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Sun F, Wang F, Hu X, Xue J, Zheng S, Su J, Lu Q. Alexithymia and negative emotions among nursing students: a moderated mediation model. BMC Nurs 2024; 23:167. [PMID: 38459516 PMCID: PMC10921665 DOI: 10.1186/s12912-024-01832-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.
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Affiliation(s)
- Feifei Sun
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Fang Wang
- Xianning Vocational Technical College, 437100, Xianning, Hubei, China
| | - Xiaojing Hu
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jiaomei Xue
- Society and Law School, Shandong Women's University, Changqing University Science and Technology Park, No. 2399, University Road, 25030, Jinan, Shandong, China
| | - Shangkun Zheng
- Human Resources Department, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jing Su
- Editorial Board, Journal of Shandong First Medical University, No. 6699 Qingdao Road, Huaiyin District, 250000, Jinan, China
| | - Qinghua Lu
- Department of Infection Management, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China.
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Yao L, Liang K, Huang L, Chi X. Relationship between fruit and vegetable consumption and internet addiction with insomnia and depression as multiple mediators during the COVID-19 pandemic: a three-wave longitudinal study in Chinese college students. BMC Psychiatry 2023; 23:939. [PMID: 38093234 PMCID: PMC10720225 DOI: 10.1186/s12888-023-05415-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The relationships between fruit and vegetable consumption (FV) and Internet addiction (IA) in college students still remained unknown together with the internal mechanisms. Given the limitations of previous cross-sectional design, longitudinal research was necessary to be conducted to explore more precise correlations. Using the three-wave data in a longitudinal design, this study aimed to explore the association between FV and IA among Chinese college students and potential multiple mediators of insomnia and depression during the COVID-19 pandemic. METHODS A total of 579 college students were recruited during three waves (T1: August 2020; T2: November 2020; T3: February 2021). FV (T1), insomnia (T2), depression (T2) and IA (T3) symptoms were reported. The descriptive statistics of the sociodemographic characteristics and correlation analyses of the study variables were calculated. The significance of the mediation effects was measured conducting a bootstrap method with SPSS PROCESS macro. RESULTS FV was negatively correlated with IA, and lower FV predicted higher risk of IA. Depression mediated the association between FV and subsequent IA. Insomnia and depression were multiple mediators, which in turn mediated the links between FV and subsequent IA. CONCLUSIONS The three-wave longitudinal study has revealed that FV had indirect effects on IA through individual mediating factor of depression and multiple mediating roles of insomnia and depression sequentially. The policy makers, educators and researchers should pay attention to the impact of the interventions from healthy diet, in order to optimize the coping strategies for preventing college students from IA.
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Affiliation(s)
- Liqing Yao
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou, China
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Macau, China
| | - Kaixin Liang
- School of Psychology, Shenzhen University, Shenzhen, China
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, China
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Liuyue Huang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Xinli Chi
- School of Psychology, Shenzhen University, Shenzhen, China.
- The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen, China.
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Huang X, Pei X, Jian W, Xu M. Socioeconomic Disparities in Individual-Level Quality-Adjusted Life Years throughout Remaining Lifetimes: A National Representative Longitudinal Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4612. [PMID: 36901620 PMCID: PMC10001792 DOI: 10.3390/ijerph20054612] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Socioeconomic disparities in health within and across low- and middle-income countries pose a significant global public health concern. While prior research has demonstrated the importance of socioeconomic status on health outcomes, few studies have employed comprehensive measures of individual-level health such as quality-adjusted life years (QALYs) in exploring the quantitative relationship. In our study, we employed QALYs to measure individual-level health, using health-related quality of life scores based on the Short Form 36 and predicted remaining life years through individual-specific Weibull survival analysis. We then constructed a linear regression model to explore the socioeconomic factors that influence QALYs, providing a predictive model of individual-level QALYs throughout remaining lifetimes. This practical tool can help individuals predict their remaining healthy life years. Using data from the China Health and Retirement Longitudinal Study between 2011 and 2018, we found that education and occupation were the primary factors influencing health outcomes among individuals aged 45 and above, while income appeared to have less of an impact when education and occupation were simultaneously controlled for. To promote the health status of this population, low- and middle-income countries should prioritize the long-term advancement of their population's education while controlling unemployment rates in the short term.
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Affiliation(s)
- Xinyi Huang
- School of Public Health (Shenzhen), Sun Yat-sen University, Gongchang Road 66, Shenzhen 518107, China
| | - Xingtong Pei
- School of Public Health (Shenzhen), Sun Yat-sen University, Gongchang Road 66, Shenzhen 518107, China
| | - Weiyan Jian
- Department of Health Policy and Management, School of Public Health, Peking University, Xueyuan Road 38, Haidian District, Beijing 100191, China
| | - Mingming Xu
- School of Public Health (Shenzhen), Sun Yat-sen University, Gongchang Road 66, Shenzhen 518107, China
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Zhao ZH, Guo JY, Zhou J, Qiao J, Yue SW, Ouyang YQ, Redding SR, Wang R, Cai ZX. Perceived social support and professional identity in nursing students during the COVID-19 pandemic era: the mediating effects of self-efficacy and the moderating role of anxiety. BMC MEDICAL EDUCATION 2023; 23:117. [PMID: 36803504 PMCID: PMC9936494 DOI: 10.1186/s12909-022-03968-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 12/16/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Health professionals, including nurses, experienced heavy workloads and significant physical and mental health challenges during the coronavirus disease (COVID) 19 pandemic, which may affect career choices for those considering nursing and for nursing students. The COVID-19 pandemic is not only a period of risk, but also an occasion to redeploy the professional identity (PI) of nursing students. However, the relationship between perceived social support (PSS), self-efficacy (SE), PI and anxiety remains unclear under the background of COVID-19. This study aims to explore whether PSS has an indirect effect on PI through mediation of SE and whether the anxiety can moderate the relationship between PSS and SE in nursing students during their internship period. METHODS An observational, national cross-sectional study was conducted following the STROBE guidelines. An online questionnaire was completed by 2,457 nursing students from 24 provinces in China during their internship during September to October 2021. Measures included Chinese translations of the Professional Identity Questionnaire for Nursing Students, the Perceived Social Support Scale, the General Self-Efficacy Scale, the 7-item Generalized Anxiety disorder scale. RESULTS Both PSS (r = 0.46, p < 0.001) and SE (r = 0.51, p < 0.001) were positively correlated with PI. The indirect effect of PSS on PI through SE was positive (β = 0.348, p < 0.001), with an effect of 72.7%. The results of the moderating effect analysis showed that anxiety attenuated the effect of PSS on SE. Moderation models indicated that anxiety has a weak negative moderating effect on the effect of PSS on SE (β =-0.0308, p < 0.05). CONCLUSIONS A better PSS and higher scores in SE were associated with PI in nursing students, and a better PSS had an indirect effect on the PI of nursing students through SE. Anxiety played a negative moderating role in the relationship between PSS and SE.
