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Zhang J, Xu F, Zhou Y, Wu J, Li Y, Qing W. Association between frailty and meaning in life of older adults in nursing home: the mediating effect of psychological resilience. Front Psychol 2024; 15:1365817. [PMID: 38952833 PMCID: PMC11216323 DOI: 10.3389/fpsyg.2024.1365817] [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: 01/05/2024] [Accepted: 05/22/2024] [Indexed: 07/03/2024] Open
Abstract
Background Meaning in life is a crucial aspect of psychological well-being, often overlooked despite its clinical significance. This warrants further investigation, especially regarding its relationship with frailty and psychological resilience. Objective This study aims to assess the status and relevance of frailty, psychological resilience, and meaning in life among older adults in Chinese nursing homes. Additionally, it explores the mediating role of psychological resilience between frailty and meaning in life, providing insights to improve the meaning in life for older adults in nursing homes. Methods Between August 2022 and November 2022, 302 older adults in Chinese nursing homes were selected using convenience sampling. The study utilized the Socio-demographic Characteristics Questionnaire, Tilburg Frailty Indicator, Connor-Davidson Resilience Scale, and the Source of Meaning Scale for Older Adults. A face-to-face questionnaire survey was conducted, and SPSS 27.0 was employed for analyzing correlations between frailty, psychological resilience, and meaning in life. The mediating effect of psychological resilience was assessed using Model 4 in the Process plug-in. Results Older adults in nursing homes exhibited a frailty total score of 4.00 (2.00, 5.00), with a prevalence of 28.5%. Psychological resilience scored 66.00 (51.75, 76.00), and meaning in life scored 149.00 (132.00, 158.25). Frailty showed a negative correlation with both meaning in life and psychological resilience, while meaning in life demonstrated a positive correlation with psychological resilience. Psychological resilience exhibited a partial mediating effect, accounting for 51.04% of the total effect between frailty and meaning in life. Conclusion Frailty incidence is high among older adults in nursing homes, with psychological resilience at a general level and meaning in life in the upper middle level. Psychological resilience plays a crucial role as a partial mediator between frailty and meaning in life. Timely assessment of frailty, targeted interventions, and improvements in psychological resilience are essential for enhancing the meaning in life and promoting successful aging.
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Affiliation(s)
- Jiquan Zhang
- Department of Nursing, Deyang People's Hospital, Deyang, China
| | - Fan Xu
- Department of Nursing, Deyang People's Hospital, Deyang, China
| | - Yang Zhou
- Department of Science and Education, Deyang People's Hospital, Deyang, China
| | - Jijun Wu
- Department of Nursing, Deyang People's Hospital, Deyang, China
| | - Yuxin Li
- Department of Nursing, Deyang People's Hospital, Deyang, China
| | - Wei Qing
- Department of Nursing, Deyang People's Hospital, Deyang, China
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Tan JDL, Maneze D, Montayre J, Ramjan LM, Wang D, Salamonson Y. Family visits and depression among residential aged care residents: An integrative review. Int J Nurs Stud 2023; 146:104568. [PMID: 37597458 DOI: 10.1016/j.ijnurstu.2023.104568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 07/10/2023] [Accepted: 07/22/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population. OBJECTIVE This literature review seeks to explore the association between family visits and depression among those living in residential aged care. METHODS An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895). RESULTS Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement. CONCLUSION Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families. TWEETABLE ABSTRACT Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial.
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Affiliation(s)
- Josh D L Tan
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Della Maneze
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Joanna Briggs Institute, Sydney, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia; School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Lucie M Ramjan
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Donna Wang
- School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia; School of Nursing, University of Wollongong, Wollongong, Australia; Australian Centre for Integration of Oral Health (ACIOH), Liverpool, Australia; Ingham Institute for Applied Medical Research, Liverpool, Australia.
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Tan Dat N, Mitsui N, Asakura S, Fujii Y, Toyoshima K, Kusumi I. Relationship between self-esteem and suicidal ideation before and during COVID-19 in a non-clinical sample: mediating effects of psychological distress and hopelessness. Front Psychiatry 2023; 14:1240715. [PMID: 37743986 PMCID: PMC10512949 DOI: 10.3389/fpsyt.2023.1240715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Several studies have highlighted the impact of the novel coronavirus disease (COVID-19) pandemic on suicide. Accordingly, investigating the risk factors of suicide during this crisis is important. Based on the escape theory of suicide, the current study examined the serial mediating roles of psychological distress and hopelessness in the relationship between self-esteem and suicidal ideation. It also aimed to explore whether or not the COVID-19 pandemic changed the mediation effect in any way. Methods Data were collected from 645 university students before and during the pandemic. The study employed mediation and multi-group analyses to test the hypotheses. Results The results demonstrated that individuals with low self-esteem reported high psychological distress, which further lead to hopelessness and eventually heightened suicidal ideation. Multi-group analysis revealed that psychological distress exerted a greater impact on suicidal ideation during COVID-19. Discussion The finding suggested that self-esteem, hopelessness, and psychological distress could help elucidate the development of suicidal ideation. Clinicians may target these factors in suicide prevention programs, particularly in the settings of the COVID-19 pandemic or future crisis.
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Affiliation(s)
- Nguyen Tan Dat
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuyuki Mitsui
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Asakura
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Health Care Center of Hokkaido University, Sapporo, Japan
| | - Yutaka Fujii
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Health Care Center of Hokkaido University, Sapporo, Japan
| | - Kuniyoshi Toyoshima
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Bareeqa SB, Samar SS, Masood Y, Husain MM. Prevalence of Suicidal Behaviors in Residents of Long-Term Care Facilities: A Systematic Review and Meta-Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231176309. [PMID: 37247610 DOI: 10.1177/00302228231176309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Long-term care facilities (LTC) plays a pivotal role in caring for geriatric population. However, the risk of suicide in long-term care institutions among older individuals is little understood (e.g., nursing homes, assisted living facilities). OBJECTIVE The purpose of this systematic review is to pool and meta-analyze the data on prevalence of suicidal behaviors in geriatric population residing in long-term care facilities. METHODS We have conducted the systematic review in accordance with the PRISMA guidelines. The utilized databases are Pubmed, Medline, Google scholar and Scopus. The Meta-analysis was done using OpenMeta [analyst] software. Subgroup analysis was also performed. RESULTS After running an analysis on pooled data from twenty cross-sectional studies with 3,023,224 participants, the prevalence of suicidal behavior is 6.4% (95% CI = 5.7-7) in LTC. CONCLUSION This meta-analysis shows pooled prevalence of suicidal behavior among geriatric residents of LTC was found to be moderately high all over the world.
