The Feeling of "Face" in Confucian Society: From a Perspective of Psychosocial Equilibrium

Concern for mianzi: Relations with adjustment in rural and urban Chinese adolescents

The present study examined relations between concern for mianzi, or the social perception of one's prestige and standing in the group, and adjustment in Chinese adolescents. Participants were seventh- and ninth-grade students in rural and urban regions of China (n = 794, Mage  = 14 years). Data were obtained from multiple sources including peer assessments, teacher ratings, self-reports, and school records. The results showed that concern for mianzi was associated with social competence, leadership, academic achievement, as well as aggression and mixed peer relationships in rural adolescents. In contrast, concern for mianzi was associated with comprehensive social, school, and psychological adjustment problems in urban adolescents. The results indicate the role of context in shaping the relations between adolescents' concern for mianzi and adjustment.

Relationship of family function and pre-hospital delay among Chinese patients with recurrent ischaemic stroke and the mediation effect of stigma

AIMS

Pre-hospital delay refers to the time span from the onset of symptoms to arrival at a hospital ≥ 3 h and is the main limitation of stroke reperfusion therapies. Family factors and stroke-related stigma may influence pre-hospital delay. However, few studies have confirmed the influence of stigma on pre-hospital delay or explored the relationships between family function, stigma, and pre-hospital delay among patients with recurrent stroke. This study aimed to explore the relationship between family function and pre-hospital delay among patients with recurrent stroke and examine the mediation role of stigma in this relationship.

METHODS AND RESULTS

A cross-sectional study was performed at the neurology departments of two hospitals in Guangzhou, China between July 2021 and April 2022. A total of 115 patients with recurrent stroke completed questionnaires and were included in the analysis. Data were collected using the Short Form Family Assessment Device, the Stroke Stigma Scale, and the Stroke Knowledge Questionnaire. Spearman's correlation and a structural equation model were used for data analysis. Family function directly influenced pre-hospital delay [β=0.27, P = 0.033, 95%CI = (0.02-0.51)] and indirectly influenced pre-hospital delay [β=0.17, P = 0.038, 95%CI = (0.02-0.34)] through stigma. Moreover, stigma partially mediated the effect of family function on pre-hospital delay.

CONCLUSION

Family function and stigma directly and indirectly influenced pre-hospital delay among patients with recurrent stroke. Future health education and interventions need to focus on strengthening and improving emotional support from family members to improve family function and reduce stigma, thereby reducing pre-hospital delay among patients with recurrent stroke.

"Help Children Walking on the Right Path": Understanding Parents' and Grandparents' Perceptions on Violence Against Children in Cambodia and Prevention Strategies

This study examined parents' and grandparents' understanding of violence against children (VAC) strategies to prevent VAC in the home. Research questions: What do parents and grandparents understand about VAC? Which child discipline practices are violent? What are strategies to prevent VAC? Participants: 30 parents and grandparents from a small rural community. Six focus group discussions (FGDs) in which participants shared their perceptions and practices relating to child discipline, forms of VAC, and proposed intervention strategies. In two community forums, participants discussed intervention strategies produced in separate FGDs and agreed on three priority strategies. During the FGDs and community meetings, none of the participants ever mentioned any laws, regulations, or government strategies to address VAC in the home. Participants expressed confusion and mixed feelings and responses on forms of VAC. Some agreed on deception, manipulation, intimidation (som lot), threats (Kom ream, harsh words, scolding (je), and physical punishment (i.e., beating or beating with an object) as an unacceptable discipline that would adversely impact children's well-being. Others agreed on cautiously using such disciplines to a certain degree and context. Participants proposed three priority strategies to address VAC in the home, of which two-community awareness and education and community-based efforts-fit with the Cambodia 2017 to 2024 Action Plan Strategies to Prevent and Respond to VAC. The third strategy, addressing alcohol harm-related violence, though not regarded in the 2017 to 2024 Action Plan, was considered pivotal in preventing VAC. Parents and grandparents have a substantial role in child protection at home. Nevertheless, without a clear definition of VAC or articulation of protecting children from violence in the home, it would be challenging to involve parents/grandparents for effective intervention. Participants' three priority strategies have a substantial policy and program implications for Cambodia's primary prevention of VAC action strategy. Community-based mobilization, education, and capacity building need to start and sustain the community.