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Affiliation(s)
- Zhi-Hui Zhao
- School of Nursing, Wuhan University, 115 Donghu Rd., Wuchang District, Wuhan, China
| | - Jin-Yi Guo
- School of Nursing, Wuhan University, 115 Donghu Rd., Wuchang District, Wuhan, China
| | - Jie Zhou
- School of Nursing, Wuhan University, 115 Donghu Rd., Wuchang District, Wuhan, China
| | - Jia Qiao
- School of Nursing, Wuhan University, 115 Donghu Rd., Wuchang District, Wuhan, China
| | - Shu-Wen Yue
- School of Nursing, Wuhan University, 115 Donghu Rd., Wuchang District, Wuhan, China
| | - Yan-Qiong Ouyang
- School of Nursing, Wuhan University, 115 Donghu Rd., Wuchang District, Wuhan, China
| | | | - Rong Wang
- Renmin Hospital of Wuhan University, Wuhan, China
- Nursing Department, East Campus of Renming Hospital of Wuhan University, Gaoxin Sixth Road, Jiangxia District, Wuhan, China
| | - Zhong-Xiang Cai
- Renmin Hospital of Wuhan University, Wuhan, China
- Nursing Department, East Campus of Renming Hospital of Wuhan University, Gaoxin Sixth Road, Jiangxia District, Wuhan, China
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Zhang C, Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Benli X, Chen Y, Li X, Kai Y, Liu Y, Zhou G. Health-related quality of life and its association with socioeconomic status and diet diversity in Chinese older adults. Front Public Health 2023; 10:999178. [PMID: 36743155 PMCID: PMC9895932 DOI: 10.3389/fpubh.2022.999178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/23/2022] [Indexed: 01/22/2023] Open
Abstract
Objectives The study aimed at examining the combined association of socioeconomic status (SES) and diet diversity (DD) with health-related quality of life (HRQoL) and exploring whether DD played a mediating role in the relationship between varied SES and HRQoL among Chinese older persons. Method A multi-stage random sampling method was conducted in Shanxi Province of China, with 3,250 older adults participating in this cross-sectional survey. SES was divided into groups by quartiles and DD by means, and these variable groups were combined in pairs to generate a total of eight combinations. The PROCESS macro developed by Hayes was employed for the simple mediation analysis. Results Compared with the reference group (those with both high SES and high DD), older adults who were classified to have lower SES or DD had elevated odds of having worse HRQoL: low SES/ low DD (OR = 1.65, 95% CI 1.41-2.92); low SES/ high DD (OR = 1.45, 95% CI 1.17-1.80); middle low SES/ low DD (OR = 1.43, 95% CI 1.24-1.65); middle low SES/ high DD (OR = 1.23, 95% CI 1.03-1.47); upper high SES/ low DD (OR = 1.41, 95% CI 1.21-1.65); and high SES/ low DD (OR = 1.30, 95%CI 1.10-1.53). The mediation analysis revealed that DD mediated the relationship between SES and HRQoL (B=0.011, 95% CI 0.008-0.013), with its indirect effects accounting for 39.29% of the total effects. Conclusions These findings highlighted the role of DD as a mediator of the relationship between SES and HRQoL. As DD could be protective, modifiable, and easy for older adults to understand and implement, village clinics and community health stations should work collaboratively to design proper DD intervention measures for better HRQoL.
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Affiliation(s)
- Chichen Zhang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China,School of Health Management, Southern Medical University, Guangzhou, China,Institute of Health Management, Southern Medical University, Guangzhou, China,*Correspondence: Chichen Zhang ✉
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China,School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, China,Shunde Hospital, Southern Medical University, Guangzhou, China
| | - Xue Benli
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yiming Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Xinru Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yan Kai
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yuxi Liu
- School of Humanities and Management, Institute for Health Law and Policy, Guangdong Medical University, Dongguan, China
| | - Guangqing Zhou
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Block C, König HH, Hajek A. Oral health and quality of life: findings from the Survey of Health, Ageing and Retirement in Europe. BMC Oral Health 2022; 22:606. [PMID: 36517821 PMCID: PMC9753255 DOI: 10.1186/s12903-022-02599-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of this study was to clarify the link between oral health and quality of life among older adults in Europe. METHODS Cross-sectional data from wave 5 (n = 59,048 observations) were used from the representative Survey of Health, Ageing and Retirement in Europe. Oral health was quantified by three questions: presence of all natural teeth (yes; no); among individuals with missing natural teeth, the number of missing teeth and the extent of replaced natural teeth were quantified. Quality of life was quantified using the widely used CASP-12. Multiple linear regressions were used to determine the association between oral health and quality of life, adjusting for various potential confounders. RESULTS Multiple linear regressions showed that higher quality of life was associated with (1) the presence of all natural teeth and among individuals with missing natural teeth, with (2) a lower number of missing natural teeth and (3) completely replaced natural teeth. Additionally, quality of life was positively associated with younger age, being female, being married or in a partnership, higher income, higher educational level, not currently smoking, a lower number of functional impairments, better self-rated health, a lower number of depressive symptoms and a lower number of chronic diseases. CONCLUSION Study findings showed an association between oral health and quality of life among older adults in Europe. Thus, the importance of good oral health for successful ageing was stressed. Future research is required to clarify the underlying mechanisms. Moreover, longitudinal studies are required to confirm our current findings.
