Family life stress coping and mental health among vietnamese marriage migrant women in south korea a mixed methods study

Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Family Life Stress, Coping, and Mental Health among Vietnamese Marriage Migrant Women in South Korea: A Mixed Methods Study1 Nguyen Thi Phuong Thao* Abstract: Vietnamese marriage migrant women experience multiple stressors associated with married life in South Korea While there are a number of studies investigating acculturative stress, relatively little work has examined family life stress and its harmful effect on mental health among these marriage migrant women The purpose of this paper is to explore the impact of family life stress on depression and the mediating roles of some personal coping resources (self-esteem and specific coping behaviors) on this relationship among a sample of Vietnamese marriage migrant women living in South Korea The study utilizes a mixed methods design A quantitative survey is completed by 301 Vietnamese migrant wives with a mean age of 29 years (SD=5.49) Qualitative interviews are conducted with five Vietnamese migrant wives and analyzed using thematic analysis The findings indicate that family life stress is positively related to depression, both directly and indirectly through low self-esteem and greater use of avoidant coping The study provides several implications for social work research and practice Keywords: Family life stress; coping; depression; Vietnamese marriage migrant women; South Korea Received: 1st March 2016; Reviesed: 29th March 2016; Accepted:10thApril 2016 Introduction bachelors to find their wives (Chung et al 2013; Lee et al 2015) Globally, on the other hand, rapid growth of the Korean economy has served as a pull factor attracting many young women from neighboring countries to South Korea (Lee et al 2015) In particular, the number of marriage migrant women from Vietnam has grown each year and occupied the highest proportion of marriage migrant groups in this country, followed by Chinese and Korean-Chinese2 women (Statistics Korea 2015) According to the During the last two decades, a number of women from Asia have migrated to South Korea through transnational marriage with Korean men The phenomenon of marriage migration is attributed to both domestic and global factors (Chung et al 2013; Lee et al 2015) Domestically, declining marriage and birth rates, and a disproportionate sex ratio in rural areas have made it hard for rural or low-income This paper is a revised version of the author’s doctoral dissertation from the Seoul National University (2016, February) *Institute of Social Welfare, Seoul National University, South Korea email: thao_npo@naver.com Korean-Chinese (termed “Chosonjok”) refer to Koreans with citizenship of China, who are residing in China (doopedia.co.kr, http://terms.naver.com/entry.nhn?docId=1176421&cid=409 42&categoryId=39994) 194 N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 2015 Statistics, the number of unnaturalized Vietnamese migrant wives has risen to nearly 40,000, which constitutes 30.4 percent of female marriage migrants in South Korea Most of these women have chosen transnational marriage as a way to improve not only their lives but their natal families’ lives as well (Hoang 2013) Nevertheless, migration decision may put foreign wives at risk for facing multiple stressors and challenges related to cultural adaptation (Castro et al 2010) or acculturation-which refers to changes in attitudes, beliefs, and behaviors that occur as an individual adjusts to a new culture (Berry 1997) For instance, migrant wives may experience such acculturative stressors as language barriers, discrimination, or pressures to assimilate (Williams et al 1991) In the case of marriage migrant women, particularly, they also have to face other potential stressors associated with transnational marriage such as family conflicts, child rearing as a mother of a “multicultural child”, or financial hardship (Jeong et al 2010; Lee et al 2015; Nam 2010; Park 2012) A great deal of evidence has demonstrated that exposure to stress may lead to mental health problems, particularly depression (Noh et al 1996; Pearlin et al 1981; Williams et al 1991) Empirically, Vietnamese wives have reported higher levels of depressive symptoms than other Asian women (Chae et al 2014; Choi et al 2012) Thus, a growing body of research recently has emerged to explore difficulties as well as to identify risk and protective factors for depression among Vietnamese marriage migrant women (Byun 2012; Chae et al 2014; Choi et al 2012) However, previous studies have placed primary emphasis on acculturative stress (Chae et al 2014), not giving much attention to familyrelated stress in marriage migrants The present 195 study, thus, has been conducted in an effort to fill this gap by exploring the impact of family life stress on depression among Vietnamese migrant wives Further, the current study also identifies some coping resources, including self-esteem and specific coping behaviors (problem solving, support seeking, and avoidance) in the relationship between family life stress and depression to provide a broader understanding of the stress process among Vietnamese wives Indeed, research has emphasized the role of coping in the migration process as migrants have to cope with the challenges and stressors for adaptation to the new culture (Berry 1997, 2006) Very few studies to date have examined coping behaviors in marriage migrant women in South Korea Therefore, the main objectives of this mixed-methods study are (1) to understand the effect of family life stress on mental health; and (2) to explore the mediating roles of coping resources (self-esteem, coping behaviors) in this relationship, utilizing the stress process model (Pearlin et al 1981) as a theoretical framework Significant findings from this study are expected to enhance people’s understanding of stress and coping in Vietnamese marriage migrant women and provide useful information for social workers when working with Vietnamese wives Specifically, the current study addresses the following research questions: - What is the relationship between family life stress and depression among Vietnamese marriage migrant women in South Korea? - Do self-esteem and coping behaviors mediate the relationship between family life stress and depression among Vietnamese marriage migrant women in South Korea? 196 N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Literature review 2.2 Depression among marriage migrant women in South Korea 2.1 The stress process model The stress process paradigm (Pearlin et al., 1981) is one of the most widely held perspectives in the sociology of mental health (Noh et al 1996) The basic conceptual framework of the stress process model focuses on the interrelationships among three major components: the sources of stress (i.e life events, chronic stress), the mediators of stress (i.e social resources, psychological resources, specific coping responses), and mental health outcomes (e.g depression, anxiety) (Pearlin et al 1981) In this model, it is assumed that a change in one of these factors can lead to changes in the others, thus comprising chains of effect (Pearlin 1999) Several assumptions have been proposed regarding the roles of coping and psychosocial resources in the stress process First, it begins with the assumption that unchecked external stressors will disrupt one’s psychological equilibrium and induce psychological outcomes in the form of distress or depression (Pearlin et al 1981) Second, it is further hypothesized that certain psychosocial resources and coping may intervene in this process so as to (1) eliminate or change conditions leading to the problems, (2) alter the meaning of the situation in a manner