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Affiliation(s)
| | | | - Yasir Masood
- Department of Social Sciences, Washington University in St. Louis, St Louis, MO, USA
| | - Mustafa M Husain
- Department of Psychiatry, Neurology and Medicine, UT Southwestern Medical Centre, Dallas, TX, USA
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Koç M, Sarı T, Altıntaş B, Kissal A, Gürhan N. Investigation into the Relationship Between COVID-19 Anxiety and Spiritual Orientation in Elderly Individuals in Nursing Homes and Care Centers in Turkey. JOURNAL OF RELIGION AND HEALTH 2023:1-18. [PMID: 36973605 PMCID: PMC10042407 DOI: 10.1007/s10943-023-01799-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Spirituality is seen as a coping strategy for reducing stress and anxiety. This research aimed to investigate the relationship between COVID-19 anxiety and the spiritual orientation of individuals aged 65 and over in nursing homes and elderly care centers during the COVID-19 pandemic in Turkey. The findings showed that with increasing age, coronavirus anxiety levels decrease, and spiritual orientation increases. There was a negative relationship between the time of diagnosis of COVID-19 and coronavirus anxiety (r = - .48; p = 0.01). Those diagnosed with COVID-19 had higher coronavirus anxiety levels (U = 374.5; p < 0.001) and had lower spiritual orientation (U = 593.5; p > 0.05). As spiritual orientation increases in elderly individuals, their level of anxiety decreases.
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Affiliation(s)
- Medine Koç
- Psychiatric Nursing Department, Faculty of Health Science, Tokat Gaziosmanpasa University, 60250 Tokat, Turkey
| | - Tuba Sarı
- Psychiatric Nursing Department, Institute of Graduate Studies, Tokat Gaziosmanpasa University, 60250 Tokat, Turkey
| | - Büşra Altıntaş
- Psychiatric Nursing Department, Institute of Graduate Studies, Tokat Gaziosmanpasa University, 60250 Tokat, Turkey
| | - Aygul Kissal
- Public Health Nursing Department, Faculty of Health Science, Tokat Gaziosmanpasa University, 60250 Tokat, Turkey
| | - Nermin Gürhan
- Psychiatric Nursing Department, Faculty of Health Science, Tokat Gaziosmanpasa University, 60250 Tokat, Turkey
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6
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Ding JY, Wu WT, Liang Z, Yu C, Xiao XH. Depression and activities of daily living in elderly people applying for admission to public nursing facilities. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-6. [PMID: 36757805 DOI: 10.1080/23279095.2023.2169828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The present study aims to (1) investigate the prevalence of positive screening for depression among elderly people applying for admission to public nursing facilities in Shenzhen and (2) to explore the correlation between depression and activities of daily living (ADL) among the elderly. METHODS Visual and hearing acuity, ADL (obtained using the Barthel index), cognition and depression levels, and communication and social interaction skills were assessed in all elderly adults aged ≥60 years who applied for admission to public nursing facilities in Shenzhen between April 1, 2018, and December 31, 2019. RESULTS A total of 1,113 elderly adults, 34.95% of whom were assessed as being depressed, were evaluated. Regarding dependence on the care of others, the ADL assessment results showed that 11.86% of the study subjects were fully dependent, 10.51% were severely dependent, 12.58% were moderately dependent, 42.86% were mildly dependent, and only 22.19% were fully capable of self-care. The univariate analysis suggested that gender, cognition level, visual and hearing acuity, and communication and social interaction skills were all correlated with the occurrence of depression. The prevalence of positive screening for depression was relatively high among subjects with an ADL score of ≤65; With an ADL score of ≤65, the prevalence of depression increased by 6% with every 1-point ADL score decrease. CONCLUSION The prevalence of depression among elderly adults applying for admission to public nursing facilities in Shenzhen was high. For this reason, nursing facility caregivers should focus on screening elderly adults (especially subjects with impaired ADL function) for depression in order to improve their quality of life.
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Affiliation(s)
- Jing-Yun Ding
- Department of Geriatrics, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Wei-Tao Wu
- Department of Geriatrics, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Zhen- Liang
- Department of Endocrinology, The 2nd Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Cong Yu
- Department of Nursing, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiao-Hua Xiao
- Department of Geriatrics, First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
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Liu Y, Zhang D, Wang R, Wang P, Su Y. Physical disability, low self-esteem, and suicidal ideation among Chinese nursing home residents: the moderating role of resilience. Aging Ment Health 2023; 27:263-271. [PMID: 35081837 DOI: 10.1080/13607863.2022.2032595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This study aimed to investigate the mediating role of self-esteem in the relationship between physical disability and suicidal ideation, and whether the mediation effect was moderated by resilience among nursing home residents. METHODS Participants were 538 nursing home residents recruited from 37 nursing homes in Jinan, China (mean age = 78.13 years, SD = 8.72). The Lawton and Brody Activities of Daily Living Scale, Rosenberg Self-Esteem Scale, 10-item version of the Connor-Davidson Resilience Scale, and Beck Suicidal Ideation Inventory-Chinese Version were used. Mediation and moderated mediation analyses were performed using Models 4 and 15 of the PROCESS macro for SPSS. RESULTS The prevalence of suicidal ideation among the nursing home residents was 14.90%. The mediation analysis showed that self-esteem partially mediated the association between physical disability and suicidal ideation. Resilience was a protective factor for suicidal ideation and moderated the relationship between physical disability and suicidal ideation, and between self-esteem and suicidal ideation. CONCLUSION Both physical disability and lower self-esteem are important in understanding the development of suicidal ideation among nursing home residents. Improving resilience may be crucial for suicide prevention.
