Resilience in work-related stress among female sex workers in Hong Kong

A Confounding Discourse Analysis of Vietnamese Sex Workers' Talk in the City of Kaiyuan, China

BACKGROUND

Vietnamese female sex workers (VFSWs) cross the border into Kaiyuan City, Yunnan Province yearly. However, very little is known about both the health and psychological issues VFSWs experience. The objectives of this study were to explore the dominant discourses that emerged from the VFSWs' talk. The interviews occurred between May 2018 and June 2018 with 20 VFSWs who worked in Kaiyuan City, China. The English translated transcripts were analyzed using an eclectic feminist method of discourse analysis. Two discourses emerged. First, "Agency when working in Karaoke Bars and other Indoor Venues", and second, "Negative Impacts on Psychological Well-being and Other Problems from Migration." As for Discourse 1, the VFSWs positioned themselves as having agency over choosing their clientele as well as agency over what they were willing to negotiate with their clients to establish boundaries of their bodies. As for the Discourse 2, while there was a discourse of agency in their work there was also a contrasting, confounding discourse around the negative impact on psychological well-being and reports of stress as a migrant worker. Discourse 1 and Discourse 2 are confounding. When analyzed together, the discourses suggest that the impacts on psychological well-being may be more related to the migrant status of the women, supporting the notion of systemically influenced agency.

Culturally sensitive conceptualization of resilience: A multidimensional model of Chinese resilience

Cultural sensitivity is missing in the widely researched construct of resilience. The assumption that resilience takes the same form in all cultures fails to acknowledge that culture shapes the interpretation and instantiation of resilience. Examining how suffering and adversity are perceived and dealt with in Chinese contexts, can identify cultural concepts related to resilience. In this paper, we examine the ways in which Confucianism, Buddhism, and Taoism, the three main belief systems that have influenced Chinese people's perception of the nature of life, can serve as sources of strength to individuals facing adversity. We summarise three culturally inflected elements of dealing with adversities and compare them with existing, widely researched notions of resilience. Taking a socio-ecological perspective to explore resilience, this paper proposes a multidimensional model that can improve understanding of culturally embedded resilience.

Syndemic Factors and Resiliency Among Latina Immigrant Indirect Sex Workers in an Emergent Immigrant City

Female sex workers (FSW) constitute a highly vulnerable population challenged by numerous co-existing, or syndemic, risk factors. FSW also display resilience to these, and some evidence suggests that resilience may be associated with protective factors that improve health outcomes. We conducted in-depth interviews with indirect sex workers (n = 11) and their clients (n = 18). Interviews were coded utilizing an iterative, modified constant comparison method to identify emergent themes. We identified five syndemic risk factors (difficulty finding work due to undocumented status, shame and mental health hardship, lack of social support, alcohol use, and violence) and five resilient factors (rationalizing sex work, identifying as a "decent" woman, fulfilling immigrant goals, reducing alcohol consumption, and creating rules to reduce risk of violence and HIV/STIs). Understanding the syndemic risk factors and resiliency developed by FSW is important to develop tailored, strength-based interventions for HIV/STIs and other risks.

Impacts of im/migration experience on work stress among sex workers in Vancouver, Canada

OBJECTIVES

Despite the precarious and unsafe working conditions frequently experienced by sex workers (SWs) and im/migrant workers, there remains a paucity of research on work-related stress and links to duration of im/migration residency among SWs. This study analyzes the relationship between duration of residency and two dimensions of work stress among SWs in Metro Vancouver.

METHODS

Data were drawn from a longitudinal cohort of women SWs across Metro Vancouver (2010-2014). Multivariable confounder models with generalized estimating equations were developed to examine the independent effects of duration of residency on decision authority and job demands, after adjusting for confounders.

RESULTS

Of 545 SWs, 9.7% were recent im/migrants, 13.9% were long-term im/migrants, and 76.2% were non-migrants. In comparison to non-migrant SWs, recent (β coefficient - 1.02, 95% CI - 1.57 to - 0.47) and long-term im/migrants (β coefficient - 0.87, 95% CI - 1.36 to -0.38) faced decreased work stress related to job demands after adjustment for key confounders. Decision authority did not retain a significant independent association after adjusting for the same factors.

