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Hung WC, Wu CY, Lee MB, Chan CT, Chen CY. Loneliness and suicide risks in the general population before and during first-year COVID-19 in Taiwan. J Formos Med Assoc 2024; 123:510-516. [PMID: 38307799 DOI: 10.1016/j.jfma.2023.12.014] [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: 03/20/2023] [Revised: 08/31/2023] [Accepted: 12/25/2023] [Indexed: 02/04/2024] Open
Abstract
PURPOSE Loneliness is a critical issue affecting the general population. Current evidence from national surveys of loneliness is scarce. The study aimed to examine the impact of COVID-19 pandemic on the prevalence of loneliness and its associating suicide risks in Taiwan. METHODS Four annual telephone interview surveys were performed by the Taiwan Suicide Prevention Center in 2015-2017 and 2020 during COVID outbreak. Each year the sample was randomly selected by stratifying the general public in different geographical areas and fulfilled a questionnaire collecting information including loneliness, psychological distress, and suicide risk assessment. All the data were analyzed using SPSS25 analysis. RESULTS A total of 8460 participants were recruited. The average prevalence of loneliness was 12.6 %. Feelings of loneliness was significantly correlated with psychological distress and most risk factors relating to suicide. The odds of loneliness for lifetime suicidal ideation, lifetime suicide attempt, and future suicide intent were 4.9, 5.1, and 9.2, respectively. During the COVID-19 period, loneliness and suicidality demonstrated a noteworthy decline trend, whereas "no one trustworthy to talk to" was the only item that showed significant increase under the pandemic and also impacted on loneliness. CONCLUSION Nearly one in ten Taiwanese people felt lonely before and during COVID-19. Loneliness was closely linked with various suicide risk factors such as lifetime suicide ideation and attempt or future intention. Although psychological distress and suicide risk were not increased during COVID-19, maintaining trustful relationships to seek support appeared to be critical to prevent the risks of loneliness or suicide.
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Affiliation(s)
- Wei-Chieh Hung
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
| | - Chia-Yi Wu
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan.
| | - Chia-Ta Chan
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan.
| | - Chun-Ying Chen
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
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Stegen H, Duppen D, Savieri P, Stas L, Pan H, Aartsen M, Callewaert H, Dierckx E, De Donder L. Loneliness prevalence of community-dwelling older adults and the impact of the mode of measurement, data collection, and country: A systematic review and meta-analysis. Int Psychogeriatr 2024:1-15. [PMID: 38525677 DOI: 10.1017/s1041610224000425] [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: 03/26/2024]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it. DESIGN Systematic review and meta-analysis. SETTING We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021. PARTICIPANTS We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title. MEASUREMENTS A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries. RESULTS Our initial search identified 2,021 studies of which 45 (k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% (n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence. CONCLUSIONS This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.
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Affiliation(s)
- Hannelore Stegen
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Daan Duppen
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Perseverence Savieri
- Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lara Stas
- Core facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Honghui Pan
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Brussels Interdisciplinary Research centre on Migration and Minorities (BIRMM), Brussels, Belgium
| | - Marja Aartsen
- Norwegian Social Research, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Hannelore Callewaert
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Eva Dierckx
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Alexianen Zorggroep Tienen, Psychiatric Clinic, Tienen, Belgium
| | - Liesbeth De Donder
- Society and Ageing Research Lab (SARLab), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Bugallo-Carrera C, Dosil-Díaz C, Anido-Rifón L, Pacheco-Lorenzo M, Fernández-Iglesias MJ, Gandoy-Crego M. A systematic review evaluating loneliness assessment instruments in older adults. Front Psychol 2023; 14:1101462. [PMID: 37179898 PMCID: PMC10166865 DOI: 10.3389/fpsyg.2023.1101462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/31/2023] [Indexed: 05/15/2023] Open
Abstract
Introduction and objectives The experiences and changes that come along with old age may lead to a feeling of loneliness, usually followed by negative physical and mental manifestations. In this systematic review, we evaluated the existing tools to assess loneliness in older adults. Methods We performed a literature search in the Web of Science, Medline, and PsycINFO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After, we examined the psychometric properties of the instruments with a focus on reliability, validity, and main conclusions. Results We included 27 articles published between 1996 and 2021. Conclusion To date, there are few instruments to assess loneliness in older adults. In general, they present adequate psychometric properties, although it is true that some scales show somewhat low levels of reliability and validity.