Culture-related differences in the neural processing of probability during mixed lottery value-based decision-making

This study evaluated how differences in economic risk-taking in Westerners and East Asians reflect cultural differences in the analytic or holistic processing of probabilistic outcomes during value-based decisions. Twenty-seven Americans (US) and 51 Taiwanese (TW) young adults completed a functional magnetic resonance imaging (fMRI) Lottery Choice Task (LCT) experiment. Participants accepted or rejected stakes with varying probabilities of winning or losing different magnitudes of points. TW participants accepted more stakes when win probabilities were > 0.50, whereas US participants reduced their acceptance rates of winning stakes more discriminately as win probabilities decreased. Both groups rejected losing stakes (win probabilities < 0.50) with similar frequency. Critically, ventromedial prefrontal cortex (VMPFC) responses correspondingly showed greater discrimination between win probability conditions in US than TW groups. Our findings highlight a neurocognitive mechanism in the VMPFC for how cultural differences in distinguishing between probabilistic reward outcomes shape neural computations of risk and prospects.

Positive psychology interventions in the United Arab Emirates: boosting wellbeing - and changing culture?

As the science of wellbeing has grown, universities have adopted the challenge of prioritizing the wellbeing of students. Positive psychology interventions (PPIs), activities designed to increase the frequency of positive emotions and experiences, which help to facilitate the use of actions and thoughts that lead to human flourishing, are being increasingly used worldwide. Known to boost wellbeing and a number of other variables, it nonetheless remains unknown whether their use can influence other variables in non-Western cultures. In this study, we determined the impact of PPIs on a variety of wellbeing outcomes. The 6-week PPI program was conducted in the United Arab Emirates on Emirati university students (n = 120) who reported more positive emotion and overall balance of feelings that favored positivity over time relative to a control group. Yet, there was no effect found on negative emotions, life satisfaction, perceived stress, fear of happiness, locus of control, or somatic symptoms, and no effect on levels of collectivism or individualism. Our findings nonetheless support the use of PPIs in higher education as they show an increase in the experience of positive emotion, with this in itself bringing positive life outcomes, and no negative impact on culture. Our findings serve to build a foundation for understanding for whom PPIs work best - and least - around the world.

Individual and family preferences of job qualities matter: association between face needs, locked-in job status, and burnout among high-tech workers in Taiwan

Background

Studies on the health impacts of being locked in a job are primarily conducted in Western countries, with the theory based on the value of individualism. But the socially-oriented concerns should be considered in workers’ locked-in status in Chinese society. So the current study aims at evaluating socially-oriented concerns on workers’ locked-in status in Taiwan.

Methods

Anonymous surveys were conducted with 1102 workers at high-tech companies in Taiwan from October 2015 to January 2016 to assess their “face” needs-- a sociological concept linked to the dignity, prestige, and reputation that a person has in terms of their social relationships, locked-in status of the job, and burnout. In addition to being separated into three groups by lock-in score, participants were categorized by the conflict of preference of the job between themselves and their family. Chi-square, ANOVA, Pearson correlation, and regression tests were conducted.

Results

Among the 1102 participants, 18% had jobs that they did not prefer but their family preferred. Participants with higher face needs and higher locked-in status had a significantly higher risk of developing personal and work-related burnout. However, the analysis using “locked-in job conflict of preference between themselves and their family” showed a more coherent result. Participants with a job which “self does not prefer but family do” had twice the risk of having personal and work-related burnout (OR = 2.03 and 2.34, respectively). Participants with a job which neither themselves nor their family prefer had four times the risk of having personal and work-related burnout (OR = 4.10 and 4.17, respectively).

Conclusions

The current study suggests an importance in considering a socially-oriented job preference in locked-in status evaluations within the Chinese culture. Workers’ whose locked-in status preference conflicted with their family’s preference showed a significantly negative impact on their health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11269-8.