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Affiliation(s)
- Yuqi Liu
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Dan Zhang
- School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Peng Wang
- Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China.,Shandong Provincial Key Laboratory of Mental Disorders, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
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8
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Wang P, Gao P, Yu Z. The role of social exclusion in the formation of suicidal ideation among the elderly in rural pension institutions. Front Psychol 2022; 13:1019898. [PMID: 36570993 PMCID: PMC9780458 DOI: 10.3389/fpsyg.2022.1019898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Social exclusion as well as a sense of belonging and depression have been identified as risk factors for suicide among older adults in pension institutions. In particular, the elderly living in rural pension institutions is more likely to have poor mental health and a higher incidence of suicidal ideation. This study explored the mechanism of social exclusion on suicidal ideation among the elderly in rural pension institutions, and the moderating effect of interpersonal trust. Methods The social exclusion experience scale, sense of belonging, depression self-rating scale (CES-D), suicidal ideation scale (BSI-CV), and interpersonal trust scale (ITS) were used to investigate the elderly in rural pension institutions. A total of 1,387 samples (53.35% female) were collected, ranging in age from 65 to 95 years (M = 72.8, SD = 6.173). Results The results of the study found that: (1) social exclusion increases the suicidal ideation of the elderly in rural pension institutions, and the sense of belonging and depression play a significant chain-mediated role in the relationship between social exclusion and suicidal ideation in the elderly. (2) Interpersonal trust moderates the impact of social exclusion on the sense of belonging, depression, and suicidal ideation. Specifically, interpersonal trust can alleviate the promotion effect of social isolation on suicidal ideation and depression, and can also reduce the adverse effect of social exclusion on the sense of belonging. Discussion This study validates that social exclusion is a risk factor for suicidal ideation in the rural elderly and identifies interpersonal trust as a protective factor against social exclusion and its negative outcomes in the elderly. This study provides a scientific basis for improving the depression status of the elderly in rural China and formulating suicide prevention measures.
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Affiliation(s)
- Pingda Wang
- School of Economics and Management, Northeast Agricultural University, Harbin, China
| | - Peng Gao
- School of Economics and Management, Northeast Agricultural University, Harbin, China
| | - Zehui Yu
- School of Business, China University of Political Science and Law, Beijing, China
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Li M, Ao Y, Deng S, Peng P, Chen S, Wang T, Martek I, Bahmani H. A Scoping Literature Review of Rural Institutional Elder Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610319. [PMID: 36011954 PMCID: PMC9408389 DOI: 10.3390/ijerph191610319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 05/31/2023]
Abstract
Under circumstances of pervasive global aging combined with weakened traditional family elder care, an incremental demand for institutional elder care is generated. This has led to a surge in research regarding institutional elder care. Rural residents' institutional elder care is receiving more attention as a major theme in social sciences and humanities research. Based on 94 articles related to rural institutional elder care, this study identified the most influential articles, journals and countries in rural institutional elder care research since 1995. This was done using science mapping methods through a three-step workflow consisting of bibliometric retrieval, scoping analysis and qualitative discussion. Keywords revealed five research mainstreams in this field: (1) the cognition and mental state of aged populations, (2) the nursing quality and service supply of aged care institutions, (3) the aged care management systems' establishment and improvements, (4) the risk factors of admission and discharge of aged care institutions, and (5) deathbed matters regarding the aged population. A qualitative discussion is also provided for 39 urban and rural comparative research papers and 55 pure rural research papers, summarizing the current research progress status regarding institutional elder care systems in rural areas. Gaps within existing research are also identified to indicate future research trends (such as the multi-dimensional and in-depth comparative research on institutional elder care, new rural institutional elder care model and technology, and correlative policy planning and development), which provides a multi-disciplinary guide for future research.
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Affiliation(s)
- Mingyang Li
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China
| | - Yibin Ao
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Shulin Deng
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Panyu Peng
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Shuangzhou Chen
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Tong Wang
- Faculty of Architecture and Built Environment, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Igor Martek
- School of Architecture and Built Environment, Deakin University, Geelong 3220, Australia
| | - Homa Bahmani
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
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Health effects of loneliness and social isolation in older adults living in congregate long term care settings: A systematic review of quantitative and qualitative evidence. Arch Gerontol Geriatr 2022; 102:104728. [DOI: 10.1016/j.archger.2022.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022]
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Lam JSH, Links PS, Eynan R, Shera W, Tsang AKT, Law S, Fung WLA, Zhang X, Liu P, Zaheer J. "I thought that I had to be alive to repay my parents": Filial piety as a risk and protective factor for suicidal behavior in a qualitative study of Chinese women. Transcult Psychiatry 2022; 59:13-27. [PMID: 34928737 PMCID: PMC8859686 DOI: 10.1177/13634615211059708] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Filial piety involves the Confucian view that children always have a duty to be obedient and to provide care for their parents. Filial piety has been described as both a risk and a protective factor in depression and suicide. This qualitative study aimed to explore the role of filial piety in the suicidal behavior of Chinese women. Qualitative interviews were conducted with Chinese women with a history of suicidal behavior living in the Beijing area (n = 29). Filial piety data were extracted and analyzed in accordance with constructivist grounded theory. The women described five specific family and filial piety factors and how they influenced their ability to fulfill family role obligations, which was described as a nexus connecting these factors to depression, suicidal behavior, and recovery. The five factors were: 1) rigidity of parental filial expectations, 2) perception of family relationships as positive/supportive or negative/harsh, 3) whether filial piety is of high or low personal value in the woman's life, 4) any experiences of rebellion leading to punitive consequences, and 5) how much filial piety she receives from her children. These factors could inform suicide risk assessments in this population. They can be harnessed as part of recovery and protect against future suicidal behavior.
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Affiliation(s)
| | | | | | | | | | - Samuel Law
- University of Toronto
- St. Michael's Hospital
| | - Wai Lun Alan Fung
- Mount Sinai Hospital and North York General Hospital
- Tyndale University
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12
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Durmuş M, Öztürk Z. The Effect of COVID-19 Outbreak on Older Adults' Hopelessness, Loneliness and Spiritual Well-Being in Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:851-865. [PMID: 34997453 PMCID: PMC8740876 DOI: 10.1007/s10943-021-01494-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 06/14/2023]
Abstract
The aim of this study was to determine the hopelessness, loneliness and spiritual well-being of older adults and the relationship between these three concepts during the COVID-19 pandemic. This research used a cross-sectional, descriptive approach. Data were collected between October 13 and November 13, 2020, with 476 individuals over 65 years living in three different cities in Turkey. Data were collected using a demographic information form, Beck Hopelessness Scale (BHS), Loneliness Scale (UCLA-LS) and Spiritual Well-being Scale (FACIT-Sp). During the COVID-19 outbreak, it was found that there was a significant negative relationship between hopelessness, loneliness and spiritual well-being of older adults. In this study, it was found that during the COVID-19 pandemic, the level of hopelessness and loneliness among older adults was below the average score, and their spiritual well-being levels were moderate. Based on the findings of the present study, it is recommended that practices which increase hope, strengthen social ties and spiritual support, should be implemented for older individuals during the COVID-19 pandemic period or any other times during which social distancing is mandatory.