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Affiliation(s)
- César Bugallo-Carrera
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Dosil-Díaz
- Department of Developmental Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Manuel Gandoy-Crego
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
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Lwi SJ, Ford BQ, Levenson RW. Cultural differences in caring for people with dementia: a pilot study of concern about losing face and loneliness in Chinese American and European American caregivers. Clin Gerontol 2023; 46:207-222. [PMID: 36309843 PMCID: PMC9928887 DOI: 10.1080/07317115.2022.2137448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Heavy demands upon dementia caregivers can lead to a number of poor health outcomes including declines in physical, mental, and brain health. Although dementia affects people from all backgrounds, research in the US has largely focused on European American caregivers. This has made providing culturally-competent care more difficult. This study begins to address this issue by empirically examining how culturally-shaped beliefs can influence loneliness in family caregivers of people with dementia. METHODS We conducted a preliminary questionnaire study with Chinese American and European American family caregivers of people with dementia (N = 72). RESULTS Chinese American caregivers were more concerned than European American caregivers about losing face, which in turn, was associated with greater loneliness. This pattern remained when accounting for caregiver gender, age, and relationship to the person with dementia. CONCLUSIONS These preliminary findings highlight the role that cultural beliefs can play in adverse caregiver outcomes, and suggest that addressing concerns about losing face may be an important way for healthcare providers to help reduce loneliness among Chinese American caregivers. CLINICAL IMPLICATIONS Understanding how cultural beliefs influence caregiver outcomes is critical as healthcare professionals work to provide culturally-competent care and design culturally-sensitive interventions.
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Affiliation(s)
- Sandy J Lwi
- VA Northern California Health Care System, Martinez, California, USA
| | - Brett Q Ford
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Robert W Levenson
- Department of Psychology, University of California, Berkeley, California, USA
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Chen J, He X, Shen Y, Zhao Y, Cui C, Liu Y. Demographic differences in public acceptance of waste-to-energy incinerators in China: High perceived stress group vs. low perceived stress group. Front Psychol 2022; 13:948653. [DOI: 10.3389/fpsyg.2022.948653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
Demographic characteristics have been recognized as an important factor affecting public acceptance of waste-to-energy (WTE) incineration facilities. The present study explores whether the differences in public acceptance of WTE incineration facilities caused by demographic characteristics are consistent in residential groups under different perceived stress using data collected by a large-scale questionnaire survey (1,066 samples) conducted in three second-tier cities in China. The result of data analysis using a T-test (one-way ANOVA) shows firstly that people with low perceived stress have higher public acceptance of WTE incineration facilities. Second, the differences in public acceptance of WTE incineration facilities caused by demographic characteristics (gender, educational attainment, and age) vary in residential groups with different perceived stress levels. The findings enrich the knowledge system related to demographic characteristics research on NIMBY infrastructure projects and provide the theoretical basis for the government to formulate more targeted policies about NIMBY infrastructure sitting.
