Social Support Networks, Coping and Positive Aging Among the Community-Dwelling Elderly in Hong Kong

199 Pages·2019·11.55 MB·English

by  Susu Liu

Susu Liu
Social Support Networks,
Coping and Positive
Aging Among the
Community-Dwelling
Elderly in Hong Kong
Social Support Networks, Coping and Positive
Aging Among the Community-Dwelling Elderly
in Hong Kong
Susu Liu
Social Support Networks,
Coping and Positive
Aging Among the
Community-Dwelling
Elderly in Hong Kong
123
SusuLiu
Department ofSociology andSocial Work
SoochowUniversity
Suzhou,China
ISBN978-981-13-3782-6 ISBN978-981-13-3783-3 (eBook)
https://doi.org/10.1007/978-981-13-3783-3
JointlypublishedwithHuazhongUniversityofScienceandTechnologyPress,Wuhan,China
TheprintededitionisnotforsaleinChinaMainland.CustomersfromChinaMainlandpleaseorderthe
printbookfromHuazhongUniversityofScienceandTechnologyPress.
ISBNoftheChinaMainlandedition:978-7-5680-3825-6
LibraryofCongressControlNumber:2018965425
©HuazhongUniversityofScienceandTechnologyPress2019
Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart
of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission
orinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar
methodologynowknownorhereafterdeveloped.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom
therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse.
The publisher, the authors and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinor
for any errors or omissions that may have been made. The publisher remains neutral with regard to
jurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations.
ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSingaporePteLtd.
Theregisteredcompanyaddressis:152BeachRoad,#21-01/04GatewayEast,Singapore189721,
Singapore
Contents
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1.1 The Situation of Global Aging . . . . . . . . . . . . . . . . . . 1
1.1.2 Hong Kong: A Fast Aging Society . . . . . . . . . . . . . . . 2
1.1.3 Positive Aging: A Productive Approach
to Well-Being in Old Age. . . . . . . . . . . . . . . . . . . . . . 3
1.1.4 Hong Kong Elderly: Living Under a Blending
Chinese Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2 Research Gap and Research Problems . . . . . . . . . . . . . . . . . . . 5
1.2.1 What Are the Components of Positive Aging
Among the Community-Dwelling Elderly
in Contemporary Hong Kong? . . . . . . . . . . . . . . . . . . 5
1.2.2 What Is the Effect of Social Support Networks
and Coping on Positive Aging?. . . . . . . . . . . . . . . . . . 6
1.2.3 What Is the Effect of Emotional Closeness
on Positive Aging?. . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.2.4 What Is the Role of Domestic Helpers
in Providing Social Support to the Elderly? . . . . . . . . . 7
1.3 Rationale and Significance of the Study . . . . . . . . . . . . . . . . . . 8
1.4 Research Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
1.5 Layout of the Thesis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2 Literature Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
2.1 Overview of Literature Review . . . . . . . . . . . . . . . . . . . . . . . . 15
2.2 Research Approaches of Aging . . . . . . . . . . . . . . . . . . . . . . . . 15
2.2.1 Positive Aging and Successful Aging . . . . . . . . . . . . . 16
2.2.2 Subjective Well-Being and Quality of Life . . . . . . . . . 23
v
vi Contents
2.3 Social Support Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
2.3.1 Definition of Social Support Network . . . . . . . . . . . . . 28
2.3.2 Concepts in Relation to Social Support Network . . . . . 30
2.3.3 Dimensions of Social Support Network . . . . . . . . . . . . 33
2.4 Coping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
2.4.1 Coping: Origins and Definitions . . . . . . . . . . . . . . . . . 39
2.4.2 Coping Strategies: Dimensions and Theoretical
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
2.5 Domestic Helper as a Support Provider . . . . . . . . . . . . . . . . . . 44
2.5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
2.5.2 The Hong Kong Context . . . . . . . . . . . . . . . . . . . . . . 45
2.5.3 The Mainland China Context . . . . . . . . . . . . . . . . . . . 46
2.5.4 FDHs in Singapore and Japan. . . . . . . . . . . . . . . . . . . 46
2.5.5 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
3 Conceptual Framework. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
3.1 Theoretical Background of the Study . . . . . . . . . . . . . . . . . . . . 55
3.1.1 Convoy Model of Social Support . . . . . . . . . . . . . . . . 56
3.1.2 Socioemotional Selectivity Theory. . . . . . . . . . . . . . . . 58
3.1.3 Hierarchical Compensatory Model. . . . . . . . . . . . . . . . 59
3.1.4 Strengths Perspective . . . . . . . . . . . . . . . . . . . . . . . . . 59
3.2 Conceptual Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