Fluctuating interpretations: Striving to maintain a sense of self in early dementia

This study aimed to develop a conceptual framework of the experience of persons living with the early stages of dementia. A grounded theory approach examined the experience from the perspective of the patient. Data were collected from dyads of persons with mild dementia and their family caregivers (N = 17) using face-to-face interviews at three timepoints over a one-year period. Transcribed interviews were analyzed with constant comparative analysis. The core category was "Fluctuating interpretations: striving to maintain one's sense of self." Interpretations were comprised of three subcategories: being a stranger to oneself, sense-making, and strategies for coexistence. Different situations influenced the process and affected individuals' attitudes and behaviors. Interpretations were a protective vehicle and stabilizing force that enabled persons with dementia to coexist with disease changes. Perspectives of persons with dementia during the early stages should be considered when designing intervention strategies for patient-centered care.

Resilience-building module for undergraduate nursing students: A mixed-methods evaluation

In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.

Experiences of Family Resource Utilization Among Taiwanese Parents of Children with Developmental Delay

PURPOSE

To describe the experiences of the utilization of family resources by parents of children with developmental delay (DD) when receiving early intervention (EI) services.

DESIGN AND METHODS

A Descriptive phenomenological approach was applied to conduct this study. Purposive sampling was utilized to select 17 parents of children with DD from a teaching hospital in northern Taiwan. Data were collected from January 2015 to March 2016 through face-to-face interviews that lasted between 55 and 80 min. Data analysis was performed using Giorgi's phenomenological method.

RESULTS

Four themes emerged: parents receiving EI services feel as if they are admitting that their child has an abnormality; parents' dedication in helping their children to progress; parents feel that they are needing to extend their resources in an already limited environment; and lastly, parents expressed that they are facing an uncertain future.

CONCLUSIONS

The findings highlight the dedication of parents in utilizing family resources to help their children progress. Constrained by the environment and an uncertain future, parents utilized family strengths to help them respond to stressful family situations and maintain family functions.

PRACTICE IMPLICATIONS

Health professionals could assist by providing more EI resources to parents to help cope with family stress arising from having children with DD. It's recommended that health professionals pay attention to Taiwanese culture and how it influences family acceptance for EI services, and work toward establishing friendly EI environments that meet the needs of these children and their families.

The parental experiences of caring for children with childhood cancers in Singapore: a pilot focus group study

Background:

Research on the parental experiences of caring for children diagnosed with cancer in Singapore are limited and not well understood.

Objectives:

We conducted a pilot focus group to understand the experiences of Singaporean parents whose child had survived cancer.

Methods:

Using convenience sampling, five parents were invited to participate in a focus group discussion regarding the psychosocial needs at the time of cancer diagnosis and into survivorship. The discussion was transcribed verbatim and analysed using Braun and Clarke’s 6-step approach to thematic analysis.

Results:

The analysis revealed three major themes of intrapersonal impact, interpersonal connectedness and financial implications.

Conclusions:

The identified themes indicated some universal and unique caregiving experiences among Singaporean parents and those reported in western and other Asian cultures. In particular, the findings provided an update on the parental experiences of caring for children with cancer in Singapore and highlighted the need for ongoing research and the development of early and holistic psychosocial support services for these parents.

Application and Perceived Effectiveness of Complementary and Alternative Intervention Strategies for Attention-Deficit/Hyperactivity Disorder: Relationships with Affiliate Stigma

This cross-sectional questionnaire survey study was designed to examine the complementary and alternative intervention strategies (CAIS) employed by caregivers for their children’s attention-deficit/hyperactivity disorder (ADHD) and the associations of affiliate stigma with the employment and rated effectiveness of these strategies in Taiwan. A total of 400 caregivers of children with ADHD participated. CAIS that the caregivers employed and their effectiveness rated by the caregivers were surveyed. Associations of affiliate stigma with the application and rated effectiveness of the strategies were determined using logistic regression analysis. The results indicated that sensory integration (30.3%), exercise training (29.3%), sugar restriction (20.5%), and omega fatty acid supplementation (11.3%) were the most common CAIS that the caregivers employed. Caregivers with stronger affiliate stigma were more likely to employ sensory integration, exercise training, and omega fatty acid supplementation but also rated them as ineffective in treating their children’s ADHD. Various CAIS were employed by the caregivers to manage their children’s ADHD. Affiliate stigma was significantly associated with the application and rated ineffectiveness of several CAIS.