CONCLUSION

Job demands varied significantly by duration of residency. This may be explained by changing working conditions and experiences over the course of arrival and settlement among im/migrant SWs, as well as the role of formal work environments in supporting im/migrant SWs' well-being. Given high rates of work stress related to job demands and low decision authority among all SWs, decriminalization of sex work, improved occupational standards, and culturally sensitive interventions to promote collectivization and improved access to working conditions remain needed.

Evaluation and mechanism analysis of HIV prevention programme using resilience framework among female sex workers: A randomised controlled trial

Background

Evidence shows traditional sexual harm reduction for female sex workers (FSW) based on health behaviour theories is effective but short-lived. This study aimed to evaluate and understand the effectiveness of a resilience-promoting programme in improving psychological health and, ultimately, safe sex practice.

Methods

A randomised controlled trial was conducted at three Hong Kong-based non-governmental organisations. 127 sex workers were recruited and randomly assigned to the intervention or control groups. The former received a six-session resilience-promoting programme designed to improve self-esteem, self-efficacy and coping skills, whereas the latter had the usual care. Between-group differences in psychological outcomes and condom use were tested using the intention-to-treat, with ANOVA and chi-square tests, measured at baseline, post-intervention and 3-month follow-ups. Multiple mediation analysis was used to examine how the intervention worked through resilience factors.

Results

Significant between-group improvements in adaptive coping (F_1,119 = 5.82, p < .05) and reduction in psychological distress (F_1,118 = 5.00, p < .05) were seen at post-intervention and 3-month follow-ups, with significant time × group interaction changes suggesting the changes occurred at different rates between the two groups. Condom use during the last transactions had increased in the intervention group and the rate of consistent condom use during transactions improved in the intervention group at follow-ups (χ² = 4.35, p < .05). Self-esteem and resilience significantly mediated the effect of intervention at reducing psychological distress.

Conclusions

These findings suggest that resilience improves the psychological health and general wellbeing of Chinese FSWs.

Is there room for resilience? A scoping review and critique of substance use literature and its utilization of the concept of resilience

Research in the area of illicit substance use remains preoccupied with describing and analyzing the risks of people who use drugs (PWUD), however more recently there has been a drive to use a strengths-based or resilience approach as an alternative to investigating drug use. This leads us to ask: what can be known about PWUD from the point of view of resilience? The objective of this scoping review is to analyze how the concept of resilience is defined, operationalized, and applied in substance use research. Popular health, social science, psychology, and inter-disciplinary databases namely: SCOPUS, PUBMED, PsycINFO, and Sociological Abstracts were searched. Studies were selected if they used the concept of resilience and if substance use was a key variable under investigation. A total of 77 studies were identified which provided a definition of resilience, or attempted to operationalize (e.g., via scales) the concept of resilience in some manner. Data were charted and sorted using key terms and fundamental aspects of resilience. The majority of studies focus on youth and their resistance to, or engagement in, substance use. There is also a small but growing area of research that examines recovery from substance addiction as a form of resilience. Very few studies were found that thoroughly investigated resilience among PWUD. Consistently throughout the literature drug use is presented as a 'risk factor' jeopardizing one's ability to be resilient, or drug use is seen as a 'maladaptive coping strategy', purporting one's lack of resilience. Currently, substance use research provides a substantial amount of information about the internal strengths that can assist in resisting future drug use; however there is less information about the external resources that play a role, especially for adults. Though popular, outcome-based conceptualizations of resilience are often static, concealing the potential for developing resilience over time or as conditions change. Studies of resilience among PWUD predominantly concentrate on health-related behaviours, recovery-related factors or predefined harm reduction strategies. Indeed, overall, current conceptualizations of resilience are too narrow to recognize all the potential manifestations of resilience practices in the daily lives of individuals who actively use drugs.

Refining Trait Resilience: Identifying Engineering, Ecological, and Adaptive Facets from Extant Measures of Resilience

The current paper presents a new measure of trait resilience derived from three common mechanisms identified in ecological theory: Engineering, Ecological and Adaptive (EEA) resilience. Exploratory and confirmatory factor analyses of five existing resilience scales suggest that the three trait resilience facets emerge, and can be reduced to a 12-item scale. The conceptualization and value of EEA resilience within the wider trait and well-being psychology is illustrated in terms of differing relationships with adaptive expressions of the traits of the five-factor personality model and the contribution to well-being after controlling for personality and coping, or over time. The current findings suggest that EEA resilience is a useful and parsimonious model and measure of trait resilience that can readily be placed within wider trait psychology and that is found to contribute to individual well-being.