that reduces its threat, or (3) keep the symptoms of stress within manageable bounds (Pearlin et al 1978) Consequently, the stress process framework undergirds the core components of the present study concerning the relationship between family life stress and depression, as well as the potential mediating effects of some psychological and coping resources among Vietnamese marriage migrant women in South Korea Depression is common in many societies and has been defined in recent years as a major global public health problem (Karasz 2005) In South Korea, depression is also arising as a major mental health problem among marriage migrant women (Kim et al 2010) The high prevalence of depression in migrant wives has been shown in earlier research Roh and Kim (2012), for example, have studied mental health among over 200 marriage migrant women in rural areas and reported 52.9% of the participants being at risk for clinical depression and approximately 23.4% having depression In Kim and colleagues’ (2015) recent study on female marriage migrants living in urban and rural areas, 39.9% of the participants have been found to be at risk for clinical depression Common problems such as acculturative stress, marital stress, economic and language difficulties, or lack of social support may predispose female marriage immigrants to a high risk of increasing mental health problems (Roh et al 2012; Shu et al 2011) Particularly, Vietnamese marriage migrant women have been found to have higher levels of depressive symptoms than other Asian wives such as Japanese or Chinese (Cha et al 2008; Lim et al 2010) Choi and colleagues (2012) have examined the prevalence of postpartum depression in immigrant Vietnamese mothers in Korea and found that 34.3% of the participants represented serious depression Most of the Vietnamese marriage immigrant women in Chae and associates' (2014) study also have been reported to be at risk for an impairment in mental health functioning Several factors for such high levels of depression among Vietnamese wives are suggested as marital discord, inadequate social support, poor Korean language ability, and strong ties to the original culture (Cha et al 2008; Choi et al 2012) N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 197 2.3 Family life stress and depression among marriage migrant women (Hammen 2005; Noh et al 1996; Paykel 2003; Pearlin et al 1981) Previous research has reported numerous pressures that marriage migrant women may face in their daily lives in South Korea, particularly financial hardship and family conflicts (Kim et al 2011; Lee 2013) While the family plays an extremely important role in life for Vietnamese people (Nguyen 2003), family conflict has a profound negative impact on their mental health status (Kim 2011) The main cause of conflicts between migrant wives and Korean family members is considered the lack of mutual understanding of cultural differences in family values (Kim et al 2007; Won et al 2014) Indeed, adapting to the Korean patriarchal culture is considered a big challenge for Vietnamese marriage migrant women as Vietnam is a wellknown Asian country that has relative gender equality (Knodel et al 2004) Hence, they may find it hard to understand such Korean traditional customs or beliefs as paternalistic authority, daughters-in-law’s role overload, or mothers-inlaw’s interference (Jeong et al 2010; Park 2012) In addition, lack of respect towards the foreign wives among Korean husbands and in-laws has also contributed to increasing family conflicts as well as daily life stress in Vietnamese marriage migrant women (Jeong et al 2010) Also, the presence of children can increase stress levels and mental health problems among migrant wives (Shu et al 2011) According to Shu and colleagues (2011), migrant mothers suffer from more pressures than local mothers because they have to both adjust to an alien culture and serve as a mother in the Korean family (Shu et al 2011) Moreover, children’s Korean language ability and school bullying are also everyday concerns among migrant mothers in South Korea (Park 2012) The weight of evidence has demonstrated that exposure to such life stressors can potentially increase depressive symptoms 2.4 Stress, self-esteem, and depression Self-esteem is a primary personal resource in the stress process model (Noh et al 1996) Selfesteem “involves the judgments one makes about one’s own self-worth” (Pearlin et al., 1981, p.340) and is regarded a protective psychological resource that help people adapt to stressful situations (Greenberg et al 1992) This type of resources has been shown to be negatively associated with psychological distress among persons experiencing life stress (Pearlin et al 1981; Noh et al 1996) In the stress process, selfesteem is considered a mediator which is hypothesized to be diminished by uncontrollable external stressors, then resulting in psychological distress or a loss of well-being (Pearlin et al 1981) Many empirical studies have demonstrated the mediating role of self-esteem in the relationship of stress to depression (Jesse et al 2014; Lee et al 2013) Specifically, exposure of stress is often linked to decreasing levels of self-esteem, which in turn increase depressive symptoms (Jesse et al 2014; Lee et al 2013) 2.5 Stress, coping behaviors, and depression Coping responses or strategies are defined as “cognitive and behavioral efforts to master, reduce, or tolerate the internal and/or external demands that are created by the stressful transaction” (Folkman 1984: 843) As responses to stress are various; many researchers have categorized these coping behaviors In 1980, Folkman and Lazarus proposed two major types of coping: problem-focused coping, which aims at taking actions to deal directly with the problems, and emotion-focused coping, which 198 N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 involves efforts to reduce emotional distress, such as avoiding, blaming, minimizing, wishful thinking, ventilation, or seeking social support In 1990, Amirkhan classified coping behaviors into three categories, including problem-solving, social support-seeking, and avoidant behaviors The Amirkhan’s (1990) classification of three types of coping behaviors has been widely used in many studies for its generalizability across populations (Ager et al 1998; as cited in Desmond, Shevlin, and MacLachlan 2006) Problem solving refers to instrumental and problem-focused approaches to management of stress; seeking support involves a process of turning to others for seeking comfort, help, and advice; and avoidance relates to escape responses regarding physical and/or psychological withdrawal (Desmond et al 2006) Particularly, the classification of these three categories of coping may reflect Asians’ culture regarding the use of seeking support and avoidance coping (Wong et al 2010) For instance, researchers noted that Asians’ coping behaviors are shaped by Asian cultural values and worldviews indicating that individuals should adjust their feelings or behaviors to fit their environment so as to preserve social harmony, which emphasize the importance of accepting rather than confronting the problems, and the need for saving their face by not disclosing the problems to others (Inman et al 2007) Likewise, other studies have found greater reluctance to seek social support among many Asian Americans than European Americans and stated that this trend is linked to Asian Americans’ concerns that social support would result in a disruption of group harmony or loss of face (Kim et al 2006; Wong et al 2010) Hence, the present study used the Amirkhan’s (1990) classification to explore coping behaviors utilized by Vietnamese marriage migrant women in dealing with family life stress they experience in South Korea In the stress process, coping