Intergeneration social support affects the subjective well-being of the elderly: Mediator roles of self-esteem and loneliness

Age-Related Alterations in Endocrine Markers Do Not Match Changes in Psychosocial Measures: Findings From the Men's Health 40+ Longitudinal Study

While life expectancy continues to increase, aging can bring several distinct endocrine and psychosocial changes. The study aimed to investigate the interplay between biopsychosocial factors of healthy aging in specifically healthy aging men. Ninety-seven healthy aging men were investigated at two time points spanning 4 years. Participants completed questionnaires measuring several psychosocial dimensions and gave saliva samples for hormone quantification during a laboratory appointment. The study applied a random intercept mixed-model approach. Age-related changes were found in most endocrine markers (cortisol, testosterone, dehydroepiandrosterone-sulfate, and progesterone), except for estradiol. Psychosocial measures remained stable, except for increased social support. Further, changes in endocrine and psychosocial measures were independent of each other. The results suggest that in healthy aging men, age-related endocrine changes occur, but do not necessarily determine a change in psychosocial measures. Potentially, preventive interventions can be derived from these results.

The Impact of Intergenerational Relationship on Health and Well-Being of Older Chinese Americans

BACKGROUND/OBJECTIVES

Among older adults, intergenerational support can help to improve well-being. This study examines the correlation between intergenerational relationships and the subjective well-being among older Chinese immigrants in the United States.

DESIGN

Hierarchical multiple regression analyses were applied to test the association between intergenerational relationships and self-rated well-being. The mediating effects of sense of control and the moderation effects of support from friends were also tested.

SAMPLE

A cross-sectional sample of 2717 older Chinese immigrants, aged 60 years and older, with children and grandchildren was drawn from the Population Study of Chinese Elderly.

MEASUREMENTS

Study measures included four items concerning intergenerational relationships: the Pearlin Mastery Scale, two items on seeking support from friends, and single items measuring self-rated health status and quality of life.

RESULTS

Only the feeling of closeness with children was positively linked with subjective well-being, while coresidence and frequency of talking were not. Support from friends moderated the association with self-rated health status, while sense of control partially mediated the association between feeling of closeness and both self-rated health status and quality of life.

CONCLUSION

A stronger sense of closeness with children correlates to self-rated health status and quality of life among older Chinese immigrants. The effects of sociocultural changes affecting Chinese American families, and potential implications for older adults' health, could be addressed through strategies to develop emotional closeness with their families and to support sense of control and well-being among older Chinese adults. J Am Geriatr Soc 67:S557-S563, 2019.

Human needs in COVID-19 isolation

To reduce the spread of COVID-19, the World Health Organization and the majority of governments have recommended that the entire human population should ‘stay-at-home’. A significant proportion of the population live alone or are vulnerable to mental health problems yet, in the vast majority of cases, individuals in social isolation have no access to mental healthcare. The only resource is people themselves using self-help, self-medication and self-care. During prolonged COVID-19 isolation, an in-built system of homeostasis can help rebalance activity, thought and feeling. Increased physical activity enables a reset of physical and mental well-being. During periods of lockdown, it is recommended that exercise should be as vigorously promoted as social distancing itself.

Can Flow Alleviate Anxiety? The Roles of Academic Self-Efficacy and Self-Esteem in Building Psychological Sustainability and Resilience

A growing number of studies suggest that flow experience is associated with life satisfaction, eudaimonic well-being, and the perceived strength of one’s social and place identity. However, little research has placed emphasis on flow and its relations with negative experiences such as anxiety. The current study investigated the relations between flow and anxiety by considering the roles of self-esteem and academic self-efficacy. The study sample included 590 Chinese university students, who were asked to complete a self-report questionnaire on flow, anxiety, self-esteem, and academic self-efficacy. Data were analyzed using structural equation modeling (SEM) with AMOS software, in which both factorial analysis and path analysis were performed. Results revealed that the experience of flow negatively predicted anxiety, and both self-esteem and academic self-efficacy fully mediated the path between flow and anxiety. Specifically, self-esteem played a crucial and complete mediating role in this relationship, while academic self-efficacy mediated the path between self-esteem and anxiety. Our findings enrich the literature on flow experience and help with identifying practical considerations for buffering anxiety and more broadly with fostering strategies for promoting psychological sustainability and resilience.

