Objective: To understand family caregivers' decision-making process to place their family members with terminal cancer in inpatient hospice care, especially in the social-cultural contexts whereby the caregivers have a dominant say about the care of their seriously ill family members. Methods: A qualitative study with a phenomenological approach was undertaken to understand the lived experience of caregivers of persons with terminal cancer in the decision-making process. Semi-structured qualitative interviews were conducted with a purposive sample of 17 caregivers in Shanghai, China. Thematic analysis was used to analyze the data. Results: The caregivers underwent a winding and socioculturally mediated four-stage process. The stages are (i) trigger for alternatives: lost hope for a cure, (ii) meandering the see-saw process, (iii) the last straws: physical limitations and witnessing unbearable suffering, and (iv) the aftermath: acceptance versus lingering hope. Caregivers' attitudes towards death and their family members with advanced cancer expressed care wishes influence the state of the aftermath. Conclusions: Chinese sociocultural values and beliefs about caregiving and death provide insightful explanations for the observed process. Practical implications: Training healthcare professionals in cultural competence, developing an effective hospice referral system, and delivering socioculturally acceptable death education are critical interventions to facilitate better decision-making experiences.

Given the vital basis of the professional judgments made by social workers, this article proposes a framework with which to study the complex mechanisms involved in their judgments that considers three Ps: personal experience, professional training, and practice environment. Using a qualitative case study analysis, the authors apply the framework to examine the experiences of 20 Chinese social workers based in Hong Kong. Three cases have been selected to illustrate three trajectories as revealed from the 20 cases. Consistent with the notion of reflective practice, the analysis enhances the understanding of the forces behind the judgments that social workers make.

There has been considerable interest in the concept of consumer-directed care (CDC) for ageing populations. One type of CDC employs vouchers that older people can use to procure a panel of social services that best fits their needs. The voucher-based strategy has been institutionalised in Hong Kong as the Community Care Service Voucher for the Elderly (CCSV). Using a qualitative, semi-structured interview method, researchers probed the experiences of two groups (twenty-six CCSV users and twenty-seven CCSV non-users) with the voucher programme between March 2014 and September 2015 during the first phase of CCSV. The interviews revealed a set of social and institutional supports needed to empower clients to effectively utilise the voucher. These supports (or forms of capital) were consistently present amongst active CCSV users and deficient amongst non-users. The research demonstrates that instituting a voucher does not, by itself, lead to optimised choices but, rather, that a network of institutional and social resources must be assembled in support of the voucher programme. In some instances, a case management approach may be needed, as older people (and family) need to combine different forms of institutional and social support to comprehend the voucher programme and utilise it for their particular needs.

An evaluation of the role played by the social work profession during the outbreak of COVID-19 is necessary. Although social workers have made efforts to address people's needs during the pandemic, it is worth examining the role they have played in safeguarding health equality. Focusing on the case of Hong Kong, we found that the profession was generally ill-prepared for the outbreak, and in particular, for confronting the attendant social inequalities. We identified three possible reasons for these findings: 1) non-governmental organizations were caught off-guard by the outbreak, 2) there was no clearly articulated intervention agenda to inform practitioners of the roles they should play in such a large-scale crisis, and 3) having become more formalized and standardized, social work services may have become less flexible in responding to emerging community needs. We conclude this article by suggesting three directions that could allow the profession to better pursue its mission during large-scale crises.

This article identifies different aspects of the embeddedness dilemma in a rural social economy project in South China. The term 'alternative commodification' is proposed to summarize the practitioners' strategy. This strategy highlighted social embeddedness of economic development, but on the other hand involved the village deeper into the commodification process. Participants of the project only focused on newly emerged economic opportunities, with little concern of the embeddedness goal. Based on social transformation theory of Wright, the article also identifies two social reproduction mechanisms brought by marketization reform as structural barriers for realizing embeddedness goal: universal commodification and consumerism, both of which intensify villagers' demand for cash income and ignorance of social dimensions of the project. Future research also needs to identify more barriers and methods to overcome obstacles in the process of developing social economy.

