The Impact of Foreign Postings on Accompanying Military Spouses: an Ethnographic Study

The impact of foreign postings on accompanying military spouses: an ethnographic study

Blakely, G., Hennessy, C., Chung, M. C., & Skirton, H. (2014). The impact of foreign postings on accompanying military spouses: an ethnographic study. Health Psychology Research, 2(2), 73-77. https://doi.org/10.4081/hpr.2014.1468

Published in: Health Psychology Research

Document Version: Publisher's PDF, also known as Version of record

Queen's University Belfast - Research Portal: Link to publication record in Queen's University Belfast Research Portal

Publisher rights ©Copyright 2014 The Authors This is an open access Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/3.0/), which permits use, distribution and reproduction for non-commercial purposes, provided the author and source are cited.

General rights Copyright for the publications made accessible via the Queen's University Belfast Research Portal is retained by the author(s) and / or other copyright owners and it is a condition of accessing these publications that users recognise and abide by the legal requirements associated with these rights.

Take down policy The Research Portal is Queen's institutional repository that provides access to Queen's research output. Every effort has been made to ensure that content in the Research Portal does not infringe any person's rights, or applicable UK laws. If you discover content in the Research Portal that you believe breaches copyright or violates any law, please contact [email protected].

Download date:30. Sep. 2021 Health Psychology Research 2014; volume 2:1468

The impact of foreign postings disruption of this familiar network in conjunction with an international posting presents fur- Correspondence: Gillian Carter (nee Blakely), on accompanying military ther unique challenges to military spouses due School of Nursing and Midwifery, Queen's spouses: an ethnographic study to the supplementary stress of culture shock.6 University Belfast, Medical Biology Centre, 97 Additional financial strains, limited spousal Lisburn Road, Belfast, BT9 7BL, United Kingdom. Gillian Blakely,1 Catherine Hennessy,1 employment opportunities, extreme climate Tel.: +44.2890.975762. E-mail: [email protected] Man C. Chung,2 Heather Skirton1 and communication difficulties are recognized as key areas of stress.7-9 However, enhanced 1Faculty of Health, and Human Sciences, Key words: health professionals, international family unity, travel and new cultural experi- School of Nursing and Midwifery, relocation, overseas, spouses, wellbeing. ences are also cited as positive attributes of Plymouth University, UK; 2Department of relocation.9-11 Psychology, Natural Science and Public Contributions: GB, HS, CH and MCC, study Burrell et al. reported that the health and design; GB and CH, data collection and analysis; Health, Zayed University, Dubai, United wellbeing of individuals is affected by many GB, HS, CH and MCC, manuscript writing. Arab Emirates social situations,1 therefore it is reasonable to suggest that relocation to unfamiliar sur- Conflict of interests: the authors declare no roundings can have an impact on an individ- potential conflict of interests. ual’s health and lifestyle. In particular the per- Abstract ception of loss is identified as having a signif- Funding: this research was supported by a Faculty of Health, Education and Society PhD stipend icant impact on military spouses’ wellbeing.11 awarded to Gillian Blakely. As part of an ethnographic study, the impact The accumulation of psychological losses is 12 of foreign postings on spouses who accompany also noted by Makowsky et al. to intensify the Received for publication: 19 March 2013. military personnel was explored. Individual stress of relocation, specifically through the Revision received: 9 May 2013. interviews and focus groups with 34 British loss of cherished relationships, personal iden- Accepted for publication: 10 May 2013. military spouses based in one location in tity and autonomy, causing significant dis- southern Europe were conducted. Key findings tress.13 This work is licensed under a Creative Commons suggested that reaction to a foreign posting Research investigating the experiences of onlyAttribution NonCommercial 3.0 License (CC BY- was a reflection of personal attitudes, prior