title: Changes in perceived filial obligation norms among coresident family caregivers in Japan.
abstract: OBJECTIVE
  Japan introduced a nationwide long-term care insurance (LTCI) system in 2000, making long-term care (LTC) a right for older adults regardless of income and family availability. To shed light on its implications for family caregiving, we investigated perceived filial obligation norms among coresident primary family caregivers before and after the policy change.
  
  
  METHODS
  Descriptive and multiple regression analyses were conducted to examine changes in perceived filial obligation norms and its subdimensions (financial, physical, and emotional support), using 2-wave panel survey data of coresident primary family caregivers (N = 611) in 1 city. The baseline survey was conducted in 1999, and a follow-up survey 2 years later.
  
  
  RESULTS
  On average, perceived filial obligation norms declined (p < .05). Daughters-in-law had the most significant declines (global and physical: p < .01, emotional: p < .05) among family caregivers. In particular, physical support, which Japan's LTC reform targeted, declined significantly among daughters and daughters-in-law (p < .01). Multiple regression analysis indicated that daughters-in-law had significantly lower perceived filial obligation norms after the policy introduction than sons and daughters (p < .01 and p < .05, respectively), controlling for the baseline filial obligation and situational factors.
  
  
  CONCLUSIONS
  Our research indicates declining roles of daughters-in-law in elder care during Japan's LTCI system implementation period. Further international efforts are needed to design and implement longitudinal studies that help promote understanding of the interplay among national LTC policies, social changes, and caregiving norms and behaviors.
authors.affiliation: National Institute of Public Health, Ministry of Health, Labour and Welfare, Saitama, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Tsutsui
authors.affiliation: School of Public Health, University of Illinois at Chicago. naoko@uic.edu.
authors.forename: Naoko
authors.initials: N
authors.lastname: Muramatsu
authors.affiliation: School of Management and Information, University of Shizuoka, Japan.
authors.forename: Sadanori
authors.initials: S
authors.lastname: Higashino
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007353:Insurance, Long-Term Care; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010287:Parent-Child Relations; D010465:Perception; D012044:Regression Analysis; D012111:Residence Characteristics; D012380:Role; D012941:Social Responsibility; D012944:Social Support
keywords: Caregiving norms; Informal care; Long-term care insurance system