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Affiliation(s)
- Mustafa Durmuş
- Department of Gerontology, Faculty of Health Sciences, Mus Alparslan University, 49100, Muş, Turkey.
| | - Zeynep Öztürk
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, 25240, Erzurum, Turkey
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13
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Dong D, Cai Q, Zhang QZ, Zhou ZN, Dai JN, Mu TY, Xu JY, Shen CZ. Dignity and its related factors among older adults in long-term care facilities: A cross-sectional study. Int J Nurs Sci 2021; 8:394-400. [PMID: 34631989 PMCID: PMC8488850 DOI: 10.1016/j.ijnss.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 06/25/2021] [Accepted: 08/06/2021] [Indexed: 10/27/2022] Open
Abstract
Objectives This study aimed to explore the dignity and related factors among older adults in long-term care facilities. Methods Cross-sectional data were obtained from a sample of 253 Chinese older adults dwelling in long-term care facilities. Dignity among older adults was measured using the Dignity Scale, and its potential correlates were explored using multiple linear regressions. Results Results showed that the total score of the Dignity Scale is 151.95 ± 11.75. From high to low, the different factors of dignity among older adults in long-term care facilities were as follows: caring factors (4.83 ± 0.33), social factors (4.73 ± 0.41), psychological factors (4.66 ± 0.71), value factors (4.56 ± 0.53), autonomous factors (4.50 ± 0.57), and physical factors (4.38 ± 0.55). A higher score of the Dignity Scale was associated with higher economic status, fewer chronic diseases, less medication, better daily living ability and long-time lived in cities. Conclusion Older adults with low economic status, more chronic diseases, and poor daily living ability, taking more medications, or the previous residence in rural areas seem to be most at low-level dignity in long-term care facilities and thus require more attention than their peers.
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Affiliation(s)
- Die Dong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qian Cai
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qiong-Zhi Zhang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhi-Nan Zhou
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jia-Ning Dai
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ting-Yu Mu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jia-Yi Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Cui-Zhen Shen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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Ge M, Zhu D, Lee H. WITHDRAWN: Health risk assessment of rural older population. Work 2021:WOR205350. [PMID: 34275921 DOI: 10.3233/wor-205350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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Affiliation(s)
- Minshu Ge
- The school of Finace, RenMin University of China, Beijing, China
| | - Dan Zhu
- Shanghai National Accounting Institute, Shanghai, China
| | - Hallie Lee
- Economic management Department, DePauw University, Greencastle, USA
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15
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Zhang D, Wang R, Zhao X, Zhang J, Jia J, Su Y, Wang K. Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents. Aging Ment Health 2021; 25:1262-1272. [PMID: 32602736 DOI: 10.1080/13607863.2020.1786798] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support. METHODS Residents (N = 538; Aged ≥60years; 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects. RESULTS Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011-0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005-0.167]). Support from family and nursing home staff moderated the direct (path c') and indirect path (path b) of the mediation model, respectively. CONCLUSIONS Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.HighlightsWe evaluated suicidal ideation in mainland Chinese nursing home residentsLoneliness and suicidal ideation were partially mediated by resilienceSocial support moderated the effect of loneliness and resilience on suicidal ideationThe results were self-reported and are not generalizable to all of ChinaResilience and social support can buffer against suicidal ideation among residents.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- Department of Health Management, Heze Medical College, Heze, Shandong, China
| | - Jie Zhang
- China Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA.,School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
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16
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How Loneliness Worked on Suicidal Ideation among Chinese Nursing Home Residents: Roles of Depressive Symptoms and Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105472. [PMID: 34065364 PMCID: PMC8160705 DOI: 10.3390/ijerph18105472] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 01/21/2023]
Abstract
Suicide in later life is becoming severe under rapid population aging, especially for nursing home residents. Loneliness, an increasingly represented issue among nursing home residents, is found to be a risk factor for depressive symptoms. Both loneliness and depressive symptoms may contribute to the development of suicidal ideation. According to the Protective Factor Model, resilience can act as a moderating role interacting with risk factors to buffer the negative effects on the outcome. The present study aimed to assess the mediating role of depressive symptoms and the moderating effect of resilience on the risk factors of suicidal ideation to attenuate the adverse contribution among nursing home residents. A total of 538 nursing home residents participated in this cross-sectional study, and their suicidal ideation, resilience, loneliness, and depressive symptoms were measured. The mediating effect and moderated mediation model were tested using the Macro Process of SPSS 21.0. Statistics showed that 19.7% of participants had suicidal ideation. The mediating model (H1: B = 0.477, p < 0.001; H2: B = 0.325, p < 0.001; H3: B = 0.308, p < 0.001) and the moderating effect of resilience interacting loneliness (H4: B = −0.133, p < 0.001; H6: B = −0.109, p < 0.001) and depressive symptoms (H5: B = −0.077, p < 0.001) were statistically significant. The findings indicated the protective effect of resilience in alleviating the negative influence of risk factors for suicidal ideation, suggesting that positive psychological interventions for resilience building might be effective in suicide prevention among nursing home residents.
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Jing Z, Li J, Fu PP, Wang Y, Yuan Y, Zhao D, Hao W, Yu C, Zhou C. Physical multimorbidity and lifetime suicidal ideation and plans among rural older adults: the mediating role of psychological distress. BMC Psychiatry 2021; 21:78. [PMID: 33549084 PMCID: PMC7866476 DOI: 10.1186/s12888-021-03087-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Previous studies have revealed that single physical chronic condition was associated with suicidal ideation/plans, but few studies have examined the relationship between multimorbidity and suicidal ideation/plans, and no studies have explored the underlying potential mechanism on this relationship in China. This study aimed to explore association between physical multimorbidity and suicidal ideation as well as plans, and further examine the mediating role of psychological distress (PD) on this relationship. METHODS This study was based on the data from a survey about the health service of rural elderly household in Shandong, China. A total of 3242 adults aged 60 years and older were included in this study. PD was measured by Kessler Psychological Distress Scale (K10). Ordinal and binary logistic regression analyses were employed to explore the association between physical multimorbidity, PD and suicide ideation/plans. Bootstrapping analysis was further used to examine the mediation effect of PD on the association of multimorbidity and suicidal ideations/plans. RESULTS The prevalence of multimorbidity, lifetime suicidal ideation, and suicidal plan in rural older adults was 35.2, 10.6 and 2.2%, respectively. Older adults living in rural areas with two or more chronic physical conditions experienced significantly higher risk of suicidal ideation and suicidal plans. The association between multimorbidity and suicidal ideations/plans was partially mediated by PD, of which, the mediating effect of PD accounted for 31.7 and 25.5% of the total effect, respectively. CONCLUSION This study demonstrated the associations between physical multimorbidity and suicidal ideation/plans, and the mediating role of PD on this relationship among Chinese rural elderly. Healthcare providers in rural community should provide regular surveillance for the mental health status among the rural elderly with multimorbidity, and carry out various effective intervention measures to improve the mental health status, so as to reduce the risk of suicide.