Moderating Role of Self-Esteem Between Perceived Organizational Support and Subjective Well-Being in Chinese Nurses: A Cross-Sectional Study

Purpose

Nurses are undertaking tremendous physical and psychological pressure, which may reduce their subjective well-being (SWB). This study is aimed to identify the relationship among perceived organizational support (POS), self-esteem, and SWB, and to further explore whether self-esteem could be a moderator in the association between POS and SWB in Chinese nurses.

Materials and Methods

This study was conducted in Liaoning Province in China, in 2018. 606 valid questionnaires were collected. Demographic factors, job conditions, the Index of Well-Being, Survey of Perceived Organizational Support (SPOS), and Rosenberg's Self Esteem Scale (RSES) were included in each questionnaire. The association among POS, self-esteem, and POS × self-esteem interaction with SWB were examined by hierarchical multiple regression analysis. The interaction was visualized by using simple slope analysis.

Results

Average score of SWB in Chinese nurses was 8.27 ± 2.64. Being married was positively related to SWB, while having longer work time per week, having night shift and dissatisfied with nurse-patient relationship were correlated with lower SWB. POS and self-esteem were important factors for SWB. Self-esteem could moderate the relationship between POS and SWB. When self-esteem was higher, POS had a greater effect on SWB.

Conclusion

Subjective well-being of nurses in the study was at a low level. Self-esteem could moderate the association between POS and SWB. More interventions related to POS and self-esteem will be helpful to improve SWB among nurses.

Self-Esteem Mediates the Relationships Between Social Support, Subjective Well-Being, and Perceived Discrimination in Chinese People With Physical Disability

Background: Disabilities have a negative effect on mental health and individuals with such conditions are especially susceptible to mental disorders. Previous research has established that in normal population, social support is significantly correlated with subjective well-being (SWB) through mediating variables; however the internal mechanism underlying this in people with physical disability remains unclear. This study aims to examine whether self-esteem and perceived discrimination play a mediating role in the relationship between social support and SWB in a sample of people with physical disability in China. Methods: A total of 210 people with physical disability of Chinese ethnicity were recruited to complete a series of questionnaires. This included the Chinese Social Support Rating Scale (CSSRS), Rosenberg Self-esteem Scale (RSES), Disability Discrimination Perception Questionnaire (DDPQ), and the Chinese Happiness Inventory (CHI). Path analysis was implemented on the data. Results: The model showed excellent fit to data: χ 2 = 2.314, p > 0.05; root-mean-square error of approximation (RMSEA) = 0.079; standardized root-mean residual (SRMR) = 0.035; comparative fit index (CFI) = 0.989; and Tucker-Lewis index (TLI) = 0.936. The results showed that self-esteem significantly mediated the relationship between social support and SWB, and perceived discrimination in people with physical disability. However, there is no mediating effect of perceived discrimination between social support and SWB. Conclusion: These findings demonstrate that self-esteem may be a critical resource in mediating the relationships between social support, SWB, and perceived discrimination in people with physical disability.

Evaluation of the geriatric curriculum implemented at Shiraz University of Medical Sciences, Iran, since 2017: A qualitative study