behaviors are regarded as an important resource “that people can tap to mediate the stressful impact of life problems” (Pearlin et al 1981:341) The critical role of coping in immigrants’ adaptation to the new environment is also well recognized (Berry 1997; Yakhnich et al 2008) That is, coping successfully with stress helps migrants adaptive to the new society, while unsuccessful coping may lead to maladaptive outcomes including specific behaviors and thought or negative emotional patterns such as depression (Berry 1997) Regarding the roles of specific coping behaviors, previous studies have shown that support seeking and problem solving are often associated with lower levels of depressive symptoms, while using avoidance can lead to high depressive symptoms (Crockett et al 2007; Martin et al 2013; Roohafza et al 2014) On the basis of the findings from existing research, in the current study it is hypothesized that 1) family life stress will be positively associated with depression among Vietnamese marriage migrant women; 2) self-esteem and coping behaviors will mediate the effects of family life stress on depression Specifically, it is further hypothesized that 2-1) low self-esteem will augment the effects of family life stress on depression; 2-2) problem-solving behaviors will reduce the effects of family life stress on depression; 2-3) support-seeking behaviors will reduce the effects of family life stress on depression; 2-4) avoidant behaviors will augment the effects of family life stress on depression The conceptual research model for this study is shown in Figure N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 199 Figure 1: Research model (Adapted from Wolf, Stidham, and Ross 2015) Methods 3.1 Study design This study used a quantitative-qualitative explanatory sequential design in which the qualitative data were used to illuminate the quantitative results (Creswell 2006) The purpose of this design was to gain more detailed information about family life stress and specific coping behaviors among Vietnamese marriage migrant women The study was approved by Seoul National University’s Institutional Review Board (approval number 1503/001-003) 3.2 Quantitative phase The quantitative data were obtained via a crosssectional survey, using a structured questionnaire Criteria for selecting the participants for the quantitative phase included (1) Vietnamese women; (2) being married with Korean men; (3) currently residing in South Korea; (4) having basic reading ability in the Vietnamese language; and (5) being willing to participate the survey Two sampling techniques were used in this phase: (1) convenience sampling, drawn from multicultural family support centers; and (2) snowball sampling, with participants referred to the researcher by other participants of the study Data collection was performed both directly by the researcher and indirectly by some representative participants Totally, 420 questionnaires were distributed to Vietnamese marriage migrant women residing in Seoul city, Incheon city, and Gyeonggi, Gyeongsang, Chungcheong and Jeolla provinces over two months of June and July, 2015; of these, 400 questionnaires were returned in which 30 obtained by convenience sampling and 370 obtained by snowball sampling Then, 60 cases were excluded due to missing and 301 cases having children were used in the final analysis as the aim of the study is to investigate the impact of stress including child-related stressors on mental health among Vietnamese women 3.3 Questionnaire A comprehensive questionnaire was created including four widely used standardized 200 N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 questionnaires: the Center for Epidemiologic Studies Depression Scale (CES-D), the Family Inventory of Life Events and Change (FILE), the Rosenberg Self-Esteem Scale (RSES), and the Coping Strategy Indicator (CSI) Specifically, the Vietnamese version of the CES-D (Radloff 1977) was used to explore depressive symptoms among Vietnamese wives in South Korea This is a 20-item self-reported scale that assesses the severity of depressive symptoms during the past week on a 4-point Likert scale (ranging from = “less than one day” to = “five to seven days”) Items were scored either 0-3 or 3-0 with positive items (items 4, 8, 12, and 16) being scored reversely Possible range of scores is zero to 60, with the higher scores indicating the presence of more symptomatology This scale has been validated in Vietnamese language (Nguyen et al 2007) High internal consistency has been reported with Cronbach’s alpha coefficients ranging from 87 to 92 among Vietnamese population samples (Doan 2011; Nguyen et al 2007) The scale also showed very good internal consistency (α = 89) in this study Family life stress was measured through a 28item scale which was adopted and standardized by Choi (1990) from the 71-item FILE (McCubbin et al 1981) This scale addresses five aspects of life which can cause stress, including difficult relationships to the husband, children, parents-inlaw, and economic and health problems For each of items, respondents reported the degree to which they perceived the problems using a 5-point Likert scale ranging from “strongly disagree (0)” to “strongly agree (4)” Factor scores were calculated as the mean of each participant’s responses to all items in the scale Higher scores indicate higher levels of stress The internal consistency (.95) of the scale has been established with 289 Vietnamese, Filipino, Chinese, Mongolian, Thailand, and Japanese wives living in Seoul city and Gyeonggi province, South Korea (Park 2012) The scale also had good internal consistency (α = 92) in this study Additionally, the internal consistency of each of the five subscales was moderate with 80 for Marital Stress (6 items), 73 for Parenting Stress (5 items), 87 for In-law Stress (6 items), 65 for Financial Problems (6 items), and 64 for Health Problems (5 items) The Vietnamese version of the RSES (Rosenberg 1965) was adopted to measure feelings of self-worth and self-acceptance among the participants All items were answered using a 5point Likert scale format ranging from strongly disagree (0) to strongly agree (4) Negativelyphrased items were reverse scored Factor scores were calculated as the mean of each participant’s responses to all items, with higher scores indicating higher self-esteem The internal consistency (.86) and the test-retest reliability (.80) of this scale were established with Vietnamese-born students in America (Dinh et al 1994) In this study, the internal consistency of the RSES was 72 The CSI (Amirkhan 1990) was used to identify specific coping behaviors the participants used to cope with life stress Respondents were asked to identify a stressful event occurring within the last six months and to consider the manner in which they had coped with it For each of items, respondents reported the degree to which they used the strategy by using a 3-point Likert scale: not at all (0), a little (1), or a lot (2) Each of the three subscales (Seeking Social Support, Problem Solving, and Avoidance) contained 11 items, and subscale scores were calculated as the mean of each participant’s responses to appropriate items Higher scores reflect greater use of a specific coping strategy Li (2014) affirmed the CSI scale’s validity and reliability on Asian samples In this study, Cronbach’s alpha coefficients also indicated adequate internal consistency for the scale (.89), and for each of the subscales with 83 for Seeking Social Support, 87 for Problem Solving, and 75 for Avoidance N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Additionally, the questionnaire comprised sociodemographic characteristics, including age, education, monthly income, length of stay, use of broker agency, and Korean language, which