PurposeLong-distance caregiving (LDC) technologies play a significant role in enabling distant care and facilitating living-alone older adults to keep socially connected. However, there is scarce research exploring the older adults’ attitudes towards and intention to use such technologies. This paper is based on a systematic review of existing literature to explore the multifarious factors influencing independent community-living older adults’ attitudes towards and intention to use LDC technologies.MethodsArticles published in English between 2006 and 2020 were reviewed by searching electronic databases of PubMed, ProQuest, EBSCOhost. The inclusion criteria were limited to quantitative, qualitative, or mixed-methods studies that involved: 1) distant caregiving; 2) older adults aged 60 years or above, who were living alone or with only their spouse in the community (even though the samples might also involve other non-older adults); 3) technologies including ICT-based devices, systems, or programs enabling data transmission were used; 4), intention to use or behavioral usage in regard to the technologies were reported or discussed.ResultsIn total, 41 out of 8674 articles were included. Both determinants and moderators of affecting the use of the ICT-based LDC technologies were identified with theoretical guidance. To summarize, there are personal factors involved, such as personality, concerns regarding security and privacy, health conditions, requisite knowledge, financial conditions, and influence from significant others, encompassing formal and informal caregivers; and factors related to the devices, in terms of their user-friendliness and functionality.ConclusionThis review highlights the importance of striking a good balance between functionality and privacy concerns, besides considering the direct and indirect cost to users. LDC technology education should be promoted at the societal level to facilitate older adults’ better understanding of the device utilities by enhancing their technological literacy. Implications for various stakeholders to cope with the challenges of an aging population are also discussed.

Objectives: This study aimed to examine the longitudinal relationship between two central concepts in aging research-self-perceptions of aging (SPA) and perceived control of life (COL). Method: The data came from three measurement points over a 9-year period in the Health and Retirement Study (HRS). A random intercepts cross-lagged panel model (RI-CLPM) was estimated. Results: The covariations between SPA and COL across 9 years were evident at both the between-person level and the within-person within-time level. The results revealed a reciprocal relationship between SPA and COL: Higher than usual negative SPA predicted within-person decreases in COL 4 years later, and lower than usual COL predicted future within-person increases in negative SPA. Furthermore, SPA were found to have a somewhat larger effect on COL than the corresponding influence of COL on SPA. Discussion: This study enriches the stereotype embodiment theory and the practice by documenting a reciprocal interrelationship between SPA and COL.

This study aims to identify older people's home- and community-based care (HCBC) service need patterns and explore the role of living arrangement and filial piety in affecting such patterns. A total of 556 older people were selected in Beijing, China. Latent class analysis and multinomial logistic regression were adopted to identify the service need patterns and the influencing factors. A three-class model of service need patterns was explored (high-needs group, moderate-needs group, and low-needs group). Living arrangement was related to HCBC service need patterns. Compared with the high-needs group, those living with at least two family members were more likely to express low needs or moderate needs. Living arrangement was a moderator for the effect of filial piety on HCBC needs. Greater recognition of the effects of living arrangement and filial piety should enrich the Andersen model and provide a robust stimulus for long-term care policy development and for service delivery and social work.

This study explored perceptions of filial care among second-generation Chinese immigrants in the Netherlands. The provision of filial help or care can be regarded as a cultural phenomenon known as filial piety and it can be considered within the broad scope of caregiving as “family care”. Fifteen interviews were conducted, and a thematic analysis was applied. The findings showed that care was given in the form of language brokering, information inquiry, home visits, and facilitative and social support. Care was perceived as a moral duty among the participants and was grounded in their perceived sense of responsibility. The participants’ perspectives on current and future care included practical and normative considerations for meeting parental needs, and included opinions based on filial piety norms. In conclusion, this study showed that filial piety, specifically filial care, is still relevant to the younger immigrant Chinese community in the Netherlands.

