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Journal article

Living arrangement choices of the elderly in Hong Kong

Author:
CHI Iris
Journal article citation:
Asia Pacific Journal of Social Work, 5(1), January 1995, pp.33-46.
Publisher:
Times Academic

The traditional preference of the Chinese is for the elderly to live with their children. It is also observed that there is a growing preference among the elderly to lead an independent life. It is not clear how well received this new preference for independent living among the elderly in Hong Kong is. This paper is an attempt to find out the factors that differentiate co-residence and independent living of the elderly persons in Hong Kong.

Journal article

Moderating effect of communication difficulty on the relationship between depression and pain: a study on community-dwelling older adults in Hong Kong

Authors:
CHAN Wallace Chi Ho, KWAN Chi Wai, CHI Iris
Journal article citation:
Aging and Mental Health, 19(9), 2015, pp.829-834.
Publisher:
Taylor and Francis

Objectives: This study examined the relationship between depression and pain, and the moderating effect of communication difficulty on this relationship, among community-dwelling older adults in Hong Kong. Method: Logistic regression was used to analyse secondary data regarding 12,402 Chinese older adults applying for long-term care service in Hong Kong in 2012. Results: Approximately 30% of participants were depressed and 37% experienced communication difficulty. Depression was associated with increased pain. Communication difficulty was found to moderate the relationship between depression and pain. Pain scores increased more when individuals who experienced communication difficulty reported being depressed, compared to those who did not experience communication difficulty. Conclusion: The moderating effect of communication difficulty may be explained by the interaction between depression and communication difficulty. Participants who were depressed and concurrently experienced communication difficulty may be more likely to catastrophise their pain and may tend to report or experience more pain. Health care professionals need to be aware of the different effects of communication difficulty on the pain experiences of older adults. Psychosocial intervention may be provided to minimize older adults’ communication barriers to pain management. (Edited publisher abstract)

Journal article

Reciprocal relationship between pain and depression in elderly Chinese primary care patients

Authors:
CHOU Kee-Lee, CHI Iris
Journal article citation:
International Journal of Geriatric Psychiatry, 20(10), October 2005, pp.945-952.
Publisher:
Wiley-Blackwell

This study examines the reciprocal relationship between pain and depression and to identify whether social support, functional disability or social functioning mediated the link between pain and depression among Hong Kong Chinese elderly primary care patients. Three hundred and eighteen patients were assessed by a trained assessor with MDS-HC at baseline and these subjects were randomly selected from attendants of three randomly selected elderly health centers in Hong Kong. These patients were re-assessed one year after baseline evaluation. Multiple regression analyses revealed that pain at baseline significantly predicted depression at 12-month follow-up assessment when age, gender, martial status, education, and depression at baseline were adjusted for, but depression at baseline was not associated with pain at 12-months after baseline measure while controlling for age, gender, martial status, education, and pain at baseline. However, depression did predict the onset of pain. Moreover, social support, physical disability or social functioning did not mediate the impact of pain on depression. These data suggest that pain is an important predictor of depression in elderly primary care patients. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.

Journal article

Gender differences in expectations predictive of volunteer experience among older Chinese professionals in Hong Kong

Authors:
MJELDE-MOSSEY Lee Ann, CHI Iris
Journal article citation:
Journal of Ethnic and Cultural Diversity in Social Work, 13(4), 2004, pp.47-64.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

This study examines gender differences in expectations predictive of volunteer experience. A sample of 438 Chinese professionals in Hong Kong ages 45-79, including retired (36.3%) and employed (63.7%), were asked about their expectations for volunteer work. Gender was evenly distributed, with 49.8% male and 50.2% female. Forty-three percent (43%) had volunteer experience. A multivariate logistic regression model was fit to sub-samples by gender, and gender differences emerged. For males, married and the expectation to utilize own skills were associated with volunteer experience. For females, self-rated health, retired, and the expectation to meet the needs of others were associated with volunteer experience. These results suggest that gender differences in expectations may influence volunteer activity. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Cross-cultural gerontology research methods: challenges and solutions

Author:
CHI Iris
Journal article citation:
Ageing and Society, 31(3), April 2011, pp.371-385.
Publisher:
Cambridge University Press

This article reviews the historical development and modern state of cross-cultural research in gerontology. Cross-cultural research in gerontology is important because the social processes of ageing vary. It aims to distinguish universal from culturally-specific processes and determine how cultural factors influence individual and population ageing. In doing so, it has to overcome many challenges such as how to design an equivalent and unbiased study, how to access different cultures, and how to ensure that questions are meaningful for different cultures. Appropriate strategies include using an international multicultural research team, becoming familiar with the local culture, maintaining good relationships with community leaders, studying only those aspects of behaviour that are functionally equivalent, using appropriate measures, and encouraging equal partnership and open communication among colleagues. To highlight the complexity of cross-cultural research and lessons learnt from such research experience, this article describes an example study of long-term care that involved researchers from more than 30 countries.