non-military spouses (e.g. diplomatic, clergy or NC 3.0). experiences, support, ability to adjust to corporate spouses), who are also accustomed ©Copyright G. Blakely et al., 2014 change and strength of relationship with the to frequent international relocations indicates Licensee PAGEPress, Italy serving spouse and community. For many the that a successful foreign posting isuse at least Health Psychology Research 2014; 2:1468 experience was positive due to the increased partly dependent on their ability to adjust.12,14 doi:10.4081/hpr.2014.1468 opportunity for family time, for others this Some individuals possess the necessary skills helped to compensate for the difficulties expe- to acclimatize to overseas locations because of rienced. Some military spouses experienced their previous experiences.9,11 However, the significant distress on the posting, particularly stoic response of other trailing spouses (a if the family was not well-supported. The phrase highlighted by Keenan,15 to represent Materials and Methods potential implications of military spouses not those who frequently relocate due to their hus- adapting to foreign postings have significant band or wife’s employment) is identified as The design was an ethnographic study uti- implications for healthcare practice. Provision potentially detrimental to their health.3,11 lizing qualitative methods and was conducted of more appropriate support resources before The authors of the present study conducted from the perspectives of the military spouses and during the posting would facilitate the a systematic review examining the experi- on an overseas posting, with the intention of transition for the military spouse and their ences of military spouses on a foreign providing a holistic interpretation of their family. posting.16 The findings indicated that research 17 investigating the specified topic was limited. experiences. The author GB was a military Of 13 relevant papers, only three were complet- spouse and had spent a lengthy period within ed in the last ten years with only Jervis’s work this environment, observing and participating Introduction Non-commercialrepresenting British military spouses. 1,9,11 in the daily lives of the British and Military Therefore, the present qualitative exploratory communities. Undertaking fieldwork enabled Geographical mobility can cause major study was undertaken to address this gap in the direct investigation of the experiences of upheavals in the lives of military families and the literature with a view to explore ways to the military spouse in context. As a participant relocations to foreign postings have been iden- maximize spousal health and wellbeing. The observer GB’s presence as a researcher was tified as imposing a significant strain on the aim of the study was to investigate the experi- overt and as a military spouse was also an family, especially the military spouse.1,2 Whilst ence of the accompanying spouses of British active member of the group. Therefore, recog- these spouses are recognized for their endur- military personnel relocated to a foreign coun- nizing and accounting for these roles was cru- ing ability to cope with extended periods of try. The main research questions included: i) cial to the research. separation due to their serving spouses being What is the emotional, social and psychological Ethnographic data collection consisted of posted away from home, there appears to be impact on spouses of British military person- semi-structured individual interviews and less understanding of the impact of relocation nel when relocated to a foreign country? ii) focus groups, in conjunction with researcher’s on military families when posted together to What methods are employed by the spouses to field notes relating to these interviews and overseas locations.1,3 One effect of frequent adjust to a new environment? iii) What types groups. The same schedule of open ended relocations is the interruption to established of emotional and social support are desired or questions designed to explore the participants’ support networks,4 which normally contribute used by spouses when living in a foreign com- understanding of experiencing an overseas to the wellbeing of spouses and their families munity? posting was used for interviews and focus through providing appropriate resources.5 The groups. These questions were developed from