Summary The academia and the profession have long overlooked the importance of material interest in the profession of social work. In order to address this research gap, we first reviewed the historical role that material interest has played in differentiating professions from nonprofessions and analyzed its decreasing status along the development of professions due to the two competing discourses of professionalization and de-professionalization. We concluded with the fundamental question, “does material interest still matter for the professions under the current professional environments,” and answered this question by purposively selecting one of the most important organizational outcomes of the social work workplace—turnover intentions—as our dependent variable. We then conducted a meta-analysis to investigate the relationship between salary and turnover on 24 studies with a combined sample of 9343 social workers. Findings The results showed that salary was negatively related to social workers’ intentions to leave organizations (r = −.18, ρ = −.21). Specifically, both social workers’ actual salary and their satisfaction with pay and benefits were negatively associated with individual employees’ turnover intentions. Applications This research also supported Barth’s argument that despite social workers’ earnings are “unresponsive” to the labor market, they are not so different from other professions in the workforce market. Research implications both for the third model of the profession—institutionalist professionalism—in contemporary society and for salary raises were discussed.

Objectives The current study examined the patterns of adaptation of rural-to-urban migrant children in China as compared with their peers in urban schools. It also explored the potential factors relating to school adaptation by employing the cultural and structural perspectives, which emphasizes the access to social relations and the socioeconomic status in a society. Methods We conducted surveys in a district with a large number of migrants in Shanghai. This cross-sectional study recruited 1577 children from 12 primary schools, who completed self-reported questionnaires. Results Attending a public school can promote the children's adaptation, including the access to more family resources (d = 0.77, p < 0.05; 0.47, p < 0.05; 0.28, p < 0.05) and social relations (Cohen's d = 0.17, p < 0.05; 0.28, p< 0.05; 0.11, p < 0.05). However, policy limitations and lack of family resources are primary factors that prevent children from attending public schools. Children from families with higher income (OR = 1.28, 95% CI [1.05, 1.55], p < 0.05), higher parental education achievement (OR = 1.19, 95% CI [1.05, 1.35], p < 0.01), and homeownership (OR = 2.03, 95% CI [5.35, 10.95], p < 0.001) are more likely to enroll in a public school. Conclusions The study's findings contribute to the growing knowledge about migrant children's adaptation and can guide future policy-making. The adaptation gap between migrant children from public and migrant schools raises a concern about the upward mobility of migrant children from disadvantaged families, which requires more attention and support from local government.

The work-to-family hypothesis and the family-to-work hypothesis provide alternate explanations for the housework-earnings relationship. This study examines these competing theoretical perspectives and explores the longitudinal, cross-lagged relationship between housework time and market earnings. The data consist of five waves (2004–2015) of an ongoing open cohort study with 1827 married Chinese adults living in urban China. The random intercept cross-lagged panel model, which can separate stable, between-person differences from within-person processes, was applied. Overall, this study found that the bidirectional housework-earnings relationship mainly occurred at the between-person level: higher market earnings were related to less housework time. Few relationship was observed at the within-person level: over the 12-year investigation period from 2004 to 2015, women’s (but not men’s) within-person fluctuations in market earnings influenced their housework time 2 years later only from 2004 to 2006. Overall, this study partially lends support to the work-to-family hypothesis but fails to show evidence for the family-to-work hypothesis.

Objectives: This study examines the lead-lag relationship between physical and mental health among older adults. Method: Data are collected from 16,417 older adults aged 50 years and older participating in the biannual Health and Retirement Study (HRS). Participants were assessed on up to 11 measurement points over a 21-year period from 1994 to 2014. Physical health was measured as a composite of chronic diseases, functional limitations, and difficulties in basic and instrumental activities of daily living. Mental health was measured with the modified CES-D. Bivariate latent change score models (BLCSM) were estimated. Results: Both physical and mental health declined in the observed years, with slower declining rates over time. A reciprocal relationship emerged, with the prior level of physical health acting as the leading indicator of subsequent change in mental health, and the prior mental health state acting as the leading indicator of subsequent changes in physical health. Additionally, the influence of physical health on mental health changes was larger than the corresponding effect of mental health on subsequent physical health. Conclusion: This study demonstrates the reciprocal relationship between physical and mental health in later adulthood and highlights the need to pay attention to the mental health of older people with physical health problems.

In order to address the ascending turnover rate among social workers in China, this article presents the idea, based on social identity theory, that professional identity is an important factor influencing turnover rate. Employing structural equation modelling (SEM) techniques, the study found that professional identity was negatively associated with social workers' turnover intentions, and that social workers' job satisfaction mediated the relationship between professional identity and their turnover intentions. The findings suggest that more work needs to be done on social work education and public image construction in China.