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Affiliation(s)
- Zhengyue Jing
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Jie Li
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Pei Pei Fu
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Yi Wang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Yemin Yuan
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Dan Zhao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Wenting Hao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Caiting Yu
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012, Shandong, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012, Shandong, China.
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18
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Chai Y, Luo H, Yip PSF, Perlman CM, Hirdes JP. Factors Associated With Hospital Presentation of Self-Harm Among Older Canadians in Long-Term Care: A 12-Year Cohort Study. J Am Med Dir Assoc 2021; 22:2160-2168.e18. [PMID: 33454310 DOI: 10.1016/j.jamda.2020.12.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to examine the incidence of, and factors associated with, hospital presentation for self-harm among older Canadians in long-term care (LTC). DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS The LTC data were collected using Resident Assessment Instrument-Minimum Data Set (RAI-MDS) and Resident Assessment Instrument-Home Care (RAI-HC), and linked to the Discharge Abstract Database (DAD) with hospital records of self-harm diagnosis. Adults aged 60+ at first assessment between April 1, 2003, and March 31, 2015, were included. METHODS Adjusted hazard ratios (HRs) of self-harm for potentially relevant factors, including demographic, clinical, and psychosocial characteristics, were calculated using Fine & Gray competing risk models. RESULTS Records were collated of 465,870 people in long-term care facilities (LTCF), and 773,855 people receiving home care (HC). Self-harm incidence per 100,000 person-years was 20.76 [95% confidence interval (CI) 20.31-25.40] for LTCF and 46.64 (44.24-49.12) for HC. In LTCF, the strongest risks were younger age (60-74 years vs 90+: HR, 6.00; 95% CI, 3.24-11.12), psychiatric disorders (bipolar disorder: 3.46; 2.32-5.16; schizophrenia: 2.31; 1.47-3.62; depression: 2.29; 1.80-2.92), daily severe pain (2.01; 1.30-3.11), and daily tobacco consumption (1.78; 1.29-2.45). For those receiving HC, the strongest risk factors were younger age (60-74 years vs 90+: 2.54; 1.97-3.28), psychiatric disorders (2.20; 1.93-2.50), daily tobacco consumption (2.08; 1.81-2.39), and frequent falls (1.98; 1.46-2.68). All model interactions between setting and factors were significant. CONCLUSIONS AND IMPLICATIONS There was lower incidence of hospital presentation for self-harm for LTCF residents than HC recipients. We found sizable risks of self-harm associated with several modifiable risk factors, some of which can be directly addressed by better treatment and care (psychiatric disorders and pain), whereas others require through more complex interventions that target underlying factors and causes (tobacco and falls). The findings highlight a need for setting- and risk-specific prevention strategies to address self-harm in the older populations.
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Affiliation(s)
- Yi Chai
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Hao Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; Department of Computer Science, The University of Hong Kong, Hong Kong, China.
| | - Paul S F Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Christopher M Perlman
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - John P Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Bethell J, Aelick K, Babineau J, Bretzlaff M, Edwards C, Gibson JL, Hewitt Colborne D, Iaboni A, Lender D, Schon D, McGilton KS. Social Connection in Long-Term Care Homes: A Scoping Review of Published Research on the Mental Health Impacts and Potential Strategies During COVID-19. J Am Med Dir Assoc 2020; 22:228-237.e25. [PMID: 33347846 PMCID: PMC9186333 DOI: 10.1016/j.jamda.2020.11.025] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 01/23/2023]
Abstract
Objectives Good social connection is associated with better health and wellbeing. However, social connection has distinct considerations for people living in long-term care (LTC) homes. The objective of this scoping review was to summarize research literature linking social connection to mental health outcomes, specifically among LTC residents, as well as research to identify strategies to help build and maintain social connection in this population during COVID-19. Design Scoping review. Settings and Participants Residents of LTC homes, care homes, and nursing homes. Methods We searched MEDLINE(R) ALL (Ovid), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Sociological Abstracts (ProQuest), Embase and Embase Classic (Ovid), Emcare Nursing (Ovid), and AgeLine (EBSCO) for research that quantified an aspect of social connection among LTC residents; we limited searches to English-language articles published from database inception to search date (July 2019). For the current analysis, we included studies that reported (1) the association between social connection and a mental health outcome, (2) the association between a modifiable risk factor and social connection, or (3) intervention studies with social connection as an outcome. From studies in (2) and (3), we identified strategies that could be implemented and adapted by LTC residents, families and staff during COVID-19 and included the articles that informed these strategies. Results We included 133 studies in our review. We found 61 studies that tested the association between social connection and a mental health outcome. We highlighted 12 strategies, informed by 72 observational and intervention studies, that might help LTC residents, families, and staff build and maintain social connection for LTC residents. Conclusions and Implications Published research conducted among LTC residents has linked good social connection to better mental health outcomes. Observational and intervention studies provide some evidence on approaches to address social connection in this population. Although further research is needed, it does not obviate the need to act given the sudden and severe impact of COVID-19 on social connection in LTC residents.