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Affiliation(s)
- Celina Block
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
| | - André Hajek
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
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7
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Zheng Z, Xu W, Wang F, Qiu Y, Xue Q. Association between vitamin D3 levels and frailty in the elderly: A large sample cross-sectional study. Front Nutr 2022; 9:980908. [PMID: 36238456 PMCID: PMC9553132 DOI: 10.3389/fnut.2022.980908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/09/2022] [Indexed: 12/03/2022] Open
Abstract
Background Frailty is recognized as a cornerstone of geriatric medicine. Accurately screening and identifying frailty can promote better quality and personalized medical services for the elderly. Previous studies have shown that the association between vitamin D and frailty in the elderly population is still controversial. More research is needed to explore the association between them. Materials and methods We used three waves of data from the National Health and Nutrition Examination Survey (NHANES). Based on the widely accepted AAH FRAIL Scale, we measured and evaluated the participants’ frailty from five aspects: fatigue, resistance, ambulation, illness, and loss of weight. All possible relevant variables are included. Machine learning XGboost algorithm, the Least Absolute Shrinkage Selection Operator (LASSO) regression and univariate logistic regression were used to screen variables, and multivariate logistic regression and generalized additive model (GAM) were used to build the model. Finally, subgroup analysis and interaction test were performed to further confirm the association. Results In our study, XGboost machine learning algorithm explored the relative importance of all included variables, which confirmed the close association between vitamin D and frailty. After adjusting for all significant covariates, the result indicated that for each additional unit of 25-hydroxyvitamin D3, the risk of frailty was reduced by 1.3% with a statisticaldifference. A smooth curve was constructed based on the GAM. It was found that there was a significant negative correlation between 25-hydroxyvitamin D3 and the risk of frailty. Conclusion There may be a negative correlation between 25-hydroxyvitamin D3 and the risk of frailty. However, more well-designed studies are needed to verify this relationship.
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Affiliation(s)
- Zitian Zheng
- Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Peking University Fifth School of Clinical Medicine, Beijing, China
| | - Wennan Xu
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fei Wang
- Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yudian Qiu
- Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Qingyun Xue
- Department of Orthopedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Peking University Fifth School of Clinical Medicine, Beijing, China
- *Correspondence: Qingyun Xue,
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Ding Y, Liu C, Xu H, Wang M, Zhang J, Gu J, Cui Y, Wei L, Zhang Y. Effect of social support on illness perception in patients with atrial fibrillation during "Blanking Period": Mediating role of sense of mastery. Nurs Open 2022; 10:115-122. [PMID: 35855521 PMCID: PMC9748061 DOI: 10.1002/nop2.1284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/12/2022] [Accepted: 06/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM To explore whether sense of mastery can mediate the relationship between social support and illness perception in patients with atrial fibrillation (AF) who were at the "Blanking Period." DESIGN A cross-sectional design. METHODS 405 patients with AF who were at the "Blanking Period" in the Affiliated Hospital of Qingdao University were recruited; they completed a set of questionnaires, including the Perceived Social Support Scale, the Personal Mastery Scale and the Brief Illness Perception Questionnaire. RESULTS Social support and sense of mastery were both adversely connected to illness perception. The indirect effect of social support on illness perception through sense of mastery was negative, accounting for 86.04% of the total effect. CONCLUSION During the "Blanking Period," better social support and sense of mastery contribute to a positive illness perception of AF patients. Social support also can influence patients' illness perception indirectly via the mediator of sense of mastery.
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Affiliation(s)
- Yun‐Mei Ding
- School of NursingQingdao UniversityQingdaoChina,Affiliated Hospital of Qingdao UniversityQingdaoChina
| | | | - Hong‐Xuan Xu
- Department of Health SciencesLund UniversityLundSweden
| | - Mao‐Jing Wang
- Affiliated Hospital of Qingdao UniversityQingdaoChina
| | | | - Jia‐Yun Gu
- School of NursingQingdao UniversityQingdaoChina
| | - Yan Cui
- Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Lili Wei
- Department of NursingAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Zhang
- Department of NursingAffiliated Hospital of Qingdao UniversityQingdaoChina
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Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Dong F, Xue B, Zhang C. Differences in Health-Related Quality of Life and Its Associated Factors Among Older Adults in Urban and Rural Areas. Risk Manag Healthc Policy 2022; 15:1447-1457. [PMID: 35923554 PMCID: PMC9342693 DOI: 10.2147/rmhp.s373077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Urban-rural health disparity is one of the most prominent challenges in China today. The goal of this study is to find differences in health-related quality of life (HRQoL) and its associated factors among older people in urban and rural areas. Methods A multi-stage stratified sampling method was conducted in Shanxi Province, with a total of 3250 older adults participated in this cross-sectional survey. HRQoL was assessed using the Chinese version of the EQ-5D-5L. Tobit regression models were employed to identify associated factors for HRQoL. Results The mean EQ-5D utility score of the total sample was 0.87± 0.23, with a statistically significant difference observed between urban (0.89 ± 0.22) and rural areas (0.86 ± 0.23). Obesity (Coe=−0.10, p=0.021) and nutrition awareness (Coe=−0.14, p=0.009) were two unique associated factors to rural older adults’ HRQoL. While, age (Urban: Coe=0.13, p=0.001; Rural: Coe=−0.019, p<0.001), socioeconomic status (Urban: Coe=0.13, p<0.001; Rural: Coe=0.14, p<0.001), number of chronic non-communicable diseases (Urban: Coe=−0.20, p<0.001; Rural: Coe=−0.15, p<0.001), sleep quality (Urban: Coe=−0.22, p<0.001; Rural: Coe=0.15, p<0.001) and daytime sleepiness (Urban: Coe=−0.13, p<0.001; Rural: Coe=−0.13, p<0.001) were found to be associated with HRQoL regardless of the residential area. Conclusion This study suggested that rural older adults are facing HRQoL disadvantages compared to those in urban area. Accordingly, more attention should be devoted to rural older adults’ HRQoL, particularly to the unique factors like body weight and nutrition awareness. Targeted policies and interventions should be implemented to improve HRQoL and bridge the urban-rural HRQoL gap.
