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Huang H, Zhang L, Dong W, Tu L, Tang H, Liu S, Chen H, Xie N, Chen C. Stigma and loneliness among young and middle-aged stroke survivors: A moderated mediation model of interpersonal sensitivity and resilience. J Psychiatr Ment Health Nurs 2024; 31:596-606. [PMID: 38164762 DOI: 10.1111/jpm.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Loneliness is common among young and middle-aged stroke survivors. It not only hinders the recovery of their neurological and physical functions but also increases the risk of stroke recurrence, disability, and even death. Improving the mental health of young and middle-aged stroke survivors is of utmost importance. However, previous research has not yet investigated the impact of interpersonal sensitivity and resilience on the relationship between stigma and feelings of loneliness. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study confirms that stigma has a positive impact on loneliness among young and middle-aged stroke survivors. Interpersonal sensitivity partially mediates the relationship between stigma and loneliness, and resilience plays a moderating role in the mediating mechanism. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses can formulate nursing interventions to reduce loneliness of young and middle-aged stroke survivors with the goals of improving stigma, reducing interpersonal sensitivity and cultivating resilience. ABSTRACT: Introduction Previous studies have not explored the impact of interpersonal sensitivity and resilience on the relationship between stigma and loneliness. However, improving the resilience of young and middle-aged stroke survivors and increasing their social participation is of great significance for reducing patients' loneliness of patients and promoting their physical and mental rehabilitation. Aims To investigate the influence of stigma, interpersonal sensitivity and resilience on loneliness among young and middle-aged stroke survivors. Methods A cross-sectional design was used to collect data. A total of 330 participants completed measures of stigma, resilience, interpersonal sensitivity and loneliness. The descriptive statistical approach, Pearson's correlation analysis and Hayes' PROCESS Macro Model 4 and 7 in regression analysis were used to analyse the available data. Results The results revealed that young and middle-aged stroke survivors' stigma, resilience, interpersonal sensitivity and loneliness were significantly correlated between every two variables, with coefficients ranging between -0.157 and 0.682. Interpersonal sensitivity played a partial mediating role in stigma and loneliness, accounting for 63.27% of the total effect; This process was moderated by resilience. Discussion Stigma positively predicts participants' loneliness. As a mediating mechanism with moderating, interpersonal sensitivity and resilience further explain how stigma affects loneliness. Implications for Practice Understanding this mechanism is of guiding significance to reduce loneliness of young and middle-aged stroke patients and promote their physical and mental rehabilitation.
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Affiliation(s)
- Haitao Huang
- Institute of Nursing and Health, Henan University, Kaifeng, China
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Liao Zhang
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Wanglin Dong
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Ling Tu
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Haishan Tang
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Shejuan Liu
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Hong Chen
- Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Naze Xie
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Chaoran Chen
- Institute of Nursing and Health, Henan University, Kaifeng, China
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Wang Q, Huang X, Liu M, Wang C, Sun Z, Huang C, Tang S. Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis. Aging Ment Health 2024:1-12. [PMID: 38952191 DOI: 10.1080/13607863.2024.2367044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/20/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To determine a pooled prevalence of depression and its influencing factors among nursing home residents. METHOD PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors. RESULTS This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65). CONCLUSION The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.
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Affiliation(s)
- Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Chunyu Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zaiqing Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Chen YT, Hassett AL, Khanna D, Murphy SL. Resilience partially mediates the association between perceived social isolation and life satisfaction in people with systemic sclerosis. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2024; 9:154-161. [PMID: 38910596 PMCID: PMC11188843 DOI: 10.1177/23971983241232853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/23/2024] [Indexed: 06/25/2024]
Abstract
Objectives Systemic sclerosis (SSc) negatively affects quality of life, yet the factors influencing life satisfaction, a key aspect of well-being, remain unclear in this population. Social isolation is common in SSc, potentially linked to decreased life satisfaction, but the underlying mechanisms are unexplored. Resilience, a modifiable psychological resource, may act as a mediator in this relationship among people with SSc. This study aimed to examine the relationship between perceived social isolation and life satisfaction and to investigate whether resilience mediates this relationship. Methods The Patient-Reported Outcomes Measurement Information System Social Isolation Short Form, the Connor-Davidson Resilience Scale, and the Satisfaction with Life Scale were used to assess perceived social isolation, resilience, and life satisfaction. Linear regressions were conducted using the PROCESS macro for SPSS. Results Among 163 individuals with SSc who provided complete data at baseline (mean age = 54.7 ± 11.9 years), 47% had diffuse cutaneous SSc, and 57% had an early disease duration. Perceived social isolation was negatively associated with life satisfaction. Resilience partially mediated the association between perceived social isolation and life satisfaction in people with SSc. Conclusions Findings revealed a significant association between perceived social isolation and life satisfaction and the mediating role of resilience in this association among people with SSc. Results suggest resilience may act as a protective mediator, counteracting the negative influence of perceived social isolation on life satisfaction. Findings support the promotion of social connection and resilience to enhance life satisfaction in people with SSc. Clinical Trials Registration # NCT04908943.
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Affiliation(s)
- Yen T Chen
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Scleroderma Program, University of Michigan, Ann Arbor, MI, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Afton L Hassett
- Chronic Pain & Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Dinesh Khanna
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Scleroderma Program, University of Michigan, Ann Arbor, MI, USA
| | - Susan L Murphy
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Scleroderma Program, University of Michigan, Ann Arbor, MI, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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Hajek A, Zwar L, Gyasi RM, Kretzler B, König HH. Prevalence and determinants of loneliness among the oldest old living in institutionalized settings : Study findings from a representative survey. Z Gerontol Geriatr 2024; 57:214-219. [PMID: 37266683 PMCID: PMC11078814 DOI: 10.1007/s00391-023-02196-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/03/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND There is very limited knowledge regarding the prevalence and determinants of loneliness in oldest old residents of nursing or old age homes. OBJECTIVE To examine the prevalence and determinants of loneliness among the oldest old living in institutionalized settings in Germany. MATERIAL AND METHODS Data were taken from the representative survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+) including individuals ≥ 80 years living in North Rhine-Westphalia. The study focused on individuals living in institutionalized settings. Sociodemographic, lifestyle-related, and health-related determinants were included in multiple linear regression models. RESULTS Approximately 56.6% of the individuals were not lonely, 25.7% and 17.8% of the individuals were moderately and severely lonely, respectively. Regression analyses showed that higher loneliness was associated with being married (β = 0.48, p < 0.05), high education (compared to low education, β = 0.46, p < 0.05), having a small social network size (β = -0.02, p < 0.05), having poor self-rated health (β = -0.25, p < 0.05), and more depressive symptoms (β = 0.25, p < 0.001). CONCLUSION A significant proportion of the institutionalized oldest old individuals reported moderate or severe loneliness, which underpins the relevance of this topic. Understanding the determinants of loneliness may help to address institutionalized adults aged 80 years and over at risk of loneliness.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany.
| | - Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
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Ai F, Li E, Dong A, Zhang H. Association between disability and cognitive function in older Chinese people: a moderated mediation of social relationships and depressive symptoms. Front Public Health 2024; 12:1354877. [PMID: 38689766 PMCID: PMC11058663 DOI: 10.3389/fpubh.2024.1354877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Objective Many previous studies have found that disability leads to cognitive impairment, and in order to better understand the underlying mechanisms between disability and cognitive impairment, the present study aimed to investigate the moderating role of social relationships, including their role as mediators between disability and cognitive impairment in depressive symptoms. Study design This is a cross-sectional study. Methods A total of 5,699 Chinese older adults from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS) were included in this study, and PROCESS macro was used to perform simple mediator and moderator mediator analyses, which were used to analyze the relationship between depressive symptoms and social relationships between disability and cognitive impairment. Results The results of this study showed significant correlations between disability, cognitive impairment, depressive symptoms, and social relationships, and that depressive symptoms mediated the relationship between disability and cognitive functioning [B = -0.232; 95% CI: (-0.304, -0.164)], and that social relationships mediated disability and cognitive functioning through pathway a (Disability-Depressive Symptoms) [B = 0.190; 95% CI: (0.020, 0.036)], path b (depressive symptoms-cognitive impairment) [B = 0.029; 95% CI: (0.015, 0.042)], and path c' (incapacitation-cognitive impairment) [B = 0.492; 95% CI: (0.298, 0.685)] to modulate the effect of incapacitation on cognitive impairment. In addition, social activities and social networks moderated the mediation model directly or indirectly, whereas social support moderated only the direct effect. Conclusion This study explains the intrinsic link between incapacitation and cognitive impairment in Chinese older adults, and that social relationships and depressive symptoms can directly or indirectly modulate the effects between them. This provides a basis for healthcare professionals to be able to better develop interventions that can be used to improve the level of cognitive functioning and mental health of older adults.
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Affiliation(s)
| | | | | | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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Zhang C, Liu Y, Zeng L, Luo X, Fan G, Shi H, Shen J. Combined associations of cognitive impairment and psychological resilience with all-cause mortality in community-dwelling older adults. J Affect Disord 2024; 351:962-970. [PMID: 38346647 DOI: 10.1016/j.jad.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Cognitive impairment and psychological resilience are closely related in older adults, but their combined effect on mortality has not been reported. Using a nationally representative sample from the Chinese Longitudinal Healthy Longevity Study, this study examined the interactions between cognitive impairment and psychological resilience and their associations with overall survival. METHODS A total of 32,349 community-dwelling older adults (86.85 ± 11.16 years, 56.06 % female) were enrolled in 1998, 2000, 2002, 2005, 2008, 2011, and 2014; all participants were followed until 2018. Cognitive function and psychological resilience were assessed using the Mini-Mental State Examination (MMSE) and the 7-item psychological resilience questionnaire (PRQ), respectively. Illiterate subjects with an MMSE score <18, or literate subjects with an MMSE score <24 were defined as having cognitive impairment. Cox proportional risk regressions were used to analyze the association of cognitive impairment and psychological resilience with all-cause mortality. RESULTS After 146,993.52 person-years of follow-up, 23,349 older adults died. Both MMSE and PRQ scores (as continuous variables) were negatively associated with mortality risk after adjusting for all covariates. The hazard ratio (HR) of all-cause mortality for cognitive impairment was not significantly moderated by levels of psychological resilience (P-interaction = 0.094). In joint analyses, participants with combined cognitive impairment and low resilience (by the median of PRQ: < 25 points) had the highest risk of mortality (adjusted-HR: 1.56, 95%CI: 1.48-1.61), which was higher than that of patients with either condition alone. There was a significant additive interaction effect of cognitive impairment and low resilience on all-cause mortality (relative excess risk due to interaction: 0.11, 95 % CI: 0.09-0.13), and 7 % of the overall mortality risk was attributable to their synergistic effect. CONCLUSIONS Cognitive impairment and low resilience are synergistically associated with increased risk of all-cause mortality in community-dwelling older adults. The potential mechanisms underlying this combined effect warrant further exploration.
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Affiliation(s)
- Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Ye Liu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Lvtao Zeng
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Xuanmei Luo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Guoqing Fan
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| | - Ji Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
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Sun F, Wang F, Hu X, Xue J, Zheng S, Su J, Lu Q. Alexithymia and negative emotions among nursing students: a moderated mediation model. BMC Nurs 2024; 23:167. [PMID: 38459516 PMCID: PMC10921665 DOI: 10.1186/s12912-024-01832-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.
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Affiliation(s)
- Feifei Sun
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Fang Wang
- Xianning Vocational Technical College, 437100, Xianning, Hubei, China
| | - Xiaojing Hu
- Department of Nursing, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jiaomei Xue
- Society and Law School, Shandong Women's University, Changqing University Science and Technology Park, No. 2399, University Road, 25030, Jinan, Shandong, China
| | - Shangkun Zheng
- Human Resources Department, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China
| | - Jing Su
- Editorial Board, Journal of Shandong First Medical University, No. 6699 Qingdao Road, Huaiyin District, 250000, Jinan, China
| | - Qinghua Lu
- Department of Infection Management, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, 250014, Jinan, Shandong, China.