were used as control variables in this study as these variables have been found to influence depressive symptoms among marriage migrant women (Ha et al 2013; Kang et al 2010; Youn et al 2010; Won et al 2014) Age was measured by asking respondents to indicate their exact age Education was measured by asking respondents to indicate the highest education they received, ranging from zero (no education at all), one (elementary school), to five (university or more) Income was measured by asking respondents to indicate the average monthly salary they earned from work, ranging from zero (no income), one (less than 500,000 won), to five (more than 3,000,000 won) Length of stay was measured by asking respondents how long they had been living in Korea in year- and month-unit Use of broker agency was measured by asking respondents whether they married the current spouse through a marriage broker The last control variable was Korean language proficiency which was measured by asking respondents’ perception of how fluent they were in Korean speaking, listening, reading, and writing on a 5-point Likert scale, ranging from one (very poor) to five (very good) In the regression model, factor scores were calculated as the mean of participant’s responses to all items of four skills, with higher scores indicating higher levels of language ability In the current study, quantitative data were coded and entered into the Statistical Package for Social Science (SPSS) program (version 21) for statistical analysis The method of regression analysis was utilized to test the research questions and hypotheses The process of analysis included the initial and main analysis phases The initial analysis phase was descriptive statistics of all variables to provide information on general characteristics of the participants, and the main 201 analysis included three regression models to identify the relationships among the variables In particular, I used bootstrap method through the PROCESS macro for SPSS developed by Hayes (2013) to test a multiple mediator model with four mediators: selfesteem, problem solving, support seeking, and avoidance Bootstrapping is a nonparametric approach involving the process of repeatedly sampling from the data set and estimating the indirect effect in each resampled data set based on confidence intervals (Hayes 2008) There is significant mediation at the 05 level if the biascorrected 95% confidence interval excludes zero (Hayes 2013) The mediating effects of four mediators were assessed based on Baron and Kenny’s (1986) four steps in establishing mediation 3.4 Qualitative phase In the qualitative phase, I used a multiple case study approach (Yin 2002) to provide the rich and detailed descriptions of the participants’ experiences (Monette et al 2005) of stress and coping through in-depth semistructured telephone interviews in Vietnamese with five participants who completed the survey Each of the interviews took approximately 1-1.5 hour(s) The interview questions included: (1) How you feel about your family life in South Korea? (2) What makes you stressed in your family life in South Korea? (3) How does that stressor affect your mental health? (4) How you cope with your family life stress? Five telephone interviews were recorded and transcribed verbatim Data were analyzed using Rubin and Rubin’s (1995) formal systems for the analysis of qualitative data (coding, categorizing, linking different themes to one another) (O’Connor and Gibson 2003) Quantitative results 4.1 Descriptive statistics Descriptive statistics for the variables are shown in Table 202 N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Table 1: Descriptive statistics (n = 301) Variables Age Education None Elementary school Middle school High school Vocational school University or more Monthly income None Below KRW 500,000 KRW 500,000–999,000 KRW 1,000,000–1,999,000 KRW 2,000,000–2,999,000 More than KRW 3,000,000 Length of stay Use of broker agency No Yes Korean language proficiency Listening Speaking Reading Writing Depression Family life stress Marital stress Parenting stress In-law stress Financial problems Health problems Self-esteem Coping behaviors Problem solving Support seeking Avoidance Frequency (%) 301 (100) Mean (SD) 29.49 years (5.49) (0.7) 23 (7.6) 85 (28.2) 119 (39.5) 41 (13.6) 31 (10.3) 170 (56.5) (3.0) 34 (11.3) 70 (23.3) 14 (4.7) (1.3) 301 (100) 5.25 years (3.45) 143 (47.5) 158 (52.5) 301 (100) 301 (100) 301 (100) 301 (100) 301 (100) Note: SD = standard deviation With respect to socio-demographic characteristics, the mean age of the participants at the time of the survey was 29.49 years (SD = 5.49) The majority (76.1%) of the participants had high school education or less, while 13.6% completed vocational school and 10.3% were university graduates or more Regarding monthly income, 56.5% of the participants 3.31 (.88) 3.19 (.87) 3.36 (.86) 3.12 (.88) 22.31 (11.35) 1.66 (.59) 1.66 (.77) 1.69 (.71) 1.61 (.86) 1.77 (.60) 1.55 (.70) 2.34 (.47) 1.24 (.44) 1.02 (.40) 0.81 (.35) reported to have no income or to be unemployed Of the employed, 37.6% reported their monthly income of less than two million won, while only 6.0% reported higher income levels The average length of stay in Korea of the participants was 5.25 years (SD = 3.45) More than a half of the participants (52.5%) used a marriage broker for the current transnational marriage In terms of N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Korean language ability, the mean score for reading skills was the highest (M = 3.36, SD = 0.86), while the mean score for writing was the lowest (M = 3.12, SD = 0.88) As for depression, the mean score for this factor was 22.31 (SD = 11.35), higher than the cut-off score over 21 for having depressive symptoms (Cho & Kim, 1998).The mean score for family life stress was 1.66 (SD = 0.59) Specifically, financial hardship appeared to be the biggest life stressor (M = 1.77, SD = 0.60), while health problems were the smallest stressor (M = 1.55, SD = 0.70) among the participants The mean score for self-esteem was 2.34 (SD = 0.47) Regarding coping behaviors, the participants tended to use problem-solving behaviors (M = 1.24, SD = 0.44) more than support-seeking (M = 1.02, SD = 0.40) or avoidance behaviors (M = 0.81, SD = 0.35) 4.2 Mediation analysis The results for the mediation analysis are shown in Table In the first step (Model 1), family life stress was included in the model to examine its total effects on depression while controlling for socio-demographic variables This model accounted for 27.7% of the explained variance in depression (R2 = 277, F(7, 293) = 16.071, P< 001) The findings show that a high level of family life stress predicted higher levels of depressive symptoms (b = 8.133, P< 001) Of the socio-demographic variables, only Korean language showed a significant effect on depression with low language proficiency associated with high levels of depressive symptoms (b = -2.883, P< 001) In the second step (Model 2), the relationships between family life stress and mediators were explored, controlling for sociodemographic variables As can be seen in the 203 table, family life stress showed its significant effects on self-esteem and avoidance coping, but not problem-solving or support-seeking behaviors Specifically, a high level of family life stress predicted lower levels of self-esteem (b = -0.299, P< 001) and greater use of avoidance behaviors (b = 0.223, P< 001) In the final model (Model 3), the relationships between mediators and depression were examined while controlling for family life stress In this model, the predictors accounted for 41.2% of the explained variance in depression (R2 = 412, F (11, 289) = 18.381, P< 001) Selfesteem negatively predicted depression, indicating that low self-esteem was linked to a high