3.2.1 Conceptual Framework of Social Support
Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
3.2.2 Conceptual Framework of Positive Aging . . . . . . . . . . 62
3.2.3 Integrated Conceptual Framework of the Study . . . . . . 62
3.3 Hypotheses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
3.3.1 Hypotheses Set 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
3.3.2 Hypotheses Set 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
3.3.3 Hypotheses Set 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
3.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
4 Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
4.1 Research Design: A Mixed-Method Study . . . . . . . . . . . . . . . . 69
4.2 Pilot Study: In-Depth Interview . . . . . . . . . . . . . . . . . . . . . . . . 71
4.2.1 Sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
4.2.2 Sample Size Determination. . . . . . . . . . . . . . . . . . . . . 72
4.2.3 Informants Recruitment. . . . . . . . . . . . . . . . . . . . . . . . 73
4.2.4 Construction of Interview Guidelines. . . . . . . . . . . . . . 73
4.2.5 Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
4.2.6 Data Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
4.2.7 A Review of the Qualitative Study . . . . . . . . . . . . . . . 75
Contents vii
4.3 Main Study: Cross-Sectional Survey . . . . . . . . . . . . . . . . . . . . 76
4.3.1 Sampling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
4.3.2 Sample Size Determination. . . . . . . . . . . . . . . . . . . . . 76
4.3.3 Multi-stage Sampling Procedure . . . . . . . . . . . . . . . . . 77
4.3.4 Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
4.3.5 Data Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
4.4 Scale Construction and Validation . . . . . . . . . . . . . . . . . . . . . . 79
4.4.1 Scale Construction . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
4.4.2 Scale Validation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
4.5 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
5 Findings of In-Depth Interview. . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
5.1 Case Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
5.2 Thematic Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
5.2.1 Thematic Findings on Social Support Network. . . . . . . 95
5.2.2 Thematic Findings on Positive Aging . . . . . . . . . . . . . 96
5.2.3 Thematic Findings on Stress . . . . . . . . . . . . . . . . . . . . 98
5.2.4 Thematic Findings on Coping. . . . . . . . . . . . . . . . . . . 98
5.3 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
6 Descriptive Findings of Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
6.1 Sample Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
6.1.1 Demographic Factors and the Sample Features. . . . . . . 101
6.1.2 Social-Economic Factors and Indicators
of Elder Caregiving . . . . . . . . . . . . . . . . . . . . . . . . . . 104
6.2 Descriptive Statistics of Main Variables . . . . . . . . . . . . . . . . . . 105
6.3 Correlations Between Main Variables and Demographic
Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
6.4 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
7 Hypotheses Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
7.1 Hypotheses Testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
7.1.1 Testing of Hypothesis Set 1 . . . . . . . . . . . . . . . . . . . . 111
7.1.2 Testing of Hypothesis Set 2 . . . . . . . . . . . . . . . . . . . . 116
7.1.3 Testing of Hypothesis Set 3 . . . . . . . . . . . . . . . . . . . . 120
7.2 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
8 Domestic Helper as a Support Provider . . . . . . . . . . . . . . . . . . . . . 125
8.1 Support Provided by Domestic Helpers . . . . . . . . . . . . . . . . . . 125
8.1.1 Descriptive Statistics of Respondents Who
Employ Domestic Helpers . . . . . . . . . . . . . . . . . . . . . 125
8.1.2 Extent of Satisfaction Towards Services Provided
by Domestic Helpers . . . . . . . . . . . . . . . . . . . . . . . . . 127
viii Contents
8.2 Employment of Domestic Helper and Positive Aging . . . . . . . . 128
8.3 Pros and Cons of Employing Household Domestic Helper . . . . 128
8.4 Discussion and Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
8.4.1 A Variety of Support Provided by Domestic
Helper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
8.4.2 The Relationship Between Employment
of Domestic Helper and Positive Aging. . . . . . . . . . . . 130
8.4.3 A Large Pool of Employing Domestic Helper
in Elder Care in the Future . . . . . . . . . . . . . . . . . . . . . 131
8.4.4 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
9 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
9.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
9.2 Expanded Positive Aging Index (PAI) as a Validated Tool
to Measure Well-Being in Later Life . . . . . . . . . . . . . . . . . . . . 133
