Depression and resilience mediates the effect of family function on quality of life of the elderly

Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit

BACKGROUND

Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients.

METHODS

The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel's Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty.

RESULTS

According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients.

CONCLUSIONS

Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.

Resilience and successful aging: A systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis investigates the relationship between successful aging (SA) and resilience in older adults, focusing on individuals aged 60 and above, to address a significant gap in understanding how resilience contributes to SA.

METHODS

Following the Cochrane review guidelines, we conducted searches in databases such as Web of Science, PsycNet, and PubMed up to December 2021 and used PRISMA as a tool for reporting the results. Our inclusion criteria were studies on psychological resilience and SA in older adults aged 60 and above. Exclusion criteria included studies on physical resilience, medical outcomes of SA, other indicators not used in screened studies (e.g., prevalence, means), populations with suicidal ideation or chronic/palliative illnesses, studies considering resilience as an indicator of SA, and qualitative studies on the association between resilience and SA.

RESULTS

A total of 21 studies were included and assessed for risk of bias using funnel plot and trim-and-fill methods. The meta-analysis revealed a medium effect size indicating a positive relationship between resilience and SA. However, high heterogeneity warrants a cautious interpretation of these results. No significant differences were found between older adults in the general population and those in retirement communities, nor were geographical variations (Asia, Europe, America) found to moderate this relationship.

DISCUSSION

The findings highlight the intrinsic link between older adults' attitudes towards aging, their subjective evaluations, and their level of psychological resilience. Resilience acts as a protective factor against psychological and physical adversities, underscoring the importance of resilience-enhancing strategies in interventions aimed at promoting SA. The conclusions drawn from this analysis should be approached with caution due to the heterogeneity of the included studies.

Assessing family function: older adults vs. care nurses: a cross-sectional comparative study

BACKGROUND

This study aimed to assess family function in home care for older adults. Understanding family dynamics is essential for providing quality care to older adults choosing to age in place.

METHODS

In a cross-sectional study, 53 patients aged 65 or older receiving home care were evaluated, along with four home care nurses. The General Function of Family Assessment Device (FAD-GF) was used for self-assessment to examine family resources.

RESULTS

Only 5.7% of older adults reported good family function. Strong correlations were found between assessments by nurses and older adults. Among the six aspects of family function, "problem solving," "communication," "affective responsiveness," and the overall results showed no disparities between the evaluations of older adults and nurses.

CONCLUSIONS

Home care nurses can effectively assess family function using the FAD-GF, particularly after six months of care. This assessment can help identify family issues and enhance home care quality through nurse training in FAD-GF application.

Family Functioning and Depressive Symptoms Among HIV-Positive Men Who Have Sex with Men: Mediating Roles of Stigma and Resilience

Background

Depressive symptoms are common among HIV-positive men who have sex with men (MSM). This study aims to explore (1) the relationship between family functioning and depressive symptoms and (2) the mediating roles of stigma and resilience in the relationship among HIV-positive MSM.

Methods

We used data from a cross-sectional study of a convenience sample in Hunan Province, China, conducted in 2019. The data analysis included 191 HIV-positive MSM with an average age of 26.98 years. All participants completed self-report questionnaires on demographic variables, family functioning, stigma, resilience, and depressive symptoms.

Results

Better family functioning was significantly associated with lower depressive symptoms. Both stigma (Indirect effect = -0.04, 95% CI, -0.10 ~ -0.001) and resilience (Indirect effect = -0.06, 95% CI, -0.12 ~ -0.01) were significant partial mediators in the relationship between family functioning and depressive symptoms. A parallel and chain mediating role of stigma and resilience in the relationship between family functioning and depressive symptoms was also supported (Indirect effect = -0.03, 95% CI, -0.08 ~ -0.01).

Conclusion

Improving family functioning is crucial for alleviating depressive symptoms among HIV-positive MSM in China. Depression assessment and reduction should be an integral part of prevention and treatment programs targeting stigma and resilience.

Resilience-happiness nexus in community-dwelling middle-aged and older adults: Results from Gan-Dau Healthy Longevity Plan

The core of healthy aging is intrinsic capacity (IC) that consists of major elements, i.e., cognition, locomotion, vitality, sensory capacity, and psychological aspect. This cross-sectional study analyzes data of the Gan-Dau Healthy Longevity Plan, targeting community-dwelling adults aged 50 years or older. The participants completed the assessment, in addition to WHO IC, including the Mini-Mental Status Examination (MMSE) for cognitive performance, 6 m walking speed (m/s),timed up-and-go test (s) and hand grip strength (Kg) for locomotor assessment, Cardiovascular health study (CHS) for frailty assessment, Mini Nutrition assessment short form (MNA-SF) for nutrition. Psychological aspect including the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the Geriatric Depression Scale-5 (GDS-5) for depressive symptoms, the Brief Resilience Scale (BRS) for resilience, and the Chinese Happiness Inventory (CHI) for happiness levels. The study enrolled 810 participants (mean age of 68.45 ± 8.05 years, 32% male) and revealed that 94.7% of participants exhibited impairments in IC, with visual capacity and cognition being the most common deficit items of IC. Resilience levels varied, with 37.4% of men and 33.5% of women exhibiting moderate to low resilience. Only 23.4% of male participants and 21.1% female participants reported a high level of happiness. Resilience was found to partially mediate the relationship between intrinsic capacity and happiness, with approximately 6.6% of the variance in happiness being mediated by resilience. In conclusion, the study provides valuable insights into the connections between psychological aspect, IC, and healthy aging.

Family function and emotional behavior problems in Chinese children and adolescents: A moderated mediation model

BACKGROUND

Studies have shown that family function is associated with emotional behavior problems. However, the underlying relationship mechanisms between family function and emotional behavior problems in children and adolescents is not fully understood. Therefore, the purpose of this study is to explore the mediating effect of resilience and the moderating effect of sleep quality using a moderated mediation model.

METHODS

6363 children and adolescents in grades four to nine were surveyed in some areas of Anhui Province, China. Family function, resilience, sleep quality, and emotional behavior problems were measured through a self-administered questionnaire. All data analysis was by performed by SPSS 23.0.

RESULTS

The results showed that family function was negatively associated with emotional behavior problems (r = -0.307, p < 0.01). Resilience partially mediated the relationship between family function and emotional behavior problems (indirect effect = -0.108, accounted for 38.4 %). Sleep quality moderated the relationship between family function and resilience (β = -0.039, P < 0.001).

CONCLUSION

Resilience and sleep quality respectively played a mediating and moderating effect in the relationship between family function and emotional behavior problems. These findings suggest that we should pay attention to the family function of children and adolescents in time, improve their resilience and sleep quality, so as to effectively reduce the occurrence of emotional behavior problems.

Effect of Supervised and Unsupervised Exercise Training in Outdoor Gym on the Lifestyle of Elderly People

The aim of this study was to investigate the effectiveness of supervised and unsupervised physical training programs using outdoor gym equipment on the lifestyles of elderly people.

