. 5 TABLE OF CONTENTS Page UST OF FIGURE. 8 LISTOFTABLES 9 ABSTRACT II CHAPTER I: INTRODUCTION Introduction 13 Background and Significant of Problem. 15 Family Caregiving-A Universal Valuable Sodai Resource 15 Issues Related to Family Caregivmg withm and across Cultures 16 Individual Versus Group (Ethnic) Di^rences 18 Lack of Attendon to the Largest Growing Fastest Minority. 20 Statement of Problem. 21 Significance of the Study. 22 Theoretical Orientation 23 Sodal Exchange Theory. 23 Role Theory. 24 Stress-coping Theory. 26 Summary. 30 Theoretical Framework. 31 Beliefs and Values 32 Subjective Beliefs of Traditional Filial Obligation J4 Subjective Feelings about Role Requkements. 35 Caregiving Appraisal 36 Perceived Burdens. 37 Perceived Rewards 38 Use of Copmg. 39 Consequences of Family Caregiving. .40 Caregivers' Health Status .40 Hypotheses .41 Summary. .43 CHAPTER 2: LITERATURE REVIEW Subjiective Beliefs of Traditional Filial Obhgation .45 Concept of Traditional Mai Piety in Chinese Culture. .46 Research Findings 53 Conceptualizatioa and OperationalLzation 56 6 TABLE OF CONTENTS - Continued Page Subjective Feelings about Role Requirements 58 Research Findings. 58 Conceptualization and Operationalization 6 L Perceived Burdens 62 Research Rndings 62 Conceptualization and Operationalization 63 Perceived Rewards .72 Research Findings ,11 Conceptualization and Operationalization J5 Use of Coping J5 Research Findings .75 Conceptualization and Operationalization J1 Caregiver's Health Status 83 Research Findings 83 Conceptualization and Operationalization 85 CHAPTER 3: METHODOLOGY Research Design 88 Causal Model Testing. 89 Modified Cross-cultural Approach. .93 Hypothesized Causal Statements in the Conceptual Model ^9 Sampling Procedures. 104 Instrumentation 109 The Revised Yang's Filial Values Subscale (YFVS-R) 110 The Revised Yang's Filial Affection Subscale (YFAS-R)— 113 Poulshock and Deimling Burden Inventory (BI) 113 Personal-Sodal Cost Subscale (PSCS) 114 Physical-Emotional Cost Subscale (PECS) 116 Economical Cost Subscale (ECS) 116 Picot's Caregiver Rewards Subscale (PCRS) 116 Behavioral-Oriented Subscale (BOS) 117 Cognitive-Oriented Subscale (COS) 118 Physical Component Summary Subscale (PCSS) 119 Mental Component Summary Subscale (MCSS) 120 Process for cultural equivalence for English Version 6istrument. 121 Data Analysis Plan 123 Summary. 134 7 TABLE OF CONTENTS - Continued Page CHAPTER 4: DESCRIPTION OF SAMPLE AND RESULTS Description of the Sample 135 Characteristics of Caregivers 136 Characterfetics of Care Redpients 139 Kinship Between the Caregivers and the Care Redpients 144 Caregiving Involvement 144 Results Related to Subjective Feelings about Role Requirements 149 Psychonaetric Properties of Measures 154 Description of Study Variables 164 Estimation of Correlations 166 Descriptive Statistics 167 Results of Evaluation of Model Adequacy. 171 Results of the Origmal Model Testmg 172 Evaluation of Poor Fitting and Justification of Modification 173 Causal Hypothesced Paths for the Efet Revised Model 177 Causal Hypothesued Paths for the Second Revised Model 178 Results of the Revised Models 179 Summary. 188 CHAPTER 5: DISCUSSIONS, IMPUCATIONS, LIMITATIONS, RECOMMENDATIONS AND CONCLUSION Brief Discussion of Sample Profile 190 Interpretation and Discussion of Models Testing 192 Findings in Related to Theoretical Orientations 204 Implications 206 Limitations and Recommendations .211 Conclusion 213 APPENDIX A, 215 APPENDDCB 218 APPENDDCC .220 APPENDDCD 225 REFERENCES 251 8 USTOFHGURES Page Figure L. Conceptual Firainework 33 Figure 2, The Original Model 101 Figure 3. Measurement Models 102 Figure 4. The Fist Revised Model 175 Figure 5. The Second Revised Model 176 Figure 6. The First Revised Model with Standardized Path Effects 183 Figure 7. The Second Revised Model with Standardized Path Effects 186 9 UST OF TABLES Page Table I. Chinese among Asian Population m the Study Sites 106 Table 2. Age, Length
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