Objective: This study examines the impact of the PC 3-sessions Training Project (PC-project), designed to improve professional competency among social workers in China. Methods: Using a quasi-experimental approach, 170 social workers from social work organizations (SWOs) or community organizations (COs) participated. The experimental group (Group 1), with 127 members, participated in all three sessions; comparison Group 2, with 22 participants, attended the last two sessions; and comparison Group 3, with 21 individuals, participated in the third session. Results: Those who participated in all three sessions improved in four dimensions of professional competency: teamwork skills, community work skills, case management skills, and supportive skills, while the comparison groups showed no significant improvement. In addition, social workers in COs developed their professional competency in more dimensions than those in SWOs. Conclusions: The PC-project is effective in improving social workers' professional competencies; hence, this program should be used in China for training and continuous development.

Although many studies have described society-wide changes in adult women's care-giving for ageing family members, few have examined how this informal eldercare has changed across care-givers' lifecourse and the temporal changes across different time periods and birth cohorts. Using a hierarchical age-period-cohort model to disentangle the confounding effects of age, period and cohort, this study examines the lifecourse and temporal changes in women's informal eldercare in China that can be attributed to the processes of ageing and social transformation. It advances understanding of the extent to which urbanisation and education have affected women's care-giving over time. The results reveal positive age, period and cohort effects which, together, indicate that the tradition of xiao ( filial piety) is in a stable state or even resurgent. Higher education and urban residency are both positively related to women's care-giving behaviour. As women age, the gap between residency differences in eldercare decreases. This study supports the argument that xiao culture is resilient and resistant to change, and that education can function as an enabler to promote it.

The present study explores within-gender differences in domestic labor by studying housework variations across five different groups of women in contemporary China. We defined five groups of women according to their urbanization status in general and hukou (i.e., household registration) in particular. (a) Rural natives are women with rural hukou who have stayed in rural areas, (b) rural migrants are women with rural hukou who have migrated to an urban area but have not obtained an urban hukou, (c) policy-based converters are women with rural origins who have converted to being urban residents due to policy privileges, (d) merit-based converters are women with rural origins who have converted to urban residents because of their merit (i.e., education), and (e) urban natives are those who are born urban hukou holders. Multivariate results on a national dataset with 2186 partnered women (aged 18–60) revealed that among women with rural origins, converters spent the least time on housework, rural natives the most, and rural migrants fell in between. Successful converters, particularly merit-based converters, expressed the strongest desire to pursue gender equality and deliberately devoted less time to domestic work. Additional Propensity Score Matching (PSM) analysis that compared women who have migrated to cities with women who have stayed in rural areas provides evidence that moving to urban areas has a negative association with women’s housework time, irrespective of their official household registration status, no matter whether they are migrant women who are not officially recognized or are successfully converted urban women.

Prior research has shown that time availability, relative resources, and gender perspective have great effects on couples’ division of housework, yet less attention has been paid to how the magnitude of these influences varies by cohort. By embedding the three dominant micro-level perspectives on housework in a macro-level context (i.e. cohort-level), this study examines each of the three perspectives’ explanatory powers for explaining the housework behaviors of two post-1976 cohorts: the early- and late-reform marriage cohorts. Regression results and Relative Importance analyses examining the three perspectives on housework show dissimilar effects for the two cohorts: the relative resources and gender perspectives better predict the housework gender gap in early-reform couples, while the time availability perspective better predicts the housework gender gap in late-reform couples. Specifically, the three most important predictors of the housework gender gap for the early-reform cohort are wife’s weekly paid work hours, wife’s proportion of couple’s income, and wife or her parents owning the house, while for the younger, late-reform cohort, the three most important predictors are wife’s employment, wife’s weekly paid work hours, and number of co-living children, suggesting that the relative resources perspective is weakened for the late-reform cohort. In addition, both the Relative Importance analyses and the Seemingly Unrelated Regression estimations reveal that although early-reform couples are likely to ‘do gender’ as a performance, this diminishes for late-reform Chinese couples. These changes indicate an uneven process regarding gender equality and the need to take cohort into account when testing the micro-level theoretical perspectives on the housework gap.