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Affiliation(s)
- Jennifer Bethell
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | - Katelynn Aelick
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, Canada
| | - Jessica Babineau
- Library and Information Services, University Health Network, Toronto, Canada; The Institute for Education Research, University Health Network, Toronto, Canada
| | - Monica Bretzlaff
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, Canada
| | | | | | - Debbie Hewitt Colborne
- Behavioural Supports Ontario Provincial Coordinating Office, North Bay Regional Health Centre, North Bay, Canada
| | - Andrea Iaboni
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Dee Lender
- Ontario Association of Residents' Councils, Newmarket, Canada
| | - Denise Schon
- Lakeside Long-Term Care Centre Family Council, Toronto, Canada
| | - Katherine S McGilton
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Hu C, Zhao D, Gong F, Zhao Y, Li J, Sun Y. Risk factors for suicidal ideation among the older people living alone in rural region of China: A path analysis. Medicine (Baltimore) 2020; 99:e21330. [PMID: 32702929 PMCID: PMC7373625 DOI: 10.1097/md.0000000000021330] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In China, suicide accounts for twenty-six percent of all suicides worldwide; however, researches on the suicidal ideation among older people living alone in the rural region are few. We performed a cross-sectional study to explore the prevalence and influence factors of suicidal ideation, and provide a theoretical basis for suicide prevention among older people living alone in rural region.695 older people living alone in rural region were selected by using stratified cluster sampling. Chi-square for categorical variables, T-test for continuous variables, and path analysis were conducted to statistical analysis.The prevalence of suicidal ideation among the elderly living alone in rural China was 23.6%. Path analyses showed that depression had the most substantial influence on suicidal ideation among the elderly living alone, it was also as a mediator between physical, economic status, social support, anxiety, and suicidal ideation; anxiety and social support had both direct and indirect influence on suicidal ideation; physical status and economic status had indirection impact.The incidence of suicidal ideation among the elderly living alone was high in Dangtu county. Psychological disorders (anxiety and depression) had the strongest impact on suicidal ideation. Strategies and measures targeting these relevant factors (economic status, physical status, and social support) should be taken to reduce the burdens of suicidal ideation among the elderly living alone in China.
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Affiliation(s)
- Caiyun Hu
- Department of Scientific Research, The First Affiliated Hospital of Anhui Chinese Medical University, Heffei
| | - Dongdong Zhao
- The First Affiliated Hospital of Anhui Medical University, Hefei
| | - Fengfeng Gong
- Medical department, Fuyang Hospital of Anhui Medical University, Fuyang
| | - Yuanyuan Zhao
- The Fifth Sanatorium for Retired Cadres, Anhui Provincial Military Region, Hefei
| | - Jie Li
- School of Public Health, Anhui Medical University, Hefei
| | - Yehuan Sun
- School of Public Health, Anhui Medical University, Hefei
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21
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Ramírez Arango YC, Flórez Jaramillo HM, Cardona Arango D, Segura Cardona ÁM, Segura Cardona A, Muñoz Rodríguez DI, Lizcano Cardona D, Morales Mesa SA, Arango Álzate C, Agudelo Cifuentes MC. Factors Associated With Suicidal Ideation in Older Adults From Three Cities in Colombia, 2016. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 49:142-153. [PMID: 32888657 DOI: 10.1016/j.rcp.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 08/14/2018] [Accepted: 09/08/2018] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Suicidal ideation refers to thoughts that range from a vague idea of committing suicide to a specific suicide plan. OBJECTIVE To explore factors such as demographic, social, family, abuse, risk of depression, habits and health conditions, which influence suicidal ideation in the elderly people in the cities of Medellín, Barranquilla, and Pasto (Colombia), with the intention to identify those associated factors that can be used in public health programs focused on this population. METHODS Cross-sectional analytical study was conducted using a secondary source, demographic, social, clinical variables, social support, discrimination, abuse, happiness, depression, functional capacity, and as a dependent variable were asked the question: "Have you ever thought about committing suicide?" A descriptive, bivariate and multivariate analysis was performed. RESULTS The median age was ≤ 69 [interquartile range, 11] years, and 58.2% were women. The prevalence of suicidal ideation was 6.4%, and of these, 28.7% had made plans to end their lives, and 66.7% had tried at least once. A statistical association was found with informal employment, cigarette consumption, alcohol and psychoactive substances, risk of depression, having a disability, dissatisfaction with their quality of life, with their health, with their economic situation, as well as feeling unhappy, bad treatment and bad relationships among family members, poor social support, sexual and economic abuse, and finally, discrimination. CONCLUSIONS Suicidal ideation in older adults in three cities of Colombia is explained by the sexual and economic abuse that this population is suffering, as well as bad personal relationships between the members of the family of the older adult. The risk of depression increases the probability of having thoughts against one's life.
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Abstract
AIMS Loneliness is increasingly recognised as a serious public health issue worldwide. However, there is scarce research addressing the association between loneliness and suicide in older adults in rural China. We set out to examine loneliness and other psychosocial factors in elderly suicide cases and explore their interaction effects. METHODS Using a 1 : 1 matched case-control design, data were collected from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including demographic characteristics, loneliness, depression, hopelessness and social support. The chi-square automatic interaction detection (CHAID) tree model and multivariable logistic regression analysis were used to explore the relationships of these factors and suicide. RESULTS The CHAID tree model showed that loneliness, hopelessness and depressive symptoms were closely associated with completed suicide and that loneliness and hopelessness interacted with each other. The result of multivariable logistic regression showed that individuals who were unemployed [odds ratio (OR) = 2.344; 95% confidence interval (CI): 1.233-4.457], living alone (OR = 2.176; 95% CI: 1.113-4.254), had lower levels of subjective social support (OR = 2.185; 95% CI: 1.243-3.843), experienced depressive symptoms (OR = 6.700; 95% CI: 3.405-13.182), showed higher levels of hopelessness (OR = 7.253; 95% CI: 3.764-13.974) and felt higher levels of hopelessness × higher levels of loneliness (OR = 2.446; 95% CI: 1.089-5.492) were significantly associated with an elevated suicide risk in older people in rural China. CONCLUSIONS Regular evaluation of loneliness, hopelessness and depression can help detect older adults who are at risk of committing suicide. Interventions should target social support systems, particularly among people living alone, to alleviate feelings of loneliness and hopelessness. Treating depression is also key to preventing suicide among elderly people in rural China.