Journal article

Reciprocal relationship between fear of falling and depression in elderly Chinese primary care patients

Authors:
CHOU Kee-Lee, CHI Iris
Journal article citation:
Aging and Mental Health, 12(5), September 2008, pp.587-594.
Publisher:
Taylor and Francis

The objective of the current study is to investigate the link between depression and fear of falling in Hong Kong Chinese older adults in primary are settings. Using longitudinal data collected on 321 Chinese primary care patients 65 years of age and older, the authors investigated the reciprocal relationship between fear of falling and depression and examined whether functional disability and social functioning mediated the link between fear of falling and depression. Participants were recruited from three primary care units in Hong Kong. Subjects were assessed in Cantonese by two trained assessors with Minimum Data Set-Home Care twice over a period of one year. Findings revealed that fear of falling at baseline significantly predicted depression at 12 month follow-up assessment after age, gender, marital status, education and depression at baseline were adjusted, but depression at baseline did not predict fear of falling at 12 months after fear of falling at baseline was adjusted. Moreover, social functioning mediated the impact of fear of falling on depression. The findings presented here indicate that fear of falling potentially increases the risk of depression in Chinese older adults in primary care settings.

Journal article

Economic status of the elderly in Hong Kong: homogeneous or heterogeneous?

Authors:
CHOU Kee-Lee, CHOW Nelson W. S., CHI Iris
Journal article citation:
International Social Work, 49(2), March 2006, pp.218-232.
Publisher:
Sage

This article examines the economic status of elderly people in Hong Kong based on data collected by the government. The Hong Kong elderly population is not a homogeneous group, as their economic status is significantly related to their gender, age, marital status, education and employment status.

Journal article

The temporal relationship between falls and fear-of-falling among Chinese older primary-care patients in Hong Kong

Authors:
CHOU Kee-Lee, CHI Iris
Journal article citation:
Ageing and Society, 27(2), March 2007, pp.181-193.
Publisher:
Cambridge University Press

Although the association between falls and fear-of-falling has been established by previous studies, the temporal ordering of the two is uncertain. Moreover, the common and unique risk factors that contribute to falls and to fear-of-falling have not been investigated in either primary health-care settings or Asian societies. The aims of this study were to examine the temporal sequencing of fear-of-falling and a fall, and to identify the risk factors associated with the two. A prospective cohort study with three six-month measurement waves was conducted in primary-care settings in Hong Kong. The sample was derived from the waiting list control group of a randomised clinical trial, and 321 respondents participated in the three waves. They were evaluated with the Minimum Data Set for Home Care. It was found that falls and fear-of-falling at baseline were not independent predictors of respectively developing a fear-of-falling and becoming a faller, but that age was a common independent predictor for falls and the onset of a fear-of-falling. Individuals with a fear-of-falling were at risk of both falling and a fear-of-falling at 12 months. The good news is that no vicious cycle of falls and fear-of-falling was found, and modifiable risk factors, including IADL limitations, environmental hazards, and fear-of-falling were identified, so that effective prevention programmes for falls and for fear-of-falling can be designed.

Journal article

Assessing tradition in Chinese elders living in a changing social environment: implications for social work practice

Authors:
MJELDE-MOSSEY Lee, CHI Iris, LOU Vivian W.Q.
Journal article citation:
Journal of Human Behavior in the Social Environment, 11(3/4), 2005, pp.41-57.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

Social workers are increasingly challenged to provide culturally sensitive services to older immigrants from diverse backgrounds. Assessment tools developed in the elder's own cultural context can maximize appropriate assessment and planning. This article describes the development of a tool for measuring adherence to tradition in Chinese elders. In Chinese tradition, an elder's purpose, meaning, and self-worth are derived, in large part, from their contribution to family, relatives, and the community. Existing measures of filial piety and acculturation do not capture this dimension. Filial piety involves being on the receiving end of care, honour, and obedience from younger generations. Acculturation is the opposite of adherence to tradition. One thousand five-hundred and two Chinese elders in China were asked questions on mutual aid and intergenerational exchange. Factor analysis extracted nine items loading into two factors reflective of traditional exchange. The authors conclude that this measure could prove useful in understanding the effect of traditional beliefs upon various psychosocial outcomes. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Combined effect of vision and hearing impairment on depression in elderly Chinese

Authors:
CHOU Kee-Lee, CHI Iris
Journal article citation:
International Journal of Geriatric Psychiatry, 19(9), September 2004, pp.825-832.
Publisher:
Wiley-Blackwell

Sensory impairment and depression are common in old age and the relation between depression and vision as well as hearing impairment have been established. However, few studies have directly compared their effects and examined the impact of dual sensory loss. The purpose of this study is to compare impacts of self-reported hearing and vision loss as well as the effect of double sensory impairment on depression. This article analyzes cross-sectional data collected from a representative community sample of 2,003 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in a face-to-face format and data including vision and hearing impairment, socio-demographic variables, health indicators, family support, and depression were obtained. Logistic regression analyses revealed that visual impairment was significantly related to depression even after age, gender, marital status, education, self-reported health status, the presence of 11 diseases, functional limitation and family support were controlled but hearing loss was not. Hearing impairment did not add to the likelihood of depression where visual impairment was already present. The impact of visual impairment on psychological well-being among elderly Chinese is more robust than hearing loss. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.

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