Acculturation Stress and Health Promotion Behaviors of the Korean Chinese Elderly Immigrants Living in Korea

Xianglan Jin; Misoon Song

doi:10.16952/pns.2016.13.2.70

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Jin and Song: Acculturation Stress and Health Promotion Behaviors of the Korean Chinese Elderly Immigrants Living in Korea

Original Article

Perspectives in Nursing Science 2016;13(2):70-80.

Published online: 19 October 2016

DOI: https://doi.org/10.16952/pns.2016.13.2.70

Acculturation Stress and Health Promotion Behaviors of the Korean Chinese Elderly Immigrants Living in Korea

Xianglan Jin¹, Misoon Song^2,

¹Graduate Student, College of Nursing, Seoul National University, Seoul

²Professor, College of Nursing ․ The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Song, Misoon College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8826, Fax: +82-2-765-4103, E-mail: msong@snu.ac.kr

Received 23 August 2016 Revised 1 September 2016 Accepted 1 September 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

This study examined the relationship between acculturation stress and health promotion behaviors in the Korean Chinese elderly immigrants living in Korea, focusing on the buffering effects of social support. Methods: We included 132 completed questionnaires in the analysis. The buffering effect was examined using a hierarchical regression analysis by adding interaction terms. Results: Health promotion scores were significantly higher in the group with a higher education level, lower depressive symptom scores, and higher levels of social support. However, no statistically significant differences were found in the health promotion behaviors by gender, age, spouse, job, financial stability, subjective health status, chronic disease, regular health checkups, or acculturation stress. The hierarchical regression analysis demonstrated that social support had a buffering effect on the relationship between acculturation stress and health promotion behaviors in the Korean Chinese elderly immigrants. Specifically, the relationship between the acculturation stress stemming from the difficulties in the workplace and health promotion behaviors was attenuated by social support. Conclusion: These findings indicate that social support significantly moderates the relationship between acculturation stress and health promotion behaviors in the Korean Chinese elderly immigrants living in Korea. A variety of strategies to enhance social support should be incorporated in the health promotion programs to decrease the negative effects of acculturation stress in the Korean Chinese elderly living in Korea.

Keywords: Elderly, Immigrants, Social support, Acculturation, Health promotion

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Fig. 1

Buffering effect of social support on acculturation stress and health promotion behavior.

Table 1.

Demographic Characteristics of Subjects (N=132)

Characteristics	Categories	n(%)
Gender	Male	26 (19.7)
Gender	Female	106 (80.3)
Age (year)	60~64	76 (57.6)
	65~69	30 (22.7)
	≥70	26 (19.7)
Spouse	No	55 (41.7)
Spouse	Yes	77 (58.3)
Job	No	51 (38.6)
Job	Yes	81 (61.4)
Household	Alone	17 (12.9)
	With family members	80 (60.6)
	With others	35 (26.5)
Acculturation stress	Low	44 (33.3)
	Middle	45 (34.1)
	High	43 (32.6)
Period residing in Korea (year)	＜5	41 (31.1)
	＜10	45 (34.1)
	≥10	46 (34.8)
Subjective health status	Good	35 (26.5)
	Middle	67 (50.8)
	Not good	30 (22.7)
Chronic disease	No	43 (32.6)
Chronic disease	Yes	89 (67.4)
Health insurance	No	73 (55.3)
Health insurance	Yes	59 (44.7)
Intention to return to China	No	35 (26.5)
Intention to return to China	Yes	97 (73.5)
Education	Elementary school	32 (24.2)
	Middle school	56 (42.4)
	≥High school	44 (33.3)
Monthly income (10,000 won)	＜150	67 (50.8)
Monthly income (10,000 won)	≥150	65 (49.2)
Financial stability	No	46 (34.8)
Financial stability	Yes	86 (65.2)
Type of housing	Own home/key money	21 (15.9)
	Monthly rent	64 (48.5)
	Church/work place	47 (35.6)
Visa qualification	F-4	100 (75.8)
	F-5	14 (10.6)
	Other	18 (13.7)
Purposes of migrant	Employment	96 (72.7)
	Living with family	26 (19.7)
	Other	10 (7.6)
Depression	Normal	67 (50.8)
	Mild	45 (34.1)
	Moderate or Severe	20 (15.2)
Regular health checkups	No	81 (61.4)
Regular health checkups	Yes	51 (38.6)

Table 2.

Level of Subscales of Acculturation Stress, Social Support, and Health Promoting Lifestyle Profile (N=132)

Variables	Categories	M±SD
Acculturative stress	Homesickness	3.20±1.29
	Difficulties of communication	2.24±0.86
	Culture shock	2.79±0.96
	Perceived discrimination	2.95±1.04
	Difficulties in the workplace	2.85±0.90
	Interpersonal difficulties	2.93±0.87
	Total (range: 1~5)	2.77±0.69
Social support	Emotional support	3.86±1.03
	Informational support	3.76±1.17
	Evaluative support	3.83±1.03
	Material support	3.54±1.18
	Total (range: 1~5)	3.77±1.04
Health promoting lifestyle profile	Self-realization	3.15±0.65
	Health responsibility	2.27±0.65
	Physical activity	2.11±0.82
	Nutrition	3.01±0.56
	Interpersonal relations	2.85±0.67
	Stress management	2.58±0.71
	Total (range: 1~4)	2.70±0.52

Table 3.