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Duan A, Zhao H, Zhou C. The Effects of a Healthy Lifestyle on Depressive Symptoms in Older Chinese Adults: The Mediating Role of Psychological Resilience. Cureus 2024; 16:e57258. [PMID: 38686246 PMCID: PMC11057559 DOI: 10.7759/cureus.57258] [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] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
Objectives This study aimed to validate the interrelationships and potential pathways of influence between healthy lifestyles, psychological resilience, and depressive symptoms in the Chinese elderly population. Methods We utilized data from the Chinese Elderly Health Influential Factors Tracking Survey 2018 and included 9448 samples for the study after screening according to the qualifying conditions. The interrelationships among healthy lifestyles, psychological resilience and depressive symptoms were analyzed using stepwise regression, and the robustness of mediation effects was assessed using Sobel and Bootstrap test. Results Among Chinese older adults, healthy lifestyles were negatively associated with depressive symptoms (β = -0.310, 95% CI: -0.405, -0.215), positively associated with psychological resilience (β = 0.137, 95% CI:0.071, 0.023), and psychological resilience was negatively associated with depressive symptoms (β = -1.014, 95% CI: -1.037, -0.990). Conclusions Psychological resilience partially mediated the association between healthy lifestyles and depressive symptoms, with the mediating effect accounting for 44.8% of the total effect. Our study contributes to the understanding of the relationship between healthy lifestyles and depressive symptoms in the elderly population and emphasizes the important role of psychological resilience. It is recommended that the government and policymakers improve depressive symptoms among older adults through comprehensive measures such as promoting healthy lifestyles and education, providing psychological support services, and creating a favorable environment.
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Affiliation(s)
- Ailing Duan
- Public Health, Chongqing Medical University, Chongqing, CHN
| | - Hang Zhao
- Public Health, Chongqing Medical University, Chongqing, CHN
| | - Chunmin Zhou
- Public Health, Chongqing Medical University, Chonqing, CHN
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Zhao X, Si H. Exploring the chain mediating roles of frailty and depressive symptoms in the relationship between pain and cognitive function among nursing home older adults. Psychogeriatrics 2024; 24:426-432. [PMID: 38323495 DOI: 10.1111/psyg.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/18/2023] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND The prevalence of cognitive decline is high among nursing home older adults. Pain is a vital factor in cognitive function. Furthermore, the current literature lacks the complex association between pain, frailty, depressive symptoms, and cognitive function. The aim of this study was to explore the chain mediating roles of frailty and depressive symptoms in the association between pain and cognitive function among nursing home older adults. METHODS This is a population-based cross-sectional study, conducted in China, of 210 nursing home older adults aged 64-98 years old, who completed the measurements of sociodemographic information, pain, frailty, depressive symptoms, and cognitive function. Mediation analyses tested the indirect effect of frailty and depressive symptoms in the relationship between pain and cognitive function by PROCESS macro. RESULTS Pain, frailty, as well as depressive symptoms, were negatively related to cognitive function. Frailty mediated the association between pain and cognitive function. Importantly, mediation analyses showed that frailty and depressive symptoms acted as sequential mediators of pain and cognitive function. CONCLUSIONS These findings have crucial clinical implications, as they suggest targeting physiological and psychological factors in older adults with chronic pain to alleviate cognitive decline.
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Affiliation(s)
- Xia Zhao
- Department of Health Management, Heze Medical College, Heze, China
| | - Huaxin Si
- School of Public Health, Peking University, Beijing, China
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Zhang C, Dong Y, Li S, Li M, Gao Y, Liu Y, Liu X, Zhou C, Li J. Ghrelin and depressive symptoms in patients with first-episode drug-naïve major depressive disorder: The mediating role of hypothalamic-pituitary-adrenal axis. Asia Pac Psychiatry 2024; 16:e12552. [PMID: 38348641 DOI: 10.1111/appy.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/13/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the global burdens of disease, and its pathogenesis remains unclear. An increasing amount of research indicates that ghrelin regulates mood in patients with MDD. Still, current results are inconsistent, and the mechanisms underlying how ghrelin modulates depressive symptoms are inconclusive, especially in first-episode drug-naïve MDD patients. Therefore, this study aims to investigate the relationship and potential mechanism between ghrelin and first-episode drug-naïve MDD. METHODS Ninety first-episode drug-naïve MDD patients and 65 healthy controls (HCs) were included. Hamilton Depression Scale (HAMD-17) as a measure of depressive symptoms. Plasma levels of ghrelin and hypothalamic-pituitary-adrenal axis (HPA-axis) hormones were measured in all participants. RESULTS Compared to HCs, the ghrelin levels were higher in the MDD (p < .001) and still showed significance after covarying for sex, age, and Body Mass Index (BMI). Ghrelin was positively related to corticotropin-releasing-hormone (CRH) levels (r = .867, p < .001), adrenocorticotropic hormone (ACTH) levels (r = .830, p < .001), and cortisol levels (r = .902, p < .001) in partial correlation analysis. In addition, there was a positive correlation between HAMD total score and ghrelin levels (r = .240, p = .026). Other than that, the HAMD total score also had a positive correlation with the CRH (r = .333, p = .002) and cortisol (r = .307, p = .004) levels. Further mediation analysis demonstrated that the relationship between ghrelin and HAMD total score was mediated by CRH (ab-path; β = .4457, 95% CI = 0.0780-1.0253, c-path; β = .2447, p = .0260, c'-path; β = -.2009, p = .3427). CONCLUSIONS These findings revealed that plasma ghrelin provides a pivotal link to depressive symptoms in first-episode drug-naive MDD patients. CRH mediated the relationship between ghrelin and HAMD total score. It might provide new insights into understanding the pathogenesis of MDD, contributing to intervention and treatment from this approach.
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Affiliation(s)
- Chuhao Zhang
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yeqing Dong
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - ShuHua Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
- Department of Clinical Psychology, Tianjin TEDA Hospital, Tianjin, China
| | - Meijuan Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Ying Gao
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yuan Liu
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Xueying Liu
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Chi Zhou
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
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Yoon S, Mahapatra N. Domestic Violence, Mental Health, and Resilience Among Older Adults in the U.S. During COVID-19. J Aging Health 2024; 36:194-206. [PMID: 37282842 PMCID: PMC10251065 DOI: 10.1177/08982643231181753] [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] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The current study based on the Stress Process Model investigated the impact of experiences of domestic violence on mental health as well as resilience against negative mental health outcomes among older adults in U.S. during COVID-19. METHOD Participants included 522 older adults (ages 51-80 and older) living in US at the time of the survey. Path analysis using Mplus was employed. Results:The experience of domestic violence among older adults during the pandemic was positively associated with loneliness and anxiety directly and indirectly. However, resilience acted as a protective factor between the experiences of domestic violence and anxiety. Conclusion: The experience of domestic violence may increase loneliness and anxiety among older adults during challenging times; however, resilience may weaken these negative psychological outcomes both directly and indirectly. Findings and implications are discussed.
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Affiliation(s)
- Sukyung Yoon
- Division of Social Work, College of Health
Sciences, University of Wyoming, Laramie, WY, USA
| | - Neely Mahapatra
- Division of Social Work, College of Health
Sciences, University of Wyoming, Laramie, WY, USA
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12
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da Silva THR. Loneliness in older adults. Br J Community Nurs 2024; 29:60-66. [PMID: 38300245 DOI: 10.12968/bjcn.2024.29.2.60] [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] [Indexed: 02/02/2024]
Abstract
This article aims to provide an overview on loneliness in older people, with an emphasis on how insights from this body of literature can significantly contribute to the enhancement of care provided by community nurses. This review aims to provide a nuanced understanding of the factors contributing to loneliness, its impact on the physical and mental health of older individuals, and the role community nurses can play in mitigating and addressing loneliness.
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Affiliation(s)
- Tiago Horta Reis da Silva
- Lecturer in Nursing Education AEP, Department of Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
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13
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Aljadani R, Carnahan R, Culp K, Souza-Talarico JN. COVID-19 Pandemic Impact on the Trajectories of Cognitive Decline and Depression Symptoms in Long-Term Care Facility Residents. J Am Med Dir Assoc 2024; 25:328-334.e6. [PMID: 38195079 DOI: 10.1016/j.jamda.2023.12.003] [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: 08/17/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES To compare the longitudinal rates of change in cognition and depressive symptoms between 2019 (pre-COVID-19 pandemic) and 2020 (COVID-19 pandemic) among long-term care facility (LTCF) residents in Iowa, which ranked among the top 10 US states that suffered from extreme nursing staff shortages during this crisis. DESIGN A longitudinal cohort study analyzing the Long-Term Care Minimum Data Set (MDS) version 3.0 between January 1, 2019, and December 31, 2020. SETTING AND PARTICIPANTS LTCF residents from the state of Iowa, with a first assessment before March 10 for each year (2019 and 2020), LTCF stay period >60 days, and at least 2 documented assessments with a minimum of 45 days in between. LTCF residents with a Brief Interview for Mental Status score (BIMS) <3 were excluded. METHODS We computed doubly robust estimators by combining regression and propensity score models for BIMS (cognitive decline) and Nine-item Patient Health Questionnaire (PHQ-9; depression symptoms) monthly scores for 2020 vs 2019. RESULTS A total of 24,025 residents from 436 LTCFs were included. Our research revealed a marginally accelerated monthly decline in BIMS scores during 2020 as opposed to 2019, with a rate of -0.012 per month (95% CI -0.022, -0.002; P = .016). Simultaneously, we observed a monthly increment of 0.016 in the PHQ-9 scores among LTCF residents in 2020 (95% CI 0.006, 0.028; P = .003). CONCLUSIONS AND IMPLICATIONS Our study identified a notable yet modest increase in cognitive decline and depressive symptoms among NH residents in Iowa during the COVID-19 pandemic. Although statistically significant, the changes were small and may not have clinical relevance over 1 year. Further research is needed to examine risk factors for cognitive decline during pandemic scenarios such as social isolation, loneliness, inappropriate patient-centered care, and the relationship with staff shortage and facility resources.
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Affiliation(s)
- Rawabi Aljadani
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Ryan Carnahan
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Kennith Culp
- College of Nursing, University of Iowa, Iowa City, IA, USA
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14
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Matsuoka T, Ismail Z, Imai A, Shibata K, Nakamura K, Nishimura Y, Rubinstein E, Uchida H, Mimura M, Narumoto J. Relationship between Loneliness and Mild Behavioral Impairment: Validation of the Japanese Version of the MBI Checklist and a Cross-Sectional Study. J Alzheimers Dis 2024; 97:1951-1960. [PMID: 38306041 PMCID: PMC10894585 DOI: 10.3233/jad-230923] [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] [Accepted: 12/20/2023] [Indexed: 02/03/2024]
Abstract
Background Mild behavioral impairment (MBI) and loneliness are associated with cognitive decline and an increased risk of dementia. Objective Our aim was to examine the validity of the Japanese version of the MBI checklist (MBI-C) and investigate the relationship between loneliness and MBI. Methods The participants in this cross-sectional study included 5 cognitively normal persons and 75 persons with mild cognitive impairment. MBI-C and the revised University of California at Los Angeles loneliness scale (LS) were used to assess MBI and loneliness, respectively. Diagnostic performance of MBI-C was examined using receiver operating characteristic analysis. The relationship between MBI-C and LS was examined using multiple linear regression in 67 subjects who were assessed with both scales, with MBI-C total or domain score as the dependent variable and LS as the independent variable, adjusted for age, gender, living situation, presence of visual and hearing impairment, and Mini-Mental State Examination score. Results Per the Youden index, in this mostly MCI sample, the optimal MBI-C cut-off score was 5.5 with sensitivity 0.917 and specificity 0.949. In multiple linear regression analysis, LS score was detected as a significant predictor of MBI-C total scores, and MBI-C decreased motivation, affective dysregulation, and abnormal thought and perception scores. Conclusions The caregiver-rated Japanese MBI-C has excellent diagnostic performance. Loneliness is associated with a greater MBI burden, especially in the decreased motivation, affective dysregulation, and abnormal thought and perception domains. Interventions for loneliness in older people may have the potential to improve MBI.
