Foundations Of Nursing Research Discussion 4

Post your initial response to the article, addressing the following criteria:
· Read the process for data collection employed in the study.

· Identify the method used in the study.

· Provide a list of the tasks performed as part of data collection in the study, add comments as needed.

· Draw conclusions about the data collection process.

· Enter your responses in the organizer attached.

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1 Assistant Professor, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan 2 Professor, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan 3 Assistant Professor, Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan 4 Section Head, Department of Health, Kaohsiung City Government, Kaohsiung, Taiwan 5 Doctoral Candidate, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan

Key words Marriage migrant women, health

empowerment, participatory action research

Correspondence Dr. Hsiu-Hung Wang, Professor, No. 100,

Shih-Chuan 1st Rd., Kaohsiung 80708, Taiwan.

E-mail: hhwang@kmu.edu.tw

Accepted: August 31, 2014

doi: 10.1111/jnu.12110

Abstract

Purpose: The aim of this study was to develop, implement, and evaluate a theory-based intervention designed to promote increased health empower- ment for marriage migrant women in Taiwan. The rapid increase of interna- tional marriage immigration through matchmaking agencies has received great attention recently because of its impact on social and public health issues in the receiving countries. Design and Methods: A participatory action research (PAR) and in-depth interviews were adopted. Sixty-eight women participated in this study. Eight workshops of the health empowerment project were completed. Findings: Through a PAR-based project, participants received positive out- comes. Four outcome themes were identified: (a) increasing health literacy, (b) facilitating capacity to build social networks, (c) enhancing sense of self- worth, and (d) building psychological resilience. Conclusions: PAR was a helpful strategy that enabled disadvantaged migrant women to increase their health literacy, psychological and social health, and well-being. Clinical Relevance: The findings can be referenced by the government in making health-promoting policies for Southeast Asian immigrant women to increase their well-being. Community health nurses can apply PAR strategies to plan and design health promotion intervention for disadvantaged migrant women.

The rapid increase of international marriage immigration through matchmaking agencies has received great atten- tion recently because of its impact on social (e.g., demo- graphic structure and culture) and public health (e.g., healthcare services) issues in the receiving countries. The U.S. Citizenship and Immigration Services (2013) reported that the “mail-order bride” business results in 4,000 to 6,000 marriages between U.S. men and foreign women each year. In Asian countries, an increasing num- ber of women from Mainland China, Vietnam, Indone- sia, the Philippines, Thailand, Malaysia, and Cambodia have migrated through international marriage to Taiwan, Foundations Of Nursing Research Discussion 4

Singapore, Japan, South Korea, and Hong Kong (Hsia, 2010). In Taiwan, the immigration of Southeast Asian brides started in 1987 in rural areas of Taiwan (Yang & Wang, 2012). However, the number of undocumented international marriage immigrant women is often under- estimated. According to Taiwan’s Ministry of the Inte- rior (2012), there has been an influx of 410,000 foreign spouses in Taiwan, including 140,000 from Southeast Asia and approximately 260,000 from Mainland China. The Ministry of the Interior (2012) reported that the overall immigrant population in Taiwan has grown dra- matically, especially immigrants from Mainland China

Health Empowerment Among Immigrant Women Yang et al.

(318,390; 67.45%), Vietnam (87,274; 18.49%), Indone- sia (27,648; 5.86%), Thailand (8,333; 1.77%), and the Philippines (7,468; 1.58%), making the influx of racial or ethnic immigrant minorities an increasingly challenging social and public health issue.

For many women in developing countries, interna- tional marriage immigration has emerged as a way to escape poverty and achieve a better life by marrying men from more financially developed countries. For men in East Asia who experience difficulties finding a wife, matchmaking agencies can arrange a trip to al- low men to locate a partner in a few days and return to their homeland with a new bride. The bridal candi- dates, however, are called by many derogatory terms, such as “mail-order brides” or “foreign brides,” and are often treated with disrespect and derision in the receiving country (Choe, 2005).

Health Care Among Immigrant Women in Transnational Marriages

The growing number of immigrant women has be- come a significant global concern in the social and public health sectors. According to the United Nations’ Commit- tee on the Elimination of Discrimination Against Women (2009), immigrant women may not only be subject to sex discrimination in their receiving country but also face specific health challenges. Indeed, one of the primary goals outlined in Healthy People 2020 is to eliminate health disparities among different segments of vulnera- ble populations, such as immigrants (U.S. Department of Health and Human Services, 2013). Studies showed that immigrant women in Taiwan not only tended to be more vulnerable to illness but also experienced more barriers to their health care than nonimmigrants. A cross-cultural comparison indicated that Vietnamese immigrant women in Taiwan had a generally lower health-related quality of life than native Taiwanese women (Yang & Wang, 2011a). Lin and Wang (2008) investigated Southeast Asian pregnant immigrant women and found they had irregular prenatal examination behavior.

Immigration is a stressful, unexpected life event in which immigrants experience a complicated process of re-adaptation in the host society (Meleis & Lipson, 2004). To cope with the challenges of living in a new coun- try, marriage migrant women in Taiwan are also vulnera- ble to psychological distress, which can negatively impact their health and well-being (Yang, Wang, & Anderson, 2010). Moreover, greater acculturative stress increases the risk for developing psychological problems, partic- ularly in the initial months of immigrating to the new host society (Berry, 1997). The lack of true friendships,

personal relationships, and social support in their host country intensifies their loneliness and social isolation (Yang & Wang, 2011b).

Marriage migrant women’s marginalized status and dif- ficulties in accessing adequate health care indicate a lack of empowerment to effectively seek the resources they need to improve their health and well-being. Shearer (2007) asserted that health empowerment may increase one’s awareness in health and one’s own healthcare decisions. Ensuring health empowerment among mar- riage migrant women may improve their ability to access health care, achieve better health, and overcome their marginalized status in their receiving country. The aim of this study was to develop, implement, and evaluate a theory-based intervention designed to promote increased health empowerment for marriage migrant women in Taiwan. Foundations Of Nursing Research Discussion 4