Different Experiences of Adult Child and Spousal Caregivers with Family Conflict

Previous research indicates that different types of caregivers report distinct levels of family conflict (Dieker et al., 2019). However, as half (52%) of the participants in the previous study did not report family conflict, the purpose of this study was to examine the relationships among types of caregivers, family conflict, and caregiver burden in those who experience family conflict. Participants (N = 277; aged 19 to 87; M = 52.96) comprised of 197 adult child and 80 spousal caregivers. They completed the Caregiver Reaction Scale (O’Malley & Qualls, 2017) to assess different aspects of the caregiving experience. Hierarchical regressions (block 1: demographics, block 2: family conflict) were computed to predict caregiving burden. For spousal caregivers, the final model explained 2.2% of the variance in caregiving burden, F(7, 69) = 0.22, p = .98. None of the variables were significant. Additionally, family conflict did not uniquely influence caregiving burden beyond demographics, Fchange(2, 69) = 0.03, p = .97. For adult child caregivers, the set of predictors accounted for 20.5% of the variance in caregiving burden, F(7, 183) = 6.75, p < .001. Having more family beliefs and support conflict predicted greater caregiving burden (ps < .01). Family conflict scores also significantly explicated caregiver burden beyond demographics, Fchange(2, 183) = 17.60, p < .001. Results suggest that family conflict is a stronger driver of caregiver burden for adult child than spousal caregivers. Findings imply the need for clinicians to target appropriate interventions for adult child caregivers to reduce caregiver burden.

P–508 The relational self in fertility decision-making: Chinese lesbians exploring donor conception and biological ties

Study question How does the cultural importance attached to biological family ties shape Chinese lesbians’ decision-making processes regarding whether and how to have children? Summary answer The cultural significance of biological ties shapes Chinese lesbians’ fertility decisions, including those regarding conception methods, who will get pregnant, and whose sperm to use. What is known already Previous research has shown that normative expectations towards opposite-sex marriage and biological parenthood impose significant psychological burden on lesbians in China, where same-sex couples are not entitled to the rights to partnership/marriage, assisted reproductive technology (ART), and parenthood. Despite the legal barriers, online discussions on same-sex parenthood and commercial consultation services targeted at same-sex couples who want to travel overseas to use ART have emerged in recent years. While more lesbians have become parents of donor conceived children in Western developed countries, little is known about Chinese lesbians’ reproductive experiences in the context of increasing reproductive transactions that transgress borders. Study design, size, duration In-depth, semi-structured interviews were conducted with 35 Chinese lesbians between July 2017 and June 2018 in Beijing, China. To better understand the context and social and clinical implications of global ART services for Chinese society, I also carried out participant observation by attending informal gatherings organised by the local lesbian community and public events targeted at (same-sex) individuals and couples who want to travel overseas to use ART and producing fieldnotes after the events. Participants/materials, setting, methods Participants were aged between 25 to 45. The majority were in their thirties. Each interview took around 2 hours and was audio-recorded and transcribed. The interview guide covered questions about their family beliefs, views on and/or experiences of donor conception, and perceived and actual difficulties in pursuing motherhood. With the assistance of NVivo (a qualitative data analysis software), I carried out thematic analysis of the interviews and fieldnotes to identify common patterns across the dataset. Main results and the role of chance Participants shared a belief that being biologically connected with their (prospective) children was, to varying extents, important to their families. They were at different stages of fertility decision-making, ranging from achieved motherhood (8 participants), actively planning to pursue motherhood (9), hesitation in taking action (11), and a lack of interest in or hope of becoming a mother (7). Almost all participants expressed that they did not prefer adoption and that they were reluctant to involve known sperm donors, who were considered a threat to their parental status. Rather, they were inclined to seek ART overseas in order to create their desired biological ties in a clinical setting. Issues including donor screening, desire for family resemblances, the status of biological and social mothers, and plans to purchase sperms from the same donor to conceive “siblings” were discussed in the interviews. It is evident that when deciding on whether to have a child and how to involve any third parties, participants tended to embrace the relational self and carefully balance individuals desires with familial and social expectations. The felt need to legitimise their relationships with donor conceived children imposes psychological burden on lesbian intended parents and discourages many from pursuing motherhood. Limitations, reasons for caution The findings of this qualitative study are not intended to be generalised to the whole lesbian population in China. Given the hidden nature of this population, my research, despite its small sample size, represents a significant step forward and calls for more quantitative and qualitative studies on lesbians’ fertility health. Wider implications of the findings: This study shows that lesbians’ journeys to donor conception require not only medical and legal support but also psychosocial care that attends to one’s perceived importance of biological ties and family beliefs. It sensitises healthcare professionals to the specific fertility-related psychosocial needs and concerns among lesbians in a family-centred context. Trial registration number Not applicable