level of depressive symptoms (b = -7.040, P< 001) Of the three types of coping behaviors, only avoidance was significantly associated with depression with greater use of avoidance related to higher levels of depressive symptoms (b = 8.641, P< 001) Based on these findings, the mediating roles of self-esteem and avoidance coping were assessed in the following step The results obtained in Model showed that family life stress was still a significant predictor for depression when mediators were controlled (b = 4.153, P< 001) Also, there was a decrease in its effect on depression when mediators were included (b1 = 8.133, P< 001; b2 = = 4.153, P< 001; where b1 is the total effect of family life stress on depression in Model 1, and b2 is the direct effect of family life stress on depression while controlling for mediators in Model 3) Such findings supported the partial mediation of self-esteem and avoidance (Baron et al 1986) Thus, a bootstrap analysis was performed to test the statistical significance of the indirect effects of self-esteem and avoidance on the relationship between family life stress and depression The bootstrapping estimates are shown in Table N T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 204 Table 2: Results of the mediation analysis [Model 2] Stress → Mediators [Model 1] [Model 3] Stress → Variables Depression Stress, Mediators → Depression Self-esteem Problem solving Support seeking Avoidance B (SE) B (SE) B (SE) B (SE) B (SE) B (SE) 14.932** (5.214) 2.022*** (.218) 0.893*** (.229) 0.809*** (.216) 0.568** (.175) 24.918*** (5.542) Age -0.004 (.142) 0.013* (.006) 0.008 (.006) -0.001 (.006) -0.007 (.005) 0.143 (.131) Education 0.161 (.569) 0.012 (.024) 0.057* (.025) 0.035 (.024) 0.018 (.019) 0.110 (.522) Monthly income 0.475 (.413) -0.012 (.017) -0.038* (.018) -0.001 (.017) 0.003 (.014) 0.379 (.379) Length of stay 0.287 (.219) 0.007 (.009) 0.011 (.010) 0.005 (.009) 0.013 (.007) 0.225 (.200) -2.883*** (.810) 0.115*** (.034) -0.023 (.036) 0.008 (.034) -0.018 (.027) -1.903* (.755) 1.543 (1.251) -0.000 (.052) -0.079 (.055) -0.010 (.052) 0.012 (.042) 1.443 (1.143) 8.133*** (1.007) -0.299*** (.042) 0.036 (.044) 0.057 (.042) 0.223*** (.034) 4.153*** (1.040) (Constant) Korean language Use of broker Family life stress Self-esteem -7.040*** (1.354) Problem solving 0.214 (1.491) Support seeking -1.043 (1.539) Avoidance 8.641*** (1.759) R 277 255 067 016 160 412 F 16.071*** 14.299*** 2.997** 0.693 7.979*** 18.381*** Note: * P< 05; ** P< 01; *** P< 001 B = unstandardized coefficient; SE = standard error N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 205 Table 3: Bootstrapping estimates for the indirect effects Path/effect B (SE) 95% CI Family life stress → Self-esteem → Depression 2.106 (.491) [1.269, 3.203] Family life stress → Avoidance → Depression 1.926 (.540) [1.043, 3.184] Note: B = unstandardized coefficient; SE = standard error; CI = confidence interval As can be seen in Table 3, the biascorrected 95% confidence interval for the indirect effects of family life stress on depression through the mediators of selfesteem and avoidance excluded zero, which indicated the significance of these indirect effects (b1 = 2.106, [1.269, 3.203]; b2= 1.926, [1.043, 3.184]) Specifically, a high level of family life stress predicted low self-esteem and/or greater use of avoidance behaviors, which in turn were associated with high levels of depressive symptoms Qualitative findings 5.1 Family life stressors During the interviews the participants shared their own experiences with familyrelated stress in South Korea Four themes emerged including (1) different parenting practices, (2) the devaluation of foreign wives, (3) the unconcernedness of the husband, and (4) the interference or control of the in-laws Different parenting practices “Child-rearing practices are different between Vietnam and Korea, but my husband and mother-in-law always force me to teach the child only in Korean ways This makes me extremely stressed (Interview 2).” The devaluation of foreign wives “My mother-in-law looks down on me for being Vietnamese and young She considers that all things of Vietnam, food for example, are not good Sometimes, I made Vietnamese food at home but she (mother-in-law) dumped it into the wastebasket (Interview 3).” “My husband looks down on me because he gave money to marry me, so my child also does not respect me… Sometimes, I regret coming here… (Interview 4).” The unconcernedness of the husband “My husband is unconcerned with my feelings or interests He got married only for having someone to take care for him and his family… He thinks he only needs to give me money… But I, as a Vietnamese woman and a wife, need his love and concern, not material things… (Interview 5).” The interference or control of the in-laws “My mother-in-law interferes with everything I do, from my room decoration, moving in… to parenting and matters with my husband (Interview 3).” “I can go out only with my husband or inlaws… They (husband and in-laws) not allow me to meet many Vietnamese people because they think that it would bring about a lot of “bad” things (Interview 1).” 5.2 Stress and mental health According to the qualitative data, the participants expressed their feelings of complete isolation, depression or desperation when experiencing family life stress “I felt completely isolated from my Korean family when I suffered from stress in the 206 N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 relationships with my husband and in-laws… (Interview 1).” “I felt low self-esteem, no hope, and absolutely depressed when I had many problems with my in-laws… I even thought of suicide… (Interview 3).” 5.3 Stress coping behaviors The qualitative data illuminated in more detailed coping behaviors that Vietnamese wives employed when experiencing family life stress Four themes were revealed from the interviews: (1) avoidance; (2) positive thinking; (3) problem solving; and (4) support seeking Avoidance Two of the five participants attempted to avoid facing up to the stress through withdrawal/isolation and distraction One participated in social activities or used alcohol to distract herself from uncomfortable feelings “When I got stressed, I often spent time alone… I did not talk to anyone… (Interview 1).” (withdrawal/isolation) “I tried to forget stressful experiences by participating in many social activities… Sometimes, I turned to drink heavily… (Interview 4).” (distraction) Positive thinking “I thought of my child, of the whole family… and tried to live for the child’s better future (Interview 2).” Problem solving “I decided to take part in Korean language classes to improve my language… so that I can exactly express my opinions and educate my children (Interview 3).” Support seeking “When I felt stressed-out, I went to meet my friends (both Korean and Vietnamese), talked about my problems and asked for their advice (Interview 5).” Discussion The present mixed-methods study aims to examine the effects of family life stress on depression and some coping resources (selfesteem, specific coping behaviors) in this relationship among 301 Vietnamese marriage migrant women in South Korea Quantitatively, the first hypothesis was supported with family life stress being positively associated with depression, replicating the findings of earlier research on marriage migrant women (Ha and Kim 2013; Kim et al 2013; Shu et al 2011) The qualitative results provided more detailed information about such negative feelings when Vietnamese wives experienced family life stress as complete isolation from the family or desperation While previous studies primarily focus on acculturative stress, this finding highlights the significant influence of familyrelated stress on mental health among Vietnamese marriage migrant women in South Korea In