The transition of eldercare responsibility and traditional filial piety concepts and its urban-rural differences in China: an age-period-cohort analysis from 2006 to 2017.

BACKGROUND: With rapid urbanization, massive migration, and non-family-based eldercare involvement, Chinese concepts of eldercare responsibility and filial piety are shifting. We performed age-period-cohort (APC) analyses to assess the transition of old-age pension coverage, eldercare responsibility, and filial piety concepts and its urban-rural differences among Chinese adults using data from the China General Social Survey (2006-2017). METHODS: Old-age pension coverage (yes/no) and primary eldercare responsibility (government/offspring/self/sharing) were investigated in 2010, 2012, 2013, 2015, and 2017. Filial piety was evaluated using customized questionnaires in 2006 and 2017. The APC effects were estimated using mixed effects and generalized additive models. RESULTS: Among 66,182 eligible participants (mean age: 48.8 years, females: 51.7%) in the six waves, APC analyses indicated that old-age pension coverage increased with aging and over time. Across cohort groups, it grew as the cohort was younger in urban residents but decreased in rural residents. The concept of offspring-based (> 50%) and government/self/offspring-shared eldercare (> 30%) predominated. APC analyses revealed that the offspring-based concept declined with aging (OR = 0.81, 95% CI: 0.79-0.84), whereas the government-based (OR = 1.37, 95% CI: 1.33-1.41) and self-based (OR = 1.55, 95% CI: 1.47-1.63) concepts increased with aging. People born around the 1940s have a comparatively higher possibility to perceive that the primary eldercare responsibility should be undertaken by the government and elder parents. In contrast, people born in the younger cohort were more likely to perceive that adult children are responsible for their parents' primary eldercare. Filial piety score slightly increased with aging (ß = 0.18, SD: 0.05) but decreased as the birth cohort was younger. In addition, rural participants were more likely to perceive offspring-based eldercare and maintain filial piety, and the related urban-rural difference was intensified by aging. CONCLUSIONS: The traditional concept that eldercare solely relies on offspring has changed to relying on multiple entities, including the government and self-reliance. Diluted filial piety in people born in the young cohort requires reinforcement. Moreover, future healthy aging policies need to focus more on urban-rural disparities to promote equity in social well-being.

Effects of sexual orientation-based prejudice and discrimination in family of origin on depressive symptoms and life satisfaction in a Chinese sample: Reciprocal and authoritarian filial piety as moderators.

Experiencing prejudice and discrimination from family has been found to be positively associated with mental health problems among sexual minorities. Emerging evidence also shows the value of contextualizing the internalization of minority stress by considering individual cultural factors, such as filial piety. We examined whether authoritarian filial piety (AFP) and reciprocal filial piety (RFP) moderated the link between distal stressors in one's family and mental health outcomes. A total of 362 (56.9% male; age: M = 24.55, SD = 6.60) Chinese lesbian, gay, bisexual, queer/questioning, and other non-heterosexual (LGBQ+) individuals participated in this study. They provided demographic information and completed a battery of measures for AFP and RFP, sexual orientation-based prejudice and discrimination in family of origin (SOPDF), depressive symptoms, and life satisfaction. Structural equation modeling results showed that SOPDF had a positive and negative link with depressive symptoms and life satisfaction, respectively. In addition, we identified AFP and RFP as significant moderators for the association between SOPDF and depressive symptoms, and the association between SOPDF and life satisfaction, respectively. Specifically, the positive effect of SOPDF on depressive symptoms was greater for participants with higher levels of AFP; the negative effect of SOPDF on life satisfaction was greater for participants who endorsed higher levels of RFP. Our findings corroborated past studies' conclusion about the detrimental impact of familial sexual stigma on LGBQ+ people's mental health. Furthermore, such impact on negative and positive mental health outcomes are respectively conditioned by the degree to which LGBQ+ individuals endorse AFP and RFP. These findings underscore the importance for therapists who endorse family therapy to help LGBQ+ clients navigate familial sexual stigma and consider the role of filial piety beliefs in shaping the impact of familial sexual stigma on these clients' mental health.

Filial beliefs reduce aggression in different cultures: A conditional process model.