P–480 Adding fuel to the flame of low fertility: Fertility intention and perceived socio-political stability of young adults in Hong Kong

Study question How does perceived socio-political stability impact on the fertility intention of Hong Kong adults? Summary answer Political and economic uncertainties play an especially significant role in reproductive decision-making among young adults in Hong Kong, where traditional family beliefs diminish in importance. What is known already Hong Kong has one of the lowest fertility rates in the world, despite the importance placed on values like family lineage and childbearing as a filial obligation. Previous investigation of Hong Kong students’ perception of reproduction showed that proximal factors such as having a stable relationship and personal maturity as the most important conditions for parenthood. It is yet to be explored whether more distal factors such as the economy and political stability also play a role in reproductive decision-making among Hong Kong adults, especially under the influence of the Anti-Extradition Bill Movement from onwards. Study design, size, duration This study uses cross-sectional data from an online survey that explores the fertility attitudes, intentions, and behaviours and perceived socio-political stability of Hong Kong Chinese adults. Data were collected between July and August 2020. Participants/materials, setting, methods Participants were 629 childless Hong Kong Chinese women (mean age = 30±6.68) recruited through community network and social media. Participants answered questions on fertility intention, and rated the extent to which ‘political environment’, ‘economic stability’ and ‘education system’ are important social-political factors in considering family formation, and to which they agree with traditional family beliefs. We conducted binary logistic regression with fertility intention as the criterion variable and social-political factors of family formation as predictors. Main results and the role of chance Participants considered the ‘political environment’ and ‘education system’ very important factors when considering family formation, especially among those aged 25 or below. More than 70% of respondents said they would like to have children, yet only 44% said they plan on actualizing their parenthood goals in the near future. Regression analyses showed significant main effects of age and gender on fertility intention, such that younger (P<.001) and male (P<.01) participants were less likely to intend on becoming parents. The more participants valued ‘political environment’ (B = 0.48, P<.001) and ‘economic stability’ (B = 0.39, P<.05), the less likely it is for them to intend on becoming parents, controlling for age and gender. There was also significant interaction between age and importance of ‘political environment’ (P<.01), indicating that for whom ‘political environment’ is an important condition for parenthood, younger participants had lower intention of having children than older participants. There was no significant effect of gender. Overall, participants did not subscribe to traditional beliefs such as that childbearing is ‘a necessary part of married life’ or that it is ‘a filial obligation as sons or daughters’ (ratings = 1.95 – 3.05, out of 5). Limitations, reasons for caution Participants were recruited by self-selection through community network and social media, potentially favouring individuals who were more concerned with fertility issues to begin with. Additionally, men were largely under-represented in this sample (15%), potentially obscuring any significant gender differences relating to traditional family beliefs and determinants of reproductive decisions. Wider implications of the findings: With economic and political uncertainties expected to persist, these findings call for increased psychosocial and fertility education for young adults in navigating long-term parenthood goals and reproductive options, and policies that assist young adults in overcoming personal and structural barriers to parenthood amid diminishing confidence in governmental support. Trial registration number Not applicable

Analyzing Burmese refugee children’s multimodal work

Researchers have investigated how family literacy practices can effectively support children’s literacy development in school. However, few studies have explored the lived experiences of Burmese refugee families in the United States. Utilizing a social semiotics multimodal perspective, this qualitative study examines how two Burmese refugee children made meaning by blending different modes. The data sources include video recordings, artifacts, and interviews. The findings illustrate three major themes that span time and space: family past experiences across global contexts, representation of current life experiences in the United States, and family beliefs carried across global contexts and Gawa’s dream for the future. The findings also show that the participants drew upon multimodal semiotic resources to create and share family storybooks. Implications include the importance of integrating multimodal perspectives into classroom learning and the possibilities of bridging home and school literacy.