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Chen X, Woo J, Yu R, Chung GKK, Yao W, Yeoh EK. Subjective Social Status, Area Deprivation, and Gender Differences in Health among Chinese Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9857. [PMID: 36011511 PMCID: PMC9408352 DOI: 10.3390/ijerph19169857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
This study examined the gender differences in the main and interactive effects of subjective social status and area deprivation on health among older adults in Hong Kong. Data for this study came from the baseline of MrOs and MsOs studies, including 4000 Chinese men and women ≥ 65 in Hong Kong. Subjective social status was assessed using the MacArthur Scale of subjective social status scale. Our results reaffirm that subjective social status is an independent indicator of health after adjusting for objective SES measures (e.g., education and income). Perceived rank on the community ladder was more closely related to health among older people than was the society ladder, particularly for women. Although area-level social deprivation was not significantly associated with the health of older people, it may moderate the effect of subjective social status on health. Women with a lower perceived status in the community were more likely to experience depressive symptoms but better grip strength when living in more deprived neighborhoods. The findings suggested that subjective social status provides important information for the physical and mental health of the older population. Policymakers may implement interventions to enhance the subjective social status of older adults. Given the greater contribution of relative status in the community to the health of women, these policies and interventions should target to improve women's perceived status in the community.
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Affiliation(s)
- Xi Chen
- Department of Sociology and Social Policy, Lingnan University, Hong Kong SAR, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruby Yu
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Gary Ka-Ki Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wei Yao
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
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Ock M, Pyo J, Jo MW, Herdman M, Luo N. Perceptions of the General Public About Health-related Quality of Life and the EQ-5D Questionnaire: A Qualitative Study in Korea. J Prev Med Public Health 2022; 55:213-225. [PMID: 35677995 PMCID: PMC9201084 DOI: 10.3961/jpmph.22.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS). METHODS We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations. RESULTS In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale. CONCLUSIONS While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.,Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.,Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Lee CN, Huang YL, Chang HH, Kuo CY, Lu TH, Hsieh YT, Chang WH, Yang YK, Chen PS, Tseng HH. Associations of emotion recognition, loneliness, and social functioning in euthymic patients with bipolar disorder. Kaohsiung J Med Sci 2022; 38:703-711. [PMID: 35394707 DOI: 10.1002/kjm2.12539] [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: 10/29/2021] [Revised: 02/11/2022] [Accepted: 03/07/2022] [Indexed: 11/05/2022] Open
Abstract
Emotion recognition deficit is related to impaired community functioning. Loneliness is also associated with impaired social performance. However, the way in which emotion recognition and loneliness may contribute to social functioning remains unclear in euthymic patients with bipolar disorder. We aimed to examine emotion recognition ability in Han Chinese euBD patients relative to healthy controls (HCs) and to investigate the associations between emotion recognition, loneliness, and social functioning. Thirty-nine HCs and 46 euthymic BD patients completed an emotion recognition task and nonsocial cognitive measures related to executive function and attention. The UCLA loneliness scale and Social Performance Scale were administered to evaluate psychological loneliness and social functioning, respectively. We observed lower emotion recognition accuracy, higher loneliness, and poorer social functioning in the BD patients after adjustment for demographic data. Loneliness was negatively associated with global social functioning in both the BD and HC groups. Higher loneliness and lower emotion recognition accuracy were associated with poorer social functioning in euthymic BD in different subdomains. Our study confirmed a subtle impairment of emotion recognition ability in euthymic BD. Loneliness impacts globally on social functioning, while emotion recognition ability may affect specific subdomains of social functioning in euthymic BD. Alleviation of loneliness and enhancement of social cognition might improve social functioning in BD patients.