METHODS

physically independent elderly people were randomly distributed into three groups: supervised training (n: 20; ST), unsupervised training (n: 20; UT) and control (n: 20; C). The ST and UT groups completed a 12-week program, with exercises performed three times a week. The ST group underwent weekly 30 min sessions consisting of a 5 min warm-up (walking at 60% of HRmax), followed by 20 sets of 30, "monitored by a metronome with 30" of passive recovery between sets and a five-minute cool-down. The following equipment was used: elliptical, rowing, surfing and leg press. The UT group was instructed to freely attend the gym and train spontaneously using the same equipment used by ST. Lifestyle changes were evaluated using a questionnaire containing specific domains.

RESULTS

no significant differences were identified in the domains for family, physical activity, nutrition, smoking, sleep, behavior, introspection, work and overall score; however, the values corresponding to the alcohol domain for the ST and UT groups were lower (p < 0.05) than the C group, remaining even lower after the 12 weeks of intervention. Time effect (p < 0.05) was found only in the ST group for the physical domains, sleep, behavior and overall score.

CONCLUSION

elderly people submitted to supervised and unsupervised physical exercise programs using outdoor gym equipment present positive changes in lifestyle parameters compared to physical inactive elderly people.

Effects of family function, depression, and self-perceived burden on loneliness in patients with type 2 diabetes mellitus: a serial multiple mediation model

BACKGROUND

Type 2 Diabetes mellitus (T2DM) has become a major lifestyle disease endangering human health worldwide. Patients with T2DM face varying degrees of loneliness, which adversely affects their family and the larger society. This study investigates the serial multiple mediating roles of depression and self-perceived burden between family function and loneliness in the T2DM population of China.

METHODS

In total, 260 T2DM patients were included. They rated themselves based on UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Family Care Index, and Self-Perceived Burden Scale. Pearson and Spearman correlation analyses were conducted to clarify the association among variables. The SPSS macro-PROCESS program was used for a series of multiple mediation analyses.

RESULTS

Family function, depression, self-perceived burden, and loneliness were significantly correlated (P < 0.01). Family function not only has a direct negative impact (effect = -2.809; SE = 0.213; 95%CI: LL = -3.228, UL = -2.390) on loneliness, but also has an indirect impact on loneliness through the independent mediating role of depression (effect = -0.862; SE = 0.165; 95%CI: LL = -1.202, UL = -0.567) and self-perceived burden (effect = -0.288; SE = 0.107; 95%CI: LL = -0.525, UL = -0.114) and the chain mediating role of depression and self-perceived burden (effect = -0.202; SE = 0.066; 95%CI: LL = -0.342, UL = -0.088).

CONCLUSIONS

Diversified interventions aimed at improving family function of T2DM patients would help in reducing the level of depression and self-perceived burden, and ultimately reducing loneliness.

Double Stigma in Portuguese Lesbian, Gay, and Bisexual Older Adults: A Study of Health Status

The double stigma-sexual stigma and ageism-can affect the health status of lesbian, gay, and bisexual (LGB) older adults, but little is known about this topic in Portugal and internationally. The aim of this study was to assess the health status and the prevalence of chronic diseases of Portuguese LGB older adults, as well as to assess the relationship between double stigma and health status. A sample of 280 Portuguese LGB older adults completed a chronic disease questionnaire, the Homosexuality-Related Stigma Scale, the Ambivalent Ageism Scale, and the SF-12 Short Form Health Survey. A structural equation model was performed using the double stigma variables as independent variables and health status as outcome. The mental health status of Portuguese LGB older adults was lower when compared to people from studies from more than 10 countries. Higher sexual self-stigma, sexual enacted stigma related to health care, and benevolent ageism significantly explained the worse general health status. The double stigma significantly affects the health status of these older adults in a profile of internalization of sexual stigma and benevolent age discrimination, and not necessarily by a hostile/aggressive profile. More research is needed on the double stigma.

The Association between Intergenerational Support and Self-Rated Health among Chinese Older Adults: Do Resilience and Gender Matter?

This study aims to examine the association between intergenerational support and self-rated health (SRH) levels using data collected from Chinese older adults residing in Honolulu, United States (N = 329). We also investigated the mediating role of resilience and the moderating role of gender in the association. We found that receiving emotional support was significantly and positively associated with better SRH for the whole sample. The positive effect of receiving emotional support on health was significant among older women only. In contrast, the beneficial effect of providing economic support on health was significant among older men only. We found that resilience significantly mediated the positive effect of received emotional support on SRH, and this effect was found for the whole sample and among older women. However, resilience did not mediate the positive effect of the economic support provided on SRH among older men.

Relationship of serum estradiol and progesterone with symptoms and sex difference in schizophrenia: A cross-sectional study in Iran

Background

Schizophrenia is a devastating disease characterized by frequent relapses, cognitive decline, and emotional and functional disability, with unknown causes. The phenomenology and clinical course of schizophrenic disorders are different between the two genders, which is thought to be related mainly to the effects of steroid sex hormones on the nervous system. Regarding inconsistencies in the studies, we aimed to compare the levels of estradiol and progesterone between schizophrenia patients and healthy individuals.

Methods

This cross-sectional study was conducted on 66 patients referred to the specialized clinical psychiatric ward of a teaching hospital in the north of Iran, for 5 months in 2021. Thirty-three schizophrenia patients confirmed by a psychiatrist based on DSM5 criteria were included in the case group, and 33 individuals without a psychiatric disease were included in the control group. We completed a demographic information checklist for each patient, along with the Simpson-Angus extrapyramidal side effect scale (SAS) for drug side effects and the positive and negative syndrome scale (PANSS) for the severity of the disease symptoms. Then, a 3-ml blood sample was taken from each participant to determine the serum levels of estradiol and progesterone. The data were analyzed by SPSS16 software.

Results

Thirty-four (51.5%) and 32 (48.5%) participants in this study were male and female, respectively. The mean serum level of estradiol was 22.33 ± 13.65 pm/dl in schizophrenia patients and 29.36 ± 21.32 pm/dl in the control group, showing no significant difference between the two groups (P = 0.4). However, the mean serum level of progesterone was significantly lower in schizophrenia patients (0.37 ± 1.39 pm/dl) than in control subjects (3.15 ± 5.73 pm/dl) (P < 0.001). The PANSS and SAS scores were not significantly correlated with the level of sex hormones (P > 0.05). Serum estradiol and progesterone levels based on sex significantly differed between the two groups (except for female estradiol).

Conclusion

Considering the hormonal differences between schizophrenia patients and control subjects, determining hormonal levels in these patients and using complementary hormonal therapies with estradiol or similar compounds can be beneficial as the starting point of schizophrenia treatment, where therapeutic responses can draw the future developmental framework.

Sexual function and its association with sexuality and quality of life in older women

Abstract Objective to analyze the sexual function and its association with the sexuality and quality of life of elderly women. Methods this is a cross-sectional web survey study developed with 166 elderly women. Four self-administered instruments were used to obtain biosociodemographic, sexual function, sexuality and quality of life data. The analysis was performed using the Mann-Whitney test, Spearman correlation and linear regression, considering a 95% confidence interval. Results the greatest influence of sexual function was observed in the sexual act dimension of sexuality (β=0.524; [95%CI=0.451-0.597]; p<0.001; R2=54.8%) and between the intimacy facet of quality of life (β =0.501; [95%CI=0.380-0.622]; p<0.001; R2=29.0%). In general, the regression model showed that sexual function remained associated with sexuality (β=0.888; [CI95%=0.749-1.028]; p<0.001; R2=49.1%) and the quality of life of the participants (β=0.352; [CI95%=0.264-0.439]; p<0.001; R2=27.7%). Conclusion and implications for the practice sexual function is associated with the sexuality and quality of life of older women, assuming a directly proportional behavior which, in turn, can become a strategy to add quality to the additional years of life of this population.