Background: Recently, there has been an increase in life expectancy due to improvements in nutrition, health, and sanitation. The aim of this study was to evaluate the geriatric curriculum in the field of general medicine at Shiraz University of Medical Sciences (SUMS), Iran to improve the quality of services provided to this population in the community. Methods: This was a qualitative study­­. Six educational hospitals and ambulatory centers of Shiraz University of Medical Sciences participated in this study. Within these centers, 15 medical education faculty members and educational experts, 6 medical students, 6 elderly patients and 6 nurses working in the university related to the geriatric field were selected using purposive sampling. Data were gathered through semi-structured interviews, focus group discussion and field observations in the teaching hospital and ambulatory setting of SUMS from June 2017 to May 2018.  Based on the qualitative research, the data underwent conventional content analysis and the main themes were developed from this. Results: Three main themes were extracted from the data: effective clinical education, geriatrics curriculum challenges and promotion strategies for geriatric medicine. Subcategories that emerged were a competent curriculum teacher, a challenging program, management of resources, promotion of the program, and the revision required in the curriculum, which were related to other concepts and described in the real-world situation of the geriatric curriculum in the university, as observed in field observations. Conclusions: This study identified three concepts as main themes that can be used to explain how to implement a geriatric curriculum in a medical university. The main contributing factor to different views of the participants was identified as the revision required to the curriculum for integrative care in a geriatric patient. This should be taken into consideration while planning any programs and decisions aimed at education of medical students on this topic.

Impact of perceived social support on depression in Chinese rural-to-urban migrants: The mediating effects of loneliness and resilience

The present study aimed to examine whether loneliness and resilience played the roles of mediators on the relationship between perceived social support and depression. A total of 712 Chinese rural-to-urban migrants from Nanjing, who were measured with perceived social support, resilience, loneliness, and depression, participated in the study. Results indicated that perceived social support and resilience were negatively associated with depression. Loneliness was a significant and negative predictor for depression. In addition, we also revealed that resilience and loneliness partially mediated the relationship between perceived social support and depression. These findings might develop a better understanding of depression in the course of migration.

Suicidality in the elderly: Role of adult attachment

Attachment styles reflect interpersonal relationship patterns in many ways. Although there is increasing evidence regarding the relationship between attachment styles and suicidality in adults, few studies have been conducted among the elderly population. Present study aims to investigate the link between attachment style and risk of suicidality in elderly people. A secondary analysis of cross-sectional data among geriatric outpatients at psychiatric clinics in Thailand with respect to whether patients had depressive disorders according to DSM-IV by using Mini-Neuropsychiatric Interviews (MINI). MINI-Module C was used to assess suicidality. Other measures included the experience of close relationship questionnaire and a brief cognitive assessment, Mental Status Examination T10. One-hundred and ninety-one elderly people were included, 50.8% females and 119 (62.3%) had depressive disorder. Anxiety attachment predicted suicidality, determined with questions related to the following areas; "want to hurt myself", "suicidal ideation", "suicidal planning", and "suicidal attempted in lifetime". Anxiety attachment style was significantly increased the level of suicide risk. We concluded that high anxious attachment, such as preoccupied attachment style, was associated with suicidality in elderly people. Further investigation focusing on variables associated with attachment and suicidality, particularly depression or anxiety, is warranted.

Strengths in older adults: differential effect of savoring, gratitude and optimism on well-being

Objetive: The present study aimed to compare the efficacy of three separate strengths training-based interventions - Gratitude, Savoring, and Optimism - in older adults. Method: The sample comprised 124 older adults, namely, 74 women and 50 men, non-institutionalized individuals who regularly attend day centers in the provinces of Jaén and Córdoba, southern Spain. Their ages ranged between 60 and 89 years. The measures used were Anxiety, Depression, Life Satisfaction, Positive and Negative Affect, Subjective Happiness, and Resilience. Results: Training in Gratitude and Savoring increased scores in Life Satisfaction, Positive Affect, Subjective Happiness and Resilience, and reduced Negative Affect, whereas training in Optimism failed to produce a significant change in these variables. The Savoring and Optimism interventions decreased scores in Depression but, contrary to hypothesis, this was not the case for Gratitude. Conclusion: These results represent an important step in understanding what type of strengths work best when it comes to enhancing well-being in older adults and consequently helping them tackle the challenges of everyday life and recover as quickly as possible from the adverse situations and events that may arise.