9.2.1 Expanded PAI as a Validated Measurement Tool
for Chinese Community-Dwelling Older Adults. . . . . . 134
9.2.2 Expanded PAI as a Tool to Measure a Two-Factor
Model of Positive Aging. . . . . . . . . . . . . . . . . . . . . . . 135
9.3 The Interpretation of Social Network Composition
and the Prevalence of Peer Support . . . . . . . . . . . . . . . . . . . . . 136
9.3.1 The Interpretation of Social Network Composition
in the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
9.3.2 The Prevalence of Peer Support Among
Community-Dwelling Older Adults . . . . . . . . . . . . . . . 138
9.3.3 The Preference of Companionship Support
from Peer Groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
9.4 The Effect of Social Support Networks on Positive Aging. . . . . 140
9.4.1 The Contribution of Family and Peer Support
Networks to Positive Aging . . . . . . . . . . . . . . . . . . . . 141
9.4.2 The Interpretation of Emotional Closeness
and Its Effect on Positive Aging . . . . . . . . . . . . . . . . . 142
9.5 The Significant Functions of Social Support. . . . . . . . . . . . . . . 144
9.6 Coping in Later Life and Its Mediating Effects on Social
Support Networks and Positive Aging . . . . . . . . . . . . . . . . . . . 145
9.6.1 Age and Coping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
9.6.2 The Mediating Effect of Coping on Social
Support Network and Positive Aging. . . . . . . . . . . . . . 147
9.7 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Contents ix
10 Implications of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
10.1 Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
10.1.1 Promoting Positive Aging in Chinese Societies . . . . . . 151
10.1.2 Investing in and Consolidating the Social Support
Network of the Elderly. . . . . . . . . . . . . . . . . . . . . . . . 154
10.1.3 Improving Coping Capacity in Later Life . . . . . . . . . . 155
10.1.4 Improving the Service Quality of Domestic Helpers. . . 155
10.2 Limitations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
10.3 Directions for Future Research. . . . . . . . . . . . . . . . . . . . . . . . . 157
10.3.1 Longitudinal Study. . . . . . . . . . . . . . . . . . . . . . . . . . . 157
10.3.2 Further Research in Relation to Social Support
Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
10.3.3 Further Research on Emotional Closeness . . . . . . . . . . 159
10.3.4 Survey of a More Representative Sample. . . . . . . . . . . 159
10.3.5 Validation of Expanded PAI . . . . . . . . . . . . . . . . . . . . 160
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
11 Conclusions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
11.1 Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
11.1.1 Contribution to Knowledge Building. . . . . . . . . . . . . . 161
11.1.2 Contribution to Model Testing . . . . . . . . . . . . . . . . . . 162
11.1.3 Contribution to Policy Making . . . . . . . . . . . . . . . . . . 163
11.1.4 Contribution to Social Work Practice. . . . . . . . . . . . . . 164
11.2 Conclusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Appendix A... .... .... .... ..... .... .... .... .... .... ..... .... 167
Appendix B... .... .... .... ..... .... .... .... .... .... ..... .... 171
List of Figures
Fig. 3.1 Conceptual framework of structural components
of social support network.... .... .... .... .... .... ..... .. 60
Fig. 3.2 Conceptual framework of positive aging. .... .... .... ..... .. 62
Fig. 3.3 Integrated conceptual framework of the study .... .... ..... .. 63
Fig. 4.1 Flow of research design of the mixed-method study.... ..... .. 71
Fig. 4.2 Confirmatory factor analysis of the original expanded
PAI (20-item). Note: Goodness-of-fit values: v2 (N = 393;
df = 165) = 312.596; p = 0.000; CFI = 0.940; GFI = 0.926;
RMSEA = 0.045; SRMR = 0.0559. Standardized b-coefficients
were shown and all the coefficients were significant except for
the item undertaking paid work after retirement... .... ..... .. 87
Fig. 4.3 Confirmatory Factor Analysis of the Revised Expanded PAI
(19-item). Note: Goodness-of-fit values: v2 (N = 393;
df = 146) = 251.375; p = 0.000; CFI = 0.956; GFI = 0.936;
RMSEA = 0.043; SRMR = 0.0500. Standardized b-coefficients
were shown and all the coefficients were significant.... ..... .. 88
Fig. 7.1 Mediationmodelofsocialsupportnetwork,copingandpositive
aging. Note: a-path, b-path, c’-path and c-path are all
standardized b-coefficients ... .... .... .... .... .... ..... .. 119
Fig. 7.2 Mediation model of the size offamily social network, problem
coping and positive aging. Note: All the coefficients were
significant standardized values .... .... .... .... .... ..... .. 119
Fig. 7.3 Joint mediation model of peer emotional closeness, problem
coping, emotion coping and positive aging. Note: All the
coefficients were significant standardized values... .... ..... .. 120
xi