Função sexual e sua associação com a sexualidade e a qualidade de vida de mulheres idosas

Resumo Objetivo analisar a função sexual e sua associação com a sexualidade e com a qualidade de vida de mulheres idosas. Método trata-se de um estudo transversal, do tipo web survey, desenvolvido com 166 mulheres idosas. Foram utilizados quatro instrumentos autoaplicáveis para a obtenção dos dados biosociodemográficos, da função sexual, sexualidade e qualidade de vida. A análise foi realizada com o teste de Mann-Whitney, correlação de Spearman e regressão linear, considerando um intervalo de confiança de 95%. Resultados a maior influência da função sexual foi observada na dimensão ato sexual da sexualidade (β=0,524; [IC95%=0,451-0,597]; p<0,001; R2=54,8%) e entre a faceta intimidade da qualidade de vida (β=0,501; [IC95%=0,380-0,622]; p<0,001; R2=29,0%). De modo geral, o modelo de regressão demonstrou que a função sexual permaneceu associada à sexualidade (β=0,888; [IC95%=0,749-1,028]; p<0,001; R2=49,1%) e à qualidade de vida das participantes (β=0,352; [IC95%=0,264-0,439]; p<0,001; R2=27,7%). Conclusão e implicações para a prática a função sexual está associada à sexualidade e à qualidade de vida das mulheres idosas, assumindo comportamento diretamente proporcional que, por sua vez, pode se tornar uma estratégia para agregar qualidade aos anos adicionais de vida dessa população.

The relationship among pregnancy-related anxiety, perceived social support, family function and resilience in Chinese pregnant women: a structural equation modeling analysis

BACKGROUND

Accumulating evidence suggests that pregnancy-related anxiety (PRA) has adverse impacts on maternity health and infant development. A substantial body of literature has documented the important influence of family function, perceived social support and resilience on PRA. However, research identifying the mediating mechanisms underlying this relationship in China are still lacking. Therefore, the current study aimed to investigate the prevalence of PRA under the three-child policy in China, and also explore the interrelationships among perceived social support, family function, resilience, and PRA.

METHODS

In this cross-sectional study, a convenient sampling method was used to select 579 pregnant women who underwent prenatal examination at the maternity outpatient departments of the First Affiliated Hospital of Chongqing Medical University in China from December 2021 to April 2022. Participants were required to complete the following questionnaires: the demographic form, the Chinese Pregnancy-related Anxiety scale, the 10-item Connor-Davidson Resilience Scale, the APGAR Family Care Index Scale, and Multidimensional Scale of Perceived Social Support. Pearson correlation analysis was utilized to examine the rudimentary relationship among the study variables. Bootstrapping analyses in the structural equation modeling were applied to identify the significance of indirect effects.

RESULTS

There were 41.4% of pregnant Chinese women indicating PRA. Correlational analyses indicated that perceived social support, family function and resilience were negatively associated with PRA (r = - 0.47, P < 0.01; r = - 0.43, P < 0.01; r = - 0.37, P < 0.01, respectively). The results of bootstrapping analyses demonstrated significant indirect effects of perceived social support (β = - 0.098, 95% CI [- 0.184, - 0.021]) and family function (β = - 0.049, 95% CI [- 0.103, - 0.011]) on PRA via resilience.

CONCLUSIONS

Chinese pregnant women are suffering from high levels of PRA. Better family function and perceived social support might reduce the occurrence of PRA, as well as by the mediating effects of resilience. Healthcare providers must be concerned about PRA and perform corresponding actions to reduce it. By strengthening social support and improving family function, antenatal care providers could effectively reduce or prevent PRA. And more importantly, implementing resilience-promoting measures are also essential to relieve anxiety and support mental health in pregnant women.

The associations between depressive symptoms, functional impairment, and quality of life, in patients with major depression: undirected and Bayesian network analyses

BACKGROUND

Depressive symptoms, functional impairment, and decreased quality of life (QOL) are three important domains of major depressive disorder (MDD). However, the possible causal relationship between these factors has yet to be elucidated. Moreover, it is not known whether certain symptoms of MDD are more impairing than others. The network approach is a promising solution to these shortfalls.

METHODS

The baseline data of a multicenter prospective project conducted in 11 governances of China were analyzed. In total, 1385 patients with MDD were included. Depressive symptoms, functioning disability, and QOL were evaluated by the 17-item Hamilton Depression Rating Scale (HAMD-17), the Sheehan Disability Scale (SDS), and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). The network was estimated through the graphical Least Absolute Shrinkage and Selection Operator (LASSO) technique in combination with the directed acyclic graph.

RESULTS

Three centrality metrics of the graphical LASSO showed that social life dysfunction, QOL, and late insomnia exhibited the highest strength centrality. The network accuracy and stability were estimated to be robust and stable. The Bayesian network indicated that some depressive symptoms were directly associated with QOL, while other depressive symptoms showed an indirect association with QOL mediated by impaired function. Depressed mood was positioned at the highest level in the model and predicted the activation of functional impairment and anxiety.

CONCLUSIONS

Functional disability mediated the relationship between depressive symptoms and QOL. Family functionality and suicidal symptoms were directly related to QOL. Depressed mood played the predominant role in activating both anxiety symptom and functional impairment.

Exploring the mediating effects of negative and positive religious coping between resilience and mental well-being

Background:

The purpose of the study was to examine more thoroughly the relationship between trait resilience and mental well-being. Although research demonstrates that this relationship is partially mediated by stress-related variables, no study has taken into account the mediating role of religious coping. We examined the mediating role of both variants of religious coping, positive and negative, along with specific strategies within the scope of religious coping strategies in a group of practicing Catholics.

Method:

Participants were 317 people aged 19–60 years (M = 24.34; SD = 6.30). The respondents indicated their gender and age, and then completed the RS-14 (trait resilience), RCOPE (religious coping), and WEMWBS (mental well-being) scales.

Results:

The results displayed a significant relationship between resilience and mental well-being (r = 0.67; p &lt; 0.001). The relationship between resilience and positive religious coping was negligible (r = 0.09; p = 0.74), contrary to the relationship between resilience and negative coping that was significant but weak (r = −0.29; p &lt; 0.001). Although the relationships between overall negative and positive religious coping with mental well-being were irrelevant, we found significant relationships between some strategies and mental well-being. The mediation analysis has demonstrated that the general negative religious coping and the strategies of demonic reappraisal, passive religious deferral, and spiritual discontent have enhanced the positive relationship between resilience and mental well-being. Contrary to expectation, positive strategies did not mediate the relationship between resilience and mental well-being, except religious practices (c′path totaled β = 0.66; t = 15.74, p &lt; 0.001). The insignificant mediation effect can stem from the fact that the relationship between positive religious coping and stress is noticeable only in the long term. We controlled age and sex as statistically significant covariates so that the mediation effects obtained were devoid of the influence of those critical variables on the models.