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Affiliation(s)
- Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Psychiatry, NHO Maizuru Medical Center, Maizuru, Japan
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute and O’BrienInstitute for Public Health, University of Calgary, Calgary, Canada
- NIHR Exeter Biomedical Research Centre, University of Exeter, UK
| | - Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keisuke Shibata
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kaeko Nakamura
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yukihide Nishimura
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ellen Rubinstein
- Department of Sociology and Anthropology, North Dakota State University, Fargo, ND, USA
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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15
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Al-Jadidi S, Alharrasi M, Al-Shukaili A, Alkalbani A, Muthukrishnan A. Psychological Symptoms of COVID-19 Pandemic Among Community-Dwelling Older People in Oman and Associated Risk Factors. SAGE Open Nurs 2024; 10:23779608231226102. [PMID: 38250457 PMCID: PMC10798079 DOI: 10.1177/23779608231226102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction The COVID-19 pandemic has led to a dramatic loss of human lives worldwide. Objective This study aimed to investigate the psychological factors of the COVID-19 pandemic in the community-dwelling older population. Method This was a cross-sectional study of older people aged ≥60 years with no mental or psychological illnesses. A total of 193 participants were recruited. The study questionnaire included anxiety- and depression-related questions tailored for the COVID-19 pandemic. The questionnaire was developed through a literature review and expert review. Data was collected from December 2020 to January 2022. Results The psychological symptoms of COVID-19 were high in this sample (mean 29.18 ± 3.57). Gender (female) was found to have a strong positive relationship with the psychological symptoms of COVID-19 score (p = 0.003). Chronic illnesses (β = 0.19, p < 0.001), living alone (β = 0.39, p < 0.001), and having a family member or a friend with COVID-19 (β = 0.15, p < 0.001) were also found to have a strong positive relationship with the psychological symptoms of COVID-19 score. Conclusion The negative psychological effects of COVID-19 were high among the older population in Oman. In this study, female gender, chronic illnesses, living alone, and having a family member or a friend with COVID-19 were associated with worse COVID-19 psychological symptoms. Older women were affected by COVID-19 more than older men. In addition, those who had chronic illnesses, lived alone, or had a family member or a friend with COVID-19 were more psychologically burdened by the pandemic than those without those characteristics. Particular attention should be given to older adults who have chronic illnesses, live alone, or have a family member or a friend with COVID-19. Support groups and psychological counseling programs are essential for older people during a pandemic.
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Affiliation(s)
| | | | | | - Ali Alkalbani
- Intensive Care Unit, Sultan Qaboos University Hospital, Muscat, Oman
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16
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Jensen-Campbell LA, Liegey Dougall A, Heller AC, Iyer-Eimerbrink P, Bland MK, Hull K. Do Social Support and Loneliness Influence Emerging Adults' Mental Health during the First Year of the COVID-19 Pandemic? Brain Sci 2023; 13:1691. [PMID: 38137139 PMCID: PMC10741457 DOI: 10.3390/brainsci13121691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Youths' mental health is at a crisis level, with mental health problems doubling in the US since the pandemic began. To compound the mental health crisis, there is a global loneliness epidemic, with emerging adults worldwide experiencing some of the highest rates. One study with two phases examined the influence of social support and loneliness on mental health in US emerging adults during the pandemic, including changes in these relationships over one year. Emerging adults (N = 449) completed online questionnaires via Prolific in May 2020 (Phase 1) and again from January to May 2021 (N = 253; Phase 2). More perceived support was related to reduced loneliness, with family support having the most significant influence. Loneliness mediated the link between perceived support and adverse health outcomes. Higher loneliness predicted more perceived stress and sleep difficulties concurrently and over time. There was a bidirectional relationship between loneliness and depression, such that higher levels of either variable at Time 1 predicted increases in the other over time. Results highlight the detrimental impact of loneliness on emerging adults' mental health.
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Affiliation(s)
- Lauri A. Jensen-Campbell
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
| | - Angela Liegey Dougall
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
| | - Abigail C. Heller
- Department of Psychology, Belmont University, Nashville, TN 37212, USA;
| | - Priya Iyer-Eimerbrink
- Department of Psychology, University of North Texas at Dallas, Dallas, TX 75241, USA;
| | - Michelle K. Bland
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
| | - Kristen Hull
- Department of Psychology, University of Texas at Arlington, Arlington, TX 76019, USA; (A.L.D.); (M.K.B.); (K.H.)
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17
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Balki E, Hayes N, Holland C. The Indirect Impact of Educational Attainment as a Distal Resource for Older Adults on Loneliness, Social Isolation, Psychological Resilience, and Technology Use During the COVID-19 Pandemic: Cross-Sectional Quantitative Study. JMIR Aging 2023; 6:e47729. [PMID: 37999938 DOI: 10.2196/47729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/11/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, government-mandated social distancing prevented the spread of the disease but potentially exacerbated social isolation and loneliness for older people, especially those already vulnerable to isolation. Older adults may have been able to draw from their personal resources such as psychological resilience (PR) and technology use (TU) to combat such effects. Educational attainment (EA) or early-life EA may potentially shape later-life personal resources and their impact on the effects of the pandemic lockdown on outcomes such as loneliness. The developmental adaptation model allows for the supposition that social isolation, TU, and PR may be affected by early EA in older adults. OBJECTIVE This study examined the indirect impact of EA on pandemic-linked loneliness in a sample of older adults. The developmental adaptation model was used as the conceptual framework to view EA as a distal influence on loneliness, social isolation, PR, and TU. We hypothesized that EA would predict TU and PR and have a moderating impact on social isolation and loneliness. We also hypothesized that PR and TU would mediate the effect of EA on loneliness. METHODS This was a cross-sectional observational study, in which data were gathered from 92 older adults aged ≥65 years in the United Kingdom from March 2020 to June 2021, when the country was under various pandemic-linked social mobility restrictions. The data captured demographic information including age, gender, ethnicity, and the highest degree of education achieved. The University of California Los Angeles Loneliness Scale, Connor-Davidson Resilience Scale, Lubben Social Network Index, and Technology Experience Questionnaire were used as standardized measures. Pearson correlation, moderation, and mediation regression analyses were conducted to investigate the hypotheses. RESULTS We found a higher prevalence of loneliness in older adults than in prepandemic norms. EA was correlated with greater TU and PR and moderated the impact of social isolation on loneliness. PR mediated and TU partially mediated the relationship between EA and loneliness. CONCLUSIONS Early-life EA was confirmed as a distal resource for older adults and played an indirect role in affecting loneliness levels during the pandemic. It has an impact on present-day personal resources, such as PR and TU, which affect loneliness and also moderate the impact of social isolation on loneliness. Policymakers should be aware that older adults with low levels of EA may be more vulnerable to the harmful impacts of loneliness when isolated by choice.
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Affiliation(s)
- Eric Balki
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| | - Niall Hayes
- The Directorate, Nottingham Trent University, Nottingham, United Kingdom
| | - Carol Holland
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
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18
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Macharia JM, Raposa BL, Sipos D, Melczer C, Toth Z, Káposztás Z. The Impact of Palliative Care on Mitigating Pain and Its Associated Effects in Determining Quality of Life among Colon Cancer Outpatients. Healthcare (Basel) 2023; 11:2954. [PMID: 37998446 PMCID: PMC10671794 DOI: 10.3390/healthcare11222954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
Pain continues to be a significant problem for cancer patients, and the impact of a population-based strategy on their experiences is not completely understood. Our study aimed to determine the impact of palliative care on mitigating pain and its associated effects in determining the quality of life (QoL) among colon cancer outpatients. Six collection databases were used to perform a structured systematic review of the available literature, considering all papers published between the year 2000 and February 2023. PRISMA guidelines were adopted in our study, and a total of 9792 papers were evaluated. However, only 126 articles met the inclusion criteria. A precise diagnosis of disruptive colorectal cancer (CRC) pain disorders among patients under palliative care is necessary to mitigate it and its associated effects, enhance health, promote life expectancy, increase therapeutic responsiveness, and decrease comorbidity complications. Physical activities, the use of validated pain assessment tools, remote outpatient education and monitoring, chemotherapeutic pain reduction strategies, music and massage therapies, and bridging social isolation gaps are essential in enhancing QoL. We recommend and place a strong emphasis on the adoption of online training/or coaching programs and the integration of formal and informal palliative care systems for maximum QoL benefits among CRC outpatients.
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Affiliation(s)
- John M. Macharia
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Bence L. Raposa
- Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre Str 14/B, 7400 Kaposvár, Hungary
| | - Csaba Melczer
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary;
| | - Zoltan Toth
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Zsolt Káposztás
- Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
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19
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Wu CY, Lee MB, Huong PTT, Chen IM, Chen HC, Hsieh MH. Longitudinal Outcomes of Resilience, Quality of Life, and Community Integration in Treatment-Resistant Depression: A Two-Group Matched Controlled Trial. J Am Psychiatr Nurses Assoc 2023:10783903231204881. [PMID: 37904528 DOI: 10.1177/10783903231204881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
BACKGROUND Current evidence of nonpharmacological intervention for patients with treatment-resistant depression (TRD) is lacking. AIMS: To examine whether an 8-week nurse-led cognitive-behavioral based group intervention would enhance resilient coping and life quality among community-based patients with TRD. METHOD The participants were randomly sampled from a cohort of TRD recruited from two general teaching hospitals. The two groups were assessed with multiple outcome measures at baseline (T0); 8-week post-baseline (T1); and at 3, 6, and 9 months after T1 (T2-4). Psychoeducation was nested in the cognitive behavioral group intervention to facilitate discussion. RESULTS Of the 23 participants (mean age 56 years, 69.6% female) in the experimental group, higher resilient coping and lower mental distress levels at T1 as well as later improved quality of life and community integration at T2-4 were observed compared to the controls across COVID-19 (T3). Overall, the scores of resilience and community integration were higher throughout the four follow-up points of observations for the experimental group. CONCLUSION The findings indicated that an 8-week nurse-led cognitive-behavioral based group intervention may enhance the TRD patients' resilient coping and mental distress levels while providing the potentials for community reintegration after mental health psychoeducation engagement. It is imperative for the nurses caring for patients with TRD to extend from clinical-based intervention to community-based self-care approach, with the importance of short-term stress management and healthy lifestyle development highlighted during the community reintegration trajectory.
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Affiliation(s)
- Chia-Yi Wu
- Chia-Yi Wu, RN, PhD, School of Nursing, National Taiwan University College of Medicine, Taipei; Department of Nursing, National Taiwan University Hospital, Taipei
| | - Ming-Been Lee
- Ming-Been Lee, MD, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; National Taiwan University College of Medicine, Taipei
| | | | - I-Ming Chen
- I-Ming Chen, MD, PhD, National Taiwan University Hospital, Taipei
| | - Hsi-Chung Chen
- Hsi-Chung Chen, MD, PhD, National Taiwan University Hospital, Taipei
| | - Min-Hsien Hsieh
- Min-Hsien Hsieh, MD, PhD, National Taiwan University Hospital, Taipei
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20
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Zhang Y, Chen X, Sun Y, Feng S, Wang F, Gu H, Jia H, Zhang Q, Ding W, Lu H, Zhang J. Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis. Front Public Health 2023; 11:1257133. [PMID: 37954046 PMCID: PMC10634533 DOI: 10.3389/fpubh.2023.1257133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/29/2023] [Indexed: 11/14/2023] Open
Abstract
Background Transitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes. Methods This cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels. Results After applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = -0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p < 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis. Conclusion Our findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.