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Affiliation(s)
- Chia Ning Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Lien Huang
- Department of Psychology, Fo Guang University, Yilan, Taiwan
| | - Hui Hua Chang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pharmacy, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Che Yu Kuo
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ting Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei Hung Chang
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Alsubheen SA, Oliveira A, Habash R, Goldstein R, Brooks D. Systematic review of psychometric properties and cross-cultural adaptation of the University of California and Los Angeles loneliness scale in adults. CURRENT PSYCHOLOGY 2021; 42:1-15. [PMID: 34785877 PMCID: PMC8586628 DOI: 10.1007/s12144-021-02494-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 12/30/2022]
Abstract
This systematic review assessed the psychometric properties and the cross-cultural adaptation of the University of California and Los Angeles Loneliness scale (UCLA-LS) in adults. A systematic search of four electronic databases (PubMed, EMBASE, Scopus, and PsycINFO) was conducted from inception until March 2021. We followed the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines for data extraction and evidence synthesis. Eighty-one studies assessed the validity and reliability of the UCLA-LS, translated into many languages, and applied across several countries/societies. Three versions of the 20-item and nine short versions of the UCLA-LS with 3 to 20 questions were identified. High-quality evidence supported the internal structure of the UCLAs: 4, 6, 7 and 10, while low-to moderate-quality evidence supported the construct validity of the UCLAs: 3, 4, 6, 8, 16 and 20. Moderate-quality evidence supported the test-retest reliability of version 3 UCLA-20 with excellent interclass coefficients values of 0.76-0.93. The UCLAs: 4, 6, 7 and 10 had the most robust internal structure and may therefore be the most useful for informing clinicians and social psychologists engaged in assisting those with loneliness. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12144-021-02494-w.
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Affiliation(s)
- Sanaa A. Alsubheen
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Lab3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Institute for Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
| | - Razanne Habash
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
| | - Roger Goldstein
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS Building Room 430, Hamilton, ON L8S 1C7 Canada
- Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON Canada
- Department of Physical Therapy and Rehabilitation Science, University of Toronto, Toronto, ON Canada
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10
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Huang PH, Chi MJ, Kuo CL, Wu SFV, Chuang YH. Prevalence of Loneliness and Related Factors Among Older Adults in Taiwan: Evidence From a Nationally Representative Survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211035745. [PMID: 34431380 PMCID: PMC8392793 DOI: 10.1177/00469580211035745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Loneliness is a common problem among older populations, and very few studies have examined loneliness among older adults in Taiwan. AIM This study aimed to understand the prevalence of loneliness and factors associated with it among older adults in Taiwan. METHODS Data from the Taiwan Longitudinal Study of Aging collected in 2015 were analyzed and involved 4588 participants aged ≥65 years. The outcome variable was a self-reported loneliness question, and independent variables included demographic characteristics, a self-reported health status, physical function, number of comorbidities, cognitive function, and social support. A multivariate logistic regression was used to identify predictors of loneliness. RESULTS The prevalence of loneliness among older adults in Taiwan was 10.5%. The multivariate logistic regression showed that old persons who were male, lived alone, perceived that they had a poor health condition, had no spouse, had no job, and had poor emotional support had higher likelihood of feeling lonely. CONCLUSIONS This study investigated loneliness in a nationally representative sample of older adults and revealed that one-tenth of this older population might experience loneliness which requires immediate action. Special attention should be given to the aforesaid factors in older adults to identify problems and provide interventions as early as possible in order to prevent loneliness and thus reduce the resultant negative effects on physical and mental conditions. Appropriate interventions should be developed to prevent or ameliorate feelings of loneliness among older populations using rigorous research designs such as randomized controlled trials.