Conclusion:

This is the first study to investigate the role of religious coping as a mediator in the relationship between resilience and mental well-being.

Quality of Life, Hopelessness, Impulsivity, and Suicide in the Rural Elderly in China: A Moderated Mediation Analysis of Psychological Autopsy Data

Background

People who had died by suicide always being associated with negative emotions and even mental disorders. Understanding mechanisms underlying the association between quality of life (QOL), hopelessness, and suicide are of great significance. In this study, we aimed to test a model in which the QOL-suicide relationship was mediated by hopelessness and moderated by impulsivity.

Methods

Participants (N = 484, including 242 suicide deaths and 242 matched controls) were rural residents 60 years of age and older, randomly selected from 12 rural counties in China using a two-stage stratified cluster sampling method. Data were collected with standard psychological autopsy technique from informants (n = 968). The outcome variable was a suicide death. QOL, hopelessness, and impulsivity were assessed using validated scales. The proposed relationships were tested using mediation and moderated mediation models.

Results

Of the total sample, 55.8% were men with a median age of 75.5 years. Results from the moderated mediation analysis indicated that QOL was negatively associated with suicide (beta = −0.141, p < 0.01); this association was mediated by hopelessness (indirect effect: beta =0.578, p < 0.01), accounting for 73% of the total effect. Impulsivity significantly moderated the mediation effect from QOL to hopelessness (beta =0.005, p < 0.01).

Conclusions

Study findings have confirmed the negative association between QOL and suicide with psychological autopsy data, and demonstrated the role of hopelessness in mediating the QOL-suicide relation that is further modified by impulsiveness. These findings depend on our understanding of the suicide epidemiology among the elder in rural China and provide information much needed for suicide prevention.

The mediating role of coping in the relationship between family function and resilience in adolescents and young adults who have a parent with lung cancer

PURPOSE

Resilience plays an important role in helping individuals to adapt to adversity and improve their psychosocial outcomes. This study aims to examine the mediating role of coping in the relationship between family function and resilience in adolescents and young adults (AYAs) who have a parent with lung cancer.

METHOD

A total of 135 AYAs with a lung cancer parent were recruited from a tertiary grade A cancer center in southern China, and investigated using a self-designed general information questionnaire, the Resilience Scale for Chinese Adolescents, the Simplified Coping Style Questionnaire, and the Family Adaptation, Partnership, Growth, Affection, Resolve index.

RESULTS

The mean score of AYAs' resilience was (3.61 ± 0.49), and its influencing factors included AYAs' years in work, family function, and positive coping. The total effect of family function on resilience was significant (total effect = 0.38, 95% CI [0.048-0.115]), and a positive indirect effect was identified for family function on resilience via positive coping (indirect effect = 0.10, 95% CI [0.005-0.043]).

CONCLUSION

Family functioning can facilitate resilience either directly or by promoting positive coping. This study suggests that individualized interventions can be made to improve resilience by promoting family function, or by enhancing positive coping in AYAs with a lung cancer parent.

Studying suicide using proxy-based data: reliability and validity of a short version scale for measuring quality of life in rural China

Background

To evaluate the reliability and validity of the short version six-item Quality of Life Scale (QOLS-6) and the consistency of subject-proxy data in a case-control psychological autopsy study on elderly suicide in rural China.

Methods

A two-stage stratified cluster sampling method was used to select research sites. We used self-administered questionnaires to collect proxy-based information from informants and subject-based information from living comparisons.

Results

A total of 242 pairs of suicide cases and living comparisons were selected in our research. Subject-proxy consistency for QOLS-6 was good (Intraclass correlation coefficient (ICC) was 0.688) in living controls. Good internal consistency of QOLS-6 was validated by Cronbach’s α being greater than 0.6 among suicide cases and living comparisons. The mean scores of quality of life were lower among suicide cases than living controls. Quality of life was negatively correlated with depression, loneliness, hopelessness, impulsiveness and stressful life events, while it was positively correlated with activities of daily living and family function.

Conclusions

QOLS-6 has good reliability and validity, which can be used for assessing quality of life among Chinese rural older adults. It is shorter and easier than any other scale for measuring quality of life and can be used as a screening tool in future studies.

Psychometric Evaluation of the Making it CLEAR Questionnaire: A Resilience Measure for Older Adults

Background and Objectives

Previous efforts to develop a resilience measure for older adults have largely failed to consider the environmental influences on their resilience, and have primarily concentrated on the resilience of community-dwelling older adults. Our objective was to validate a new multidimensional measure of resilience, the Making it CLEAR (MiC) questionnaire, for use with older adults at the point of discharge from hospital.

Research Design and Methods

This study tested the structure, validity, and reliability of the MiC questionnaire. The questionnaire consists of 34 items, which assess the “individual determinants of resilience” (IDoR) and the “environmental determinants of resilience” (EDoR) across 2 subscales. 416 adults aged 66–102 years participated. Exploratory factor analysis, item analysis, and linear regression were undertaken.

Results

The IDoR subscale contained six factors which were labeled “Self-efficacy,” “Values,” “Interpersonal skills,” “Life orientation,” “Self-care ability,” and “Process skills.” The EDoR subscale contained five factors related to “Person–environment fit,” “Friends,” “Material assets,” “Habits,” and “Family.” Both subscales demonstrated acceptable convergent validity and internal consistency, while individual items showed acceptable levels of discrimination and difficulty.

Discussion and Implications

The study provides evidence supporting the validity and quality of the MiC questionnaire. The results suggest that the MiC questionnaire could be used to identify the resilience needs of older adults at the point of hospital discharge. However, future research should identify which items of the MiC questionnaire are associated with hospital readmission, in order to develop an easily applicable screening tool for clinical practice.

Urban-rural differences in the association between social activities and depressive symptoms among older adults in China: a cross-sectional study

BACKGROUND

Participation in social activities has positive health effects among older adults; however, few studies have investigated the association between social activity and depressive symptoms among Chinese older adults. This study aimed to examine the association between social activities and depressive symptoms among older adults in China regarding urban-rural differences.

METHODS

Data were collected from 8255 respondents from the 2015 China Health and Retirement Longitudinal Study. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Type and frequency of social activities were collected via a questionnaire. Multivariate logistic regression analysis was used to explore the relationship between social activities and depressive symptoms.

RESULTS

In our study, the prevalence of depressive symptoms was lower in urban older adults compared with rural older adults (25.2% vs. 40.7%). After adjustment for all covariates, our results indicated that interacting with friends almost weekly or almost daily (almost weekly: OR = 0.568, 95%CI: 0.337-0.955; almost daily: OR = 0.664, 95%CI: 0.453-0.973) and participating in community organizations almost daily were inversely associated with depressive symptoms among urban older adults (OR = 0.107, 95%CI: 0.012-0.952). Interacting with friends almost daily (OR = 0.847, 95% CI: 0.720-0.996) and participation in hobby groups either almost every week or almost daily were both inversely associated with depressive symptoms among rural older adults (almost weekly: OR = 0.683, 95%CI: 0.518-0.902; almost daily: OR = 0.567, 95%CI: 0.440-0.731). Participating in sports groups almost daily was inversely associated with depressive symptoms among both urban and rural older adults (urban: OR = 0.664, 95%CI: 0.445-0.991; rural: OR = 0.506, 95%CI: 0.366-0.700).

