Caught between Two Worlds: Transnational Caregiving Anxiety Among the Chinese One-Child Generation In the U.S.

Background and Purpose: Transnational caregiving creates distinct psychosocial challenges for immigrants balancing family obligations abroad with careers in the host country. For only-child Chinese immigrants, the absence of sibling support and filial piety tradition may intensify cross-border caregiving anxiety. This study aimed to examine the correlates and underlying causes of transnational caregiving anxiety among the Chinese one-child generation in the US.

Methods: This study employed a convergent mixed-methods design. Participants were recruited via social media platforms using purposive sampling and completed an online survey that collected their sociodemographic information and self-reported transnational caregiving related anxiety levels (range: 0-10) and its causes. Descriptive statistics were used to summarize sample characteristics and anxiety levels, and logistic regression analyses were conducted to identify sociodemographic correlates of caregiving anxiety among participants with Low vs High levels of caregiving anxiety. Open-ended responses were analyzed thematically to identify sources of anxiety. To integrate the qualitative and quantitative strands, the total number of qualitative themes identified in each participant's response was quantified and used as a predictor of anxiety levels. The qualitative findings were further employed to contextualize and explain the quantitative results.

Results: Among 161 eligible participants who completed the survey, 152 reported transnational caregiving anxiety. They were predominantly female (77.99%), highly educated (86.96% with a master’s degree or higher), and employed (73.91%). The mean age was 32.61 years (SD=5.41). The average anxiety score was 6.06 (SD=2.32). Among the 19 participants who had prior or current transnational caregiving experience (11.8%), the mean anxiety score was higher (M=7.18, SD=2.19). In bivariate analyses, female gender (p=0.033), higher education (p=0.020), the presence of caregiving needs (p=0.022), and a greater number of causes for anxiety (M=1.98 vs. 1.77, p=0.049) were significantly associated with high transnational caregiving anxiety. In the multiple regression model, female gender (OR=2.68, p=0.035) and having a graduate degree or above (OR=3.82, p=0.037) remained significant predictors of high anxiety. Eight themes emerged from thematic analysis of 134 open-ended responses, collectively capturing 280 coded causes of transnational caregiving anxiety: life plan conflict (n=67), reflecting tension between caregiving obligations and personal career and life goals; geographic distance (n=58), capturing the functional limitations of being physically far from aging parents; parental vulnerability (n=39), encompassing concerns about parents' ability to manage independently; lack of support and resources (n=33), reflecting the absence of sibling support and limited social networks to mitigate transnational caregiving demands; immigration barriers (n=31), including visa uncertainty and immigration concerns; financial burden (n=22); emotional load (n=19), reflecting guilt, grief, and feelings of helplessness; and healthcare system concerns (n=11).

Conclusions and Implications: Only-child Chinese immigrants face significant transnational caregiving anxiety, with heightened burden among women and highly educated individuals, reflecting the intersection of gendered filial obligations and career-caregiving conflicts unique to this cohort. Addressing these challenges requires culturally responsive mental health services, workplace flexibility policies, and immigration reforms that recognize the unique pressures of cross-border caregiving.