The co-occurrence of chronic pain and psychological distress and its associations with salient socio-demographic characteristics among long-term social assistance recipients in Norway

The Association Between Child Maltreatment and Loneliness Across the Lifespan: A Systematic Review and Multilevel Meta-Analysis

While there is evidence that child maltreatment is positively associated with loneliness, the strength of this association is not yet clear. It is also unclear whether the magnitude and statistical significance of this association varies across groups of individuals. Therefore, this meta-analysis examines whether there are differences in loneliness between individuals with and without maltreatment histories, and which factors may influence the association between child maltreatment and loneliness. A three-level meta-analysis was conducted on 52 studies reporting 116 effect sizes (N = 1,705,493; Mage = 30.93; 49.6% females). Results showed a medium overall effect (g = 0.45, p < .001, 95% CI [0.36, 0.53]), indicating that individuals with maltreatment histories, on average, feel lonelier than individuals without maltreatment histories. Moderator analyses showed that effect sizes were larger for emotional abuse and emotional neglect as compared to other types of child maltreatment and decreased when participants were older at the time of loneliness assessment. These findings suggest that individuals with maltreatment histories, especially those who have been emotionally abused and/or emotionally neglected, are vulnerable to experiencing loneliness across the lifespan. The results also suggest that feelings of loneliness warrant attention in prevention and intervention programs for individuals with maltreatment histories.

Long-term social assistance recipients' experiences with an increased monthly payment: a qualitative pilot study

AIMS

Ten long-term social assistance recipients in a Norwegian municipality received a greater-than-average fixed monthly payment for 12 months. This study aimed to explore whether these recipients with reduced administrative requirements and a fixed monthly payment that was greater than the average social assistance experienced reduced poverty, increased feelings of independence, better daily living, and an improved quality of life.

METHODS

The study's explorative design included 20 qualitative, in-depth, semi-structured interviews and a longitudinal electronic survey for 12 months. The 10 participants had been selected by the local labour and welfare agency based on stringent criteria and are therefore not representative of social assistance recipients in general. Individual interviews were conducted during autumn 2021 and spring 2022. The interview data were analysed using systematic text condensation, and the survey results are presented using descriptive statistics.

RESULTS

The participants included in the project described a reduced experience of poverty. They could buy additional items and set aside money, something they had not been able to do in the past, and meant a great deal to them. They expressed experiencing freedom, gaining a stronger sense of independence, and having lessened feelings of shame. Many of the participants described health issues that were incompatible with working.

CONCLUSIONS

Being given this opportunity led to a feeling of increased dignity and greater inclusion in society among this selected group of participants. They appreciated the simplified conditions and reduced requirements for administrative matters. All expressed that spending 8 months without contact with the social welfare office was a liberation.

Differences in income trajectories according to psychological distress and pain: A longitudinal study among Norwegian social assistance recipients

Aim: Mental diseases and pain are serious public health problems and are a leading cause of disability worldwide. The aim of this study is to describe how pain and psychological distress separately and in combination are associated with four income trajectories over nine years in a cohort of long-term social assistance recipients (LTRs). Methods: A cohort of 456 LTRs from 14 municipalities in Norway were divided into four groups based on the presence or absence of pain and/or psychological distress. These were surveyed in 2005, and later linked by personal identification numbers to high-quality longitudinal administrative data covering the period 2005-2013. Methods include calculation of income statuses based on main sources of income, and multinomial logistic regression analysis. Results: In the group without pain and psychological distress, earnings from work as main source of income (14.6-38.0%) and disability benefits (2.9-16.1%) increased over the period. In the 'double burden' group the proportions who had social assistance as main income decreased (68.2-21.5%) and the proportions with disability benefits increased over time (5.6-36.6%). Only 27.2% of the total sample had earnings from work as their main income in 2013. Conclusion: LTRs are extra burdened by pain and psychological distress, and this has consequences for their life opportunities and income trajectories. This study indicates that the primary goal of the social assistance system, to make the clients self-sufficient, is hard to achieve. A better co-operation between health services and work-related services is needed.