CONCLUSIONS

Our findings indicated that there is a cross-sectional association between participation in social activities and depressive symptoms among Chinese older adults, and the association differed between urban and rural older adults. This implies that participation in social activities may be significant for alleviating depressive symptoms of older adults. When encouraging older adults to participate in social activities, the government should consider urban-rural differences and take effective measures accordingly. Longitudinal studies are needed to examine the causal relationships between social activities and depressive symptoms among older adults.

Relationship between family functionality and the quality of life of the elderly

OBJECTIVE

To analyze the correlation between family functionality and the quality of life of the elderly.

METHOD

Sectional and correlational study conducted with 692 Brazilian elderly between July and October 2020. The elderly filled three instruments: biosociodemographic, family APGAR and WHOQOL-Old. The tests Kruskal-Wallis, Pearson correlation, and linear regression analyzed the data. The study considered a 95% confidence interval (p < 0.05) for all analyses.

RESULTS

The elderly with mild and severe family dysfunction presented worse quality of life when compared to the elderly with a functional family. All facets of quality of life correlated positively with family functionality.

CONCLUSION

Family functionality is positively correlated with the quality of life of the elderly, therefore requiring the inclusion of the family in health care plans to identify potential family stressors early and plan interventions to solve the problems raised.

Relationship between Family Function, Anxiety, and Quality of Life for Older Adults with Hypertension in Low-Income Communities

BACKGROUND

Effective functional family was beneficial for older adults' health, which may affect the quality of life (QoL) in hypertension patients. This study aimed to clarify the association between family function, anxiety, and QoL for older adults with hypertension in low-income communities.

METHODS

A questionnaire survey was conducted on 363 older adults with hypertension in low-income communities in Wuhan from September 2019 to November 2019. The relationships among the variables were examined by Pearson's correlation analysis. Predictor effects were tested using hierarchical multiple regressions, controlling for demographic characteristics. The structural equation model (SEM) was used to test the mediation effects of anxiety on the pathway from family function to QoL.

RESULTS

Family function was negatively correlated with the self-rating anxiety scale (SAS) score and positively correlated with the mental component score (MCS), but had no influence on the physical component score (PCS). Both PCS and MCS were negatively correlated with SAS. Anxiety was the negative predictor of MCS and PCS. Family function was the positive predictor of MCS, but had no influence on PCS. The path model indicated that anxiety significantly mediated the link between family function and QoL (R 2 = 32.8%), but only partially.

CONCLUSION

A significant correlation between anxiety, family function, and QoL was found. Anxiety had a partial mediating effect on the relationship between family function and QoL. Further research should focus on increasing the level of family function and reducing the perceived anxiety of older adults with hypertension to improve their QoL level.

Relationship of Coping Strategies and Quality of Life: Parallel and Serial Mediating Role of Resilience and Social Participation among Older Adults in Western Philippines

Growing old is frequently linked with various challenges. Hence, it is important to understand how to age successfully. Drawing on the concept that an individual’s quality of life (QOL) is influenced by their demographics, coping strategies, resilience, and social participation, the current study reports on the findings of these variables among older adults in the Western Philippines. A total of 392 volunteer older adults were surveyed. Aside from the demographics such as age, gender, marital status, average monthly income, educational attainment, and health status, the data collected also included the 30-item coping strategies for the elderly, 14-item resilience scale, 12-item social participation scale, and 35-item older people’s QOL scale. Structural equation modeling was used to verify the parallel and serial mediating role of resilience and social participation within the relationship between coping strategies and QOL. Findings show that coping strategies alone are not enough to improve QOL. The only way to improve QOL is through resiliency, as well as the ability to participate in social activities. In essence, the QOL of older adults can be improved by encouraging them to have more social participation, and at the same time, understand how it takes to become resilient.

Coping strategies mediate the association between family functioning and posttraumatic growth in family caregivers of people with dementia

OBJECTIVES

This study aimed to examine the mediating effect of coping strategies on the relationship between family functioning and posttraumatic growth in family caregivers of people with dementia (PwD).

METHODS

A total of 124 family caregivers of PwD from a memory clinic were investigated from July to October 2017. Family functioning, coping strategies, and posttraumatic growth of family caregivers of PwD were measured. Data were processed using descriptive statistics, correlation analysis, regression analysis, and structural equation modelling.

RESULTS

Posttraumatic growth was observed in family caregivers of PwD. The caregiver's gender, relationship with the patient, and difficulty balancing financial income and expenditures in the past month, as well as disease severity of PwD, are significant predictors of posttraumatic growth. There were significantly positive correlations among posttraumatic growth, family functioning and positive coping strategies (P＜0.01). Positive coping strategies exert a complete mediating effect between family functioning and posttraumatic growth (β = 0.49, P < 0.05).

CONCLUSIONS

A model of the posttraumatic growth of family caregivers of PwD can be established, and the relevant mechanisms can be explored. Healthcare providers should pay attention to the family functioning of caregivers and take effective measures to provide them with positive coping strategies to promote their posttraumatic growth.

Factors associated with self-management behaviors of patients with chronic obstructive pulmonary disease

AIMS

To examine self-management behaviors level and discuss the associated factors among chronic obstructive pulmonary disease (COPD) patients.

METHODS

A descriptive study design was used. A convenience sample of 124 COPD patients was recruited from three hospitals in Fuzhou. Self-management Behaviors, Social Support Rating Scale and The Family APGAR Score were used to collect data. Descriptive statistics, one-way analysis of variance (ANOVA), Pearson correlation and multiple linear regression were used for data analysis.

RESULTS

The overall score of self-management behaviors ranged 4-41, with a mean score of 21.26 ± 7.72. Pearson correlation analyses and ANOVA revealed that age, course of disease, education, marital status, family function, subjective support, objective support, and availability of support were positively correlated with overall self-management behaviors (p < .05). Multiple linear regression analyses revealed that subjective support and availability of support significantly predicted self-management behaviors.

CONCLUSIONS

The level of self-management behaviors of COPD patients was suboptimal. We suggest that people in the patients' social network should provide support for them, and help them use available resources to improve the level of self-management behaviors.

A systematic review and correlational meta-analysis of factors associated with resilience of normally aging, community-living older adults

Background and Objectives

Global policy emphasizes the need to promote healthy aging through supporting inclusivity, safety, and functional independence. Research indicates that efforts to enhance resilience can contribute to meeting these objectives. We employed a meta-analytical approach to examine evidence on resilience in community-living older adults.

Research Design and Methods

We searched electronic databases until January 13, 2020 for observational studies investigating factors associated with resilience in this population. Articles had to provide quantitative data based on standardized assessment and include samples where mean participants’ age and lower 95% confidence interval were more than 55 years. We included 49 studies reported in 43 articles and completed 38 independent meta-analyses, 27 for personal and 11 for contextual factors associated with resilience.

