title: Adaptation in families of children with Down syndrome in East Asian countries: an integrative review.
abstract: OBJECTIVE
  The purpose of this integrative literature review was to understand the experiences of East Asian families of children with Down syndrome and identify factors affecting their adaptation in the Resiliency Model of Family Stress, Adjustment and Adaptation.
  
  
  BACKGROUND
  Socio-cultural factors influence how well families adapt following the birth of a child with Down syndrome. Existing literature in this area has focused primarily on families from Western cultures. This is problematic because nurses care for families from all over the world. Therefore, the focus of this review is on families of children with Down syndrome living in East Asia, where Confucianism is dominant.
  
  
  METHODS
  Integrative literature review.
  
  
  METHODS
  Online databases (i.e. PubMed, CINAHL and PsycINFO) and a public search engine (i.e. Google Scholar) were used along with manual searches of reference lists and major journals. Studies were limited to original publications written in English and published between 1990-2014.
  
  
  METHODS
  Two authors independently performed integrative review processes proposed by Whittemore and Knafl and a quality assessment using the Mixed Methods Appraisal Tool.
  
  
  RESULTS
  Like families in Western cultures, some East Asian families of children with Down syndrome adapted well and even thrived while others struggled. Various socio-cultural factors, including some associated with Confucianism, played a role in how individuals, dyads and families adapted.
  
  
  CONCLUSIONS
  An understanding of socio-cultural influences can help nurses implement culturally sensitive family-centred interventions with families of children with Down syndrome. It may also facilitate policy changes concerning resources for these families.
authors.affiliation: College of Nursing & Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea.
authors.forename: Hyunkyung
authors.identifier: http://orcid.org/0000-0002-2146-5910
authors.initials: H
authors.lastname: Choi
authors.affiliation: Family Health Division, School of Nursing, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Van Riper
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D032903:Confucianism; D004314:Down Syndrome / Q000208:ethnology / Q000523:psychology*; D005192:Family Health; D005202:Asia, Eastern / Q000208:ethnology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D055815:Young Adult
keywords: Confucianism; Down syndrome; East Asia; adaptation; family; integrative literature review; nurse; the Resiliency of Family Stress, Adjustment and Adaptation