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Affiliation(s)
- Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Institute of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Chichen Zhang, School of Health Management, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, People’s Republic of China, Tel +86-20-61648756, Email
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10
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García-Mayor J, Gouveia ÉR, Marques A, De la Cruz-Sánchez E, Moreno-Llamas A, França C, Gouveia BR, Ihle A. Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira Island. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137608. [PMID: 35805268 PMCID: PMC9265542 DOI: 10.3390/ijerph19137608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2022]
Abstract
Background: People more socioeconomically vulnerable tend to have a poorer health-related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioeconomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Autonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8–10%, 39–46%, and 15–16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13–16%, 50%, and 15–21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.
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Affiliation(s)
- Jesús García-Mayor
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain; (J.G.-M.); (E.D.l.C.-S.); (A.M.-L.)
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal;
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Correspondence: ; Tel.: +351-291-705-313 (ext. 5313)
| | - Adilson Marques
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, 1499-002 Lisbon, Portugal;
- Instituto de Saúde Ambiental (ISAMB), University of Lisbon, 1649-020 Lisbon, Portugal
| | - Ernesto De la Cruz-Sánchez
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain; (J.G.-M.); (E.D.l.C.-S.); (A.M.-L.)
| | - Antonio Moreno-Llamas
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain; (J.G.-M.); (E.D.l.C.-S.); (A.M.-L.)
| | - Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal;
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
| | - Bruna R. Gouveia
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Ko Y, Jang HY, Han SY. Influence of combined cognitive impairment and social frailty on physical frailty in community-dwelling older adults. Geriatr Nurs 2022; 46:125-131. [PMID: 35696839 DOI: 10.1016/j.gerinurse.2022.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to identify the influence of combined cognitive impairment and social frailty on physical frailty. METHODS This study analyzed secondary data from the 2020 National Survey of Older Koreans, which was collected nationwide from community-dwelling individuals aged ≥ 65 years. RESULTS Combined cognitive impairment and social frailty (odds ratio (OR) =4.44, 95% confidence interval (CI)=3.14-6.28), cognitive impairment and social pre-frailty (OR =2.38, 95% CI =1.70-3.34), noncognitive impairment and social frailty (OR =2.16, 95% CI =1.54-3.04), and noncognitive impairment and social pre-frailty (OR =1.40, 95% CI =1.02-1.91) groups were more likely to be physically frail than noncognitive impairment and socially robust groups after adjusting for sociodemographic and health-related factors. CONCLUSION Healthcare providers need to be aware that older adults who suffer from both cognitive impairment and social frailty may be vulnerable to physical frailty.
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Affiliation(s)
- Young Ko
- College of Nursing, Gachon University, 191 Hambakmoeiro, Yeonsu-Gu, Incheon 21936, Republic of Korea.
| | - Hye Young Jang
- School of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea.
| | - Song Yi Han
- Department of Nursing Science, Sunmoon University, 70 Sunmoon-ro 221 beon-gil, Tangjeong-myen, Asan-si, Chungcheongnam-do 31460, Republic of Korea.
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12
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Gao T, Han S, Mo G, Sun Q, Zhang M, Liu H. Long-term tea consumption reduces the risk of frailty in older Chinese people: Result from a 6-year longitudinal study. Front Nutr 2022; 9:916791. [PMID: 36046130 PMCID: PMC9421071 DOI: 10.3389/fnut.2022.916791] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Vast accumulative evidence suggests that the consumption of tea and its components have various potential health benefits. This study used a longitudinal study to examine the causality between tea consumption and frailty in older Chinese people. Methods This study employed the longitudinal data from 2008 to 2014 of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which were systematically collected through face-to-face interviews. Two thousand four hundred and seventy three participants completed six-follow-up surveys in 2014 and were analyzed in this study. The frailty index recommended by Searle and co-authors, including 44 health deficits, was used. A Generalized Estimating Equation (GEE) was applied to determine the risk ratio (RR) with a 95% confidence interval (CI) for frailty, and further subgroup analyses were conducted to investigate whether the risk differed stratified by age, sex, and socioeconomic status. Additionally, the interaction between tea consumption with sex and frailty was tested. Results Of the 2,473 participants, 14.1% were consistent daily tea drinkers, and 22.6% reported frailty at the 6-year follow-up. Compared to non-tea drinkers, consistent daily tea drinkers reported a significantly lower ratio of having frailty [risk ratio (RR) = 0.54, 95% confidence interval (CI): 0.38-0.78], adjusting for sociodemographic characteristics, health behavior, socioeconomic status, and chronic illnesses. In further subgroup analyses, consistent daily tea consumption significantly reduced the risk of frailty for males (RR = 0.53, 95% CI: 0.32-0.87) but not females (RR = 0.65, 95% CI: 0.37-1.12); in the young (RR = 0.40, 95% CI: 0.22-0.74) but not in the oldest (aged ≥ 80) (RR = 0.66, 95% CI: 0.40-1.06); informal education (RR = 0.48, 95% CI: 0.28-0.84) but not formal education (RR = 0.62, 95% CI: 0.37-1.03); financial dependence (RR = 0.42, 95% CI: 0.25-0.71) but not financial independence (RR = 0.71, 95% CI: 0.41-1.23). Additionally, females showed a lower tea-mediated risk of frailty in occasional tea consumers (RR = 0.51, 95% CI: 0.29-0.89) and inconsistent tea drinkers (RR = 0.58, 95% CI: 0.37-0.93). Conclusions Habitual tea consumption can reduce the risk of frailty in older Chinese, and the benefit varied by age, sex, education, and financial support.