Results

A range of personal and contextual factors were significantly associated with resilience, with effects sizes predominantly small to moderate (0.1 < r < 0.49). Factors reflecting psychological and physical well-being and access to/quality of social support were associated with higher resilience. Factors indicative of poorer psychological well-being and social challenges were associated with lower resilience. Longitudinal evidence was limited. The level of between-study heterogeneity was substantial to considerable. Where relevant analysis was possible, the identified publication bias was also considerable.

Discussion and Implications

The quality of the available evidence, as well as issues related to measurement of resilience, indicates the need for further work relative to its conceptualization and assessment. The presented findings have important clinical implications, particularly within the context of the coronavirus disease 2019 impact on resilience in older adults.

Resilience in elderly people: factors associated with sociodemographic and health conditions

OBJECTIVE

to describe the sociodemographic and health characteristics of elderly people, measure the score of total resilience and by sex and verify the association of sociodemographic and health variables with total resilience and by sex.

METHODS

this is a household survey with 808 elderly people, assessed by validated instruments. Student's t test and multiple linear regression (p<0.05).

RESULTS

most were female, 60|-|79 years old. The total resilience score was 78.06, for men 81.53 and for women, 76.32. Total resilience was associated with males; positive self-perceived health; greater participation in Advanced Activities of Daily Living; fewer morbidities; absence of depressive symptoms. Among men and women, resilience was associated with greater participation in Advanced Activities of Daily Living and absence of depressive symptoms and, specifically, among women, positive self-perceived health.

CONCLUSION

these results contribute to nursing care, aiming to encourage resilience.

Effects of the Older Family Network Program on Improving Quality of Life Among Older Adults in Thailand

BACKGROUND

The evidence of promoting family members' health care for older adults by applying family networks and theory of planned behavior will lead to mental health and lower the quality of life among older adults in rural community in Thailand is unclear.

OBJECTIVE

The study aimed to assess the effects of health promotion among older adults using an aging family network program to reduce depression and improve quality of life (QOL) among older adults.

PATIENTS AND METHODS

This quasi-experimental study was enrolled on one hundred and ten older adults and their family members. Fifty-five older adult participants joined the health promoting program using family member involvement. This program trained them to change health behaviors such as eating healthy food, exercising, emotion management and disability preventive activities to reduce dementia, stroke and falls. The program was conducted in a rural community for 12 months. A comparison group program conducted usual health promoting activities by health personnel. They evaluated quality of life (QOL) using WHOQOL-OLD measurement, and 30-item geriatric depression scale before implementing interventions and after interventions at 9th and 12th months. Data were analyzed using general linear mixed model analysis.

RESULTS

After the intervention, social support and perception of health care from family members were significantly improved at the 9th month. At the 12th month, overall QOL, sensory ability, social participation, intimacy, social support, and perception of health care from family members significantly improved. Depression was also reduced at the 12th month.

CONCLUSION

These findings demonstrated that health promotion using family members improved QOL and reduced depression long term. Policymakers should implement programs to improve QOL among older adults. They need to improve the involvement of family members when conducting health promotion among older adults and support funding due to conduct on weekends or in the evening.

The relationship between family intimacy and relapse tendency among people who use drugs: a moderated mediation model

BACKGROUND

Drug addiction is difficult to overcome. The relapse rate is high, and the negative impact on individuals, families and society is severe, therefore exploring social psychological mechanisms to reduce relapse has very important theoretical and practical value. However, the underlying mechanism by which the interaction between family and individual factors influences the tendency to relapse remain unclear. Thus, the purpose of this paper is to discuss the relationship between family intimacy and relapse tendency of people who use drugs, as well as the mediating effect of psychological capital and the role of self-efficacy in it.

METHODS

A total of 817 male who use drugs were investigated via the Family Intimacy and Adaptability Scale, General Self-Efficacy Scale, Positive Psychological Capital Questionnaire and Relapse Tendency Questionnaire. Using Hayes's process macro carried out moderated mediation analysis.

RESULTS

(1) The average family intimacy score of people who use drugs was low. (2) Family intimacy negatively predicted relapse tendency in people who use drugs. (3) Psychological capital mediated the relationship between family intimacy and relapse tendency. (4) The first half of the indirect effect of family intimacy on relapse tendency was regulated by self-efficacy, compared with the low level of self-efficacy, the psychological capital level with high self-efficacy is higher.

CONCLUSION

The results of this study suggest that the intimacy between the people who use drugs and their family members should be improved, and the rehabilitation center should take various measures to enhance the psychological capital level and the level of self-efficacy of the people who use drugs, which will be helpful to reduce their relapse tendency.

The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases

Aim

To explore whether self‐efficacy has any positive or negative mediating effects between family functioning and quality of life among elders with chronic diseases.

Design

A cross‐sectional study.

Methods

Questionnaires were collected from 516 community‐dwelling elderly individuals with chronic diseases using a convenience sampling method. The questionnaires included the Self‐efficacy for Managing Chronic Disease Six‐Item Scale, the Family Adaptation Partnership Growth Affection Resolve Index and the MOS 36‐Item Short Form Health Survey.

Results

Family functioning and self‐efficacy impacted the quality of life of community‐dwelling elderly individuals with chronic diseases. Family functioning was mediated by self‐efficacy and had an indirect impact on quality of life. The mediating effect accounted for 62.50% of the total effect.

Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor-partner interdependence mediation model

PURPOSE

Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads.

METHODS

This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model.

RESULTS

This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience.

CONCLUSIONS

Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.

Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China

BACKGROUND

Perinatal depression is the most common complication of gestation and childbearing affecting women and their families, and good social support and family function are considered protective and modifiable factors. This study aimed to investigate depression status and explore inter-relationships between social support and perinatal depression considering the influence of family function in rural areas of Southwest China.

METHODS

This is a cross-sectional study. The following instruments were used: the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, and the Social Support Rate Scale. A structural equation modelling was used to test the hypothesis relationships among the variables.

RESULTS

A total of 490 rural antenatal (N = 249) and postpartum (N = 241) women (mean age (standard deviation), 28.17 ± 5.12) participated. We found that the prevalence of depression symptoms was 10.4%. Path analysis showed that family function had a direct negative correlation with depression (β = - 0.251, 95%CI: - 0.382 to - 0.118). Social support had a direct positive correlation with family function (β =0.293, 95%CI: 0.147 to 0.434) and had an indirect negative correlation with depression (β = - 0.074, 95%CI: - 0.139 to - 0.032), family function fully mediated the relationship between social support and depression.

CONCLUSIONS

Findings of this study highlight that family function should be considered as the key target for interventions aiming to lower the prevalence of perinatal depression. Family members interventions are critical to reduce depression among antenatal and postpartum women.