particular, according to the qualitative data, different parenting practices, the Korean family’s devaluation of foreign wives, the unconcernedness of the husband, and the interference or control of the in-laws were reported stressors in family life among Vietnamese migrant wives Indeed, individuals may potentially well cope with stress associated with immigration or acculturation such as homesickness or language barriers over time (Oberg 1960) Nevertheless, everyday stressors related to relationship problems in the family can accumulate and cause serious consequences on immigrants’ mental health status (Noh et al 1996) Quantitatively, the second hypothesis was partially supported with self-esteem and avoidant coping behaviors mediating the effects of family life stress on depression More specifically, the findings support hypothesis 21 by showing that self-esteem augments the N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 effect of family life stress on depression, which is consistent with many other researchers (Jesse et al 2014; Lee et al 2013; Pearlin et al 1981) However, of three types of coping, only avoidance significantly mediates the effect of family life stress on depression, supporting hypothesis 2-4 and the existing research on the positive relationships between stress, avoidance, and depression (Dulin et al 2010; Yakhnich et al 2008) This indicates that engagement in avoidant more than supportseeking or problem-solving behaviors when experiencing family life stress can make Vietnamese marriage migrant women more vulnerable to depressive symptoms The qualitative results also confirmed that avoidance behaviors (withdrawal, distraction) are used in Vietnamese wives when they are under stress This result may be related to limited social support and negative feelings among persons who are experiencing stressful family relationships (Choi et al 2008) In general, marriage is expected to bring greater emotional support, social support, and meaning or purpose in life, which contributes to improved mental health (Umberson 1987; Waite et al 2003) Therefore, an unhappy marriage may cause women to feel disappointed or helpless, and limit their desire to seek help from the husband or others (Choi et al 2008), leading to their use of avoidance rather than support-seeking or problem-solving behaviors to cope with family life stress On the other hand, the use of avoidant coping in dealing with family life stress among Vietnamese marriage migrant women may be understood from their specific context that these foreign wives often migrate to South Korea alone (Kim et al 2013), leading to their lack of social support which is needed for them to deal with their life problems and enhance mental well-being (Kim 2011) Further, as stated, Vietnamese women’s use of avoidance may also involve the perspective on the so- 207 called “saving face” culture in Asians, which indicates that Asians traditionally are less likely to express their emotional problems in order to maintain familial harmony, or to avoid showing personal weakness (Inman et al 2007; Kramer et al 2002) In addition, fear of discrimination in the family, difficulty in Korean language, and concerns about privacy and the children also may prevent Vietnamese wives from seeking help when they experience domestic problems (Park 2012) The quantitative results showed that although the mediation of avoidance was found in the expected direction, problem solving and support seeking were not significant mediators of the relationship between family life stress and depression, thus disconfirming hypotheses 2-2 and 2-3 This finding is consistent with Thorsteinsson and associates' (2013) in that support seeking does not mediate the stressdepression relationship, but inconsistent with other studies reporting the significant mediating role of problem solving between life stress and depression (Kant, D’Zurilla, and Maydeu-Olivares 1997) However, my qualitative results revealed that some Vietnamese wives utilize problem-solving and support-seeking behaviors to cope with their stress According to Delongis and Holtzman (2005), the inconsistent findings on coping behaviors may be due to the nature of the stressful situation, the social context, and the individual’s personality (Thorsteinsson et al 2013) Unexpectedly, positive thinking was emerged as a coping behavior used by Vietnamese wives from the qualitative results This finding is consistent with Choi and Eom’s (2012) qualitative study indicating that marriage migrant women utilize positive thinking (e.g “try to live for the child and the parents”) as a positive coping strategy in their lives in South Korea 208 N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Conclusion The present study illuminates the experiences of family life stress and coping resources among Vietnamese marriage migrant women in South Korea both quantitatively and qualitatively The study has demonstrated the direct effect of family life stress on depression as well as its indirect effects through selfesteem and avoidance behaviors among Vietnamese women Especially, the qualitative data provides a richer understanding of familyrelated stressors experienced by the participants and their specific coping behaviors when facing up to stress Although the findings cannot be generalized to all Vietnamese migrant wives, the current research is the first known mixed-methods study on family life stress and coping among marriage migrant women in South Korea The results demonstrate that family life stress can indirectly lead to development of depression by weakening self-esteem and increasing maladaptive coping behavior (i.e avoidance) among Vietnamese women This raises a research-worthy topic on the pathways of family life stress to depression through different coping resources among marriage migrant women On the other hand, the findings suggest that social workers should develop and provide individualized training programs in psychology for Vietnamese wives to help them deal with life stress For instance, social workers may help their clients understand the nature of the problems, the different effects of coping behaviors, and may direct them to access resources that can help them find the solutions Further, the study recommends that policy makers be more concerned about family issues and psychological problems among marriage migrant women The Korean government to date has implemented policies to help migrant wives adapt to the Korean society Most of these policies, however, focus on services for sociocultural adaptation such as Korean language teaching or supporting employment for marriage migrants (Kim and Lee 2010) It is suggested that the government should expand support projects by implementing a variety of consulting and education programs for the whole multicultural families, including migrant wives and their Korean husbands as well as the in-laws, not only for marriage migrants Such programs may be built in relation to the migrant wife’s mother language and culture, Korean and Vietnamese family values, and supportive communication skills among family members By doing so, it is expected to indirectly reduce levels of family stress and mental health problems in marriage migrant women in particular as well as the quality of life in multicultural families in general Limitations of the current study are related to its sampling methods Using a mix of convenience and snowball sampling techniques could produce a less-representative sample of the population (Monette et al 2005) Moreover, the cross-sectional nature of the data used in this study cannot address causal relations among the variables Future research should be undertaken longitudinally to give clearer understanding of the effects of stress on mental health among marriage migrant women, using