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Affiliation(s)
- Tianjing Gao
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Siyue Han
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Guangju Mo
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Qing Sun
- School of Public Health, Bengbu Medical College, Bengbu, China
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, China
- *Correspondence: Huaqing Liu
| | - Huaqing Liu
- School of Public Health, Bengbu Medical College, Bengbu, China
- Min Zhang
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13
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Gao Z, Wei X, Yang L, Cui D, Kong L, Qi L, Zhang P. Mediating role of career self-efficacy between clinical learning environment and professional identity in nursing students. J Adv Nurs 2021; 78:1012-1019. [PMID: 34449912 DOI: 10.1111/jan.15027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/13/2021] [Accepted: 08/11/2021] [Indexed: 12/23/2022]
Abstract
AIMS To explore whether the clinical learning environment (CLE) has an indirect effect on professional identity through the mediation of career self-efficacy (CSE) in nursing students. BACKGROUND The shortage of nurses has become a universal problem worldwide. Improving nurses' professional identity is considered an effective way to reduce the turnover rate of nurses. However, little is known about the relationship between the CLE, CSE and professional identity. DESIGN An observational, questionnaire-based, cross-sectional study. METHODS A web-based survey was completed by 212 undergraduate nursing students from June to August 2018. Measures included Chinese translations of the CLE, the Career Self-Efficacy Scale, and the Professional Identity Scale. RESULTS Both the CLE (r = 0.552, p < 0.01) and CSE (r = 0.868, p < 0.01) correlated positively with professional identity. The indirect effect of the CLE on professional identity through CSE was positive (β = 0.342, p < 0.05) and the effect was 77.2%. CONCLUSIONS A better CLE and higher scores in CSE were associated with professional identity in nursing students, and a better CLE had an indirect effect on the professional identity of students through CSE.
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Affiliation(s)
- Zihan Gao
- School of Nursing, Qingdao University, Qingdao, P.R. China
| | - Xiao Wei
- School of Nursing, Qingdao University, Qingdao, P.R. China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, P.R. China
| | - Dan Cui
- Department of Nursing, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Lingna Kong
- School of Nursing, Chongqing Medical University, Chongqing, P.R. China
| | - Li Qi
- School of Nursing, Qiqihaer Medical University, Qiqihar, P.R. China
| | - Ping Zhang
- School of Nursing, Southern Medical University, Guangzhou, P.R. China
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14
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Wang J, Hulme C. Frailty and socioeconomic status: a systematic review. J Public Health Res 2021; 10. [PMID: 33942603 PMCID: PMC8477231 DOI: 10.4081/jphr.2021.2036] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/08/2021] [Indexed: 11/22/2022] Open
Abstract
The relationship between frailty and socioeconomic status has been widely explored in the literature. A deeper understanding toward the underlying mechanism is required to further assist policy makers in reducing the inequalities. The objective of this study is to systematically review evidence investigating the direct relationship between frailty and socioeconomic status. The review was conducted following the principles of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Among the included studies, 52.38% explored the pattern of frailty in age and 42.86% explored mediators as the pathway variables. With various measures and methodologies, included studies did not point to the same conclusions. In terms of the pattern of frailty in age, we found evidence for the age as leveller hypothesis, the status maintenance hypothesis and the cumulative advantage hypothesis. The included mediators differed across studies. However, we found that these mediators can be categorised into behaviours, health, social factors, material resources and mental status. These categories indicate the important aspects to consider for policies aiming at reducing the inequalities in frailty. To obtain a full picture of the underlying mechanism, future research should harmonise different measures for frailty and socioeconomic indicators and apply more comprehensive sets of mediators. Significance for public health Socioeconomic differences in frailty are important indicators for health inequalities especially for ageing societies. In addition to recognising the differences, a systematic examination for the underlying mechanisms is needed to assist policy makers in reducing the inequalities. In this review, we found a considerable number of studies illustrating either the pattern of frailty in age or the mediators for the relationship between frailty and socioeconomic status. Observations regarding the pattern of frailty in age assist policy makers in determining the time point for the implementations of frailty treatments or compensation for socioeconomic disadvantages. On the other hand, observations for mediators offers a more detailed picture of the underlying mechanism and thus inform policy makers about the potential tools to reduce the inequalities. Therefore, this systematic review is of public health importance with its implication for policy making in reducing health inequalities.
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Affiliation(s)
- Jiunn Wang
- University of Exeter Medical School, Exeter.
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15
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Wang S, Zhao M, Shi Y, Zhang M, Ying J, Li H, Li Y, Xing Z, Zhang H, Sun J. Associations of frailty, loneliness and the quality of life of empty nesters: A cross-sectional study in rural areas. Int J Nurs Pract 2021; 28:e12947. [PMID: 33899309 DOI: 10.1111/ijn.12947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 03/08/2021] [Indexed: 12/20/2022]
Abstract
AIMS To explore loneliness, in association with frailty, in explaining the quality of life (QOL) of empty-nest older adults in rural China. DESIGN A cross-sectional questionnaire survey was conducted. METHODS Data collection was performed from June to August 2017 in Changchun, the capital city of Jilin province, which consists of seven districts and three counties. In total, 304 older adults aged 60 years and above participated. The characteristics of older adults were evaluated in terms of frailty status, loneliness and the QOL. One-way and two-way analyses of covariance and the area under the receiver operating characteristic curves were used to explore the relationships of frailty, loneliness and the QOL. RESULTS The one-way ANCOVA showed a significant difference among robust, prefrail and frail participants for loneliness. Moreover, an interaction effect of frailty with loneliness in determining the QOL was found. The receiver operating characteristic curves showed that loneliness and QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. CONCLUSION This study demonstrates a close relationship between frailty and loneliness, suggesting the need to simultaneously consider the two with regard to the QOL of empty-nest older adults in rural China. SUMMARY STATEMENT What is already known about this topic? There were no studies examining the associations of frailty and loneliness with QOL or the cut-point of the loneliness and QOL scores to reflect frailty. Few studies have revealed an association between loneliness and frailty. These studies focus mainly on older adults living in the community, and none consider the relationship between mental status and the frailty of empty nesters. What this paper adds? This study determined that frailty, loneliness and the QOL had a close relationship in empty nesters. There was a significant interaction among frailty, loneliness and the quality of life. Loneliness and the QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively. The implications of this paper? This study can enable governments and communities to pay attention to the psychological status of empty-nest individuals while paying attention to their psychological problems, such as loneliness, to help them improve their quality of life.