Pain Characteristics and Quality of Life in Older People at High Risk of Future Hospitalization

This study deals with how pain characteristics in conjunction with other factors affect quality of life (QoL) in a vulnerable primary care population. We recruited vulnerable older people (75+, n = 825) living in south-eastern Sweden. A postal questionnaire included pain aspects, QoL (EQ-5D-3L, RAND-36 physical functioning, attitudes toward own aging, and life satisfaction), functional status, social networks, and basic demographic information. Pain extent and localization was obtained by digitalization of pain drawings reported on standard body charts. Most respondents were experiencing pain longer than 3 months (88.8%). Pain frequency varied mostly between occasionally (33.8%) and every day (34.8%). A minority reported high pain intensity (13.6%). The lower back and lower legs were the most frequently reported pain locations (>25%). Multiple linear regression model revealed three characteristics of pain (intensity, frequency, and extent) remained inversely associated with the EQ-5D-3L index score (R² = 0.57). Individually, each of these pain characteristics showed a negative impact on the other three dimensions of QoL (R² = 0.23–0.59). Different features of pain had impact on different dimensions of QoL in this aging population. A global pain assessment is useful to facilitate individual treatment and rehabilitation strategies in primary care.

The effects of a short-term meditation-based mindfulness protocol in patients receiving hemodialysis

Mindfulness-based approaches that promote health, improve quality of life, and reduce the impact of comorbidities are key aspects in chronic diseases management. We aimed to verify the impact of a short-term meditation protocol on psychosocial and physiological parameters in chronic hemodialysis patients. We enrolled twenty-two patients, median age of 69.5 years old, into a 12-week meditation protocol that occurred during each hemodialysis session for 10-20 minutes, 3x/week, in a private tertiary hospital. We then evaluated clinical, psychological, and laboratorial parameters pre- and post-meditation. Patients exhibited a better control of serum phosphorus (-0.72 mg/dL; P = 0.002), a decrease in systolic blood pressure (-1.90 mmHg; P = 0.009), a 23% decrease in depressive symptoms (P = 0.014), and an increase of 7% in the self-compassion scale (P = 0.048) after meditation. To note, we observed an increase in 13% of the mindfulness score (P = 0.019). Our preliminary study describes the effects of a short-term meditation protocol in chronic hemodialysis setting. We observed a decrease in depressive symptoms and in blood pressure values, an improvement in self-compassion and serum phosphorous levels. In conjunction with the promising results of meditation in chronic kidney disease setting, this encouraging preliminary study supports the need for additional clinical trials.

The Associations of Family Functioning, General Well-Being, and Exercise with Mental Health among End-Stage Renal Disease Patients

OBJECTIVE

This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress. Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioning and psychological distress.

METHODS

Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item General Health Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzed using multiple linear regression analysis and path analysis.

RESULTS

The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factors of psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by general well-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated by exercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029).

CONCLUSION

The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercise were associated with psychological distress. Family functioning could affect psychological distress partially by affecting general well-being. Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.

Prevalence and related factors of depression and falls among the elderly living in rural communities of Guangzhou

Few studies have concentrated on the prevalence and related factors of depression and falls among the elderly living in rural communities of Guangzhou. A total of 335 participants aged ≥60 years were recruited by simple random sampling method. A structural equation model was applied to determine interrelationships between depression, falls and other variables. As high as 27.5% and 23.3% participants had reported depressive symptoms and falls, respectively. The path analysis showed the total effect (β = -0.58) of depression on quality of life (QOL) consisted of a direct effect (β = -0.51) and an indirect effect (β = -0.07), which was mediated by family function and number of falls, and the R ² was 0.36. The model fit indices were χ ² /df = 1.096, P > 0.05, Root Mean Square Error of Approximation (RMSEA) = 0.017, Tucker-Lewis Index (TLI) = 0.998 and Comparative Fit Index (CFI) = 0.999. Depression and falls were prevalent among the elderly living in rural communities of Guangzhou city. Pay attention to strengthen family function and prevent falls may prevent depression and improve the QOL among the elderly.

Perinatal Depression of Exposed Maternal Women in the COVID-19 Pandemic in Wuhan, China

Objective: This study aims to investigate perinatal depression in women who gave birth during the COVID-19 pandemic in Wuhan, and to evaluate the effect of the pandemic on perinatal depression prevalence. Methods: A cross-sectional investigation was conducted into women hospitalized for delivery in Hubei Maternity and Child Healthcare Hospital from December 31, 2019 to March 22, 2020, a period which encompasses the entire time frame of the COVID-19 pandemic in Wuhan. The Edinburgh Postnatal Depression Scale (EPDS) was adopted to evaluate perinatal depression status. A Chi-square test and logistic regression model were utilized for data analysis. Results: A total of 2,883 participants were included, 33.71% of whom were found to suffer from depressive symptoms. In detail, 27.02%, 5.24%, and 1.46% were designated as having mild, moderate, and severe depressive symptoms, respectively. The perinatal depression prevalence increased as the COVID-19 pandemic worsened. Compared to the period from December 31, 2019 to January 12, 2020, perinatal depression risk significantly decreased within the 3 weeks of March 2-22, 2020 (1st week: OR = 0.39, 95% CI: 0.20, 0.78; 2nd week: OR = 0.35, 95% CI: 0.17, 0.73; and 3rd week: OR = 0.48, 95% CI: 0.25, 0.94); and the postnatal depression risk significantly rose within the four weeks of January 27-February 23, 2020 (1st week: OR = 1.78, 95% CI: 1.18, 2.68; 2nd week: OR = 2.03, 95% CI: 1.35, 3.04; 3rd week: OR = 1.48, 95% CI: 1.02, 2.14; and 4th week: OR = 1.73, 95% CI: 1.20, 2.48). Conclusion: The dynamic change of perinatal depression was associated with the progression of the COVID-19 pandemic among new mothers who were exposed to the pandemic. An elevated risk of postnatal depression was also observed during the COVID-19 pandemic.

The effects of family dysfunction trajectories during childhood and early adolescence on sleep quality during late adolescence: Resilience as a mediator

RATIONALE

Sleep quality has been linked to several behavioral and psychological problems. No longitudinal study has examined the associations and underlying mechanisms between the trajectories of family characteristics and sleep quality in adolescents.

OBJECTIVE

This study investigates the effects of heterogeneous trajectories of family dysfunction on sleep quality in adolescents and examines whether resilience mediates these associations.

METHOD

Data came from 2280 adolescents participating in a longitudinal study across grades 2 through 11 in northern Taiwan. Group-based trajectory modeling was used to identify discrete developmental patterns of family dysfunction. Multiple linear regression was applied to examine the associations between family dysfunction trajectories and sleep quality. Mediation analysis was conducted to test whether resilience mediates the associations examined.

RESULTS

Four distinct trajectories of family dysfunction were identified: low persistent (26%), escalating dysfunction (21%), moderate stable (25%), and high persistent (28%). Compared to adolescents in the low-persistent trajectory, those in the escalating-dysfunction, moderate-stable, and high-persistent trajectories had significant lower levels of sleep quality (B = -0.19, p < .001, B = -0.14, p < .01, and B = -0.13, p < .05, respectively). Resilience significantly mediated the effects of all family dysfunction trajectories (relative to the low-persistent trajectory) on sleep quality (95% bootstrap confidence intervals are -0.06 to -0.02, -0.05 to -0.02, and -0.08 to -0.03 for escalating-dysfunction, moderate-stable, and high-persistent trajectories, respectively).