The dual filial piety model divides filial piety beliefs into two types: reciprocal and authoritarian filial piety beliefs (RFP vs. AFP) in terms of attitude, emotion, and obligation towards parents. Previous studies have shown that these two types of filial piety beliefs related to different psychological outcomes. Literature also suggests that some aspects of the function of filial piety beliefs may be a cultural universal. This research aimed to test the effects of filial piety beliefs on aggression using participants from two cultures (Chinese vs. Islamic). We further explored the mediating role of moral disengagement, forgiveness, and self-control between filial piety beliefs and aggression, and the moderating role of culture. The results showed that moral disengagement, forgiveness, and self-control played mediating roles in the relationship between filial piety beliefs and aggression. The functions of filial piety beliefs showed both similarities and differences across cultures. (1) RFP was negatively associated with aggression in both cultures, while AFP was negatively associated with aggression only among Muslim participants. (2) RFP can reduce the aggression of Chinese participants through moral disengagement, forgiveness, and self-control; while the RFP of Muslim participants can reduce their aggressiveness only through forgiveness. (3) AFP enhanced aggression via moral disengagement and reduced self-control among; Chinese participants, but reduced aggression via self-control among Muslim participants. Findings of this study confirmed that the functions of RFP show more similarities than differences across cultures, while functions of AFP do the opposite.

The interdependence of happiness and filial piety within the family: a study in Vietnam.

BACKGROUND: Filial piety is one of the most important values in Vietnam, as it is in a number of East Asian countries. It is an expression of children's respect, gratitude, and care for their parents. While filial piety may bring joy to parents and is a personal duty for offspring, it can also be a pressure for children. Hence, in recent years, some studies have considered filial piety as two dimensions instead of one dimension.Participants And Procedure This study focused on clarifying the relationship between filial piety and perceived family happiness with 385 adult offspring who lived in Vietnam at the time of the study. The Dual Filial Piety Scale (DFPS) and the Interdependent Happiness Scale (IHS) were used. Results: The results showed that participants regularly engaged in aspects of filial piety and there was no contradiction between authoritarian filial piety (AFP) and reciprocal filial piety (RFP). Filial piety can predict family happiness at a fairly high level. CONCLUSIONS: These results, besides showing the importance and value to the family, also give a multi-dimensional and comprehensive view of filial piety. At the social level, upholding the value of filial piety is the basis for building family happiness as well as making an important contribution to the implementation of social security in the family.

The cost of "snubbing": the effect of parental phubbing on filial piety behavior in children and adolescents.

Background: Although numerous studies have used Chinese samples to examine the consequences of parental phubbing, these studies focused on children's mental health and peer interaction. No research to date has directly explored the association between parental phubbing and child-parent interaction. Since parental phubbing is a way how parents interact with their children (parent-child), it might be associated with the way how children interact with their parents (child-parent), such as filial piety behavior, which prescribes how children behave toward their parents and remains one of the goals of parents in educating their children in modern Chinese society. Based on social exchange theory and social gender theory, this study investigated the impact of parental phubbing on filial piety behavior and tested its mediation of perceived parental rejection, its moderation of gender among children and adolescents. Methods: This study was conducted using a questionnaire method. A total of 753 students from Grade 4 to 9 (Mage = 12.28 years, SD = 1.81 years) was surveyed using the Parental Phubbing Scale, Perceived Parental Rejection Questionnaire, and the revised Dual Filial Piety Scale. Results: First, parental phubbing was negatively correlated with reciprocal filial piety (RFP) behavior, but not correlated with authoritarian filial piety (AFP) behavior. Second, perceived parental rejection played a mediating role between parental phubbing and RFP behavior. Third, this direct effect was moderated by gender, in that it was stronger for boys than for girls. Conclusion: These findings suggest that there are intergenerational costs of phubbing, such as reducing children and adolescents' RFP behavior. The present study is the first to combine parent-child interaction in the digital media era (parental phubbing) with traditional Chinese child-parent interaction (RFP behavior), which expands the research topic on the influence of parental phubbing on children and adolescents' psychological development.

Can an AI-carebot be filial? Reflections from Confucian ethics.

This article discusses the application of artificially intelligent robots within eldercare and explores a series of ethical considerations, including the challenges that AI (Artificial Intelligence) technology poses to traditional Chinese Confucian filial piety. From the perspective of Confucian ethics, the paper argues that robots cannot adequately fulfill duties of care. Due to their detachment from personal relationships and interactions, the "emotions" of AI robots are merely performative reactions in different situations, rather than actual emotional abilities. No matter how "humanized" robots become, it is difficult to establish genuine empathy and a meaningful relationship with them for this reason. Even so, we acknowledge that AI robots are a significant tool in managing the demands of elder care and the growth of care poverty, and as such, we attempt to outline some parameters within which care robotics could be acceptable within a Confucian ethical system. Finally, the paper discusses the social impact and ethical considerations brought on by the interaction between humans and machines. It is observed that the relationship between humans and technology has always had both utopian and dystopian aspects, and robotic elder care is no exception. AI caregiver robots will likely become a part of elder care, and the transformation of these robots from "service providers" to "companions" seems inevitable. In light of this, the application of AI-augmented robotic elder care will also eventually change our understanding of interpersonal relationships and traditional requirements of filial piety.

Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis.

BACKGROUND: The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. PURPOSE: To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. METHODS: A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. FINDINGS: Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. CONCLUSION: Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study.

Blessing or curse: the role of authoritarian filial piety and self-efficacy in caregiver gains among Chinese family caregivers caring for physically impaired older adults.

BACKGROUND: This study investigated the effects of authoritarian filial piety (AFP) and caregiver self-efficacy on the caregiving experience of adult children of physically impaired older adults. Socio-cultural stress and coping model was applied to test the influence of AFP on caregiver gains. METHODS: A total of 601 Chinese adult children caregivers and care-recipient dyads participated in this cross-sectional study in 2021. Four instruments were used to collect data: the 4-item Zarit Burden Interview, Positive Aspects of Caregiving Scale, Caregiver Task Inventory Scale, and Authoritarian Filial Piety Scale. All mediation and moderated mediation effects were estimated using SPSS 26.0. RESULTS: Caregiver self-efficacy was found to not only mediate but also help family caregivers convert their burden into positive gains. AFP moderates the association between caregiver burden and self-efficacy, as well as between caregiver burden and caregiver gains. CONCLUSIONS: This study provides valuable insights into filial piety, elucidating AFP's comprehensive impact on cognitive appraisals of caregiving. Culturally sensitive psychoeducational therapy, addressing AFP expectations and boosting caregiver self-efficacy, is recommended to enhance positive caregiving outcomes.

Views of healthcare professionals on their relationships with families of people living with dementia: A qualitative study.

OBJECTIVE: Healthcare professionals as well as families play a vital role in ensuring the quality of care for people living with dementia. However, the relationships between healthcare professionals and families of people living with dementia are not extensively examined, particularly within the Chinese cultural context of dementia. The goal of this study was to explore the views of healthcare professionals on their relationships with families of people living with dementia. DESIGN: This qualitative study was grounded in the interpretative phenomenological analysis framework. METHODS: Data were collected using focus-group interviews. Qualitative data were transcribed verbatim and analysed using interpretative phenomenological analysis. RESULTS: The study recruited a total of 26 healthcare professionals from 3 long-term care facilities. The study found that conflicts were inherent in the relationships between professionals and families of people living with dementia, and conflicts were found to manifest in three core domains: 1) Families demonstrated a lack of understanding about dementia, 2) Professionals faced challenges in managing families' unrealistic expectations regarding the disease status and the prognosis of people living with dementia, 3) Families did not perceive themselves as being responsible for the care of people living with dementia. CONCLUSIONS: The present study found that the prevailing factor underpinning the relational conflicts between healthcare professionals and families of people living with dementia, as reported by healthcare professionals was the perceived lack of understanding about dementia amongst families of those affected.

The role of family support in the self-rated health of older adults in eastern Nepal: findings from a cross-sectional study.

BACKGROUND: Nepal's low fertility rate and increasing life expectancy have resulted in a burgeoning older population. For millennia, filial piety shaped family cohesion and helped Nepali older adults achieve positive outcomes, but recently, it has been eroding. Furthermore, there are not enough institutional support options or alternatives to family-based care to deal with the biosocial needs of older adults. This study explored the association between family support and self-rated health among Nepali older adults. METHODS: A community-based cross-sectional survey in eastern Nepal's two districts, Sunsari and Morang, interviewed 847 older adults (≥ 60 years). The final analytical sample was 844. Participants were asked whether they received assistance with various aspects of daily life and activities of daily living from their families. Multivariable logistic regression examined the association between family support and self-rated health. RESULTS: Participants who received support with various aspects of daily life had 43% higher odds of good health, but after adjusting for control variables, the result only approached statistical significance (p = 0.087). Those who received family assistance with activities of daily living had nearly four times higher odds (OR: 3.93; 95% CI: 2.58 - 5.98) of reporting good health than participants who lacked this support. CONCLUSIONS: Given the important role of family support in Nepali older adults' health, government programs and policies should create a conducive environment to foster family-based care until more comprehensive policies for older adults' care can be put into effect. The results of this study can also help shape the global aging environment by highlighting the need for family support in older care, particularly in low-income nations with declining traditional care systems and weak social security policies.