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Affiliation(s)
- Shouqi Wang
- School of Nursing, Jilin University, Changchun, China.,Endoscopy Center, The second Affiliated Hospital of Soochow University, Soochow, China
| | - Minghui Zhao
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, China
| | - Ying Shi
- School of Nursing, Jilin University, Changchun, China
| | - Meiling Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Jie Ying
- School of Nursing, Jilin University, Changchun, China
| | - Huanhuan Li
- School of Nursing, Jilin University, Changchun, China
| | - Yuan Li
- School of Nursing, Jilin University, Changchun, China
| | | | - Haiyan Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, China
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16
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Ham DW, Han H, Kim HJ, Park SM, Chang BS, Yeom JS. Risk factors for acute proximal junctional kyphosis after adult spinal deformity surgery in preoperative motion analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:1215-1225. [PMID: 33797623 DOI: 10.1007/s00586-021-06830-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/08/2021] [Accepted: 03/26/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to examine which motion analysis parameters regarding the dynamic aspects and/or balance affect the development acute proximal junctional kyphosis (PJK) following adult spinal deformity (ASD) surgery. METHODS A total of 90 consecutive patients were recruited prospectively, who underwent a corrective surgery for ASD with sagittal imbalance. According to the development of acute PJK within 6 months after surgery, the patients were divided into the PJK+ and PJK- groups. Before surgery, three-dimensional gait analyses were performed using a motion analysis system. The preoperative continuous and categorical variables were compared between the PJK+ and PJK- groups using independent t tests and chi-square tests, respectively. Finally, a multivariate logistic regression model was used to identify the risk factors and calculate the odds ratio (OR) for acute PJK. RESULTS A total of 20 and 70 patients were classified into the PJK+ and PJK- groups, respectively. There were no differences in the spinopelvic radiologic parameters pre- and postoperatively between the PJK+ and PJK- groups. The PJK+ group showed a significantly higher mean anterior pelvic tilt (Ant-PT) angle in preoperative motion analysis than the PJK- group (P = 0.001 for both sides). Multivariate analysis identified the mean Ant-PT angle (P = 0.047; OR 1.127; 95% CI 1.002-1.267) as a significant risk factor for acute PJK. CONCLUSION Preoperative Ant-PT angle during walking was associated with a higher OR in acute PJK after surgery.
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Affiliation(s)
- Dae-Woong Ham
- Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea
| | - Heesoo Han
- Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea
| | - Ho-Joong Kim
- Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea.
| | - Sang-Min Park
- Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea
| | - Bong-Soon Chang
- Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea
| | - Jin S Yeom
- Spine Center and Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 166 Gumiro, Bundang-gu, Sungnam, 463-707, Republic of Korea
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Kim HY, Nho JH, Kim JY, Kim SR. Validity and reliability of the Korean version of the world health organization quality of life instrument-older adults module. Geriatr Nurs 2020; 42:548-554. [PMID: 33143853 DOI: 10.1016/j.gerinurse.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Abstract
The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) is a scale that measures quality of life (QoL) based on the characteristics of older adults. This study aimed to evaluate the reliability and validity of the Korean version of the WHOQOL-OLD. It was administered to 273 older adults by convenience sampling in Jeonbuk, South Korea. The six-factor model was validated by confirmatory factor analysis (χ2=462.52 [p<.001], normed χ2=1.95, comparative fit index=0.94, Tucker-Lewis index=0.92, standardized root mean residual=0.06, root mean square error of approximation=0.059). Concurrent validity was demonstrated with the WHOQOL-BREF (r = 00.708), SF-12 (r = 0.508) and the Depression, Anxiety and Stress Scale (r=-0.499). In addition, the Korean version of the WHOQOL-OLD was evaluated for known group validity. Cronbach's alpha coefficient for the total scale was 0.897. The Korean version of the WHOQOL-OLD showed acceptable validity and reliability for measuring QoL in older Korean adults.
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Affiliation(s)
- Hye Young Kim
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Republic of Korea.
| | - Ju-Hee Nho
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Republic of Korea.
| | - Ji Young Kim
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Republic of Korea.
| | - Sung Reul Kim
- College of Nursing, Korea University, 145 Anam-ro, Seongbuk-Gu, Seoul 02841, Republic of Korea.
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Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186549. [PMID: 32916809 PMCID: PMC7557756 DOI: 10.3390/ijerph17186549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/02/2020] [Accepted: 08/05/2020] [Indexed: 12/21/2022]
Abstract
Frailty is a multidimensional syndrome, which is a worldwide concern within the field of geriatrics due to the aggravating effect on the physical and mental functions of the elderly. This study aimed to determine the prevalence and risk factors of the frailty syndrome among urban-living community-dwelling elderly in Malaysia. A cross-sectional study was conducted among 301 community-dwelling elders. Frailty status was assessed using the Fried phenotype criteria. Depressive symptoms were assessed using the Geriatric Depression Scale (M-GDS-14), whereas the functional abilities and cognitive status were measured using the Lawton Instrumental Activities of Daily Living (Lawton IADL) scale and the Mini-Mental State Examination (MMSE-M), respectively. Malnutrition risk was observed through the abridged version (Short Form) of the Mini Nutritional Assessment (MNA-SF). Multinomial logistic regression analysis was employed to determine the significant predictors of the frailty syndrome. Three hundred and one elderly persons engaged in this study, with a mean age of 67.08 ± 5.536 ranging between 60 to 84 years old. The prevalence values of frailty and pre-frail were 15.9% and 72.8%, respectively, in which women appeared to be at a higher risk of frailty. The multivariate model revealed that frailty could be predicted from an increase in age, lower household income, being at risk of malnutrition, wasting (low skeletal muscle mass), and high serum C-reactive protein (CRP) level. A holistic approach is suggested for managing the frailty syndrome as it involves a decline in the multiple components of the geriatric syndrome.