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Affiliation(s)
- Yi Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Xiangfan Chen
- Department of Biobank, Nantong First People's Hospital, Nantong, China
| | - Yimei Sun
- Finance Department, Nantong First People's Hospital, Nantong, China
| | - Sujuan Feng
- Blood Dialysis Room of Nantong First People’s Hospital, Nantong, China
| | - Fang Wang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Haiyan Gu
- Nursing Department of Nantong First People’s Hospital, Nantong, China
| | - Hanyu Jia
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Quanxing Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Wenbin Ding
- The President's Office, Nantong First People's Hospital, Nantong, China
| | - Hongjian Lu
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Jidong Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
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Cai H, Guo J, Zhou J, Lai Y. Psychological resilience mediates the association between sleep quality and anxiety symptoms: A repeated measures study in college students. PLoS One 2023; 18:e0292887. [PMID: 37878594 PMCID: PMC10599530 DOI: 10.1371/journal.pone.0292887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/01/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To explore the association between sleep quality and anxiety symptoms, and the mediation effect of psychological resilience on this association by a repeated measures study. METHODS In this study, 127 college students were randomly recruited and their sleep quality and psychological status were repeatedly collected using the Pittsburgh Sleep Quality Index (PSQI) scale, Connor-Davidson resilience scale (CD-RISC), and 7-items generalized anxiety disorder scale (GAD-7). Linear mixed-effects models were used to explore the association between sleep quality and anxiety symptoms, and a mediated effects analysis was used to explore the role played by psychological resilience in this association. RESULTS This study found a positive association between sleep quality and anxiety symptoms (β = 0.40, 95% confidence interval: 0.27, 0.52). Psychological resilience scores and its various dimensions play a significant mediating role in this association. CONCLUSIONS Although the role of sleep quality in anxiety disorders is not fully understood, this study highlights the importance of improving sleep quality while enhancing psychological resilience to prevent the onset of anxiety symptoms in college students.
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Affiliation(s)
- Huangjie Cai
- Mental Health Guidance Center, Fujian Medical University, Fuzhou, China
| | - Jianhui Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jungu Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yingqian Lai
- School of Public Health, Fujian Medical University, Fuzhou, China
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22
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Kim H, Kim O, Kim KA, Chu SH, Chung ML. The moderating role of neighborhood social cohesion in the mediation effects of the loneliness between acculturation stress and post-traumatic growth among female North Korean defectors. Sci Rep 2023; 13:16965. [PMID: 37806980 PMCID: PMC10560661 DOI: 10.1038/s41598-023-43741-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023] Open
Abstract
Loneliness negatively predicts post-traumatic growth (PTG) among North Korean defectors (NKD), one of the representative groups of refugees. Additionally, evidence also suggests that females, who account for 70% of NKDs entering South Korea, are vulnerable not only to past trauma but also to the current acculturation stress and loneliness affected by neighborhood social cohesion. This study explores whether the mediating effect of loneliness on the relationship between acculturation stress and PTG was moderated by the neighborhood social cohesion among female NKDs. In this study, the data of 166 female NKDs who completed an online survey regarding acculturation stress, PTG, loneliness, and neighborhood social cohesion were used. Moderated mediation analysis was conducted using SPSS PROCESS macro program. Loneliness was associated with PTG (B = - 1.896, p < 0.001), and mediated the association between acculturation stress and PTG (indirect effect = - 0.278, 95% LLCI - 0.403, 95% ULCI - 0.166). Neighborhood social cohesion moderated the mediation effect of loneliness on the association between acculturation stress and PTG (B = - 0.016, 95% LLCI 0.001, 95% ULCI 0.035). The indirect effect of acculturation stress on PTG through loneliness was notably high for those with low neighborhood social cohesion. Therefore, increasing neighborhood social cohesion would reduce loneliness caused by acculturation stress and support the positive growth among female NKDs. This represents the most effective approach to aiding female NKDs in achieving growth, even after suffering trauma.
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Affiliation(s)
- Hokon Kim
- College of Nursing and Brain Korea 21 FOUR project, Yonsei University, Seoul, Republic of Korea
| | - Ocksim Kim
- College of Nursing and Brain Korea 21 FOUR project, Yonsei University, Seoul, Republic of Korea
| | - Kyoung-A Kim
- Department of Nursing, Suwon Women's University, Suwon, Republic of Korea
| | - Sang Hui Chu
- College of Nursing, Yonsei University, Seoul, Republic of Korea.
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea.
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, KY, USA
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23
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Zhang D, Lu Q, Li L, Wang X, Yan H, Sun Z. Loneliness in nursing homes: A qualitative meta-synthesis of older people's experiences. J Clin Nurs 2023; 32:7062-7075. [PMID: 37605069 DOI: 10.1111/jocn.16842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/09/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Older people in the nursing home environment are much less mobile and capable of taking care of themselves as they age, and most of them face the plight of loneliness, which seriously affects the quality of life of older people in their later years. AIMS A systematic review and synthesis of older people's experiences of loneliness in nursing homes. DESIGN Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. METHODS A search of PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database and the Wipu Database for qualitative studies of older people's experiences of loneliness in nursing homes was conducted with a search time frame of March 2023. Evaluation of the quality of the literature using the Joanna Briggs Institute's Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research, And the data were synthesised using Thomas and Harden's method of thematic and content analysis. RESULTS A total of 13 papers were included, and 36 research findings were distilled and integrated into three themes: causes of loneliness; feelings of loneliness; coping with loneliness; and seven sub-themes: aging and loss; environmental transformation; loneliness is a pain; loneliness is a choice; participation; strengthening social ties; and diverting attention. CONCLUSIONS Older people in nursing homes face varying degrees of loneliness, which is a subjective feeling influenced by the interplay between personal awareness and the external environment, so future care interventions should be developed in a comprehensive manner, taking into account the characteristics of the older people themselves and their external environment. NO PATIENT OR PUBLIC CONTRIBUTION This study is a meta-synthesis and does not require relevant contributions from patients or the public.
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Affiliation(s)
- Deping Zhang
- Day Surgery Room, The First Hospital of China Medical University, Shenyang, China
| | - Qizhen Lu
- Operating room, The First Hospital of China Medical University, Shenyang, China
| | - Li Li
- Central sterile Supply department, The First Hospital of China Medical University, Shenyang, China
| | - Xiaofeng Wang
- Mammography, Liaoning Cancer Hospital, Shenyang, China
| | - Hongqi Yan
- Otolaryngology-Head and Neck Surgery, General Hospital of Northern Theatre command, Shenyang, China
| | - Zijian Sun
- Haemodialysis Unit, The First Hospital of China Medical University, Shenyang, China
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24
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Li P, Zhong J, He Y, Yan H, Xie M, Meng L. Loneliness and depression among community-dwelling older adults in China during the COVID-19 epidemic: The mediating role of social support. Medicine (Baltimore) 2023; 102:e35171. [PMID: 37713830 PMCID: PMC10508438 DOI: 10.1097/md.0000000000035171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/21/2023] [Indexed: 09/17/2023] Open
Abstract
The psychological condition of community-dwelling older adults is a global concern under coronavirus disease 2019. Loneliness is the key risk factor for depression among community-dwelling older adults. This study aims to explore the role of social support as a mediating factor in the relationship between depression and loneliness among community-dwelling older adults. We conducted a cross-sectional study in Chenzhou, Hunan Province, China, from June to December 2021. The sample consisted of 570 community-dwelling adults aged over 60 years. Data were collected through a general information questionnaire, the Social Support Rating Scale, the University of California at Los Angeles Loneliness Scale, and the Center for Epidemiological Survey, Depression Scale. Statistical Package for the Social Sciences PROCESS macro was used to examine the mediating effect of social support between loneliness and depression. This study found that depression was negatively associated with social support (r = -0.381, P < .001), but it was positively correlated with loneliness (r = 0.403, P < .001); loneliness was a predictor of depression (B = 0.333, P < .001). In addition, social support significantly mediated the relationship between loneliness and depression, with an indirect effect of 0.239 (95% Bootstrap CI -0.264 to -0.510), the overall effect value for depression was 0.572, accounting for 56.3% of the total variance in depression within this model. In conclusion, the findings suggest that social support plays a mediating role between depression and loneliness in older adults. This implies that interventions aimed at reducing loneliness and enhancing social support have the potential to alleviate depressive symptoms among this population. By addressing these factors, healthcare professionals and caregivers can promote the mental well-being of older adults and contribute to improved overall quality of life.
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Affiliation(s)
- Pan Li
- School of Nursing, Xiangnan University, Chenzhou, China
- College of Nursing and Allied Health Sciences, St. Paul University Manila, Malate Manila, Philippines
| | - Jiaming Zhong
- University Library, Xiangnan University, Chenzhou, China
| | - Yongmei He
- School of Nursing, Xiangnan University, Chenzhou, China
| | - Hairong Yan
- School of Nursing, Xiangnan University, Chenzhou, China
| | - Mi Xie
- School of Nursing, Xiangnan University, Chenzhou, China
| | - Lingyao Meng
- School of Nursing, Xiangnan University, Chenzhou, China
- College of Nursing and Allied Health Sciences, St. Paul University Manila, Malate Manila, Philippines
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25
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Zhang Y, Li X, Bi Y, Kan Y, Liu H, Liu L, Zou Y, Zhang N, Fang L, Gong W. Effects of family function, depression, and self-perceived burden on loneliness in patients with type 2 diabetes mellitus: a serial multiple mediation model. BMC Psychiatry 2023; 23:636. [PMID: 37648996 PMCID: PMC10466700 DOI: 10.1186/s12888-023-05122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023] Open
Abstract
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.
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Affiliation(s)
- Yu Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China.
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
| | - Xiangning Li
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Yaxin Bi
- Northern Jiangsu People's Hospital, Yangzhou, 225009, China
| | - Yinshi Kan
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Hongyuan Liu
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Lin Liu
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Yan Zou
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Ning Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Li Fang
- Affiliated Hospital of Yangzhou University, Yangzhou, 225009, China
| | - Weijuan Gong
- Department of Basic Medicine, School of Medicine, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu, 225009, China.
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26
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Kwan RYC, Ng F, Lam LCW, Yung RC, Sin OSK, Chan S. The effects of therapeutic virtual reality experience to promote mental well-being in older people living with physical disabilities in long-term care facilities. Trials 2023; 24:558. [PMID: 37633916 PMCID: PMC10464193 DOI: 10.1186/s13063-023-07592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Mental well-being is poor in long-term care facilities (LTCF) residents. Physical disabilities, impaired social engagement, and environmental stress are also common in LTCF which exacerbate the decline of the mental well-being of older people living in LTCF. Protective elements, including nature-based, reminiscence, outdoor, and group activities, are known to be effective to promote the mental well-being of older people living in LTCF. However, limited by their physical disabilities and poor social support, older people living in LTCF are not likely to benefit from these effective measures. Virtual reality has been proven to be feasible to be environmentally unrestricted to providing LTCF residents with all protective elements promoting mental well-being. However, its effects on the mental well-being of LTCF residents living with physical disabilities are unclear. METHODS This study employs a single-blinded, two-parallel-group (intervention-to-control group ratio = 1:1), non-inferiority, randomized controlled trial. Eligible participants are aged 60 years or above, LTCF residents, and living with physical disabilities. The study will be conducted in LTCF. In the intervention group, participants will receive a 6-week VR experience program. In the control group, participants will receive the usual care provided by the LTCF. The primary outcome is mental well-being, as measured by World Health Organization Five Well-being Index at the time point of baseline (i.e., week 0) and after completion of the intervention (i.e., week 7). This study aims to recruit a total of 216 participants. Generalized estimating equations (GEE) will be used to examine the effects of the intervention. TRIAL REGISTRATION The trial has been registered at ClinicalTrials.gov (Identifier: NCT05818579 ), Registered on April 5, 2023. The latest version of the protocol was published online on 19 April 2023. All items come from the World Health Organization Trial Registration Data Set. This study has been approved by the Research Ethics Committee of Tung Wah College, Hong Kong (reference number: REC2023158). The findings will be disseminated in peer-reviewed journals, presented at international and local conferences with related themes, and shared in local media.
