Nursing Homes As Cultural Adaptive Systems: Relationship Between Acculturative Stress and Abusive Attitudes Among Immigrant Nursing Assistants

Background and Purpose:

A growing number of Chinese people are moving to South Korea because of its proximity and economic opportunity. Many of them are ethnic Korean immigrants whose ancestors were born in Korea. These Chinese-born ethnic Korean immigrants have been predominantly employed in low-paying, labor-intensive occupations that native South Koreans shun, such as healthcare aide. Although they share the same ethnic, cultural, and linguistic background with native South Koreans, Chinese Korean immigrants often experience discrimination and identity conflict in South Korea, which may contribute to the high level of acculturative stress.  However, very few studies have examined the impact of acculturative stress on their work attitude and job performance. The aim of this study was to investigate the effects of acculturative stress and culturally sensitive training on job satisfaction and abusive attitudes among immigrant frontline care workers.

Methods:

Cross-sectional design was used for this study. Participants for this study were Chinese Korean immigrant nursing assistants who were born and raised in China and immigrated to Korea. A list of long-term care facilities in the urban and suburban areas was established from the database of the South Korea Care Association, and the facilities were contacted via telephone to request the administrators’ permission to recruit Chinese Korean nursing assistants. A total of 229 Chinese Korean nursing assistants completed the survey. Survey questions included demographics, perceived discrimination, acculturative stress, job satisfaction, and abusive attitudes and valid and reliable measures were used for this study. Descriptive statistics and multiple regressions were used for the analyses using SPSS 20.0.

Results

A series of regression analysis were performed. In a regression analysis predicting job satisfaction (Adjusted R²=.21), gender, age, years of work experience, and perceived support were significant. This indicated that younger, female, more experienced, and receiving more support were associated with increased levels of job satisfaction. However, acculturative stress did not significantly predict the job satisfaction. In a hierarchical regression analysis predicting the abusive attitudes (Adjusted R²=.43), job satisfaction and acculturative stress were significant, which indicated that a high level of acculturative stress and low level of satisfaction increased abusive attitudes (β=.61, p<.001; β= -.20, p<.05, respectively). Differently from the job satisfaction model, culturally focused training experience was a significant predictor of abusive attitudes, suggesting individuals who have received a nurse aide training were more likely to treat elderly residents patiently and respectfully. Based on the multiple regression results, a mediating role of job satisfaction on the relationship between acculturative stress and abusive attitudes was investigated. However, no mediator effects were found for this study.

Discussion and Suggestions:

This study suggests that acculturative stress is a risk factor for engaging in abusive attitudes and behaviors among Chinese Korean nursing assistants, but it is not associated with decreased levels of job satisfaction. In addition, this study found that receiving a nurse aide training is particularly important to prevent abusive tendencies and behaviors of immigrant nursing assistants. Guidelines for elder maltreatment prevention and culturally appropriate interventions for acculturative stress should be discussed in social work practice.