Severe functional limitation due to pain & emotional distress and subsequent receipt of prescription medications among older adults with cancer

BACKGROUND

Certain cancer types and subsequent treatment can cause or worsen pain and emotional distress, leading to functional limitation, particularly among a growing population of older adults with cancer.

METHODS

We constructed a national sample of older adult Medicare beneficiaries with cancer using the 2007-2012 Surveillance, Epidemiology and End Results (SEER)-Medicare Health Outcomes Survey (MHOS) database linked to Medicare Part D enrollment and prescription claims data. MHOS survey responses described functional limitations due to pain and emotional distress. Using multivariable logistic regression, we estimated the association between participant characteristics and patient-reported functional limitation due to pain and emotional distress and subsequent prescription medication use.

RESULTS

Among 9105 older adults with cancer, aged 66-102 years (y), 68.6% reported moderate to severe functional limitation due to pain, and 48.3% reported moderate to severe functional limitation due to emotional distress. Nearly 10% reported severe functional limitation due to co-occurring symptoms of pain and emotional distress. Significant predictors of severe functional limitation due to co-occurring symptoms included age ≥ 80y (ref: 66-69y, adjusted relative risk (aRR): 1.74; 95% confidence interval (CI) 1.39-2.18, p < .001), stage IV disease at diagnosis (ref: stage I, aRR: 2.08; CI 1.52-2.86, p < .001), and lung cancer (ref: breast cancer, aRR: 1.84; CI 1.30-2.61, p < .001). Among 892 participants reporting co-occurring symptoms, 32.5% received neither pain nor emotional distress prescription medication.

CONCLUSIONS

Functional limitation due to pain and emotional distress persist among older adults with cancer, particularly octogenarians. Efforts to identify and target unmet supportive care needs to maintain functional independence are needed.

The Relationship Between Assistance Satisfaction and Negative Affect in Long-Term Social Assistance Recipients in China: The Moderating Role of Self-Acceptance

Public welfare in China is less universal, comprehensive, and generous when compared with other welfare regimes, especially for individuals with occupational disease. The assistance satisfaction of Chinese pneumoconiosis patients, a typical group of long-term social assistance recipients, has been linked to diminished health and psychological well-being. Self-acceptance is theorized to promote well-being, which may buffer the negative consequences of negative emotion on assistance satisfaction. This research was conducted based on the survey data of 1,345 patients in typical mining areas of China. In addition to single-factor analysis of variance, descriptive analysis, and correlation analysis, a cluster analysis was performed to explore the profiles of participants' ratings of assistance satisfaction with five governing subjects: government, employing unit, medical institution, welfare organization, and laborer themselves. The results were as follows: (1) Social assistance satisfaction perceived by Chinese long-term social assistance recipients was at an average level, wherein self-assistance satisfaction perception was the lowest among five dimensions. (2) The overall perception of assistance satisfaction of Chinese long-term social assistance recipients was significantly correlated with educational background and household monthly income; specifically, the participants with higher levels of education and lower levels of income were more likely to have higher assistance satisfaction perception. (3) Cross analysis showed that participants with higher assistance satisfaction were mainly from the low-high group, having a lower level of negative affect, and higher level of self-acceptance. (4) The average negative affect level was above the scale midpoint (3.65) and negatively associated with each of the assistance satisfaction ratings. (5) The analysis yielded three distinct profiles—medium (19.26%), high (40%), and low (40.74%)—according to their degree of assistance satisfaction. Relative to the other profiles, low assistance satisfaction participants reported greater levels of negative affect in their daily life. However, self-acceptance moderated these effects, but no moderating effect was detected for individuals reporting greater levels of assistance satisfactory. Purpose is proved empirically a positive asset for promoting psychological adjustment in the period of receiving social assistance for Chinese long-term social assistance recipients.