Comparison of Health Promotion Lifestyle Profile and Subscales according to General Characteristics (N=132)

Variables	Categories	Health Promotion Lifestyle Profile
		Self-realization	Health Responsibility	Physical Activity	Nutrition	Interpersonal Relations	Stress Management	Total
		M±SD	M±SD	M±SD	M±SD	M±SD	M±SD	M±SD
Gender	Male	3.04±0.75	2.38±0.62	2.28±0.79	2.97±0.54	2.80±0.69	2.46±0.75	2.68±0.56
	Female	3.18±0.63	2.25±0.66	2.07±0.82	3.02±0.57	2.86±0.67	2.61±0.70	2.70±0.52
	t (p)	-0.93 (.354)	0.98 (.330)	1.18 (.241)	-0.39 (.699)	-0.38 (.703)	-0.92 (.358)	-0.18 (.861)
Age (year)	60~64	3.14±0.65	2.31±0.63	2.06±0.84	3.02±0.56	2.82±0.63	2.47±0.69	2.67±0.52
	65~69	3.25±0.69	2.36±0.67	2.18±0.77	3.03±0.55	3.00±0.76	2.68±0.77	2.79±0.55
	≥70	3.08±0.65	2.07±0.68	2.18±0.83	2.95±0.60	2.75±0.67	2.76±0.69	2.66±0.52
	F (p)	0.49 (.613)	1.61 (.204)	0.36 (.697)	0.18 (.836)	1.07 (.346)	1.99 (.141)	0.57 (.565)
Spouse	No	3.25±0.60	2.24±0.70	2.14±0.85	3.02±0.53	2.83±0.70	2.74±0.71	2.74±0.51
	Yes	3.08±0.69	2.30±0.62	2.08±0.80	3.00±0.59	2.86±0.65	2.46±0.70	2.67±0.54
	t (p)	1.49 (.138)	-0.54 (.589)	0.41 (.686)	0.21 (.838)	-0.27 (.786)	2.29 (.024)^∗	0.81 (.417)
Job	No	3.03±0.67	2.25±0.69	2.19±0.84	2.96±0.58	2.89±0.66	2.75±0.69	2.70±0.54
	Yes	3.23±0.64	2.29±0.63	2.06±0.81	3.03±0.55	2.82±0.68	2.47±0.71	2.69±0.52
	F (p)	-1.72 (.087)	-0.28 (.783)	0.90 (.371)	-0.74 (.462)	0.63 (.532)	2.27 (.025)^∗	0.07 (.943)
Education	Elementary school	2.92±0.71	2.09±0.69	1.85±0.78	2.84±0.52	2.73±0.70	2.56±0.87	2.53±0.56
	Middle school	3.22±0.62	2.27±0.58	1.96±0.68	2.93±0.53	2.85±0.67	2.48±0.69	2.67±0.49
	≥High school	3.23±0.63	2.41±0.69	2.48±0.89	3.22±0.58	2.94±0.66	2.71±0.60	2.85±0.52
	F (p)	2.82 (.064)	2.23 (.112)	7.82 (.001)^∗	5.59 (.005)^∗	0.88 (.415)	1.33 (.268)	3.75 (.026^∗)
Financial stability	No	2.94±0.63	2.25±0.64	2.00±0.78	2.99±0.55	2.80±0.64	2.59±0.66	2.62±0.51
	Yes	3.27±0.64	2.29±0.66	2.16±0.84	3.02±0.57	2.87±0.69	2.57±0.74	2.74±0.53
	t (p)	-2.83 (.005)^∗	-0.35 (.728)	-1.06 (.291)	-0.26 (.798)	-0.62 (.539)	0.12 (.907)	-1.25 (.214)
Subjective health status	Good	3.26±0.69	2.28±0.71	2.33±0.84	2.94±0.66	2.84±0.72	2.55±0.76	2.74±0.58
	Middle	3.23±0.59	2.30±0.66	2.07±0.83	3.09±0.52	2.94±0.58	2.59±0.69	2.75±0.49
	Not good	2.84±0.68	2.21±0.57	1.93±0.73	2.90±0.51	2.65±0.78	2.58±0.74	2.54±0.52
	F (p)	4.71 (.011)^∗	0.21 (.810)	2.02 (.137)	1.47 (.235)	1.91 (.152)	0.04 (.960)	1.84 (.163)
Depression	Normal	3.32±0.57	2.26±0.64	2.14±0.77	3.09±0.51	2.93±0.61	2.67±0.70	2.78±0.47
	Mild	3.18±0.67	2.39±0.71	2.27±0.88	3.00±0.61	2.96±0.66	2.54±0.77	2.76±0.58
	Moderate or severe	2.51±0.48	2.05±0.47	1.63±0.65	2.76±0.56	2.31±0.65	2.35±0.57	2.29±0.37
	F (p)	14.34 (.000)^∗	1.98 (.142)	4.59 (.012)^∗	2.72 (.069)	8.56 (.000)^∗	1.65 (.196)	7.85 (.001^∗)
Chronic disease	No	3.23±0.68	2.11±0.64	2.13±0.74	2.94±0.66	2.73±0.66	2.48±0.67	2.64±0.55
	Yes	3.11±0.64	2.35±0.64	2.09±0.86	3.04±0.51	2.90±0.67	2.63±0.73	2.72±0.51
	t (p)	0.97 (.336)	-2.06 (.041)^∗	0.27 (.791)	-0.97 (.333)	-1.39 (.166)	-1.13 (.263)	-0.86 (.393)
Regular checkups	No	3.20±0.66	2.14±0.60	2.02±0.78	2.93±0.57	2.84±0.70	2.52±0.70	2.65±0.52
	Yes	3.08±0.65	2.48±0.68	2.24±0.87	3.13±0.53	2.85±0.62	2.66±0.73	2.77±0.54
	t (p)	0.98 (.331)	-3.00 (.003)^∗	-1.52 (.132)	-2.05 (.043)^∗	-0.09 (.925)	-1.11 (.271)	-1.26 (.211)
Acculturation stress	Low	3.17±0.71	2.31±0.71	2.25±0.78	3.12±0.63	2.95±0.69	2.66±0.78	2.76±0.59
	Middle	3.22±0.58	2.32±0.64	2.13±0.81	2.94±0.52	2.86±0.60	2.63±0.60	2.73±0.45
	High	3.07±0.67	2.18±0.61	1.93±0.86	2.96±0.53	2.73±0.71	2.44±0.74	2.60±0.53
	F (p)	0.58 (.560)	0.60 (.552)	1.70 (.187)	1.31 (.274)	1.26 (.288)	1.24 (.294)	1.16 (.317)
Social support	Low	3.01±0.67	2.19±0.69	2.16±0.83	2.90±0.58	2.64±0.65	2.34±0.66	2.57±0.54
	Middle	2.88±0.56	2.25±0.59	1.96±0.81	2.95±0.60	2.58±0.61	2.39±0.66	2.54±0.50
	High	3.57±0.53	2.38±0.67	2.20±0.82	3.17±0.46	3.32±0.48	3.00±0.64	2.99±0.41
	F (p)	17.01 (.000)^∗	0.89 (.411)	1.07 (.347)	2.84 (.062)	22.28 (.000)^∗	14.02 (0.00)^∗	12.03 (.000)^∗