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Fu P, Zhou C, Meng Q. Associations of Sleep Quality and Frailty among the Older Adults with Chronic Disease in China: The Mediation Effect of Psychological Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145240. [PMID: 32698531 PMCID: PMC7400303 DOI: 10.3390/ijerph17145240] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 12/12/2022]
Abstract
Frailty affects the elderly and leads to adverse health outcomes. Preliminary evaluations have suggested that sleep quality and psychological distress are predictors of frailty among older adults. However, the mechanisms by which sleep quality affect frailty had not been fully addressed in the previous research. This study aimed to explore the mediation effect of psychological distress on the association between sleep quality and frailty among the elderly with chronic diseases in rural China. A total of 2346 old adults were included in the analysis. Frailty status was measured by Fried Phenotype criteria. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and psychological distress was examined by Kessler Psychological Distress Scale (K10). Ordinal logistic regressions were performed to assess the relationships between sleep quality and frailty. Mediation test was also conducted by bootstrap method. The prevalence rate of frailty among the elderly with chronic diseases was 21% in rural China. Compared with the elder of robust status, respondents identified as having frailty have lower SES, less vigorous physical activity, and worse self-reported health status. Poor sleep quality was a significant predictor of frailty with mediators (OR = 1.44, 95% CI = 1.19-1.76). Mediation analysis suggested that psychological distress mediated 41.81% of total effect between sleep quality and frailty. This study indicated that poor sleep quality was significantly related to frailty, and psychological was a mediator of this association. However, we could not investigate causal relationships between variables since this was one cross-sectional study. These findings suggested that an early detection of sleep problems and also psychological disorders should be taken to prevent frailty among the rural older adults in China.
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Affiliation(s)
- Peipei Fu
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, NHC Key Laboratory of Health Economics and Policy Research, Jinan 250012, China;
| | - Chengchao Zhou
- School of Public Health, Cheeloo College of Medicine, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Correspondence: ; Tel.: +86-531-8838-1567; Fax: +86-531-8838-2553
| | - Qingyue Meng
- China Center for Health Development Studies, Peking University, Beijing 100191, China;
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Exploring health-related quality of life and frailty in older adults based on the Korean Frailty and Aging Cohort Study. Qual Life Res 2020; 29:2911-2919. [PMID: 32607792 DOI: 10.1007/s11136-020-02568-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The study aimed to analyze the association between frailty and health-related quality of life (HRQOL) based on the Korean Frailty and Aging Cohort Study. METHODS In this cross-sectional study, 2905 adults aged 70 to 84 years were enrolled. Frailty was determined according to the Fried frailty index. HRQOL was measured using the 5-level EuroQol questionnaire (EQ-5D-5L) and the 12-item Short-Form Health Survey version 2 (SF-12). Hierarchical linear regressions were conducted to examine the relationship between frailty and HRQOL and a logistic regression analysis was performed to estimate odds ratios of frailty status in the scores of the lowest quartiles in each scale. RESULTS Of the total respondents, 7.8% were frail, 47.0% were pre-frail, and 45.2% were robust. Frail respondents had significantly lower HRQOL scores than robust respondents, especially for EQ-5D-5L utility weights (0.74 vs 0.93). Frailty was strongly associated with decreased HRQOL in both physical and mental component summary of SF-12 (p < 0.001). Both pre-frail and frail states were related to greater odds of scoring in the bottom 25% of HRQOL scales compared to the non-frail state (p < 0.0001). CONCLUSION Frailty was associated with declined HRQOL in Korean older adults. This result recommends raising awareness about identifying and preventing frailty for better quality of life in the Korean elderly population.
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Kojima G, Taniguchi Y, Kitamura A, Fujiwara Y. Is living alone a risk factor of frailty? A systematic review and meta-analysis. Ageing Res Rev 2020; 59:101048. [PMID: 32173535 DOI: 10.1016/j.arr.2020.101048] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To examine the association of living alone with frailty in cross-sectional and longitudinal studies by a systematic review and meta-analysis. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Community-dwelling older adults with a mean age of >60 years. METHODS A systematic search of the literature was conducted according to the PRISMA guidelines. We searched PubMed in February 2019 without language restriction for cohort studies that examined the associations between living alone and frailty. The reference lists of the relevant articles and the included articles were reviewed for additional studies. We calculated pooled odds ratios (OR) of the presence and incidence of frailty for living alone from cross-sectional and longitudinal studies. RESULTS Among the 203 studies identified, data of 44 cross-sectional studies (46 cohorts) and 6 longitudinal studies were included in this review. The meta-analysis showed that older adults living alone were more likely to be frail than those who were not (46 cohorts: pooled OR = 1.28, 95 % confidence interval (CI) = 1.13-1.45, p < 0.001). Gender-stratified analysis showed that only men living alone were at an increased risk of being frail (20 cohorts: pooled OR = 1.71, 95 %CI = 1.49-1.96), while women were not (22 cohorts: pooled OR = 1.00, 95 %CI = 0.83-1.20). No significant association was observed in a meta-analysis of longitudinal studies (6 cohorts: pooled OR = 0.88, 95 %CI = 0.76-1.03). CONCLUSIONS/IMPLICATIONS The present systematic review and meta-analysis showed a significant cross-sectional association between living alone and frailty, especially in men. However, living alone did not predict incident frailty. More studies controlling for important confounders, such as social networks, are needed to further enhance our understanding of how living alone is associated with frailty among older adults.