[Health Psychology Research 2014; 2:1468] [page 73] Article the themes identified in the systematic been reached i.e. when there was a repetition dents, combined with previous experiences. review,16 and from informal conversations and of themes and no new information was Those respondents with prior experience of discussions with other military spouses prior shared.19,20 Data were collected between July relocation and adjustment believed that they to the commencement of the data collection and October 2010. The focus groups and inter- were more amenable to military postings. (none of these data were used without con- views were digitally recorded and transcribed Furthermore, this made some respondents sent). These questions reviewed: i) the initial verbatim. Data were analyzed using thematic quite philosophical about their posting, … reaction towards going on a foreign posting; ii) content analysis, which initially involved the you’re so used to moving around and making the subsequent impact of being on the posting use of a coding system to break the text into the best of wherever we are ye know, you often and how individuals coped and adapted; iii) segments.21 The text was coded in a line-by- don’t realize the full impact until you’ve moved the factors influencing the ability to settle; iv) line process according to its meaning and con- onto somewhere else (Naomi). how their husband’s role in the services influ- tent in relation to the objectives of the study, Individual responses to altered roles and enced their overall experience; v) whether the creating a bank of free nodes. Assessing for identity were seen as a reflection of personal presence or absence of children influenced similarities and differences between these adaption to change. Activities such as academ- their experience; vi) what support networks nodes then allowed grouping into a hierarchi- ic studies, employment or simply through they felt were available; vii) if they felt they cal tree structure, providing overarching retaining some form of independence were changed during the posting; viii) thoughts of themes. Specialist software for analyzing qual- seen as improving self-worth. Being proactive returning to the United Kingdom (UK), and ix) itative data, NVivo8 (QSR International), was gave some respondents the justification they advice for others about to go on a foreign post- used. believed was needed to be on the posting as ing. Interviews lasted approximately 60 min- The analysis of the data was completed inde- they did not want to be perceived as being idle. utes, while focus groups lasted between 1 and pendently by GB and HS. Additionally, However, others expressed anger at the per- 2 hours. researcher field notes made immediately fol- ceived loss of their autonomy: I just wish it Plymouth University ethics committee lowing each session and note-taker data wasn’t so distinct that you are a wife of, a approved the study and ethics approval was recorded during the focus groups, improved dependent of...and that most of the paperwork, also obtained from the Ministry of Defence. the accuracy of the session transcriptions most of the responsibility, most of the connec- ensuring information was correctly matched, 22 Adults married to a British military service per- tion with what’s going on in the community is . and to facilitate data analysis. only son who was serving in a specified location in . . , Adam’s work, Adam’s email, Adam’s ye know southern Europe were eligible for inclusion. everything (Abby). Recruitment was via advertisements posted in Identity disorientation was heightened by the weekly online British Bulletin, on the com- being recognized as a dependent and having a munity website, in the local British Results use lack of a defined societal role: …I don’t like the Community Centre and the Help, Information word dependent I think… oh that’s a bit and Volunteer Exchange (HIVE). Purposive Thirty-four military spouses participated in demeaning isn’t it, dependent? (Gemma). Also sampling was employed to obtain data from 13 individual interviews (one conducted by undermining was felt from the loss of career: individuals with a range of characteristics to email) and five focus groups. Each group con- …I had my own job but yeh coming out here I obtain a maximum variation sample.18 sisted of between three and six individuals am just a wife and mother (Hayley). Therefore, it was necessary to advertise widely (totaling 22 participants, of which one chose to Nonetheless, some participants acknowledged to ensure spouses of the three services were then complete an individual interview to pro- that being on the foreign posting was solely included in order to reach the potentially iso- vide more information – her data provided sep- due to their wish to support their serving lated groups. Eleven dimensions were chosen arate information for each analysis). The par- spouse and consequently accepted their mili- to establish a wide range of cases reflecting ticipants modal age range was 40-49, although tary spouse status without complaint. military spouses including the three service all age groups from 18-29 to 50-59 were repre- A further response to the posting was the affiliations (Royal Navy, British Army and sented. One participant was male and the Royal Air Force); the role of the serving spouse remainder were female. Twenty-two respon- generation of a changed perspective. This was (whether an officer or non-officer); and the dents were affiliated with the Royal Navy, six accomplished through personal development stage of family cycle (i.e. the presence or the British Army and six the Royal Air Force. and seeking experiences that were not part of absence of children). Twenty-five of the respondents were officer the normal lifestyle. Indeed, some respondents Following the initial advertisement,Non-commercial each spouses and the remainder were married to were quite reflective about their overseas potential participant contacted the researcher personnel of other ranks (see the Appendix for experience and recognized the personal oppor- and received an introductory letter and a par- details; please note all participants have been tunity it provided for their own development: ticipant information sheet. The researcher’s assigned a pseudonym). … it’s just [a] very rich experience living in contact details were provided and respondents Thematic analysis of the data produced six another country and learning (Caroline). were invited to ask further questions about the themes: marriage and relationships; change; In general a spouse’s attitude to the foreign study. At the start of each focus group/inter- family lifestyle and wellbeing; acclimatizing to posting was seen as a significant predictor of view, a further opportunity was given to ask a new culture and social environment; person- their willingness to adjust: in particular, questions and an advice sheet was provided in al meaning-making and individual differences; embracing the available quality family time case any topic was considered too sensitive to and support. The final two themes emerged was seen to enhance the experience. Open- discuss. If still happy to proceed, participants from both focus groups and interviews and will mindedness and a certain vivacity were con- were asked to sign a consent form. The partic- be the focus of the following discussion. sidered major constituents in adjusting suc- ipant was made aware that they were under no cessfully. Having a very proactive nature was obligation to proceed and could withdraw at Theme 1: personal meaning-making also believed to stimulate a spouse’s enthusi- any point without reason. and individual differences asm for the posting. The transference of this Data analysis was concurrent with data col- Acceptance of a new lifestyle induced by a positive outlook on arrival was felt to conse- lection. Focus groups and interviews were con- foreign posting was influenced by the charac- quently hasten the settling in process. ducted until it appeared that saturation had teristics and personal qualities of the respon-