CONCLUSIONS

Family dysfunction conferred risks for poor sleep quality in adolescents and the negative effects, in part, were through decreasing resilience. Interventions to improve sleep quality in adolescents by targeting family function may be more effective when incorporating resilience.

Disability in Daily Living Activities, Family Dysfunction, and Late-Life Suicide in Rural China: A Case-Control Psychological Autopsy Study

Background: Although late-life suicide in rural China is a matter of concern, research is scarce addressing the association between capability of daily living activities, family function, and late-life suicide. We conducted this psychological autopsy study to explore associations between disability in daily living activities, family dysfunction, and late-life suicide in rural China. Methods: Using a 1:1 matched case-control design, we collected data from 242 elderly suicide cases and 242 living community controls in rural China using the psychological autopsy method. We used Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID), Activities of Daily Living Scale (ADL), and Family Adaptive, Partnership, Growth, Affection and Resolve scale (APGAR) to assess the presence of mental disorders, capability of daily living activities, and family function, respectively. Results: Compared with the living controls, suicide cases presented more severe impairment in capability of daily living activities and poorer family function. After controlling for all other factors, capability of daily living activities and family function remained in the final model. The results of the multivariate analysis also show that the presence of a mental disorder, lower levels of social support, and increased number of life events in the last year were significantly associated with elevated suicide risk. Conclusions: Disability in daily living activities and family dysfunction are associated with elevated risk of late-life suicide in rural China. It is warranted to design programs, including family interventions, peer-support groups, and community programs, to help the rural elderly improve activities of daily living and obtain the social support they need to prevent suicidal behaviors.

Level of resilience in the elderly according to the Connor-Davidson scale: a systematic review

Abstract Objective: To identify studies on resilience in the elderly measured by the Connor-Davidson scale. Method: A systematic review of literature on the level of resilience of the elderly was carried out, based on articles indexed in the Lilacs, IBECS, MedLine and PubMed databases, according to the Prisma method. Results: 27 studies were identified which included the elderly in their samples and determined the level of resilience through the Connor-Davidson scale. The USA (6), China (6) and Australia (5) had the greatest number of articles. A study carried out with elderly people in Australia had the highest level of resilience, which was attributed to public policies that favor the resilience development capacity of the population. The lowest level of resilience was observed in Japan in a study with survivors of major natural disasters, highlighting resilience as a significant protective factor for elderly persons who experience such events during their lives. Conclusion: The studies recognize resilience as an important protective factor for coping with external adversities and natural events, whether arising from the effects of the aging process on health, or through disease.

Prevalence and associated factors of depressive symptoms among elderly inpatients of a Chinese tertiary hospital

BACKGROUND

Depression in the elderly is a serious and often underdiagnosed psychiatric disorder that has been linked to adverse outcomes in the hospital setting. This study aims to evaluate the prevalence of depressive symptoms and associated factors among elderly hospital inpatients.

METHODS

The cross-sectional study included 411 consecutively hospitalized patients aged 60 years and older. Participants were evaluated within 48 hours of admission using an interviewer-administered questionnaire including the Geriatric Depression Scale and comprehensive geriatric assessment to provide basic demographic and clinical information.

RESULTS

Most of the participants were male (64.5%), with a mean (SD) age of 75.9 (8.1) years between 60 and 97 years. The prevalence of depressive symptoms was 32.8%. Univariate analysis showed significant associations between depressive symptoms and older age, female gender, lower body mass index, number of chronic diseases, impaired family function, impaired cognition, malnutrition, increased frailty, and decreased ability to perform activities of daily living. After logistic regression, variables that remained significantly associated with depression were cognitive decline (odds ratio =1.97, 95% CI: 1.09-3.55), poor family function (odds ratio =2.01, 95% CI: 1.10-3.66), and frailty (odds ratio =5.07, 95% CI: 1.95-13.20). Depressive symptoms were independently associated with prolonged hospital length.

CONCLUSION

Depressive symptoms were prevalent among hospitalized elderly and independently associated with cognitive decline, poor family function, and frailty. Therefore, it is essential to screen for depression and perform a comprehensive geriatric assessment in these patients to identify and manage depressive symptoms.

Qualidade de vida de idosos e sua relação com o trabalho

Resumo OBJETIVO Avaliar a qualidade de vida entre idosos que trabalham e não trabalham. MÉTODO Trata-se de um estudo descritivo, de corte transversal e abordagem quantitativa com 113 idosos, no período de junho a setembro de 2014, em um grupo de convivência no município de Cajazeiras - PB, utilizando-se os questionários sociodemográficos, o WHOQOL-BREF e WHOQOL-OLD. Os dados foram analisados mediante estatística descritiva e testes T de Student e Mann-Whitney. RESULTADOS A partir da análise observou-se que os idosos que trabalham apresentaram maiores escores médios na maioria dos domínios do WHOQOL-BREF e facetas do WHOQOL-OLD, evidenciando-se o domínio Psicológico (70,0) e a faceta Habilidades Sensoriais (72,5). O domínio físico apresentou diferença estatisticamente significante (p=0,046) entre os dois grupos. CONCLUSÃO O estudo demonstrou que o trabalho é um fator importante para a qualidade de vida do idoso.

Disease activity, resilience and health-related quality of life in Chinese patients with rheumatoid arthritis: a multi-center, cross-sectional study

Background

Positive psychological constructs that can moderate or mediate the negative impact of disease activity on health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA) have not been explored widely. This study aimed to assess the associations of disease activity, resilience with HRQOL and the moderating and mediating roles of resilience among Chinese RA patients.

Methods

A multi-center, cross-sectional study was conducted in RA inpatients in northeast of China. A total 298 subjects completed the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Ego-Resiliency Scale (ERS) to measure HRQOL and resilience. For the SF-36, physical function, physical role limitation, bodily pain and general health perception are gathered into physical component summary (PCS), while vitality, social functioning, emotional role limitation and mental health are gathered into mental component summary (MCS). Disease activity was evaluated by the Disease Activity Score 28-C-reactive protein (DAS28-CRP). Hierarchical regression analysis was applied to examine the associations of disease activity, resilience and the disease activity*resilience interaction with PCS and MCS, respectively. Asymptotic and resampling strategies were utilized to examine the mediating role of resilience.

Results

The mean scores of PCS and MCS were 40.67 and 59.14, respectively. Disease activity was negatively associated with both PCS and MCS, and resilience was only positively associated with MCS. The disease activity*resilience interaction term were significantly associated with MCS (β = 0.144, P = 0.003). The associations between disease activity and MCS were gradually reduced in low (1 SD below the mean, β = −0.369, P < 0.001), mean (β = −0.218, P < 0.001) and high (1 SD above the mean, β = −0.068, P = 0.369) groups of resilience. Resilience acted as a partial mediator in the disease activity-MCS association (effect size was −0.085, BCa 95% CI: −0.159, −0.028).

Conclusions

Disease activity was negatively associated with both physical and mental HRQOL, and resilience was only positively associated with mental HRQOL. Resilience could attenuate and mediate the association between disease activity and mental HRQOL. In addition to controlling disease activity, targeted intervention strategies designed for resilience should be strengthened to improve the HRQOL of this population.