Parenting and family life experiences of mothers diagnosed with schizophrenia within Chinese cultural context.

WHAT IS KNOWN ON THE SUBJECT?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs). Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unlike in Western society, Chinese society is characterised by a family-centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter-in-law. While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re-establish connections with intimate family members. The findings highlight the following important considerations when offering family-based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents-in-law, while offering psychoeducation to MDWSs and their family members. ABSTRACT: Introduction In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method In-depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self-stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family-based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents-in-law. Implications for Practice The results highlighted the significance of culturally sensitive nursing care for MDWSs and family-centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members.

Internalized Homonegativity and Psychological Distress Among Chinese Gay Men: The Mediating Role of Loneliness and the Moderating Role of Authoritarian Filial Piety.

Purpose: Previous research has consistently found that internalized homonegativity is a salient predictor of psychological distress, but how and when this relationship occurs is unclear, especially among Chinese sexual minority individuals, who are less frequently studied in the literature. This study explored whether the cultural norm of filial piety moderates the indirect association between internalized homonegativity and psychological problems (i.e., symptoms of anxiety and depression) through a sense of loneliness. Methods: To study this question, data were collected from 426 self-identified gay men in China, from February to July 2021, using an online platform. Demographic data, loneliness, authoritarian filial piety (AFP), and internalized homonegativity were measured in this cross-sectional study. Results: In the direct and mediation models, internalized homonegativity had a significant association with psychological distress. In the moderated mediation model, AFP strengthened the effect of internalized homonegativity on loneliness. The indirect positive effect of internalized homonegativity on psychological distress through loneliness was stronger for participants with higher AFP. Conclusions: Loneliness appears to play a role in the relationship between internalized homonegativity and psychological distress. Intervention programs for reducing psychological distress among sexual minority individuals should especially target gay men who endorse high levels of AFP because as a group, their internalized homonegativity is more likely to have a stronger impact on psychological health through loneliness compared with those with low levels of AFP.

Filial Piety and the Development of Independence and Interdependence During Emerging Adulthood: A Longitudinal Study of Taiwanese Adolescents.

While filial piety has been widely studied in Confucian-influenced societies, little is known about how it may influence the development of emerging adults' independence and interdependence. Using a population-based longitudinal study in Taiwan (N = 3,149; 49.5% females), this study examined the association between filial piety in adolescence (aged 13-15) and independence and interdependence in emerging adulthood (aged 22). Results show that greater adherence to filial piety in adolescence predicts higher independence in emerging adulthood. Additionally, greater adherence to filial piety predicts higher interdependence for females, but not males, when parents hold traditional gender-role attitudes. This study underscores the significance of cultural norms and parental gender-role attitudes in shaping individuals' development during emerging adulthood.

Reverence and Reciprocity in Prioritization of Care to a Parent: The Role of Cultural Ecologies and Implications for Decolonizing Relationality.

Relationship research in the dominant psychological science portrays the prioritization of conjugal over consanguine relationships as a healthy standard. We argue that this "standard" pattern is only evident in cultural ecologies of independence. Drawing on the Confucian concept of filial piety, we conducted five studies and two mini meta-analyses to normalize the prioritization of mother over spouse. Cultural ecologies were operationalized by a variety of indexes, including histories of residential mobility, country, manipulated relational/residential mobility, and race. While participants situated in cultural ecologies of independence prioritized care to spouse over mother, participants inhabited in interdependence prioritized care to mother over spouse. Both American and Chinese participants showed greater prioritization of care for mother over spouse when they imagined a relational ecology of interdependence versus independence. Authoritarian filial piety mediated cultural-ecological variation on relational prioritization. Results illuminate cultural-ecological foundations of care and naturalize love as dutiful fulfillment of obligation.

A Sino-African perspective and the morality of procreation.

Current studies of anti/-natalism have been carried out mainly in the context of western philosophy. In this article, we offer a pro-natalist view based on Confucian and Afro-communitarian philosophy (Sino-African ethics). Grounded in this Sino-African perspective, we uphold that there is, at least, one reason to believe that not only is it morally permissible to procreate, but also that on some occasions, procreating is what morality prescribes. Specifically, we contend that, from a Sino-African perspective, procreating sometimes is the best way to fulfil duties of reciprocity and care towards our parents.

(Un)Health from parental intervention: Does the marriage formation pathway influence married people's health?