[page 74] [Health Psychology Research 2014; 2:1468] Article

Theme 2: support prior, informal tary was alleged to be quite erratic. interrupted their sense of belonging. and formal Consequently some attempted to resolve prob- Furthermore, Sluzki,26 discussed the impact of lems without any military involvement: I disrupting support networks due to relocation Some spouses felt it was essential to inves- would be cautious about going to anybody in tigate the new location prior to moving. Online and identified a significant increase in emo- information was the predominant resource the authority because things … can be blown tional needs during this period, which was and completing a reconnaissance visit (recce) out of proportion (Gail). It was also further strongly linked with heightened psychosomatic provided crucial knowledge, allowing for the alleged that spouses in general were disre- and interpersonal stress. minimization of culture shock: …you see all garded: …there is no respect, there’s no respect The loss of employment and subsequent the horror that’s here and then you come out for the spouses (Gail). impact on identity and self-worth had a nega- with your eyes wide open and that shock isn’t A certain level of reluctance existed with tive impact on the wellbeing of some study 27 there (Wendy). However, recces were also felt respect to seeking formal support whilst on the respondents. De Verthelyi, who studied the to potentially discourage some, due to having posting, due to concerns of distrust and alleged adjustment process of international student an initial aversion to the area. breaches of confidence within the welfare and spouses, felt that such a sense of loss was While the serving husband was considered medical services. The expressions really let amplified on foreign relocations. Together to be the first line (Naomi) of support, forming down, nowhere to turn, [Beverly] and really these changes contributed to the overall loss of a social network was recognized to be a key hard to know who to trust [Helen], character- status and self-identity,28,29 and was a signifi- initial step of establishing an extended support ized this sense of extreme apprehension and cant theme in the systematic review.16 In system on the foreign posting. These sources disenchantment at the support offered. Kupka and Cathro’s study examining German enhanced respondents’ ability to settle in a Compassionate leave however, for military expatriate spouses, the obligatory dependency new environment, allowing the establishment spouses in times of family turmoil was deeply status and labeling as wife of was seen to of a secure surrounding. However, because of appreciated. revoke the spouse’s right to individualism,30 as the nature of military life and frequent reloca- also identified in the present study. tions, it was a common occurrence that newly Undoubtedly changes of roles and personal formed friendships were lost, therefore social identity influence the impact of a foreign post- networks required active maintenance. Discussion ingonly and any subsequent adaption. According to An opportune support network was available Burke’s Identity Disruption Theory, such dis- in the parco (walled in area containing villas) This study was novel in that it focused ruptions occur in the identity process when for some respondents on arrival and produced specifically on the experiences of British individuals enter new cultures or assume new an opening into the community. Having these Military spouses on an overseas posting, an roles,13 as is the case of the trailing spouse. confidantes readily available offered empathic area not previously given sufficient useattention Consequently, there was a reduction of a per- reassurance: We’ve all been there and every- by researchers.16 Military spouses actually on a son’s perceived self-efficacy and of self- body out here has had that experience … so I foreign posting shared their experiences and esteem, together heightening distress and the think it is very supportive (Yvonne). attitudes, and in doing so highlighted the overall negative impact of the posting. The lack of, or the inability to form a friend- potential challenges of accompanying their ship network was identified as a substantial serving spouse overseas, which will now be Research question 2 drawback for some wives. This concept of discussed with reference to the study research Examining the role of social support on social isolation was a recognized phenomenon questions. spousal adjustment overseas, Copeland and but was not always resolved: …I have to say I Norell noted that women with the best adjust- am massively lonely here . . . I am just massive- Research question 1 ment were demonstrated to have an estab- ly lonely and everyone else seems to have a The emotional, social and psychological lished support network.4 Nonetheless, the social circle (Gail). Some respondents spoke of effect of being relocated overseas is contingent present study showed that feeling comfortable those who appeared to choose self-imposed upon the military spouse’s ability to adapt to in a new environment was not necessarily isolation by remaining behind the doors of change. These findings concur with Hausman directly proportional to the number of relation- their homes however, it is not clear whether and Reed,23 who reported that some individu- ships formed. In an additional cross-cultural this was through choice for those individuals. als experience relocation as a smooth transi- adjustment study by Norell and Copeland,31 Children were perceived as a socialNon-commercial catalyst tional process, whereas for others such a sig- having a strong marital relationship was also for establishing friendship sets. However, this nificant change is a stressful event. As identi- recognized as a significant predictor of adjust- on occasion was seen to create artificial rela- fied by Haour-Knipe,24 who examined how ment. As such, from the perspective of the non- tionships, and in general the foreign posting families coped both individually and together military spouse, Wiggins-Frame and Shehan was believed to force an unrealistic situation with the stress of moving to a new culture, argued that clergy husbands were relatively where friends were hastily formed. In parallel, there are additional stressors associated with consumed in their professional responsibili- not having children was felt to limit opportuni- an international move because of, for example, ties, which may have resulted in a lack of sup- ties for forming a friendship network and left the potential language barriers, living in a new port for their wives and children.14 A similar some feeling like recluses. culture, social isolation, distance from family argument could be made in the case of military A recognized duty of the military was to pro- or climate change. families. vide a sponsor (an individual/ married couple Social support is depicted as an exchange of Interactions of moderating factors can currently on the foreign posting) to provide resources intended to enhance wellbeing.25 As cause intercultural transitions to be complex support to new arrivals. There was a general identified in the present study for military fam- processes.27 Hence, permutations of idiosyn- despondency as to the appropriateness of allo- ilies these links are frequently disrupted due to cratic variables could guide a reaction to an cations, and the success of such pairings fluc- relocations. This is corroborated by Darcy, 2 overseas posting. In the present study, respon- tuated greatly. While the military’s facilitation who investigated social support and the well- dents expressed the importance of having an of the relocation was welcomed by some being of army wives following relocation. outgoing, proactive nature. Furthermore, respondents, this was not experienced by all Darcy identified that removal of social support openness to experience was defined as a char- and the general support provided by the mili- systems forced individuals to cope alone and acteristic deemed to facilitate the cultural