The relationship among social support, self-esteem, affect balance and loneliness in individuals with substance use disorders in China

This study analyzed the potential mediating role of self-esteem and affect balance on the relationship between social support and loneliness. Respondents were 426 substabce use disorders from the Shifosi and Dalianshan rehab facilities in China who had completed the Multidimensional Scale of Perceived Social Support, Rosenberg Self-Esteem Scale, Positive and Negative Affect Scales, and UCLA Loneliness Scale. The results indicated that self-esteem and affect balance fully mediated the relationship between perceived social support and loneliness and all the paths, ranging from social support through self-esteem and affect balance to loneliness, were significant. Finally, we analyzed possible approaches to decreasing individuals with substance use disorders' loneliness.

Intergenerational relationship, family social support, and depression among Chinese elderly: A structural equation modeling analysis

OBJECTIVE

This study aimed to investigate the association among intergenerational relationship, family social support, and elderly's depression symptoms.

METHOD

Data were obtained from China Longitudinal Aging Social Survey (CLASS) 2014, which is a continuous large-scale national social survey project conducted by the National Survey Research Center at Renmin University of China. Stratified multi-stage probability sampling method was used to collect the sample (N = 11,511). Structural equation modeling was adopted to analyze the association among intergenerational relationship, family social support, and elderly's depression.

RESULTS

Intergenerational relationship and family social support were negatively correlated with an elderly's depression level. Elderly who enjoyed positive intergenerational relationships with their children would experience adequate family social support and likely have few depression symptoms.

CONCLUSION

Intergenerational relationship directly affected the elderly's depression level. Family social support played a mediating role between intergenerational relationship and depression. Our findings could contribute to current theories and knowledge and provide implications in social policy, pension service, and social work intervention for the elderly in China.

The effectiveness on sociality and social relationship by therapeutic recreation based on partner and group activity in the institutionalized elderly

This research examined the effects on sociality and social relationship of therapeutic recreation program (TRP) based on partner and group activity in the institutionalized elderly as the level of psycho-social rehabilitations. TRP sessions were designed to encourage interaction and social relationship between two people or groups performing different types of tasks applied on Mosey’s 5-step interaction skills. TRP was conducted for a total of 8 sessions, once a week, for 8 weeks. Using a pre-post experimental design, eight volunteer’s data were analyzed to examine changes in sociality and social relationship. As the result, the degree of sociality was significantly changed from 3.14 to 3.73 (P= 0.002), as well as notable improvements of social relationships were found to have statistically increased from 3.27 to 4.10 (P=0.001). Therefore, this study suggests that partner and group-based recreation programs while considering how and when facilitate interaction between participants should be applied as a way to solve the social problems and isolation of the elderly in the future.

Social Support and Pain Outcomes After Trauma Exposure Among Older Adults: A Multicenter Longitudinal Study

OBJECTIVES

Certain forms of social support have been shown to improve pain-coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure.

METHODS

We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on sex, depressive symptoms, and marital status.

RESULTS

In our sample (N=176), patients with low perceived social support had higher pain severity 6 weeks after MVC than patients with high perceived social support after adjustment for age, sex, race, and education (4.2 vs. 3.2, P=0.04). The protective effect of social support on pain severity at 6 weeks was more pronounced in men and in married individuals. Patients with low social support were less likely to receive an opioid prescription in the emergency department (15% vs. 32%, P=0.03), but there was no difference in opioid use at 6 weeks (22% vs. 20%, P=0.75).

DISCUSSION

Among older adults experiencing trauma, low perceived social support was associated with higher levels of pain at 6 weeks.

Caregiver Burden, Care Recipient Depressive Symptomology, and Social Exchange: Does Race Matter?