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Temkin-Greener H, Orth J, Conwell Y, Li Y. Suicidal Ideation in US Nursing Homes: Association With Individual and Facility Factors. Am J Geriatr Psychiatry 2020; 28:288-298. [PMID: 32001114 PMCID: PMC7050379 DOI: 10.1016/j.jagp.2019.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/19/2019] [Accepted: 12/19/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess prevalence of suicidal ideation (SI) among new postacute and long-stay nursing home (NH) admissions and examine the associations with individual and NH-level factors. SETTING/PARTICIPANTS A total of 1,864,102 postacute and 304,106 long-stay admissions to just over 15,000 NHs between 7/1/2014 and 6/30/2015. MEASUREMENT Using 100% of the national Minimum Data Set 3.0, we identified SI and key covariates. SI was based on responses to one item on the PHQ-9 scale. For postacute residents, SI was measured at admission and discharge. For long-stay residents, SI was assessed at admission and assessments closest to 90, 180, and 365 days thereafter. Patient sociodemographics, functional and cognitive status, comorbid conditions, and other covariates were included as independent variables, as were several NH-level factors. Logistic regression models were fit to estimate SI risk at admission and at subsequent time intervals. RESULTS Observed 2-week prevalence rates of SI were highest at admission (1.24% for postacute and 1.84% for long stays) and declined thereafter at each subsequent time interval. The odds of SI were significantly increased for residents with severe depression at admission and all subsequent intervals. Residents in for-profits had significantly lower rates of SI, compared with those in not-for-profits. CONCLUSIONS Our findings demonstrate that SI risk in NHs is highest at admission and subsequently declines. We found several potentially modifiable individual-level risk factors for SI. The identification of SI may be seriously underreported in for-profit-facilities. Future research may be needed to explore how the PHQ-9 item on SI is understood by residents and recorded by staff.
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Affiliation(s)
- Helena Temkin-Greener
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry (HT-G, JO, YL), Rochester, NY.
| | - Jessica Orth
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry (HT-G, JO, YL), Rochester, NY
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry (YC), Rochester, NY
| | - Yue Li
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry (HT-G, JO, YL), Rochester, NY
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Nie Y, Hu Z, Zhu T, Xu H. A Cross-Sectional Study of the Prevalence of and Risk Factors for Suicidal Ideation Among the Elderly in Nursing Homes in Hunan Province, China. Front Psychiatry 2020; 11:339. [PMID: 32477170 PMCID: PMC7241427 DOI: 10.3389/fpsyt.2020.00339] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/03/2020] [Indexed: 11/30/2022] Open
Abstract
Our study aims to explore the risk factors for suicidal ideation and their interaction among the elderly in nursing homes in Hunan province, China. A cross-sectional study was conducted among the elderly in nursing homes in Hunan Province. Twenty-four nursing homes were selected by multistage cluster random sampling, and 817 elderly residents were investigated using a set of structured questionnaires. The main outcome measures included general information, suicidal ideation, depression symptoms, social support, activities of daily living (ADL), stressful life events, and sleep quality. Multivariate binary logistic regression was performed to explore the risk factors for suicidal ideation among the elderly in nursing homes, and additive interaction was used to analyze the interaction between risk factors. The prevalence of suicidal ideation among the elderly in nursing homes in Hunan province was 17.9% (95% confidence interval(CI): 15.2%, 20.6%). Living in a rural area (odds ratio(OR)=1.88, 95% CI: 1.03, 3.44), infrequent visits from relatives (OR=2.61, 95% CI: 1.42, 4.78), history of chronic disease (OR=2.34, 95% CI: 1.09, 5.01), depression symptoms (OR=8.11, 95% CI: 4.52, 14.54), lower social support (OR=3.85, 95% CI: 1.94, 7.61), and ADL disability status (OR=4.38, 95% CI: 2.10, 9.14) increased the risk of suicidal ideation. Additive interactions were detected between depression symptoms and ADL status, with a relative excess risk due to interaction (RERI) of 8.73 (95% CI: 2.04, 15.43), and between depression symptoms and social support, with an RERI of 5.98 (95% CI: 0.86, 11.10). The prevalence of suicidal ideation among the elderly in nursing homes is relatively high. Both physical conditions and psychosocial factors were associated with suicidal ideation among the elderly. These findings have significant implications for the prediction and prevention of suicidal behaviors.
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Affiliation(s)
- Yu Nie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Zhu
- Department of Scientific Research Management, Shanghai Health Development Research Center, Shanghai, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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25
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Zhou L, Wang G, Jia C, Ma Z. Being left-behind, mental disorder, and elderly suicide in rural China: a case-control psychological autopsy study. Psychol Med 2019; 49:458-464. [PMID: 29692283 PMCID: PMC6331683 DOI: 10.1017/s003329171800106x] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Suicide rate among rural elderly is the highest among all age groups in China, yet little is known about the suicide risks in this rapidly growing vulnerable population. METHODS This matched case-control psychological autopsy study was conducted during June 2014 to September 2015. Consecutive samples of suicides aged 60 or above were identified in three provinces (Shandong, Hunan, and Guangxi) in China. Living comparisons were 1:1 matched with the suicides in age (±3 years old), gender, and living location. Risk factors included demographic characteristics, being left-behind, mental disorder, depressive symptoms, stressful life events, and social support. RESULTS A total of 242 suicides and 242 comparisons were enrolled: 135 (55.8%) were male, mean (s.d.) age was 74 (8) years. The most frequently used suicide means were pesticides (125, 51.7%) and hanging (95, 39.3%). Independent risks of suicide included unstable marital status [odds ratio (OR) 4.19, 95% confidence interval (CI) 1.61-10.92], unemployed (compared with employed, OR 4.43, 95% CI 1.09-17.95), depressive symptoms (OR 1.34, 95% CI 1.21-1.48), and mental disorder (OR 6.28, 95% CI 1.75-22.54). Structural equation model indicated that the association between being left-behind and suicide was mediated by mental disorder, depressive symptoms, stressful life events, and social support. CONCLUSIONS Unstable marital status, unemployed, depressive symptoms, and mental disorder are independent risk factors for suicide in rural elderly. Being left-behind can elevate the suicide risk through increasing life stresses, depressive symptoms, mental disorder, and decreasing social support. Elderly suicide may be prevented by restricting pesticides, training rural physicians, treating mental disorders, mitigating life stress, and enhancing social connection.
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Affiliation(s)
- Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Guojun Wang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
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26
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Cao R, Jia C, Ma Z, Niu L, Zhou L. Disability in Daily Living Activities, Family Dysfunction, and Late-Life Suicide in Rural China: A Case-Control Psychological Autopsy Study. Front Psychiatry 2019; 10:827. [PMID: 31798474 PMCID: PMC6863879 DOI: 10.3389/fpsyt.2019.00827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022] Open
Abstract
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.