The relationship between marriage and its health consequences has been well documented. Yet, little is known about whether health disparities still exist among married people due to different marriage formation pathways. Using data from a special module of the Chinese General Social Survey, this study examines the health effects of parental intervention in children's marriage formation. Results show that parental intervention in marriage formation is negatively associated with married people's self-rated health, but the association disappears after the selection effect is controlled for. These results suggest that the selection effect largely explains the association between parent-intervened marriage and its negative health outcomes among married people. That is to say, people with poorer health are more likely to rely on their parents for marriage formation. The findings are found in both husbands and wives and hold robust in multiple robustness tests. This study extends marriage-health research from the comparison between married and single people to the comparison within the married group.

Alexithymia and Internet Addiction in Children: Meaning in Life as Mediator and Reciprocal Filial Piety as Moderator.

Purpose: To explore the psychological mechanism between alexithymia and Internet addiction, the present study constructed a moderated mediation model based on the problem behavior theory. Methods: A total of 899 middle school students (Mage=13.95, SD=1.10) were surveyed using the 20-item Toronto-alexithymia-scale, meaning in life questionnaire, dual filial piety scale, and Internet addiction disorder diagnostic scale. Results: First, alexithymia was significantly negatively correlated with meaning in life and reciprocal filial piety, and positively correlated with Internet addiction; meaning in life was significantly positively correlated with reciprocal filial piety, and negatively correlated with Internet addiction; reciprocal filial piety was significantly positively correlated with authoritarian filial piety, and negatively correlated with Internet addiction. Second, alexithymia could not only directly predict Internet addiction, but also indirectly predict Internet addiction through meaning in life. Third, reciprocal filial piety played a moderating role between meaning in life and Internet addiction, while authoritarian filial piety did not. For middle school students with low reciprocal filial piety, meaning in life can negatively predict Internet addiction; for those with high reciprocal filial piety, there is no correlation between meaning in life and Internet addiction. Conclusion: This study reveals the internal mechanism of the relationship between alexithymia and Internet addiction in middle school students, emphasizes the role of positive psychology and family environment, and provides specific evidence and theoretical guidance for preventing Internet addiction in middle school students.

Combatting ageism in the Western Pacific region.

The present viewpoint examines the manifestation of ageism, defined as stereotypes, prejudice and discrimination towards people because of their age, in the Western Pacific region. Research is still equivocal concerning the nature of ageism in the Western Pacific region, especially in East and South-East Asia (e.g., Eastern countries). There has been plenty of research to support as well as question the general notion of Eastern cultures and countries as being less ageist compared to Western cultures and countries at individual, interpersonal, and institutional levels. Although varied theoretical explanations have aimed to explain East-West differences in ageism such as the modernization theory, the pace of population aging, the proportion of older people in the country, cultural hypothesis, and GATEism, none of these theories fully accounts for the mixed findings. As such, it is safe to conclude that targeting ageism should be an important step in ensuring a world for all ages in Western Pacific countries.

Negotiating filial care in transitions: an ethnographic study of family involvement in China's nursing homes.

Based on ethnographic research conducted in two nursing homes in China, this article examines how institutional eldercare reshapes the expectations and practices of filial piety. It finds that families accept institutional care as a solution to the elderly care deficit. They expect a new division of care between labor and love, assigned to paid care workers and family members, respectively. This ideal of care division is rooted in the "intimate turn" in Chinese family life. Nevertheless, many family members go beyond this care division and remain deeply involved in nursing homes. On the one hand, adult children take on the responsibility to manage surrogate caretakers to improve the quality of care. On the other hand, they continue to provide personal care and companionship. Sharing family time is made the highest priority, especially in the face of impending death. This study goes beyond the binary division between commercial care and family care and sheds light on the transformation of filial piety in the commodification of eldercare in contemporary China.

Filial piety, love or money? Foundation of old-age support in urban China.

This article explores the intertwining issues of filial obligation, material interest and emotional intimacy in driving adult children's provision of old-age support in family settings. Drawing upon multi-generational life history interviews with urban Chinese families, this article reveals how the configuration of these multiple forces is governed by the socio-economic and demographic context of a particular time. The findings dispute a lineal modernization model of transition and generational change (from past family relations structured by filial obligation to the present emotion-laden nuclear family). Instead the multi-generational analysis reveals a tightening association of multiple forces around the younger generation, intensified by the one-child demographic structure, post-Mao commercialization of urban housing and establishment of the market economy. Finally, this article highlights the role of performance in carrying out old-age support. "Surface work" is enacted in situations where tensions between conformity to public morality and private intents (emotional or material) cannot be reconciled.