Date Presented 04/06/19
Asian immigrant parents face multiple barriers when they access and use health and education services for their child with developmental disabilities (DD). This meta-synthesis study describes parents’ experiences of role enactment while using services for their child with DD and explores if and how they address perceived cultural differences along the process. Findings may help OT better support Asian immigrant parents to negotiate cultural differences and enact their desired parental roles.
Primary Author and Speaker: I-Ting Hwang
Contributing Authors: Jessica Kramer, Ellen Cohn, Linda Barnes, Yuewu Wen
BACKGROUND: A 30 year body of literature has established that Asian immigrant parents face additional barriers when they access and utilize health and education services for their child with developmental disabilities (DD), compared to non-immigrant parents. These barriers are often attributed to cultural differences. However, there is a lack of research focusing on how parents take actions to address perceived barriers related to cultural differences, and to enact their parental roles while using services for their child after they moved to the U.S. Research questions: 1) What are Asian immigrant parents’ experiences of parental role enactment while using services for their child with DD? 2) If and how do parents address perceived cultural differences while enacting parental roles?
DESIGN: Systematic qualitative meta-synthesis. The purpose of conducting a meta-synthesis is to compare, integrate, and place findings of published qualitative studies in a larger interpretive context, and to generate theoretical frameworks which could inform future research and practice.
METHOD: Searching terms were applied in 7 databases. Two reviewers independently reviewed each abstract for inclusion using following criteria: 1) peer-reviewed qualitative study; 2) sample includes Asian immigrant parents of child with DD living in the U.S.; 3) topics related to parents’ experiences using health and education services; and 4) written in English. In total, 11 out of 822 articles were included. We used a constant comparative approach to generate codes when conducting line-by-line coding with the result section of each article, and put codes into categories which were informed by acculturation and role theories. We explored the relationships within and across these categories to propose initial themes and subthemes to generate a theoretical framework to describe parents’ experiences and coping strategies.
RESULTS: Q1: Parents generally felt positive about the disability policy and available services for children with disabilities in the U.S. However, all parents had more negative experiences to share about accessing services and/or interacting with service providers than positive experiences. Their experiences of role enactment were impacted by: 1) parents’ socio-cultural perceptions of the parental role (e.g., societal expectations for parents of children with DD, their perceptions about disability, and parents’ expectations for their child with DD), 2) individual factors (e.g., education level, existing skills and knowledge, parental self-efficacy, and their child’s age and functional level), and 3) system factors (e.g., cognitive demands of the information, service providers’ communication skills and attitudes, and current policy and practice). Q2: The meta-synthesis revealed parents’ experiences while using services increased their awareness of cultural differences that necessitate the use of coping strategies. Coping strategies include use of cultural liaisons, seeking education, and adapting communication patterns. These strategies evolved over time, as influenced by previous experiences and acculturation.
CONCLUSION: This systematic meta-synthesis suggests Asian immigrant parents use various coping strategies to address perceived cultural differences and enact their parental. How parents develop their coping strategies is an evolving process, which could be positively or negatively impacted by system factors. Impact statement: Findings of this study may help occupational therapists become more aware about how to maximize the systematic supports to better help Asian immigrant parents negotiate cultural differences effectively and enact their desired roles while using services for their child with DD.
References
Berry, J. W. (2005). Acculturation: Living successfully in two cultures. International journal of intercultural relations, 29(6), 697-712. doi:10.1016/j.ijintrel.2005.07.013
Jegatheesan, B. (2009). Cross-cultural issues in parent-professional interactions: A qualitative study of perceptions of Asian American mothers of children with developmental disabilities. Research and Practice for Persons with Severe Disabilities, 34(3-4), 123-136. doi:10.2511/rpsd.34.3-4.123
Walsh, D., & Downe, S. (2005). Meta-synthesis method for qualitative research: a literature review. Journal of advanced nursing, 50(2), 204-211. doi:10.1111/j.1365-2648.2005.03380.x