[Health Psychology Research 2014; 2:1468] [page 75] Article transition.32 Accordingly, a positive relation- of their ability to cope. In accordance with ual’s life. Failing to acclimatize to a new envi- ship was suggested between the degree of Lazarus and Folkman’s theory, when a stimu- ronment could have a significant social impact openness and a spouse’s level of adjustment,33 lus is appraised as threatening and a subse- as well as a negative effect on the spouse’s and was seen to be related to resilience in quent appropriate coping response is unavail- emotional and psychological wellbeing. sojourners.34 able, then a stress reaction occurs.37 Consequently, the strength of relationship Comparable to the present study findings, Consequently, Cohen and McKay argue that, if with the serving spouse clearly has a signifi- expatriate spouses also regarded previous there was a perception of available social sup- cant supportive influence and it is this mutual international experiences to be extremely ben- port this could stimulate a less threatening devotion that not only compels the trailing eficial for acculturation,32 and the self-reliance appraisal of the situation, and result in the spouse to accompany their spouse on the for- of such families was seen to increase with the belief that an adequate response to the situa- eign posting but to also remain throughout number of previous overseas assignments.9 tion exists.36 In particular, Rosen and despite any encompassing difficulties. Therefore, greater exposure to unfamiliar Moghadam investigated the stress-buffering The findings of this study demonstrate the environments could help to develop successful effects of social support on military wives and comparable reactions of accompanying mili- adaption strategies. concluded that perceived support from other tary spouses to that of their civilian counter- Study respondents felt quality family time unit wives was the only significant buffer.35 parts in previous non-military research. Whilst compensated for the associated relocation dis- This study was specific to deployment separa- there appears to be a greater recognition of the ruption, but a positive experience was not tion anxiety; nonetheless it indicated the influence of frequent international assign- inevitable. In particular foreign residence was importance of close relationships during peri- ments for the non-military spouse due to the found to have a significant negative relation- ods of turmoil, arguably such as international plethora of available research, the participants ship with a spouse’s psychological and physical relocations. Therefore, it can be asserted that in this current phase of study clearly indicate wellbeing.1,9 Additionally, as reported in the having access to a support network is pivotal that military spouses will also be prone to sig- systematic review,16 the likelihood of stoicism for a trailing spouse’s re-adjustment whilst nificant distress on a foreign posting, particu- in military spouses was a concern and was felt preserving their wellbeing. larly if the family is not well-supported. to potentially have a detrimental impact on Therefore, the potential health and wellbeing Limitations their health.3,11 Nonetheless, in the current implicationsonly of a British military spouse not study there was an innate determination by Despite widespread advertising, one of the successfully adapting to a foreign posting has the respondents to remain on the posting and limitations of this study could be said to be the significant implications in the field of health- to support the serving member. number of respondents who were officer care practice. Consequently, greater provision spouses (n=25) compared with the spouses of by the military and British community of sup- Research question 3 other ranks (non-commissioned status)useport resources for the military spouse, both Support was a key theme identified