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Affiliation(s)
| | - Fowie Ng
- School of Management, Tung Wah College, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
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27
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Sharp P, Oliffe JL, Kealy D, Rice SM, Seidler ZE, Ogrodniczuk JS. Social support buffers young men's resilient coping to psychological distress. Early Interv Psychiatry 2023; 17:784-791. [PMID: 36639361 PMCID: PMC10946545 DOI: 10.1111/eip.13371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/14/2022] [Accepted: 01/01/2023] [Indexed: 01/15/2023]
Abstract
AIM Social support and resilient coping can aid mental health. The aim of this study was to examine age effects of social support on men's resilient coping for psychological distress. METHODS The sample consisted of 434 help-seeking Canadian men who completed standardized measures. Regression analyses tested a moderated moderation model, controlling for COVID-19 pandemic impact. RESULTS Greater resilient coping was associated with lower psychological distress and this relationship was moderated by social support. Higher levels of social support had a significant positive effect on men's resilient coping for psychological distress. Findings indicated that younger men (18-24 years) were most positively buffered by social support. CONCLUSIONS Social support appears to be particularly important for young men's coping response to psychological distress. This is an important finding in the context of the COVID-19 pandemic, where social support networks have been challenged. Community-based and clinical programs and initiatives that proactively target young men's development of social connections and robust supportive networks, while bolstering their individual resilient coping skills, are likely to provide protections from psychological distress.
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Affiliation(s)
- Paul Sharp
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Simon M Rice
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Zac E Seidler
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Movember, Melbourne, Victoria, Australia
| | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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28
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Chen YL, Jian CR, Chang YP, Chao SR, Yen CF. Association of loneliness with suicide risk and depression in individuals with schizophrenia: moderating effects of self-esteem and perceived support from families and friends. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:41. [PMID: 37402821 PMCID: PMC10319791 DOI: 10.1038/s41537-023-00368-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 07/06/2023]
Abstract
Loneliness is prevalent among individuals with mental illnesses. This cross-sectional survey study examined the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression in individuals with schizophrenia. In total, 300 participants (267 with schizophrenia and 33 with schizoaffective disorder) completed the University of California, Los Angeles, Loneliness Scale (Version 3); suicide module of the Mini International Neuropsychiatric Interview; Center for Epidemiologic Studies Depression Scale; Family and Friend Adaptability, Partnership, Growth, Affection, and Resolve Index; and Rosenberg Self-Esteem Scale. Moderation analysis was performed to examine the moderating effects of self-esteem and perceived support from families and friends on the association of loneliness with suicide risk and depression. The results found that self-esteem was significantly associated with a reduced magnitude of depression in participants with loneliness. In addition, perceived support from friends was significantly associated with a reduced magnitude of suicide risk in participants with loneliness. Our findings indicate the importance of intervention programs that strengthen support from friends and self-esteem in reducing suicide risk and depression among lonely individuals with schizophrenia.
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Affiliation(s)
- Yi-Lung Chen
- Department of Psychology, Asia University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Cian-Ruei Jian
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY, USA
| | - Shu-Ru Chao
- Department of Social Work, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
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29
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Zhang B, Zhang W, Sun L, Jiang C, Zhou Y, He K. Relationship between alexithymia, loneliness, resilience and non-suicidal self-injury in adolescents with depression: a multi-center study. BMC Psychiatry 2023; 23:445. [PMID: 37337144 DOI: 10.1186/s12888-023-04938-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023] Open
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) behaviors are prevalent in adolescents and have adverse effects on physical and mental health. However, little is known about the relationship between NSSI and alexithymia, or the underlying mechanisms that could explain this relationship. This study aimed to elucidate the current status of NSSI in adolescent depression, and analyze the relationship between alexithymia, loneliness, resilience, and adolescent depression with NSSI, so as to provide a theoretical basis for psychotherapeutic interventions. METHOD The study sample involved inpatients and outpatients from 12 hospitals across China and adolescents with depression who met the DSM-5 diagnostic criteria for depression episode. The following scales were used: The Functional Assessment of Self-Mutilation, Toronto Alexithymia Scale, UCLA Loneliness Scale, and Connor Davidson Resilience Scale. RESULTS The detection rate of NSSI in adolescents with depression from 2021.01.01-2022.01.01 was 76.06% (1782/2343). Spearman's correlation analysis revealed a significant correlation between alexithymia, loneliness, resilience and NSSI in depressed adolescents, and the results of the non-parametric test showed that the differences between the two groups for each factor were statistically significant. Binary logistic regression results showed that alexithymia (B = 0.023, p = 0.003, OR = 1.023, 95% CI: 1.008-1.038) and depression (B = 0.045, p < 0.001, OR = 1.046, 95% CI: 1.026-1.066) are risk factors for NSSI, resilience (B = - 0.052, p < 0.001, OR = 0.949, 95% CI: 0.935 - 0.964) is a protective factor for NSSI. Alexithymia directly predicted NSSI and also indirectly influenced NSSI through the mediated effect of resilience. Loneliness moderates the first half of the path of this mediated model. CONCLUSION The present study confirms a moderated mediation effect: Alexithymia can have an impact on NSSI behaviors in depressed adolescents through the mediating role of resilience. Loneliness, as a moderating variable, moderated the first half of the pathway of the mediating model. We discuss perspectives for future research and interventions based on the findings of the study.
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Affiliation(s)
- Bing Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
- Anhui Mental Health Center, 230022, Hefei, China
- Hefei Fourth People's Hospital, Hefei, China
| | - Wei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
- Anhui Mental Health Center, 230022, Hefei, China
- Hefei Fourth People's Hospital, Hefei, China
| | - Lingmin Sun
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
- Anhui Mental Health Center, 230022, Hefei, China
- Hefei Fourth People's Hospital, Hefei, China
| | - Cheng Jiang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
| | - Yongjie Zhou
- Shenzhen Kangning Hospital, Shenzhen, China.
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
| | - Kongliang He
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China.
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China.
- Anhui Mental Health Center, 230022, Hefei, China.
- Hefei Fourth People's Hospital, Hefei, China.
- Psychological counseling department, Hefei Fourth People's Hospital, Anhui, 230000, China.
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30
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Chu WM, Tange C, Nishita Y, Tomida M, Shimokata H, Otsuka R, Lee MC, Arai H. Effect of different types of social support on physical frailty development among community-dwelling older adults in Japan: Evidence from a 10-year population-based cohort study. Arch Gerontol Geriatr 2023; 108:104928. [PMID: 36649669 DOI: 10.1016/j.archger.2023.104928] [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: 12/05/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
PURPOSE Social support is associated with multiple positive health outcomes and is negatively associated with frailty in older adults. However, most evidence came from cross-sectional research. This study aimed to longitudinally explore the relationship between different types of social support and incident physical frailty. MATERIALS AND METHODS A 10-year prospective cohort study data from the National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA) database, from 2000 to 2012 on older adults aged ≥65 years were analyzed excluding those with physical frailty at baseline, missing data, or not attending follow-up. We measured three kinds of social support, whether from within or outside family members, including emotional, instrumental, and negative support. The generalized estimating equation (GEE) model was used to examine the longitudinal relationships between social support and subsequent frailty. RESULTS The final analysis included 466 participants, with an average age of 71.3 (standard deviation [SD], 4.3) years and 7.33 years of follow-up (SD, 3.11). GEE analysis showed that emotional and instrumental supports from within and outside family members were associated with a significantly lower risk of physical frailty (odd ratio (OR) and 95% confidence interval (CI): 0.80 [0.64-1.00] and 0.74 [0.58-0.95]; 0.77 [0.60-0.99] and 0.79 [0.63-0.99], respectively). Both negative support from within or outside family members had no significant relationship with the risk of physical frailty. CONCLUSIONS This longitudinal study suggested that emotional, and instrumental support both from within or outside family members can reduce future physical frailty among older adults.
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Affiliation(s)
- Wei-Min Chu
- Education and Innovation Center for Geriatrics and Gerontology, National Center for Geriatrics and Gerontology, Aichi, Japan; Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chikako Tange
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Makiko Tomida
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Graduate School of Humanities and Social Sciences, Nagoya City University, Aichi, Japan
| | - Hiroshi Shimokata
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Meng-Chih Lee
- Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Institute of Population Sciences, National Health Research Institutes, Miaoli County, Taiwan; College of Management, Chaoyang University of Technology, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Aichi, Japan
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Behrendt D, Spieker S, Sumngern C, Wendschuh V. Integrating social support into interventions among the elderly in nursing homes: a scoping review. BMJ Open 2023; 13:e071962. [PMID: 37085297 PMCID: PMC10124279 DOI: 10.1136/bmjopen-2023-071962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES This study aimed to understand the evidence related to integration of social support into interventions, to identify literature gaps related to social support interventions, and to clarify dimensions of supportive functions, outcomes, and providers among the elderly in nursing homes. DESIGN This scoping review followed the approach by Arksey and O'Malley. The Mixed Methods Appraisal Tool V.2018 was used for quality assessment of the studies. DATA SOURCES Searches were conducted of the PubMed, ScienceDirect, Public Library of Science, SocioHub, Wiley Online Library and PsycINFO databases for publications from 2010 to 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We searched for primary studies and heterogeneous study designs published in English. Eligible studies took place in nursing and care homes and had study populations of elderly adults (older adults, geriatrics, ageing, seniors, older people and those aged 60 years and older). DATA EXTRACTION AND SYNTHESIS A data extraction form based on Joanna Briggs Institute's recommendations for scoping reviews was used. Two reviewers independently extracted data and performed quality assessment of the studies. Then, extracted data and quality assessment reports were discussed by all authors. RESULTS Thirty-one eligible studies were included in this review. 54.8% of the studies provided interventions for cognitively impaired residents. The top-three outcomes were neuropsychiatric symptoms, physical function and quality of life, respectively. The interventions were performed by nursing home staff (83.9%), other persons with specific qualifications (58.1%) and health volunteers (6.5%). Most studies (90.3%) depicted the integration of emotional and instrumental supportive functions into interventions. CONCLUSION The appropriate dimensions of supportive function, mainly emotional and instrumental support, are important to integrate into the social care of elderly people living in nursing homes.
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Affiliation(s)
- Daniel Behrendt
- Nursing Department, Städtisches Klinikum Dessau, Dessau, Germany
| | - Sybille Spieker
- Departments of Neurology and Geriatrics, Städtisches Klinikum Dessau, Dessau, Germany
- Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin and Brandenburg, Germany
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Wang M, Wu J, Yan H. The effect of horticultural therapy on older adults in pension institutions: a systematic review. Geriatr Nurs 2023; 51:25-32. [PMID: 36878128 DOI: 10.1016/j.gerinurse.2023.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/07/2023]
Abstract
AIMS To systematically evaluate the effect of horticultural therapy (HT) on older adults in pension institutions. DESIGN Systematic review was conducted based on the checklist for PRISMA. METHODS The searches were conducted in the Cochrane library, Embase, Web of Science, PubMed, Chinese Biomedical Database (CBM), and the China Network Knowledge Infrastructure (CNKI), from their inception until May 2022. In addition, manual screening of references of relevant studies was performed to identify potential studies. We conducted a review of quantitative studies published in Chinese or English. Experimental studies were evaluated using the Physiotherapy Evidence Database (PEDro) Scale. RESULTS A total of 21 studies involving 1214 participants were included in this review, and the quality of the literature was good. Sixteen studies were Structured HT. The effects of HT were significant in terms of physical, physiological, and psychological aspects. In addition, HT improved satisfaction, quality of life, cognition, and social relationships, and no negative events were found. CONCLUSION As an affordable non-pharmacological intervention with a wide range of effects, horticultural therapy is suitable for older adults in pension institutions and is worth promoting in pension institutions, communities, homes, hospitals, and other institutions that require long-term care.