Informal caregivers play a vital role in supporting seriously ill patients. However, informal caregiving is burdensome and can lead to negative health outcomes for the caregiver and the care recipient. The study's aim was to evaluate relationships among caregiver burden, care recipient depressive symptomology, and race. Guided by the social exchange perspective, we examined cross-sectional dyadic data from the National Long-Term Care Survey (N = 1279). Using ordinal logistic regression, we found that higher caregiver-reported objective burden was associated with higher care recipient depressive symptoms ( P < .05), an association that was stronger for blacks. Interestingly, despite significant levels of objective burden, there was an association between lower depressive symptoms in black care recipients when there was an exchange of the social good "helpful company" with a caregiver. These findings illustrate the importance of supporting reciprocal exchange as a promising component of maintaining balanced caregiver-care recipient relationships among black older adults and their informal caregivers.

Sources and directions of social support and life satisfaction among solitary Chinese older adults in Hong Kong: the mediating role of sense of loneliness

Based on survey data collected from 151 community-dwelling solitary Chinese older adults in Hong Kong, the present study used path analysis to examine the mediating role of sense of loneliness in the relationship between different sources and directions of social support and life satisfaction. The results showed that sense of loneliness mediated the effects of support from families, friends, and support for others on life satisfaction. In addition, a formal source of social support was not associated with life satisfaction among solitary older adults, although those with a more secure financial status had greater overall life satisfaction. These findings highlight the importance of enhancing awareness among social and health care service providers about the negative effects of insufficient social support on older adults' sense of loneliness and life satisfaction. Family and friendship networks should be expanded for solitary older adults.

Perceived social support and life satisfaction in drug addicts: Self-esteem and loneliness as mediators

This study was designed to investigate the mediation effects of both self-esteem and loneliness on the relationship between social support and subjective well-being in drug addicts. In all, 110 participants, all drug addicts from Guangdong Fangcun Brain Hospital, completed the questionnaire. Pearson’s correlation analysis showed that perceived social support was positively related to self-esteem and life satisfaction and was negatively correlated with loneliness in drug addicts. Structural equation modeling estimated by the Bootstrap method indicated that loneliness and self-esteem partially mediated the association between perceived social support and life satisfaction. These findings provided insights into the association between perceived social support and life satisfaction in drug addicts.

Comparison of two health measurements among older adults

The aims of this study were to develop composite indices for measuring the life relative independence of older adults and to compare the results with the self-rated health status to evaluate the reliability. The life relative independence measures were developed using a representative cross-sectional survey of 2336 samples in Taiwan. The results indicated that older adults have poor social health and economic security, the life relative independence is more effective in health evaluation than the self-rated health status and psychological health is associated with independence. This study provides an improved understanding of scenarios of independence for older adults.

Subjective Social Standing and Conflict Tactics Among Young Kenyan Men

Efforts to reduce intimate partner violence in sub-Saharan Africa generally approach the issue through the lens of women's empowerment. These efforts include foci on women's relative power in the relationship, educational background, and earning potential. The social status of men has largely been ignored, reducing the potential to involve them in efforts to demote intimate partner violence. In this study we consider whether a man's perceived social status predicts conflict tactics, and whether these tactics are mediated by loneliness and collective self-esteem from a community-based sample in semi-rural Kenya (n = 263). We find that men who reported lower perceived social status also reported significantly more frequent violent conflicts with their intimate partners. This association was significantly, and completely, mediated by lower collective self-esteem and higher loneliness. There was no direct association between subjective social status and negotiation-based conflict tactics, although there was an indirect association. Men with higher perceived social status reported higher collective self-esteem, and men with higher collective self-esteem reported more negotiation-based conflict tactics. These findings inform efforts to reduce intimate partner violence by involving men, showing potential to reduce violence by building self-esteem among men-particularly those with lower perceived social status.

The effect of cognitive training on the subjective perception of well-being in older adults

Background

There is a growing number of studies indicating the major consequences of the subjective perception of well-being on mental health and healthcare use. However, most of the cognitive training research focuses more on the preservation of cognitive function than on the implications of the state of well-being. This secondary analysis of data from a randomised controlled trial investigated the effects of individualised television-based cognitive training on self-rated well-being using the WHO-5 index while considering gender and education as influencing factors. The effects of cognitive training were compared with leisure activities that the elderly could be engaged in to pass time.