in the (n=9). Although a purposive sampling tech- prior to relocation and on arrival at the foreign systematic review recognizing its significance nique was used, potential participants may posting, would facilitate the transition for the to spousal adjustment.16 The present study have been influenced to volunteer by the entire family. Additionally, a more significant extended this finding by identifying the influ- involvement of their personal contacts. involvement of the accompanying spouse by ence of personal meaning-making and individ- Therefore, it is possible the experiences of the the military during this period would allow ual circumstances on the level of support non-officer spouses could have been inadver- them to regain some control of their new desired. Furthermore, comparable to the study tently under represented. lifestyle and it could also signify a greater findings, the provision of support prior to any The cross-sectional sample represented par- appreciation by the military of the military international relocation was also reported by ticipants based in only one foreign location. spouse’s role in supporting the service person. Mohr and Klein in their study exploring the Therefore, the respondents’ opinions could be experiences of expatriate spouses, to be cru- biased by the particular base location, its facil- cial to limiting uncertainty and encouraging ities and the specific support structure that adjustment.32 However, Jervis considered that was available at time of the study. Future References support offered by the military was only felt to research could incorporate the views of mili- represent what it deemed necessary.11 tary spouses based in other foreign locations 1. Burrell LM, Adams GA, Durand DB, Castro Nonetheless, the desire or need to access such in order to confirm or refute findings of this CA. The impact of military lifestyle support appeared to be a reflection of Non-commercialthe study study. Finally, this was a qualitative study, demands on well-being, army, and family respondent’s perception of the foreign posting therefore the use of a standardized instrument outcomes. Armed Forces Soc 2006;33:43- and their own expectations. was not appropriate and the concept of gener- 58. Although no formal health assessments alizability does not apply. However, due to the 2. Darcy MG. Social support and relocation: were conducted in this study, other research rigor of the method, it is possible that the find- an examination of the well-being of army demonstrates the link between social support ings are transferable to other similar settings. wives. 2000. Available from: and a trailing spouse’s wellbeing.2,5,14,35 The http://pearl.plymouth.ac.uk:8080/pearl_xm protective effect of social support from psy- lui/bitstream/handle/10026.1/1949/MONI- chosocial stress has been referred as a CA%20GORHAM%20DARCY.PDF?sequenc buffer.36 Cohen and McKay offered potential Conclusions e=1 mechanisms responsible for the moderating 3. Fernandez-Pol B. Does the military family effect of support reactions on a stressor. Of The thematic analysis identified numerous syndrome exist? Mil Med 1988;153:418-20. note, they presented an appraisal support factors influencing a military spouse’s ability 4. Copeland AP, Norell SK. Spousal adjust- mechanism founded on Lazarus and Folkman’s to adapt to the changes imposed when on a for- ment on international assignments: the stress and coping theory.37 Cohen and McKay eign posting. Hence it would be inappropriate role of social support. Int J Intercult Rel believed a support group may influence the to suggest that the reaction to a foreign post- 2002;26:255-72. extent to which a situation was appraised as ing will be a positive experience for all, as this 5. Lavee Y, McCubbin HI, Patterson JM. The threatening and/or the individual’s perception would ignore the complexities of an individ- double ABCX model of family stress and