Involving Family and Friends in Palliative Care for Persons With Kidney Disease

Family-centered palliative care for patients with kidney disease shows great promise in alleviating the suffering of patients with collateral benefits to family members. Engaging family caregivers is particularly valuable for those with kidney disease, given often multiple comorbidities, impact of dialysis on quality of life, and often conflicting end-of-life decisions. Family caregivers are at high risk for burnout, increasing the likelihood that patients themselves will not receive end-of-life care or support. Important components of family-centered palliative care include assessment, emotional support, education, assertive communication skills, referrals, and grief and bereavement support. It is crucial that the care team recognize the role of cultural norms, family beliefs, and communication patterns, tailoring family-centered care to meet the needs of each individual patient.

Mothers Left without a Man: Poverty and Single Parenthood in China

Most single-parent families in China are headed by women, and single mothers represent one of the fastest-growing groups living in poverty. Yet few studies have examined this group. This article seeks to better understand how (and why) single mothers are disadvantaged in China. Based on in-depth interviews conducted in Zhuhai, Guangzhou Province, it demonstrates that single mothers are left behind in four respects: lower income and worse economic conditions, lower employment and career development opportunities, worse physical and mental health, and poorer interpersonal relationships and less chance of remarriage. The causes of these disadvantages include Chinese family beliefs, a culture of maternal sacrifice, the traditional division of labour between men and women and social stereotypes about single mothers. The article highlights the impacts of Chinese familism culture on single mothers and advocates incorporating a gender perspective into the agenda of family policy and other relevant social policies in China.

Family formation among lalas (lesbians) in urban China: Strategies for forming families and navigating relationships with families of origin

This article explores the ways in which Chinese lesbians, who identify themselves as lalas, form their own families and navigate their relationships with families of origin. To date, there is a lack of research on families formed by same-sex couples in urban China, where homosexuality remains stigmatized. Drawing on semi-structured interviews with 35 lala-identified women in Beijing, this article shows that lalas’ formation of families has been shaped by, but at the same time shaping, their relationships with their families of origin, who tend to embrace heteronormative family beliefs. Engaging with ongoing debates on choice and individualization, this study reveals the tensions between lalas’ family aspirations and gendered, familial, material, and socio-political constraints imposed on female-led same-sex families. It contributes to sociological understanding of family change by revealing alternative paths to same-sex family formation in a context where the act of coming out is challenging and families formed by same-sex couples remain largely invisible.

Managing Children: An Insight into Malay Parents' Involvement in Their Children's Learning

Socio-economic status not only influences family beliefs about values of education, but may affect how academic expectations are communicated by parents and perceived by their children- This study examined (1) the level of parental involvement (achievement values, interest in homework, and discussion on school matters) among Malay parents, and (2) parental involvement and its relationship with academic achievement. Measures of parents ' involvement were obtained from Malay boys (12=146) and girls (n=284 ), aged seventeen, living with both biological parents. Adolescents 'perceptions of maternal and paternal involvement at home were measured using Paternal and Maternal Parental Involvement Seale (Paulson, 1994b). Results indicated that Malay parents tend to emphasize more on achievement values, less on interest in homework and discussion on school matters. In terms of gender differences, there were significant differences between mothers ' and fathers 'involvement and these differences were found to differ towards sons and daughters. Discussions and implications were outlined

Family resilience in stressful situations of disability in foreign studies

A review of foreign studies reflecting the problems of family resilience in the modern world is presented. Special emphasis is placed on studies of family resilience in stressful situations of disability of family members. It is shown that resilience of families having stressful experience of disability includes: 1) a system of family beliefs based on a positive outlook that contribute both to self-recovery after a traumatic experience and acceptance of their vulnerability; 2) patterns of family reactions to diseases allowing them to find life meaning in caring, and respond effectively to challenges of diseases, use adaptive capabilities to counteract violations, and organize themselves; 3) family communication skills and activity in problem solving; 4) family connectedness and flexibility, effective use of external support from social and non-government organizations. The family resilience construct is considered through closely related concepts of individual, family, and social resilience.