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Affiliation(s)
- Pi-Hua Huang
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan.,Department of Nursing, St Mary's Junior College of Medicine, Nursing and Management, Yilan, Taiwan
| | - Mei-Ju Chi
- School of Gerontology Health Management, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan.,Master Program in Long-Term Care, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan
| | - Chien-Lin Kuo
- Department of Allied Health Education & Digital Learning, 38028National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Fang Vivienne Wu
- School of Nursing, 38028National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, 38032Taipei Medical University, Taipei, Taiwan
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11
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A Space-Time Analysis of Rural Older People's Outdoor Mobility and Its Impact on Self-Rated Health: Evidence from a Taiwanese Rural Village. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115902. [PMID: 34072884 PMCID: PMC8198793 DOI: 10.3390/ijerph18115902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022]
Abstract
With the aggravation of rural aging, the well-being and self-rated health level of older people in rural communities are significantly lower than those in urban communities. Past studies hold that mobility is essential to the quality of life of the elderly, and well-being depends on their own adaptation strategies in the built environment. Therefore, this study combines three key factors related to active aging: environment, health and mobility, and assumes that the elderly with good health status will have environmental proactivity and a wider range of daily mobility in a poor rural built environment. This study attempts to track daily mobility by using a space-time path method in time geography and then to explore the relationship between outdoor mobility and older people's self-rated health. A 1-week mobility path survey for 20 senior citizens of Xishi Village, a typical rural village in Taiwan, was conducted by wearing a GPS sports watch. A questionnaire survey and in-depth interviews were done to provide more information about the seniors' personal backgrounds and lifestyles. The results show that when the built environment is unfit to the needs of daily activities, half of the participants can make adjustment strategies to go beyond the neighborhoods defined by administrative units. Correlation analysis demonstrated that mental health is associated with daily moving time and distance. In addition, men have higher self-rated health scores than women, and there are significant statistical differences between married and widowed seniors in daily outing time and distance. This exploratory study suggests that in future research on rural health and active aging in rural areas, understanding the daily outdoor mobility of the elderly can help to assess their health status and living demands and quickly find out whether there is a lack of rural living services or environmental planning.
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Boursier V, Gioia F, Musetti A, Schimmenti A. Facing Loneliness and Anxiety During the COVID-19 Isolation: The Role of Excessive Social Media Use in a Sample of Italian Adults. Front Psychiatry 2020; 11:586222. [PMID: 33363484 PMCID: PMC7752864 DOI: 10.3389/fpsyt.2020.586222] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/10/2020] [Indexed: 01/14/2023] Open
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) prompted people to face a distressing and unexpected situation. Uncertainty and social distancing changed people's behaviors, impacting on their feelings, daily habits, and social relationships, which are core elements in human well-being. In particular, restrictions due to the quarantine increased feelings of loneliness and anxiety. Within this context, the use of digital technologies has been recommended to relieve stress and anxiety and to decrease loneliness, even though the overall effects of social media consumption during pandemics still need to be carefully addressed. In this regard, social media use evidence risk and opportunities. In fact, according to a compensatory model of Internet-related activities, the online environment may be used to alleviate negative feelings caused by distressing life circumstances, despite potentially leading to negative outcomes. The present study examined whether individuals who were experiencing high levels of loneliness during the forced isolation for COVID-19 pandemic were more prone to feel anxious, and whether their sense of loneliness prompted excessive social media use. Moreover, the potentially mediating effect of excessive social media use in the relationship between perceived loneliness and anxiety was tested. A sample of 715 adults (71.5% women) aged between 18 and 72 years old took part in an online survey during the period of lockdown in Italy. The survey included self-report measures to assess perceived sense of loneliness, excessive use of social media, and anxiety. Participants reported that they spent more hours/day on social media during the pandemic than before the pandemic. We found evidence that perceived feelings of loneliness predicted both excessive social media use and anxiety, with excessive social media use also increasing anxiety levels. These findings suggest that isolation probably reinforced the individuals' sense of loneliness, strengthening the need to be part of virtual communities. However, the facilitated and prolonged access to social media during the COVID-19 pandemic risked to further increase anxiety, generating a vicious cycle that in some cases may require clinical attention.