Affiliate Stigma and Related Factors in Family Caregivers of Children with Attention-Deficit/Hyperactivity Disorder

This cross-sectional questionnaire study examined factors related to affiliate stigma among caregivers of children with attention-deficit/hyperactivity disorder (ADHD) and the association of affiliate stigma with caregivers’ unfavorable attitude toward ADHD and moderators. The affiliate stigma of 400 caregivers of children with ADHD was assessed using the Affiliate Stigma Scale. Caregivers’ and children’s factors related to affiliate stigma were examined using multiple regression analysis. Associations of affiliate stigma with caregivers’ unfavorable attitudes toward children’s diagnoses, pharmacotherapy, behavioral therapy, and biological explanations of the etiologies of ADHD were examined using logistic regression analysis. Female caregivers and those caring for girls with ADHD had higher levels of affiliate stigma than did male caregivers and those caring for boys. Higher education levels in caregivers and more severe inattention symptoms in children were associated with higher levels of affiliate stigma. A higher level of affiliate stigma was also significantly associated with unfavorable attitudes toward children’s diagnoses, pharmacotherapy and behavioral therapy, and etiological explanations for ADHD. Multiple factors of caregivers and children were related to affiliate stigma in caregivers of children with ADHD. Affiliate stigma is significantly associated with caregivers’ unfavorable attitude toward ADHD.

Social adjustment experiences of adolescents with Tourette syndrome

AIMS AND OBJECTIVES

To explore and describe the experience of social adjustment of adolescents with Tourette syndrome in Taiwan.

BACKGROUND

Although Tourette syndrome is a non-life-threatening disease, the inherent difficulties in controlling tics and comorbidities can cause long-term physical and psychological issues, as well as social maladjustment among adolescents. Good social adjustment can promote mental health among adolescents. Currently, it is not clear how adolescents with Tourette syndrome can self-adjust and maintain harmonious social interaction with others.

DESIGN

Descriptive phenomenological approach was used in this study. Four criteria were applied to establish the trustworthiness or methodological rigour.

METHODS

Sixteen adolescents with Tourette syndrome were recruited by purposive sampling from a medical centre in Northern Taiwan. Semistructured one-on-one interviews were performed from March 2014-April 2015 for data collection. Every participant was interviewed once or twice, and each interview lasted for duration of around 60-90 min. Data were analysed with Giorgi's phenomenological method for data analysis.

RESULTS

Three themes were identified from the adolescent' interviews. The themes were included visible and invisible destitution, moulding a socially acceptable self and coexisting friends and foes.

CONCLUSIONS

Adolescents with Tourette syndrome experienced that tics are often not understood nor accepted during social interactions with others. However, with age and autonomy of adolescents, they were able to adjust and develop a socially acceptable body image and maintain amicable social interactions with others. Accompanied by positive thinking, support from friends and families, the adolescents could achieve good social adjustments for living with Tourette syndrome.

RELEVANCE TO CLINICAL PRACTICE

The experiences and feelings highlighted in this study can bring awareness to nurses and healthcare professionals for developing interventions that promote healthy social adjustment and mental health for adolescents with Tourette syndrome.

An Emerging Integrated Middle-Range Theory on Asian Women's Leadership in Nursing

INTRODUCTION

Asian cultures reflect patriarchal cultural values and attitudes, which likely have influenced women leaders in their countries differently from women in Western cultures. However, virtually no leadership theories have been developed to reflect the experiences and development of nursing leaders from Asian cultures. The purpose of this article is to present an emerging integrated middle-range theory on Asian women's leadership in nursing.

METHODOLOGY

Using an integrative approach, the theory was developed based on three major sources: the leadership frames of Bolman and Deal, literature reviews, and exemplars/cases from five different countries.

RESULTS

The theory includes two main domains (leadership frames and leadership contexts). The domain of leadership frames includes human resources/networks, structure/organization, national/international politics, and symbols. The domain of leadership contexts includes cultural contexts, sociopolitical contexts, and gendered contexts.

DISCUSSION

This theory will help understand nursing leadership in Asian cultures and provide directions for future nurse leaders in this ever-changing globalized world.