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Affiliation(s)
- Min Wang
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Jingwen Wu
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Hong Yan
- Department of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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Chiou CP, Bai YL, Lai LY, Hsieh HC, Chang ST. Hierarchical multiple regression investigating factors associated with depressive symptoms in the middle-aged and elderly undergoing haemodialysis. BMC Public Health 2023; 23:237. [PMID: 36737709 PMCID: PMC9896830 DOI: 10.1186/s12889-023-15140-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Depressive moods are commonly seen in patients who receive haemodialysis. This can cause a lack of compliance in their treatment procedures and increase the rate of hospitalization. This study aimed to investigate the relationship between social support and degree of depression in middle-aged and elderly patients undergoing haemodialysis and the predictors of depressive symptoms. METHODS A cross-sectional correlational study was designed with a structured questionnaire survey. Patients over 40 years of age were included from five haemodialysis centres. Measures embraced a demographic and clinical characteristics questionnaire, the Centre for Epidemiologic Studies Depression Scale, and the Personal Resource Questionnaire 2000. Statistical analysis was performed using hierarchical multiple regression analysis. RESULTS A total of 179 patients over 40 years of age were included from five haemodialysis centres in the analysis. The mean CES-D score was 19.0(12.3); the majority of participants (60.3%) had a CES-D score ≥ 15, indicating likely depressive status. The mean PRQ2000 score was 75.7(15.9). The proportional mean of the PRQ2000 was 72.11%, indicating moderate social support for participants in this study. Data disclosed that marital status, number of comorbidities, exercise behaviour, and social support could significantly predict depressive symptoms; total explanatory variance was 31.3%. CONCLUSION Health care professionals should identify those at high risk of depressive symptoms when they provide care to the middle-aged and elderly patients undergoing haemodialysis. These findings may lead to greater insights into the nursing and rehabilitative care of patients treated by chronic maintenance haemodialysis.
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Affiliation(s)
- Chou-Ping Chiou
- grid.411447.30000 0004 0637 1806School of Nursing, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Ling Bai
- grid.411636.70000 0004 0634 2167Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Liu-Yuan Lai
- grid.411396.80000 0000 9230 8977Department of Nursing, Fooyin University Hospital, Pingtung, Taiwan
| | - Hsiu-Chu Hsieh
- Department of Nursing, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Shin-Tsu Chang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,Department of Physical Medicine and Rehabilitation, School of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Zhang Y, Wang T, Jin S, Zhang H, Chen L, Du S. Resilience mediates the association between alexithymia and stress in Chinese medical students during the COVID-19 pandemic. Gen Psychiatr 2023; 36:e100926. [PMID: 36711056 PMCID: PMC9871866 DOI: 10.1136/gpsych-2022-100926] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
Background Evidence indicates that medical students have had high rates of mental health problems, especially during the COVID-19 pandemic, which could be affected by alexithymia-a marked dysfunction in emotional awareness, social attachment and interpersonal relationships-and stress. However, psychological resilience might relieve alexithymia and stress levels. Aims This study aimed to investigate the role of resilience in alexithymia and stress in medical students. Methods A total of 470 medical students completed online and offline surveys, including the Toronto Alexithymia Scale-20 (TAS-20), the Connor-Davidson Resilience Scale (CD-RISC) and the College Student Stress Questionnaire (CSSQ). The data of five participants were excluded because of a lack of integrity. Mann-Whitney U test or Kruskal-Wallis test was used to compare group differences in the CD-RISC scores among categorical variables. Spearman correlation analysis was employed to evaluate the associations between resilience and alexithymia and between resilience and stress. Mediation analysis was used to test the mediating effect of resilience between alexithymia and stress. Results Of the medical students considered in the analysis, 382 (81.28%) were female and 88 (18.72%) were male. There was a significant negative correlation between the TAS-20 scores and the total and subtotal CD-RISC scores (p<0.001). The CSSQ scores also significantly negatively correlated with the total and subtotal CD-RISC scores (p<0.001). Resilience mediated the relationship between alexithymia and stress (total effect=1.044 7, p<0.001). The indirect effect of alexithymia significantly impacted stress through resilience (effect=0.167 0, 95% CI: 0.069 to 0.281). Conclusions Our findings suggest that resilience might effectively reduce alexithymia and stress. They also contributed to a better understanding of the mediating effects of resilience on alexithymia and stress during the COVID-19 pandemic. The evidence from these results encourages universities to focus on improving students' resilience.
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Affiliation(s)
- Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Tianyu Wang
- Department of Psychosomatics and Psychiatry, Southeast University, Nanjing, Jiangsu, China
| | - Shengji Jin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Heng Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lixia Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Shizheng Du
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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35
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Effects of mobile Internet use on loneliness among older adults: Health status as a possible moderator? J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01810-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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36
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Wu X, Li J, Zhang C, Zhou X, Dong X, Cao H, Duan Y, Wang S, Liu M, Zhang Q, Xie J. The effects of modified problem-solving therapy on depression, coping, and self-efficacy in elderly nursing home residents. Front Psychol 2023; 13:1030104. [PMID: 36687964 PMCID: PMC9853555 DOI: 10.3389/fpsyg.2022.1030104] [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: 08/28/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Background With the increasing trend of aging, the mental health problems of the elderly require urgent attention. Depression is a common psychological problem of the elderly, which affects their quality of life and physical health. Problem-solving therapy can effectively improve depression in the elderly, but there are few studies on problem-solving therapy for depression in the elderly in China. The purpose of this study was to evaluate the effects of modified problem-solving therapy (MPST) on depression, coping and self-efficacy in elderly nursing home residents. Methods This study was a randomized controlled trial. A total of 60 older adults from two nursing homes were recruited to participate in this study and randomly assigned to the intervention group (MPST) or the control group (usual care). The intervention lasted 8 weeks, and information on depression, coping skills, and self-efficacy was collected before the intervention, immediately after the intervention, and 3 months after the intervention. Repeated measures ANOVA was used to compare changes at multiple time points between the two groups. If the interaction effect (group * time) was significant, independent samples t-test was used to compare the differences in outcome indicators between groups at post-intervention and 3 months post-intervention. Results Compared to the control group, depression scores in the intervention group were significantly lower at the end of the intervention and remained significantly lower than the control group 3 months post-intervention (p < 0.05). Negative coping and self-efficacy in the intervention group also improved significantly at the end of the intervention, and 3 months post-intervention, while positive coping in the two groups did not differ significantly at 3 months post-intervention. Conclusion The findings of this study suggest that MPST could be beneficial in reducing depressive symptoms and enhancing positive coping and self-efficacy levels in older adults in nursing homes.
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Affiliation(s)
- Xiaoqi Wu
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China,Xiangya Nursing School, Central South University, Changsha, China
| | - Jie Li
- Xiangya Nursing School, Central South University, Changsha, China
| | - Chun Zhang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xing Zhou
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xiaoqian Dong
- Xiangya Nursing School, Central South University, Changsha, China
| | - Huan Cao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Sha Wang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Qiuxiang Zhang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha, China,*Correspondence: Jianfei Xie, ✉
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Ribeiro-Gonçalves JA, Costa PA, Leal I. Loneliness, ageism, and mental health: The buffering role of resilience in seniors. Int J Clin Health Psychol 2023; 23:100339. [PMID: 36168598 PMCID: PMC9485034 DOI: 10.1016/j.ijchp.2022.100339] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/19/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Ageism and loneliness are two relevant public health phenomena because of their negative impact on the senior's mental health. With the increase in average life expectancy, these tend to co-occur, which may increase the psychological distress (PD) of seniors. Resilience has been shown to be an important protective factor of seniors mental health, although its potential buffering role of public health risk factors with cumulative impact on mental health, such as loneliness and ageism, needs to be more studied. Aim To assess the potential mediator role of resilience between the effects of ageism and loneliness on PD in seniors. Methods A sample of 349 Portuguese seniors aged 60 years and over was collected through an online survey and during the COVID-19 pandemic period. Seniors completed the Kessler Psychological Distress Scale (K6), the Short-Form of UCLA Loneliness Scale (USL-6), the Ambivalent Ageism Scale (AAS) and the Connor-Davidson Resilience Scale (CD-RISC-10). A mediation analysis model was developed with resilience as a mediating variable. Results There were moderate to high levels of PD and moderate levels of ageism, loneliness and resilience. Resilience fully mediated the effect of ageism on PD and partially mediated the effect of loneliness on PD. Conclusions Resilience was an important protective factor of mental health against the effects of ageism, and partially protected mental health from the effects of loneliness among seniors. It is suggested that resilience be considered as a factor to be integrated in future intervention programs for mental health. The practical applicability of this study is discussed.
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Affiliation(s)
- José Alberto Ribeiro-Gonçalves
- Corresponding author at: William James Center for Research, ISPA - University Institute, Rua Jardim do Tabaco, n° 34, 1149-041 Lisboa, Portugal.
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The Association of Age With Depression, Anxiety, and Posttraumatic Stress Symptoms During the COVID-19 Pandemic in Spain: The Role of Loneliness and Prepandemic Mental Disorder. Psychosom Med 2023; 85:42-52. [PMID: 36201774 DOI: 10.1097/psy.0000000000001146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Older adults may be at lower risk of common mental disorders than younger adults during the coronavirus disease 2019 (COVID-19) pandemic. Previous research has shown shown differences by age in psychosocial well-being during the pandemic and have highlighted the moderating effect of prepandemic mental disorders on that association. In this line, we examined the association of age with self-reported symptoms of loneliness, depression, anxiety, and posttraumatic stress, as well as potential roles of loneliness symptoms and prepandemic mental disorders on the association between age and mental disorder symptoms. METHODS Cross-sectional data of 2000 adults in Spain interviewed by telephone during the COVID-19 pandemic (February-March 2021) were analyzed. Depression, anxiety, and posttraumatic stress were measured with the eight-item Patient Health Questionnaire, the seven-item Generalized Anxiety Disorder Scale, and the four-item checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), respectively. Loneliness was measured with the three-item University of California at Los Angeles Loneliness Scale. Several regression models were constructed to assess factors related to loneliness and mental disorders. RESULTS According to cutoff points used, 12.4% of participants revealed depression, 11.9% revealed anxiety, and 11.6% revealed posttraumatic stress. Age was negatively related to mental disorder symptoms and loneliness. Loneliness was associated with higher levels of mental disorder symptoms. This association was stronger in younger adults without prepandemic mental disorders and in older adults with them. The association between age and loneliness was stronger in those with prepandemic mental disorders. Loneliness mediated the association of age with mental disorder symptoms. CONCLUSIONS Interventions focused on loneliness could alleviate the impact of the COVID-19 pandemic on mental health.
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Huang JH, Wang QS, Zhuo RM, Su XY, Xu QY, Jiang YH, Li YH, Li SB, Yang LL, Zang RW, Meng CY, Liu XC. Institutional Residence Protects Against Cognitive Frailty: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231220180. [PMID: 38140825 DOI: 10.1177/00469580231220180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Based on the complex aging background, more and more older people have to live in an institution in later life in China. The prevalence of cognitive frailty (CF) is more higher in institutions than in communities. Rarely studies were conducted on the relationship between institutional residence and CF. Hence, this study were performed to determine the relationship between institutional residence (living in a nursing home) and CF in older adults. A total of 1004 older community residents and 111 older nursing home residents over 50 years of age from Hefei, Anhui Province, China were recruited. CF included physical frailty (PF) and mild cognitive impairment (MCI). PF was assessed using the Chinese version of the Fried frailty scale, MCI was assessed using the Montreal Cognitive Assessment, and the common associated factors including sedentary behavior, exercise, intellectual activity, comorbidity, medication, chronic pain, sleep disorders, nutritional status and loneliness were analyzed using regression logistic models. Multivariate regression logistic analysis showed that exercise (P = .019, odds ratio [OR] = 0.494, 95% confidence interval [CI]: 0.274-0.891), intellectual activity (P = .019, OR = 0.595, 95% CI: 0.380-0.932), medication use (P = .003, OR = 2.388, 95% CI: 1.339-4.258), chronic pain (P = .003, OR = 1.580, 95% CI: 1.013-2.465) and loneliness (P = .000, OR = 2.991, 95% CI: 1.728-5.175) were significantly associated with CF in community residents; however, only sedentary behavior (P = .013, OR = 3.851, 95% CI: 1.328-11.170) was significantly associated with CF in nursing home residents. Our findings suggest that nursing homes can effectively address many common risk factors for CF, including lack of exercise and intellectual activity, medication use, chronic pain, and loneliness, better than the community setting. Thus, residing in a nursing home is conducive to the intervention of CF.