^∗ p＜.05.

Table 4.

Buffering effect of Social Support on Acculturation Stress and Health Promotion Behavior

Model	B	SE	β	t	p	R²	F
1	3.334	.223		14.948	.000	.127	3.018^∗
Homesickness	-0.002	.041	-0.004	-0.038	.970
Difficulties of communication	-0.101	.069	-0.165	-1.464	.146
Culture shock	-0.050	.078	-0.091	-0.638	.525
Perceived discrimination	0.069	.066	0.137	1.059	.292
Difficulties in the workplace	-0.186	.050	-0.321	-3.732	.000
Interpersonal difficulties	0.020	.063	0.032	0.310	.757
2	2.647	.304		8.702	.000	.193	4.239^∗∗
Homesickness	-0.006	.040	-0.015	-0.158	.875
Difficulties of communication	0-.059	.068	-0.097	-0.877	.382
Culture shock	-0.057	.075	-0.105	-0.763	.447
Perceived discrimination	0.059	.063	0.117	0.934	.352
Difficulties in the workplace	-0.149	.050	-0.256	-2.996	.003
Interpersonal difficulties	0.033	.061	0.055	0.545	.587
Social support	0.136	.043	0.271	3.197	.002
3	0.659	.816		0.807	.421	.274	3.423^∗∗
Homesickness	-0.061	.160	-0.149	-0.378	.706
Difficulties of communication	0.168	.246	0.274	0.683	.496
Culture shock	-0.447	.279	-0.821	-1.602	.112
Perceived discrimination	0.504	.230	0.996	2.195	.030
Difficulties in the workplace	0.288	.211	0.497	1.364	.175
Interpersonal difficulties	0.086	.264	0.142	0.327	.745
Social support	0.652	.199	1.294	3.271	.001
Homesickness ^∗ Social support	0.008	.040	0.091	0.201	.841
Difficulties of communication ^∗ Social support	-0.061	.061	-0.437	-1.006	.317
Culture shock ^∗ Social support	0.108	.071	0.948	1.518	.132
Perceived discrimination ^∗ Social support	-0.121	.058	-1.152	-2.091	.039
Difficulties in the workplace ^∗ Social support	-0.109	.051	-0.880	-2.141	.034
Interpersonal difficulties ^∗ Social support	-0.013	.066	-0.107	-0.201	.841

Dependent variable: Health promotion behavior; B=Unstandardized coefficient; SE=Standard error; β=Standardized coefficient.

^∗ p＜.01

^∗∗ p＜.001.

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