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Affiliation(s)
- Gotaro Kojima
- Department of Frailty Research, Videbimus Clinic Research Center, Tokyo, Japan; Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Yu Taniguchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan; Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, Japan.
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
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Gobbens RJ, Remmen R. The effects of sociodemographic factors on quality of life among people aged 50 years or older are not unequivocal: comparing SF-12, WHOQOL-BREF, and WHOQOL-OLD. Clin Interv Aging 2019; 14:231-239. [PMID: 30787599 PMCID: PMC6363394 DOI: 10.2147/cia.s189560] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The effects of sociodemographic factors on quality of life in older people differ strongly, possibly due to the fact that different measurement instruments have been used. The main aim of this cross-sectional study is to compare the associations of sex, age, marital status, education, and income with quality of life assessed with the Short-Form Health Survey (SF-12), the World Health Organization Quality of Life Questionnaire-BREF (WHOQOL-BREF), and the World Health Organization Quality of Life Questionnaire-Older Adults Module (WHOQOL-OLD). Methods The associations between sociodemographic factors and eleven quality of life domains were examined using a sample of 1,492 Dutch people aged ≥50 years. Participants completed the “Senioren Barometer”, a web-based questionnaire including sociodemographic factors, the SF-12, the WHOQOL-BREF, and the WHOQOL-OLD. Results All the sociodemographic factors together explained a significant part of the variance of all the quality of life domains’ scores, ranging from 5% to 17% for the WHOQOL-BREF, 5.8% to 6.7% for the SF-12, and 1.4% to 26% for the WHOQOL-OLD. Being a woman and being older were negatively associated with two and four quality of life domains, respectively. Being a woman, being married or cohabiting, and having higher education and a higher income were positively associated with six, six, one, and eleven quality of life domains, respectively. Conclusion Our study showed that the associations of sociodemographic factors and quality of life in middle-aged and older people depend on the instruments used to assess quality of life. We recommend that health care and welfare professionals focus particularly on people with a low income and carry out interventions aimed at improving their quality of life.
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Affiliation(s)
- Robbert Jj Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands, .,Zonnehuisgroep Amstelland, Amstelveen, the Netherlands.,Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Roy Remmen
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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You X, Zhang Y, Zeng J, Wang C, Sun H, Ma Q, Ma Y, Xu Y. Disparity of the Chinese elderly's health-related quality of life between urban and rural areas: a mediation analysis. BMJ Open 2019; 9:e024080. [PMID: 30782725 PMCID: PMC6352780 DOI: 10.1136/bmjopen-2018-024080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 11/04/2018] [Accepted: 12/18/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study aimed to examine the urban-rural disparity in health-related quality of life (HRQoL) of the Chinese elderly and to explore the mediating roles of socioeconomic status (SES) and frequency of contact with children in the relationship between urban/rural areas and HRQoL. METHODS This cross-sectional study used data from China Health and Retirement Longitudinal Study for 2015-2016, involving 12 369 Chinese aged 45 years and over. HRQoL of respondents was measured by three-level EuroQol five dimensions (EQ-5D-3L). SES, based on principal components analysis, was combined by the individual possessions of durable consumer goods and houses. Frequency of contact with children was derived from the responses to whether they live with children and how often they contact with them. Mediation analyses were performed to examine the mediating effects of SES and frequency of contact in the relationship between urban/rural areas and HRQoL. RESULTS Urban respondents had higher scores of HRQoL than rural respondents (p<0.05). As SES and frequency of contact with children increased, the scores of HRQoL of the elderly went up as well. Mediation analyses proved the possible mediating effects of SES and frequency of contact in the relationship between urban/rural areas and HRQoL (0.0713 and 0.0064). The indirect effects induced by SES and frequency of contact were 65.45% and 5.90%, respectively. CONCLUSIONS There was a significant difference in HRQoL between urban and rural middle-aged and elderly participants, which was partially mediated by urban-rural disparities in SES and frequency of contact with children. Higher SES and frequency of contact with children contributed to higher health status in the Chinese elderly.
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Affiliation(s)
- Xinyi You
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Yali Zhang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Jinfeng Zeng
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Congju Wang
- Department of Chronic Disease Management, Centers for Disease Control and Prevention of Suzhou High-tech Zone, Suzhou, China
| | - Hongpeng Sun
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Qinghua Ma
- Department of Chronic Disease Management, The 3rd People’s Hospital of Xiangcheng District, Suzhou, China
| | - Yana Ma
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Yong Xu
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
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Cao Dinh H, Bautmans I, Beyer I, Mets T, Onyema OO, Forti LN, Renmans W, Vander Meeren S, Jochmans K, Vermeiren S, Vella-Azzopardi R, Njemini R. Association Between Immunosenescence Phenotypes and Pre-frailty in Older Subjects: Does Cytomegalovirus Play a Role? J Gerontol A Biol Sci Med Sci 2018; 74:480-488. [DOI: 10.1093/gerona/gly135] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Indexed: 02/02/2023] Open
Affiliation(s)
- Hung Cao Dinh
- Frailty in Ageing Research Group, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Belgium
| | - Ivan Bautmans
- Frailty in Ageing Research Group, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Belgium
- Department of Geriatric Medicine, Belgium
| | - Ingo Beyer
- Frailty in Ageing Research Group, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Belgium
- Department of Geriatric Medicine, Belgium
| | - Tony Mets
- Frailty in Ageing Research Group, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Belgium
- Department of Geriatric Medicine, Belgium
| | | | | | - Wim Renmans
- Laboratory of Hematology, Universitair Ziekenhuis Brussel, Belgium
| | | | - Kristin Jochmans
- Laboratory of Hematology, Universitair Ziekenhuis Brussel, Belgium
| | | | | | - Rose Njemini
- Frailty in Ageing Research Group, Belgium
- Gerontology Department, Vrije Universiteit Brussel, Belgium
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