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Affiliation(s)
- Jin Hua Huang
- The 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Hefei, Anhui Province, People's Republic of China
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Qing Song Wang
- The 901st Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Hefei, Anhui Province, People's Republic of China
| | - Rui Min Zhuo
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Xin Yu Su
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Qing Yuan Xu
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Yu Hao Jiang
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Yu Han Li
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Song Bai Li
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Lan Lan Yang
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Rui Wen Zang
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Chen Yang Meng
- Clinical College of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Xue Chun Liu
- The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui Province, People's Republic of China
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Jiang R, Ta X, Xu M, Luo Z, Du Y, Zhong X, Pan T, Cao X. Mediating Role of Depression Between Diabetes Management Self-Efficacy and Diabetes Self-Care Behavior Among Elderly Type 2 Diabetes Mellitus Patients in China. Psychol Res Behav Manag 2023; 16:1545-1555. [PMID: 37143902 PMCID: PMC10153400 DOI: 10.2147/prbm.s396916] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
Objective To investigate the current status of diabetes self-care behavior and the association between depression, self-efficacy and self-care in a sample of Chinese elderly type 2 diabetes mellitus (T2DM) patients. Methods A cross-sectional study with a convenient sample including 240 elderly T2DM patients collected the data of demographic characteristics, diabetes self-care behavior, self-efficacy and depression status. The difference of self-care behavior in different sample characteristics was compared by independent t-test. The Personal correlation analysis was employed to examine the correlation of study variables. The method of bootstrap was used to analyze mediating role of depression. Results Only 22.5% of patients reported better diabetes self-care behavior and depression partly mediated the association between self-efficacy and self-care behavior. The significant coefficient of path a (B = -0.052, p < 0.001) and path b (B = -0.423, p < 0.05) indicated negative associations of self-efficacy on depression, and depression on self-care behavior. The indirect effect (Path a × b) between self-efficacy and self-care behavior through depression was significant (B = 0.022, p < 0.05), the 95% bias-corrected bootstrap confidence interval was 0.004 to 0.006. Meanwhile, the mediating role of depression was not found significant among the participants reported 60-74 years old (B = 0.104, p < 0.001). But depression completely mediated this association among the participants reported 75-89 years old (B = 0.034, p > 0.05). Conclusion The level of diabetes self-care behavior among the elderly T2DM patients in Dahu community of Anqing city was hardly optimistic. The self-efficacy focused intervention could be encouraged for community and clinicians to improve diabetes self-care behavior. Moreover, the prevalence of depression and T2DM is increasing in younger population. More work is needed to confirm these findings, especially conducting cohort studies on different populations.
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Affiliation(s)
- Ruobing Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xin Ta
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Min Xu
- Department of Endocrinology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Zhihua Luo
- Department of Pediatrics, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Yijun Du
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xing Zhong
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Tianrong Pan
- Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Tianrong Pan, Department of Endocrinology, Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email
| | - Xiujing Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China
- Correspondence: Xiujing Cao, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China, Email
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Liu Y, Jiao D, Yang M, Cui M, Li X, Zhu Z, Sawada Y, Watanabe Miura K, Watanabe T, Tanaka E, Anme T. Role of Multifaceted Social Relationships on the Association of Loneliness with Depression Symptoms: A Moderated Mediation Analysis. Healthcare (Basel) 2022; 11:healthcare11010124. [PMID: 36611584 PMCID: PMC9819800 DOI: 10.3390/healthcare11010124] [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: 12/09/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
Strong relationship exists between loneliness and depression in older adults. However, the effect of multifaceted social relationships on the relationship between loneliness and depression has not been explored. The purpose of the current study was to find out how multifaceted social relationships affect the aforementioned processes. We investigated and evaluated the loneliness status, depression symptoms, social relationships, and demographic information of 1116 older adults aged ≥65 years living in rural Japan. The final 555 participants were included in the analysis. Statistical evidence showed a direct effect between loneliness and depression symptoms. Additionally, the mediation model found that social curiosity and participation acted as mediators between loneliness and depression symptoms. Further, independence and participation, independence, and feeling safe played a conditional moderating role in the model of loneliness-social curiosity-depression symptoms and loneliness-participation-depression symptoms, respectively. Interaction can be an individual moderator in the link between loneliness and depression symptoms without any mediator. The moderated mediation model suggests that social curiosity and participation could mediate the association between loneliness and depression symptoms. In this process, independence, participation, and feeling safe may act as moderators.
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Affiliation(s)
- Yang Liu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Dandan Jiao
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
- Department of Nursing, The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China
| | - Mengjiao Yang
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
- Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Mingyu Cui
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Xiang Li
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Zhu Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 3058577, Japan
| | - Yuko Sawada
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka 5598611, Japan
| | | | - Taeko Watanabe
- Faculty of Nursing, Shukutoku University, Chiba 2608701, Japan
| | - Emiko Tanaka
- Faculty of Nursing, Musashino University, Tokyo 1358181, Japan
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058577, Japan
- Correspondence: ; Tel.: +81-029-853-3436
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Sun Z, Su X, Zhao X, Yao Y, Zhao Y, Zhang P, Li Z, Fu S. Associations between constipation, overeating, and depression: A survey of Chinese oldest-old and centenarians. Heliyon 2022; 8:e12432. [PMID: 36590547 PMCID: PMC9801100 DOI: 10.1016/j.heliyon.2022.e12432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/18/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives Depression is a common disease of elderly population, with a global prevalence of more than 20%. Few studies have involved the associations of constipation and overeating with depression, especially in the elderly population. We aimed to address these associations in Chinese oldest-old and centenarians. Methods A total of 1863 elderly individuals from 18 regions of Hainan, China, were investigated from July 2014 to December 2016. Health survey, physical examination, and blood analyses were performed through structured questionnaires and standard procedures. The Geriatric Depression Scale (GDS-15) was used to measure depression. Results The proportions of elderly individuals with depression, constipation, and overeating were 20.80% (349), 15.14% (254), and 26.52% (445), respectively. The prevalence of constipation and overeating was significantly higher in the elderly group with depression than in those without depression (P < 0.05, all). In the multiple linear regression analyses, higher prevalence of constipation and overeating had positive and significant associations with the GDS-15 (P < 0.05, all). In the multiple logistic regression analyses, constipation (odds ratio [OR]: 2.328; 95% confidence interval [CI]: 1.540-3.521) and overeating (OR: 2.735; 95% CI: 1.920-3.898) had positive and significant associations with depression (P < 0.05, in all). Conclusions and Implications This study provides epidemiological evidence that constipation and overeating have positive associations with depression in Chinese oldest-old and centenarians. The interventions for constipation and overeating should be improved to promote prevention and treatment for depression and achieve successful aging and healthy longevity.
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Affiliation(s)
- Zhigao Sun
- Traditional Chinese Medicine Department, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Xin Su
- Department of Respiratory and Critical Care Medicine, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Xiaoqian Zhao
- Department of Cardiology, Chinese People's Liberation Army 305 Hospital, Beijing, China
| | - Yao Yao
- Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, North Carolina, USA,Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China,Corresponding author.
| | - Pei Zhang
- School of Life Science, Beijing Institute of Technology, Beijing, China,Corresponding author.
| | - Zhirui Li
- Department of Orthopedics, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China,Corresponding author.
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China,Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China,Corresponding author.
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Liao Z, Zhou H, He Z. The mediating role of psychological resilience between social participation and life satisfaction among older adults in China. BMC Geriatr 2022; 22:948. [PMID: 36482364 PMCID: PMC9733394 DOI: 10.1186/s12877-022-03635-x] [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: 04/12/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A significant correlation has been discovered between social participation and older adults' life satisfaction, but the relationships among social participation, psychological resilience, and life satisfaction remain to be confirmed. Therefore, this study aims to identify the relationship between social participation and life satisfaction for Chinese older adults and to analyse the possible mediating role of psychological resilience between these two aspects. METHODS Data on 15,779 people aged 65 years and above were extracted from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Social participation was classified into two levels: low-level involvement activities and high-level involvement activities. Hierarchical regression analysis was applied to analyse the correlations between the two levels of social participation and older adults' life satisfaction as well as the mediating effects of psychological resilience on this association. RESULTS The results indicate that two levels of social participation were each positively correlated with life satisfaction. Specifically, high-level involvement activities (β = 0.070, P < 0.001) were more strongly associated with life satisfaction than low-level involvement activities (β = 0.051, P < 0.001). Moreover, psychological resilience was found to partially mediate the association between low-level involvement activities and high-level involvement activities and life satisfaction. CONCLUSION A higher level of life satisfaction for older adults is related to participation in high-level involvement activities. Psychological resilience has a mediating effect on the association between two levels of older adults' social participation and life satisfaction. These findings suggest that the government and society should establish a more concrete understanding of the psychological resilience of older adults.
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Affiliation(s)
- Zhiliu Liao
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Hanmeng Zhou
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Zhifei He
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, People's Republic of China.
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Xu H, Peng L, Wang Z, Liu X. Effects of psychological capital and social support availability on anxiety and depression among Chinese emergency physicians: Testing moderated mediation model. Front Psychol 2022; 13:991239. [PMID: 36571060 PMCID: PMC9768176 DOI: 10.3389/fpsyg.2022.991239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Anxiety often precedes depression, and the pathway from anxiety to depression may be affected by multiple exposures. Our research aims to explore the mediating effect of the social support availability (SSA) between anxiety and depression and how it is moderated by psychological capital. Methods A cross-sectional study was conducted among Chinese emergency physicians at the top-level general hospitals in eastern China. Data were collected via the questionnaire including anxiety and depression subscales of Symptom Checklist-90, Psychological Capital Questionnaire as well as Social Support Rating Scale. The PROCESS v3.4 macro was employed to assess the mediating role of SSA and a moderating role of psychological capital. Results A total of 536 valid samples were filtered. Anxiety, depression, SSA, and psychological capital were significant correlated. Anxiety was positively associated with depression (β = 0.82, p < 0.001), and the SSA mediated the relationship between anxiety and depression (indirect effect = 0.013, 95%BootCI [0.005, 0.023]). Psychological capital (specifically, self-efficacy, hope and resilience) further played a moderating role in the relationship between SSA and depression (β = 0.06, p < 0.01). Conclusion The mental health of emergency physicians should be concerned. In order to decrease anxiety and depression, SSA and psychological capital should be increased as the interventions for emergency physicians.