more representative sampling methods In addition, qualitative research studies will be useful in exploring the nature of stressful situations, social context, and migrant wives’ beliefs in using coping behaviors References Ager, A., and MacLachlan, M 1998 Psychometric properties of the Coping Strategy Indicator (CSI) in a study of coping behaviour amongst Malawian students Psychology and Health 13: 399-409 N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Amirkhan, J H 1990 A factor analytically derived measure of coping: The Coping Strategy Indicator Journal of Personality and Social Psychology, 59: 1066-1074 Baron, R M., & Kenny, D A 1986 The moderatormediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations Journal of Personality and Social Psychology 51(6): 1173-1182 Berry, J W 1997 Immigration, Acculturation, and Adaptation Applied Psychology: An International Review 46 (1): 5-68 doi: 10.1080/026999497378467 Berry, J W 2006 Stress perspectives on acculturation In The Cambridge of acculturation psychology, eds D L Sam and J W Berry, 4357 New York, NY: Cambridge University Press Byun, S W 2012 Depression Experiences of Vietnamese Migrant Intermarriage Women Doctoral dissertation, Soonchunhyang University, Korea (in Korean) Castro, F.G., and Murray, K.E 2010 Cultural adaptation and resilience: Controversies, issues and emerging models In Handbook of Adult Resilience, eds J.R Reich, A.J Zautra, and J.S Hall, 375-403 New York: Guilford Crockett, L J., Iturbide, M I., Torres Stone, R A McGinley, M., et al 2007 Acculturative Stress, Social Support, and Coping: Relations to Psychological Adjustment among Mexican American College Students Faculty Publications, Department of Psychology Paper 299 http://digitalcommons.unl.edu/psychfacpub/299 Cha, S E., and Kim, D S 2008 The Effect of Social Roles on Depression of Foreign Wives in Korea: Focused on the Difference among Japanese, Chinese and Vietnamese Wives Korean Demography 31 (3): 131-157 (in Korean) Chae, S M., Park, J W., and Kang, H S 2014 Relationships of Acculturative Stress, Depression, and Social Support to HealthRelated Quality of Life in Vietnamese Migrant Women in South Korea Journal of Transcultural Nursing 25 (2): 137-144 doi: 10.1177/1043659613515714 Choi, H., and Marks, N F 2008 Marital Conflict, Depressive Symptoms, and Functional 209 Impairment Journal of Marriage and Family 70 (2): 377-390 Choi, S Y., Kim, E J., Ryu, E., Chang, K O., and Park, M N 2012 Postpartum Depression and Parental Self-efficacy: A Comparison of Native Korean and Vietnamese Immigrant Mothers in Korea Journal of Transcultural Nursing 23 (2): 181-187 Choi, J S., and Eom, T W 2012 A Study on the Positive Coping Process of the Marriage Immigrant Women Journal of Transactional Analysis and Counseling (1): 83-103 (in Korean) Chung, G H., and Yoo, J P 2013 Using the Multicultural Family Support Centers and Adjustment among Interethnic and Interracial Families in South Korea Interdisciplinary Journal of Applied Family Studies 62(1): 241– 253 doi:10.1111/j.1741-3729.2012.00754.x Creswell, J W 2006 Designing and Conducting Mixed Methods Research SAGE Publications DeLongis, A., and Holtzman, S 2005 Coping in context: The role ofstress, social support, and personality in coping Journal of Personality, Special Issue: Advances in Personality and Daily Experience 73: 1633-1656 doi:10.1111/j.1467-6494.2005.00361.x Desmond, D M., Shevlin, M., and MacLachlan, M 2006 Dimensional analysis of the coping strategy indicator in a sample of elderly veterans with acquired limb amputations Personality and Individual Differences 40: 249-259 Dinh, K T., Sarason, B R., and Sarason, I G 1994 Parent-child relationships in Vietnamese immigrant families Journal of Family Psychology (4): 471-488 Doan, V D K 2011 What Explains the Association between SES and Depression among Vietnamese Adults Doctoral dissertation, Queensland University of Technology Dulin, P L., and Passmore, T 2010 Avoidance of Potentially Traumatic Stimuli Mediates the Relationship Between Accumulated Lifetime Trauma and Late-Life Depression and Anxiety Journal of Traumatic Stress 23 (2): 296-299 Folkman, S., and Lazarus, R.S 1980 An analysis of coping in a middle-aged community sample Journal of Health and Social Behavior 21: 219-239 210 N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Folkman, S 1984 Personal control and stress and coping processes: a theoretical analysis Journal of Personality and Social Psychology 46: 839852 Greenberg, J., Solomon, S., Pyszczynski, T., Rosenblatt, A., Burling,J., and Lyon, D., Pinel, E 1992 Why people needself-esteem? Converging evidence that self-esteem serves ananxiety-buffering function Journal of Personality and Social Psychology 63: 913-922 Ha, J Y., and Kim, Y J 2013 Factors Influencing Depression in Married Immigrant Women in Korea Korean Journal of Women Health Nursing 19 (4): 254-264 (in Korean) Hammen, C 2005 Stress and depression Annual Review of Clinical Psychology 1: 293-319 Hayes, A F 2013 Introduction to Mediation, Moderation, and Conditional Process Analysis The Guilford Press Hoang, B T 2013 Vietnamese Women Marrying Korean Men and Societal Impacts: Case Studies in Dai Hop Commune, Kien Thuy District-Hai Phong City Academic Journal of Interdisciplinary Studies (8): 782-788 doi:10.5901/ajis.2013.v2n8p782 Inman, A G., and Yeh, C 2007 Stress and coping In Handbook of Asian American psychology, eds F T L Leong, A G Inman, A Ebreo, L Lang, L Kinoshita, and M Fu, 323-340 Thousand Oaks, CA: Sage Jeong, H Y., and Kim, J W 2010 Conflict process according to the acculturation of the Vietnamese migrated women’s family in Korea Korean Journal of Social Welfare 62 (2): 29-55 (in Korean) Jesse, D E., Kim, H., and Herndon, C 2014 Social support and self-esteem as mediators between stress and antepartum depressive symptoms in rural pregnant women Research in Nursing & Health 37 (3): 241-252 doi:10.1002/nur.21600 Kant, G L., D’Zurilla, J., and Maydeu-Olivares, A 1997 Social Problem Solving as a Mediator of Stress-Related Depression and Anxiety in Middle-Aged and Elderly Community Residents Cognitive Therapy and Reseasrch 21 (1): 73-96 Kang, Y M., and Shin, H J 2010 A Qualitative Study on the Successful Adjusting Process of Migrant Wives in Korea Korean Journal of Counseling 11 (4): 1393-1410 (in Korean) Karasz, A 2005 Cultural differences in conceptual models of depression Social Science & Medicine 60 (7): 1625-1635 Kim, H S., Sherman, D K., Ko, D., and Taylor, S E 2006 Pursuit of happiness and pursuit of harmony: Culture, relationships, and social support seeking Personality and Social Psychology Bulletin 32: 1595-1607 Kim, S.-Y., and Shin, Y.