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Affiliation(s)
- Rifang Cao
- Department of Medical Affairs,The Seventh People's Hospital of Hangzhou, Hangzhou, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Lu Niu
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Liang Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
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27
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Niu L, Jia C, Ma Z, Wang G, Yu Z, Zhou L. Validating the Geriatric Depression Scale with proxy-based data: A case-control psychological autopsy study in rural China. J Affect Disord 2018; 241:533-538. [PMID: 30153636 DOI: 10.1016/j.jad.2018.08.066] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/19/2018] [Accepted: 08/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Geriatric Depression Scale (GDS) has been widely used for late-life depression, but it lacks validation in psychological autopsy research. This study aimed to assess the validity and establish the optimal cut-off values of the GDS-30 and the GDS-15 with proxy-based data in rural China. METHODS We applied psychological autopsy to collect data from 242 consecutive suicide cases and 242 paired living community controls. RESULTS Subject-proxy concordance for the GDS-30 (ICC = 0.590) and the GDS-15 (ICC = 0.539) were fair in the living controls. Based on proxy-data, we found that the suicide cases had higher scores of depression than the living controls did; the values of Cronbach's alpha demonstrated good internal consistency of the GDS-30 and the GDS-15; the Spearman correlation analysis indicated that the GDS scores were correlated with hopelessness, loneliness, and quality of life. For suicide cases, the GDS-30 showed the highest Youden's index as 34.86% with a cut-off value at 22, when its sensitivity and specificity was 0.78 and 0.56, respectively; the score of 12 on the GDS-15 showed the highest Youden's index of 31.39%, and its sensitivity and specificity was 0.74 and 0.58, respectively. LIMITATIONS This study is limited to its generalizability to Chinese urban elderly with psychological autopsy method. CONCLUSIONS The GDS-30 and the GDS-15 were both valid tools for measuring the severity of depressive symptoms rather than screening for major depression in psychological autopsy research in rural China. The GDS-15 can be considered as a good substitute for the GDS-30.
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Affiliation(s)
- Lu Niu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou 510370, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China.
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China.
| | - Guojun Wang
- Xiangya School of Public Health, Central South University, Changsha, China.
| | - Zhenjun Yu
- Xiangya School of Public Health, Central South University, Changsha, China.
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou 510370, China.
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Fang X, Zhang C, Wu Z, Peng D, Xia W, Xu J, Wang C, Cui L, Huang J, Fang Y. Prevalence, risk factors and clinical characteristics of suicidal ideation in Chinese patients with depression. J Affect Disord 2018; 235:135-141. [PMID: 29655075 DOI: 10.1016/j.jad.2018.04.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/08/2018] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Suicide risk is greatly increased in depression. Detection of those at risk is clinically important. Hence, this study aimed to evaluate the prevalence and identify independent risk factors associated with suicidal ideation (SI) in a widespread symptomatology within and outside DSM framework. METHODS This study was part of the National Survey on Symptomatology of Depression (NSSD) which was designed to investigate the magnitude of symptoms of current major depressive episode in China. Stepwise multivariable logistic regression was performed to examine the independent risk factors for SI, including variables that are statistically significant in univariate analysis. Receiver operating characteristic (ROC) was used to evaluate the performance of the regression model. RESULTS A total of 3275 patients (1293 males and 1982 females) were included in our analysis. Of these, 1750 patients (53.4%) had SI. Independent risk predictors included crying (P = 0.000; odds ratio = 1.827), helplessness (P = 0.000; odds ratio = 1.514), worthlessness (P = 0.001; odds ratio = 1.359), hopelessness (P = 0.000; odds ratio = 1.805), unusually restless (P = 0.005; odds ratio = 1.276), self-harm (P = 0.000; odds ratio = 3.385), mood-incongruent psychosis (P = 0.000; odds ratio = 2.782), feeling losing control of oneself (P = 0.009; odds ratio = 1.352), hypersomnia (P = 0.000; odds ratio = 1.805), sensory system complaints (P = 0.000; odds ratio = 1.546), derealization (P = 0.006; odds ratio = 1.580), guilt (P = 0.002; odds ratio = 1.332), suicidal attempts (P = 0.000; odds ratio = 2.841), male gender (P = 0.001; odds ratio = 0.756), the total course of depression (P = 0.010; odds ratio = 1.003) in the regression model. In addition, the areas under the curve of the ROC and the accuracy for the regression model were 0.80 and 0.76, respectively. CONCLUSIONS This study provided an effective risk model for SI in MDD and indicated that all these factors in our model allow better the employment of preventative measures.
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Affiliation(s)
- Xinyu Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Zhiguo Wu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Daihui Peng
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weiping Xia
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jingjing Xu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chenglei Wang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lvchun Cui
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yiru Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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29
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Niu L, Jia C, Ma Z, Wang G, Yu Z, Zhou L. The validity of proxy-based data on loneliness in suicide research: a case-control psychological autopsy study in rural China. BMC Psychiatry 2018; 18:116. [PMID: 29716552 PMCID: PMC5930838 DOI: 10.1186/s12888-018-1687-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/12/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a lack of evidence for the role of loneliness on suicide using psychological autopsy method, and the validity of proxy informants' reports on loneliness is not well established. This study aimed to investigate the validity of proxy respondent reports on loneliness, and the reliability and validity of the University of California Los Angeles Loneliness Scale-6 (ULS-6) as used in psychological autopsy method with rural elderly people in China. METHODS Two hundred forty-two suicide cases and 242 normal community controls were selected, and the psychological autopsy method was utilized to collect information. Data from proxy respondents of the living controls were compared with data reported by the targets (gold standards). RESULTS Subject-proxy concordance for ULS-6 was fair (ICC = 0.447) in the living controls. The suicide cases were more likely to have a higher score of ULS-6 than the living controls. Additionally, our data supported that ULS-6 had adequate psychometric properties in both suicide and control groups: factor analyses yielded one-factor component solution; Cronbach's alpha (both > 0.90) demonstrated excellent internal consistency; the Spearman correlation analysis indicated that the ULS-6 score was positively correlated with depression; and negatively correlated with QOL and social support. CONCLUSIONS Results support proxy-based data on loneliness in research of suicide in older adults in rural China, and the ULS-6 is a psychometrically sound instrument for measuring loneliness in psychological autopsy studies.
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Affiliation(s)
- Lu Niu
- 0000 0000 8653 1072grid.410737.6The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370 China
| | - Cunxian Jia
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, China
| | - Zhenyu Ma
- 0000 0004 1798 2653grid.256607.0School of Public Health, Guangxi Medical University, Nanning, China
| | - Guojun Wang
- 0000 0001 0379 7164grid.216417.7Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhenjun Yu
- 0000 0001 0379 7164grid.216417.7Xiangya School of Public Health, Central South University, Changsha, China
| | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), 36 Mingxin Road, Liwan District, Guangzhou, 510370, China.
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