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Affiliation(s)
- Haibo Xu
- Center for Mental Health Education and Research, Xuzhou Medical University, Xuzhou, China
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Lixin Peng
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Zhen Wang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Xin Liu
- Center for Mental Health Education and Research, Xuzhou Medical University, Xuzhou, China
- School of Management, Xuzhou Medical University, Xuzhou, China
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Gao L, Yang J, Liu J, Xin T, Liu Y. Depressive symptoms and physical function among the elderly in nursing homes during the COVID-19 pandemic in China: A cross-sectional study. Medicine (Baltimore) 2022; 101:e31929. [PMID: 36451453 PMCID: PMC9704865 DOI: 10.1097/md.0000000000031929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed a heavy burden on global healthcare. Depressive symptoms and physical function impairment are 2 common health problems among the elderly, but the association between depressive symptoms and physical function in nursing homes have not been extensively investigated during the COVID-19 pandemic. The purpose of this study was to investigate the current status of depressive symptoms and physical function and analyze the prevalence and related factors of depression among elderly people in nursing homes during the COVID-19 pandemic in China. A cross-sectional study was conducted. 381 elderly people were included in 4 nursing homes who were 60 to 100 years old with more than 3 months' residential in Weifang City, Shandong Province using convenience cluster sampling. The Patient Health Questionnaire (PHQ-9) was performed to evaluate geriatric depression, the Barthel Index (BI) was administered to assess the activities of daily living, and a self-designed demographic data questionnaire was used to collect the demographic data. Multiple logistic regression analysis was conducted. 103 (27.0%) old residents reported depression according to PHQ-9. 279 (73.2%) old residents reported impaired self-care ability according to BI. The mean score of PHQ-9 and BI in the elderly was 3.56 ± 3.76 and 5.76 ± 7.05. The total PHQ-9 score of the elderly in nursing homes was positively correlated with the total activities of daily living score (R = 0.503, P < .01). Regression analysis showed that gender, self-care ability, more chronic diseases and medicines, especially Alzheimer's disease and cataract were risk factors for depression among elderly people in nursing homes (P < .05). Our study showed 27.0% depression rate among old residents in nursing homes in China in the context of the COVID-19 pandemic. Depression is relatively prevalent among the elderly in China, and we should pay attention to those with poor self-care ability and more chronic diseases and medicines.
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Affiliation(s)
- Lunan Gao
- School of Nursing, Weifang Medical University, Weifang, China
| | - Jinhong Yang
- Department of oncology, Weifang People’s Hospital, Weifang, China
| | - Jiang Liu
- School of Nursing, Weifang Medical University, Weifang, China
| | - Tingting Xin
- School of Nursing, Weifang Medical University, Weifang, China
| | - Yuxiu Liu
- School of Nursing, Weifang Medical University, Weifang, China
- *Correspondence: Yuxiu Liu, School of Nursing, Weifang Medical University, No. 7166 Baotong Western Street, Weifang 261053, China (e-mail: )
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Crespo-Martín A, Palacios-Ceña D, Huertas-Hoyas E, Güeita-Rodríguez J, Fernández-Gómez G, Pérez-Corrales J. Emotional Impact and Perception of Support in Nursing Home Residents during the COVID-19 Lockdown: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15712. [PMID: 36497786 PMCID: PMC9735792 DOI: 10.3390/ijerph192315712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Social isolation measures implemented in nursing homes during the COVID-19 pandemic generated occupational imbalance, discomfort, and mental health impairment in residents. We aimed to analyze the lived experience of elderly nursing home residents during the lockdown and social contact restrictions resulting from the COVID-19 pandemic. METHODS Exploratory qualitative study. Information was collected through in-depth interviews and field notes. An inductive thematic analysis was performed and international recommendations for the development of qualitative studies were followed. RESULTS Twenty-four participants residing in nursing homes were included. Two main themes were identified: (1) emotional impact of the experience of COVID-19 lockdown (subthemes: experience of contradictory feelings; illness and death; importance of routine; feeling busy; and role of religious beliefs); and (2) support as a therapeutic tool (subthemes: family support; peer support; and professional support). CONCLUSION Social restrictions by COVID-19 caused significant changes in residents' occupations and routines, producing fear, loneliness, and abandonment of desired occupations; however, very important supports were also identified that helped to overcome the lockdown, such as social support, spirituality, and gratitude.
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Affiliation(s)
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain
| | - Elisabet Huertas-Hoyas
- Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain
| | - Javier Güeita-Rodríguez
- Research Group of Humanities and Qualitative Research in Health Science, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain
| | - Gemma Fernández-Gómez
- Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain
| | - Jorge Pérez-Corrales
- Research Group of Humanities and Qualitative Research in Health Science, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcon, Spain
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Sierakowska M, Doroszkiewicz H. Psychosocial Determinants of Loneliness in the Era of the COVID-19 Pandemic-Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911935. [PMID: 36231233 PMCID: PMC9565138 DOI: 10.3390/ijerph191911935] [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: 08/03/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic affected the mental health and social behavior of people around the world. Due to epidemiological restrictions, the period of forced isolation contributed to the feeling of loneliness. The aim of the research is to identify factors and conditions associated to the feeling of loneliness in the era of the COVID-19 pandemic. METHODS The survey was conducted among 262 people from the north-eastern Polish area, using an online survey. The diagnostic survey method was used, using the De Jong Gierveld Loneliness Measurement Scale, the Generalized Self-Efficacy Scale (GSES), the WHOQoL-Bref questionnaire. RESULTS A statistically significant relationship was observed between the feeling of loneliness and areas of quality of life, especially psychological and social, generalized self-efficacy and marital status and way of living (p < 0.05). Higher levels of stress, social distancing, restrictions at work, health status were significantly correlated with an increase in loneliness. Remote work was associated with a lower assessment of the quality of life in the psychological field (p < 0.05). CONCLUSIONS Higher levels of loneliness were significantly more likely to affect people living alone and not in a relationship. Higher levels of loneliness were significantly associated with lower quality of life in the social and psychological domains, lower levels of self-efficacy, and remote work.
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Affiliation(s)
- Matylda Sierakowska
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, 15-096 Bialystok, Poland
| | - Halina Doroszkiewicz
- Department of Geriatrics, Faculty of Health Sciences, Medical University of Bialystok, 15-471 Bialystok, Poland
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Ciro CA, James SA, McGuire H, Lepak V, Dresser S, Costner-Lark A, Robinson W, Fritz T. Natural, longitudinal recovery of adults with COVID-19 using standardized rehabilitation measures. Front Aging Neurosci 2022; 14:958744. [PMID: 36092810 PMCID: PMC9452908 DOI: 10.3389/fnagi.2022.958744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background While studies recommend rehabilitation following post-hospitalization recovery from COVID-19, few implement standardized tools to assess continued needs. The aim of this study was to identify post-hospitalization recommendations using an interdisciplinary needs assessment with standardized rehabilitation measures. A secondary aim was to use these tools to measure recovery over a 30-day period. Materials and methods Using a 30-day longitudinal design, we completed weekly rapid needs assessments in this convenience sample of 20 people diagnosed with COVID-19 discharged from the hospital to home. We computed summary statistics and used the Wilcoxon Signed Rank Test to assess change over the 4-week course of the study with alpha level = 0.05. Results Our sample (65% male, 47% over 50 years of age, 35% White, 37% with a confirmed diagnosis of diabetes, and 47% obese) included no patients who had required mechanical ventilation. Initial assessments demonstrated the majority of our participants were at an increased risk of falls, had disability in activities of daily living (ADL) and instrumental activities of daily living (IADL), mild cognitive impairment, and dyspnea. At the 30-day follow-up, most were independent in mobility and basic ADLs, with continued disability in IADLs and cognitive function. Discussion In this sample of patients who were not mechanically-ventilated, early and individualized rehabilitation was necessary. The results of this study suggest patients would benefit from a multi-disciplinary team needs assessment after medical stabilization to minimize fall risk and disability, and to prevent secondary complications resulting from post-hospital deconditioning due to COVID-19.
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Affiliation(s)
- Carrie A. Ciro
- Department of Rehabilitation Sciences, College of Allied Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- *Correspondence: Carrie A. Ciro,
| | - Shirley A. James
- Department of Rehabilitation Sciences, College of Allied Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Hillary McGuire
- Department of Rehabilitation Sciences, College of Allied Health, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Vince Lepak
- Department of Rehabilitation Sciences, The University of Oklahoma Health Sciences Center at the OU-Tulsa Schusterman Campus, Tulsa, OK, United States
| | - Susan Dresser
- College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Amy Costner-Lark
- College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Wanda Robinson
- College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Terrie Fritz
- Anne and Henry Zarrow School of Social Work, Dodge Family College of Arts and Sciences, The University of Oklahoma, Norman, OK, United States
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Wang H, Hou Y, Zhang L, Yang M, Deng R, Yao J. Chinese elderly migrants' loneliness, anxiety and depressive symptoms: The mediation effect of perceived stress and resilience. Front Public Health 2022; 10:998532. [PMID: 36091520 PMCID: PMC9452831 DOI: 10.3389/fpubh.2022.998532] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/10/2022] [Indexed: 01/26/2023] Open
Abstract
Elderly migrants who face the dual challenges of aging and migration are more likely to suffer psychological disorders. Existing research has demonstrated a link between loneliness and psychological disorders in the general elderly population. However, we know little about the relationships among elderly migrants, and the psychological mechanisms linking them. This study aims to examine the effects of loneliness on anxiety and depressive symptoms among Chinese elderly migrants, and explore the mediating roles of perceived stress and resilience. All 654 participants were recruited in Nanjing, Jiangsu Province, China. Results showed that loneliness was significantly correlated with anxiety and depressive symptoms (p < 0.001). Perceived stress and resilience mediated the relationship between loneliness and anxiety symptoms. The mediating effect of perceived stress was 0.128 (Bootstrap 95% CI: 0.092-0.168, Ratio = 37.4%). Resilience was 0.026 (Bootstrap 95% CI: 0.005-0.049, Ratio = 7.6%). Furthermore, perceived stress and resilience also mediated the relationship between loneliness and depressive symptoms. The mediating effects were 0.111 and 0.043, respectively (Bootstrap 95% CI: 0.073-0.151, Ratio = 27.9%; Bootstrap 95% CI: 0.020-0.069, Ratio = 10.8%). All the mediating effects were significant because the bootstrap 95% CIs did not contain zero. Overall, our findings suggested that loneliness not only can directly influence elderly migrants' anxiety and depressive symptoms but also by increasing perceived stress or decreasing resilience.
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Affiliation(s)
- Hao Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yanjie Hou
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Lin Zhang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Man Yang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Ruyue Deng
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Jun Yao
- School of Nursing, Nanjing Medical University, Nanjing, China,School of Health Policy and Management, Nanjing Medical University, Nanjing, China,Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China,*Correspondence: Jun Yao
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Tian G, Li R, Cui Y, Zhou T, Shi Y, Yang W, Ma Y, Shuai J, Yan Y. Association between disability, social support and depressive symptoms in Chinese older adults: A national study. Front Public Health 2022; 10:980465. [PMID: 36062100 PMCID: PMC9437525 DOI: 10.3389/fpubh.2022.980465] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Disability and social support can impact depressive symptoms of the elderly. Yet, studies infrequently discuss the moderating role of social support when evaluating the association between disability and depressive symptoms. The purpose of this study was to explore the association between disability, social support, and depressive symptoms among the Chinese elderly, and further examine the moderating effect of social support. Materials and methods Using the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data set, we finally selected 9,231 Chinese elderly after screening. The Center for Epidemiologic Studies Depression Scale (CESD-10) was used to evaluate depressive symptoms in the elderly. Disability was measured by basic activities of daily living (B-ADL) and instrumental activities of daily living (I-ADL). Social support included contact with family and friends, sick care, and money received, measured by five self-reported questions. We used multiple linear regression and moderating model to explore the association between disability, social support, and depressive symptoms. Results A total of 9,231 patients were included in this study, and approximately 26.75% of the elderly had depressive symptoms. Study found that depressive symptoms were associated with social support (β B-ADL = -0.108, 95% CI: -0.168- -0.047; β I-ADL = -0.098, 95% CI: -0.156- -0.039), β B-ADL (β = 0.296, 95% CI: 0.248-0.343) and I-ADL (β = 0.174, 95% CI: 0.152-0.195). Moreover, the result also showed that social support moderated the effects of B-ADL ( β B - A D L * s o c i a l s u p p o r t = 0.034, 95% CI: 0.014-0.053, F = 11.57, p = 0.001) and I-ADL ( β I - A D L * s o c i a l s u p p o r t = 0.025, 95% CI: 0.017-0.033) on depressive symptoms. Conclusions The study suggests that disability and social support can affect depressive symptoms, and social support moderates the effect of disability on depressive symptoms. Therefore, taking effective measures to reduce the elderly disability rate of disability and increase their social support are necessary condition for realizing mental health.
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