-Y 2007 Multicultural families in Korean rural farming communities: Social exclusion and policy response Paper presented at the Fourth Annual East Asian Social Policy research network (EASP) International Conference, 20th-21st October 2007, Tokyo Kim, S G., and Lee, C J 2010 The effect of linguistic ability and social support on adjustment among women of multicultural families in Korea Korean Journal of Family Welfare 15 (1): 5-20 (in Korean) Kim, Y S 2011 Development of an Acculturation Scale for Female Marriage migrants in Korea The Women's Studies 81 (2): 103-146 (in Korean) Kim, K., and Choi, J 2011 A Study on Stress, Coping Style and Family Strength of International Marriage Immigrant Women Research on Secondary Education 23: 29-48 (in Korean) Kim, G S., Kim, B., Moon, S S., Park, C G., and Cho, Y H 2013 Correlates of Depressive Symptoms in Married Immigrant Women in Korea Journal of Transcultural Nursing 24 (2): 153-161 Knodel, J., Loi, V M., Jayakody, R., and Huy, V T 2004 Gender Roles in the Family: Change and Stability in Vietnam Population Studies Center, University of Michigan 04-559: 1-25 Kramer, E J., Kwong, K., Lee, E., and Chung, H 2002 Cultural factors influencing the mental health of Asian Americans Western Journal of Medicine 176: 227-232 Lee, JS., Joo, EJ., and Choi, KS 2013 Perceived stress and self-esteem mediate the effects of work-related stress on depression Stress Health 29 (1): 75-81 doi: 10.1002/smi.2428 Lee, E., Kim, S., and Lee, J K 2015 Precarious motherhood: Lives of Southeast Asian marriage migrant women in Korea Asian Journal of Women’s Studies 21 (4): 409-430 N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Li, M 2014 A Cross-Country Exploration of Factors Contributing to Problem Solving and Avoidance Paper presented at the Global Awareness Society International 23nd Annual Conference, Montego Bay Jamaica, May 2014 Lim, E., Jeong, S., and Lee, S 2010 Marriage-Based Immigrant Women’s Cultural Adaptation Types and Acculturation Stress Korean Journal of Counseling 11 (3): 957-973 (in Korean) Martin, C I., Dovey, T M., Coulthard, H., and Southall, A M 2013 Maternal stress and problem-solving skills in a sample of children with nonorganic feeding disorder Infant Mental Health Journal 34: 202-210 McCubbin, H I., Patterson, J M., and Wilson, L R 1981 FILE: Family Inventory of Life Events and Changes: Research instrument St Paul: Family Social Science, University of Minnesota Monette, D R., Sullivan, T J., and DeJong, C R 2005 Applied Social Research: A Tool for the Human Services 6th Edition, Thomson Learning Inc., Toronto Nam, B H 2010 Multicultural Families Jangseowon Publishing (in Korean) Noh, S., and Avison, W R 1996 Asian Migrants and the Stress Process: A Study of Koreans in Canada Journal of Health and Social Behavior 37 (2): 192206 Nguyen, A 2003 Cultural and social attitudes towards mental illness in Ho Chi Minh City, Vietnam Stanford Undergraduate Research Journal 2: 27-31 Nguyen, T H., Le, V A., and Dunne, M 2007 Gia tri va tin cay cua hai thang tram cam va lo au su dung nghien cuu cong dong doi voi doi tuong vi nien Journal of Public Health (7): 2531 (in Vietnamese) Oberg, K 1960 Culture shock: Adjustment to new cultural environments Practical Anthropology 7: 177-182 O’Connor, H., and Gibson, N 2003 A Step-by-step Guide to Qualitative Data Analysis A Journal of Aboriginal & Indigenous Community Heal (1): 63 Park, D S 2012 A Study on the Korean Society Adaptation of Marriage Migrant Women Korean Journal of Social Work Practice 4(1): 1-23 (in Korean) 211 Paykel, E S 2003 Life events and affective disorders Acta Psychiatrica Scandinavica 418: 61-6 Pearlin, L I., and Schooler, C 1978 The Structure of Coping Journal of Health & Social Behavior 19 (1): 2-21 Pearlin, L I., Lieberman, M A., Menaghan, E G., and Mullan, J T 1981 The Stress Process.Journal of Health and Social Behavior 22 (4): 337–356 Radloff, L S 1977 The CES-D Scale: A self-report depression scale for research in the general population Applied Psychological Measurement (3): 385-401 Roh, S Y., and Kim, E Y 2012 Factors Influencing Depression of Marriage Immigrant Women in Rural Areas Korean Journal of Adult Nursing 24 (4): 370-379 (in Korean) Roohafza, H R., Afshar, H., Keshteli, A H., et al 2014 What’s the role of perceived social support and coping styles in depression and anxiety? J Res Med Sci 19 (10): 944-949 Rosenberg, M 1965 Society and the adolescent selfimage Princeton, NJ: Princeton University Press Rubin, J H., and Rubin, S J 1995 Qualitative Interviewing, the Art of Hearing Data Sage Publications, Thousand Oaks California Shu, B C., Lung, F W., and Chen, C H 2011 Mental health of female foreign spouses in transnational marriages in southern Taiwan BMC Psychiatry 11: Statistics Korea 2015 The number of marriage migrant women Retrieved November 28, 2015, from the Korean Statistical Information Service website: http://kosis.kr/statHtml/statHtml.do?orgId=110&tblId =TX_11025_A010&vw_cd=MT_OTITLE&list_i d=110_11025_005&scrId=&seqNo=&lang_mode =ko&obj_var_id=&itm_id=&conn_path=E1# (in Korean) Thorsteinsson, E B., Ryan, S M., and Sveinbjornsdottir, S 2013 The Mediating Effects of Social Support and Coping on the StressDepression Relationship in Rural and Urban Adolescents Open Journal of Depression (1): 16 Umberson, D 1987 Family status and health behaviors: Social control as a dimension of social integration Journal of Health and Social Behavior 28: 306-319 212 N.T P Thao / Journal of Social Sciences and Humanities, Vol 2, No (2016) 194-212 Waite, L J., and Lehrer, E L 2003 The Benefits from Marriage and Religion in the United States: A Comparative Analysis Population and Development Review 29 (2): 255-276 Williams, C L., and Berry, J W 1991 Primary prevention of acculturative stress among refugee: application of psychological theory and practice Am Psycho 46: 632-641 Won, S., and Kim, H 2014 Importance of Family Values Difference Between Husbands and Wives in Determining Depression in Foreign Wives in Korean Multicultural Families: Examining the Moderating Effect of Social Support Asian Social Work and Policy Review 8: 1-15 Wong, Y J., Kim, S.-H., and Tran, K K 2010 Asian Americans’ Adherence to Asian Values, Attributions about Depression, and Coping Strategies Cultural Diversity and Ethnic Minority Psychology 16 (1): 1-8 Yakhnich, L., and Ben-Zur, H 2008 Personal Resources, Appraisal, and Coping in the Adaptation Process of Migrants From the Former Soviet Union American Journal of Orthopsychiatry 78 (2): 152–162 Yin, R K 2002 Case Study Research: Design and Methods, 3rd ed Thousand Oaks, Calif.: Sage Youn, H., and Lee, Y 2010 Mental Health of Vietnamese Migrant Wives Married to Koreans: Focus on Urban-rural Differences Korean Journal of Clinical Psychology 29: 659-684 (in Korean) Stress sống gia đình, nguồn lực đối phó, sức khỏe tinh thần phụ nữ di trú kết hôn Việt Nam Hàn Quốc: Một nghiên cứu tích hợp Nguyễn Thị Phương Thảo Tóm tắt: Số phụ nữ Việt Nam kết hôn với người Hàn di trú đến Hàn Quốc ngày tăng lên Những phụ nữ phải chịu nhiều áp lực, căng thẳng thần kinh (stress) sống gia đình mơi trường xa lạ Mặc dù có nhiều nghiên cứu stress liên quan đến việc thích nghi với văn hóa Hàn Quốc phụ nữ di trú kết hôn Việt Nam, cơng trình nghiên cứu tìm hiểu stress sống gia đình ảnh hưởng tiêu cực stress đến sức khỏe tinh thần họ Vì vậy, tiến hành nghiên cứu nhằm mối tương quan stress đời sống gia đình trầm cảm, đồng thời tìm hiểu vai trị trung gian vài yếu tố liên quan đến nguồn lực đối phó với stress (lịng tự trọng, hành vi đối phó) mối quan hệ Nghiên cứu kết hợp hai phương pháp nghiên cứu định lượng định tính Dữ liệu định lượng thu thập thơng qua khảo sát với 301 phụ nữ Việt Nam kết hôn với người Hàn sinh sống Hàn Quốc Dữ liệu định tính thu thập thông qua vấn sâu (in-depth interview) với năm phụ nữ di trú kết hôn Việt Nam phân tích dựa theo đề mục nội dung (thematic analysis) Kết nghiên cứu vai trò trung gian lòng tự trọng hành vi né tránh mối quan hệ stress sống gia đình trầm cảm Cụ thể việc chịu nhiều stress sống gia đình có liên quan đến lòng tự trọng thấp việc sử dụng hành vi tiêu cực để đối phó (né tránh), từ dẫn đến mức độ trầm cảm cao Dựa kết nghiên cứu này, viết đưa vài hàm ý cho việc nghiên cứu thực hành cơng tác xã hội Từ khóa: Stress sống gia đình; đối phó với stress; trầm cảm; phụ nữ di trú kết hôn Việt Nam; Hàn Quốc  ... defined in recent years as a major global public health problem (Karasz 2005) In South Korea, depression is also arising as a major mental health problem among marriage migrant women (Kim et al 2010)... research is the first known mixed- methods study on family life stress and coping among marriage migrant women in South Korea The results demonstrate that family life stress can indirectly lead... primarily focus on acculturative stress, this finding highlights the significant influence of familyrelated stress on mental health among Vietnamese marriage migrant women in South Korea In particular,