Methods

Cognitively healthy participants aged 60 years or above screened using the Mini-Mental State Examination (MMSE) and Major Depression Inventory (MDI) were randomly allocated to a cognitive training group or to an active control group in a single-blind controlled two-group design and underwent 24 training sessions. Data acquired from the WHO-5 questionnaire administered before and after intervention were statistically analysed using a mixed design model for repeated measures. The effect of individualised cognitive training was compared with leisure activities while the impact of gender and education was explored using estimated marginal means.

Results

A total of 81 participants aged 67.9 ± 5.59 [60–84] without cognitive impairments and absent of depression symptoms underwent the study. Participants with leisure time activities declared significantly higher scores compared to participants with cognitive training M = 73.48 ± 2.88, 95% CI [67.74–79.22] vs M = 64.13 ± 3.034, 95% CI [58.09–70.17] WHO-5 score. Gender and education were found to moderate the effect of cognitive training on well-being when compared to leisure activities. Females engaged in leisure activities in the control group reported higher by M = 9.77 ± 5.4, 95% CI [−0.99–20.54] WHO-5 scores than females with the cognitive training regimen. Participants with high school education declared leisure activities to increase WHO-5 scores by M = 14.59 ± 5.39, 95% CI [3.85–25.34] compared to individualised cognitive training.

Discussion

The findings revealed that individualised cognitive training was not directly associated with improvements in well-being. Changes in the control group indicated that involvement in leisure time activities, in which participants were partly free to choose from, represented more favourable stimulation to a self-perceived sense of well-being than individualised cognitive training. Results also supported the fact that gender and education moderated the effect of cognitive training on well-being. Females and participants with high school education were found to be negatively impacted in well-being when performance connected with cognitive training was expected.

Socioeconomic status, frailty, and subjective well-being: A moderated mediation analysis in elderly Chinese

The study examined the mechanisms underlying the link between socioeconomic status and subjective well-being and explored the role of social activities using a representative sample of older adults ( N = 2773) in Shanghai, China. Results show that frailty mediated the relationship between socioeconomic status and subjective well-being, and social activities moderated the model, such that the mediation effect of frailty was significant only when social activities were lower. Moreover, the moderated mediation model was significant only for women, not for men. Findings highlight the importance of addressing frailty of older adults and promoting social activities (especially for elderly women) in future interventions.

Does the mortality risk of social isolation depend upon socioeconomic factors?

This study considers whether socioeconomic status influences the impact of social isolation on mortality risk. Using data from the Alameda County Study, Cox proportional hazard models indicate that having a high income worsens the mortality risk of social isolation. Education may offset risk, however, and the specific pattern that emerges depends on which measures for socioeconomic status and social isolation are included. Additionally, lonely people who earn high incomes suffer especially high risk of accidents and suicides as well as cancer. Further research is needed that contextualizes the health risks of social isolation within the broader social environment.

Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population

OBJECTIVE

To explore the association between quality of life and social support in elderly osteoporosis patients in a Chinese population.

METHODS

A total of 214 elderly patients who underwent bone mineral density screening were divided into two groups: elderly patients with primary osteoporosis (case group, n = 112) and normal elderly patients (control group, n = 102). Quality of life and social support were compared between the two groups.

RESULTS

Quality of life and social support were significantly different between the case and control groups. The physical function, role-physical, bodily pain, general health, vitality, social-functioning, role-emotional and mental health scores in case group were significantly lower than those in the control group (P < 0.01). The objective support, subjective support, utilization of support, and total scores in case group were significantly lower than those in the control group (P < 0.01). Quality of life and social support were positively correlated in the case group (r = 0.672, P < 0.01).

CONCLUSION

Quality of life and social support in elderly patients with osteoporosis in China were poorer than in elderly patients without osteoporosis and were positively correlated. Our findings indicate that increased efforts to improve the social support and quality of life in elderly osteoporosis patients are urgently needed in China. Further longitudinal studies should be conducted to provide more clinical evidence to determine causative factors for the observed association between risk factors and outcomes.