[page 76] [Health Psychology Research 2014; 2:1468] Article

adaptation: an empirical test by analysis of military personnel. Nurs Health Sci 29. De Cieri H, Dowling PJ, Taylor KF. The psy- structural equations with latent variables. 2011;14:121-32. chological impact of expatriate relocation J Marriage Fam 1985;47:811-25. 17. LeCompte M, Preissle J. Ethnography and on partners. Int J Hum Resour Man 6. Fisher CD, Shaw JB. Relocation attitudes qualitative design in educational research. 1991;2:377-414. and adjustment: a longitudinal study. J 2nd Ed. London: Academic Press; 1993. 30. Kupka B, Cathro V. Desperate housewives Organ Behav 1994;15:209-24. 18. Stewart DW, Shamdasani PN. Focus - social and professional isolation of 7. Lakhani H. The socioeconomic benefits to groups: theory and practice. London: Sage; German expatriated spouses. Int J Hum military families of home-basing of armed 1990. Resour Man 2007;18:951-68. 19. Pope C, Ziebland S, Mays N. Qualitative forces. Armed Forces Soc 1994;21:113-28. 31. Norell S, Copeland AP. US-UK moves: 8. Manning FJ, DeRouin EM. Employed wives research in health care: analysing qualita- cross-cultural adjustment in american and of US army members in Germany fare bet- tive data. BMJ 2000;320:114-6. british expatriate accompanying spouses ter than those unemployed. Mil Med 20. Cameron J. Focussing on the focus group. 2002. Available from: http://www.inter- 1981;146:726-8. In: Hay I, ed. Qualitative research methods 9. McNulty PA. Does deployment impact the in human geography. Melbourne: Oxford changeinstitute.org/html/research_report health care use of military families sta- University Press; 2005. pp 156-182. s.htm#british tioned in Okinawa, Japan? Mil Med 21. Hammersley M, Atkinson P. Ethnography 32. Mohr AT, Klein S. Exploring the adjust- 2003;168:465-70. principles in practice. 3rd ed. New York: ment of American expatriate spouses in 10. Lakhani H, Thomas S, Gilroy C. Army euro- Routledge; 2007. Germany. Int J Hum Resour Man 2004;15: pean tour extension: a multivariate 22. Wong LP. Focus group discussion: a tool for 1189-206. approach. J Behav Econ 1985;14:15-42. health and medical research. Singap Med J 33. Caligiuri PM. Selecting expatriates for per- 11. Jervis S. Military wives and relocation: a 2008;49:256-60. sonality characteristics: a moderating psycho-social perspective. PhD disserta- 23. Hausman MS, Reed JR. Psychological effect of personality on the relationship tion. Bristol: University of the West of issues in relocation: response to change. J bewteen host national contact and cross- England; 2009. Career Dev 1991;17:247-58. cultural adjustment. Manage Int Rev 2000; 12. Makowsky PP, Cook AS, Berger PS, Powell 24. Haour-Knipe M. Moving families, expatria- only40:61-80. J. Women’s perceived stress and well- tion, stress and coping. London: 34. Arthur W, Bennet W. The international being following voluntary and involuntary Routledge; 2001. assignee: the relative importance of fac- relocation. JFEI 1988;9:111-22. 25. Shumaker SA, Brownell A. Toward a theory tors perceived to contribute to success. 13. Burke PJ. Identity processes and social of social support: closing conceptual gaps. Pers Psychol 1995;48:99-114. stress. Am Sociol Rev 1991;56:836-49. J Soc Issues 1984;40:11-36. use 35. Rosen LN, Moghadam LZ. Matching the 14. Wiggins-Frame M, Shehan CL. Work and 26. Sluzki CE. Disruption and reconstruction support to the stressor: implications for well-being in the two-person career: relo- of networks following migration/reloca- cation stress and coping among clergy tion. Fam Syst Med 1992;10:359-63. the buffering hypothesis. Mil Psychol husbands and wives. Fam Relat 27. De Verthelyi RF. International students’ 1990;2:193-204. 1994;43:196-205. spouses: invisible sojourners in the cul- 36. Cohen S, Mckay G. Social support, stress 15. Keenan B. Diplomatic baggage: the adven- ture shock literature. Int J Intercult Rel and the buffering hypothesis: a theoretical tures of a trailing spouse. London: John 1995;19:387-411. analysis. In: Baum A, Taylor SE, Singer JE, Murray; 2006. 28. Shaffer MA, Harrison DA. Forgotten part- eds. Handbook of psychology and health. 16. Blakely G, Hennessy C, Chung M, Skirton ners of international assignments: develop- NJ: Hillsdale; 1984. pp 253-267. H. A systematic review of the impact of for- ment and test of a model of spouse adjust- 37. Lazarus RS, Folkman S. Stress, appraisal eign postings on accompanying spouses of ment. J Applied Psychol 2001;86:238-54. and coping. New York: Springer; 1984.

Non-commercial

[Health Psychology Research 2014; 2:1468] [page 77]