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Affiliation(s)
- Valentina Boursier
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Francesca Gioia
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Adriano Schimmenti
- Kore University of Enna, Faculty of Human and Social Sciences, Enna, Italy
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Intergenerational coresidence and subjective well-being of older adults in China: The moderating effect of living arrangement preference and intergenerational contacts. DEMOGRAPHIC RESEARCH 2019. [DOI: 10.4054/demres.2019.41.48] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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14
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Luo Y, Zhang L, He P, Pang L, Guo C, Zheng X. Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults. BMJ Open 2019; 9:e026532. [PMID: 31488464 PMCID: PMC6731895 DOI: 10.1136/bmjopen-2018-026532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Health disparities in schizophrenia are well established. However, it is less understood whether area-level socioeconomic status (SES) is differentially associated with schizophrenia depending on individual-level SES. Therefore, using a nationally large representative data, this study investigated the association between individual-level SES, area-level SES and their interaction with schizophrenia in Chinese adults from a multilevel perspective. SETTING Household interviews in 734 counties (districts), 2980 towns (streets) and 5964 communities (villages) from 31 provinces, People's Republic of China, as part of the cross-sectional survey of Second China National Sample Survey on Disability. PARTICIPANTS 1 909 205 men and women aged 18 years old and above. PRIMARY AND SECONDARY OUTCOME MEASURES A screen followed by clinical diagnosis was used to identify schizophrenia, and schizophrenia was ascertained according to the International Statistical Classification of Diseases, 10th Revision (code F20). RESULTS 1-SD increase in individual SES was associated with decreased risk of schizophrenia (OR=0.45, 95% CI 0.43 to 0.46). 1-SD increase in area-level SES was associated with increased risk of schizophrenia (OR=1.30, 95% CI 1.24 to 1.37). The interaction of individual SES and area-level SES was statistically significant (OR=1.05, 95% CI 1.02 to 1.08); as the level of area SES increased, schizophrenia risk of lower SES people grew faster than the risk of higher SES people. CONCLUSIONS Area-level SES is particularly important to mental health of low SES individuals, with low SES people in high SES counties having the highest risk of schizophrenia than other groups. Action to reduce SES disparities in schizophrenia will require attention to the area-level context of low SES adults.
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Affiliation(s)
- Yanan Luo
- Institute of Population Research, Peking University, Beijing, China
| | - Lei Zhang
- Institute of Population Research, Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Lihua Pang
- Institute of Population Research, Peking University, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing, China
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15
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Heidari M, Ghodusi Borujeni M, Kabirian Abyaneh S, Rezaei P. The Effect of Spiritual Care on Perceived Stress and Mental Health Among the Elderlies Living in Nursing Home. JOURNAL OF RELIGION AND HEALTH 2019; 58:1328-1339. [PMID: 30796566 DOI: 10.1007/s10943-019-00782-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of this study was to investigate the effect of spiritual care on the perceived stress and mental health of the elderlies living in nursing home in Isfahan. This is a semi-experimental study with pretest and posttest design with control group. Ninety eligible elderlies living in the nursing home were divided into intervention and control groups through census and random allocation. The interventional spiritual care was conducted for the intervention group for 90 days. After conducting the spiritual care, the majority of the elderlies (62.22%) in the intervention group had a low perceived stress level and the majority of the subjects (64.44%) in the control group had a high perceived stress level. Therefore, after performing spiritual care, a significant difference was observed at the perceived stress level of the two groups (X2 = 3.22 and P = 0.001). The results of mental health level indicated that the mean score of the general health questionnaire was ranged between 10.95 and 27.2. After performing care, a significant difference was observed in mental health level of both groups, and 31.11% and 53.33% of the participants were suspected to general disorder in the intervention and control groups, respectively. Based on the results, there was a significant difference in the mental health level of both groups after the implementation of spiritual care (X2 = 6.56 and P = 0.001). Further, a significant negative correlation was found between the perceived stress and mental health (r = - 0.241 and P = 0.01). Considering the spiritual health as one of the health dimensions influencing the psychosocial variables of elderlies seems necessary. Policymakers and planners of health area contribute to the improvement of mental health level by using comprehensive care approach with an emphasis on the spiritual dimension of care for the elderly people.
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Affiliation(s)
- Mohammad Heidari
- School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | | | - Parvin Rezaei
- Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Life satisfaction as the main factor behind the elderly`s health knowledge utilization: A qualitative study in an Iranian context. Med J Islam Repub Iran 2019; 32:115. [PMID: 30815410 PMCID: PMC6387817 DOI: 10.14196/mjiri.32.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Indexed: 11/18/2022] Open
Abstract
Background: The elderly population’s health has become a priority as their numbers are on the rise and they are increasingly becoming vulnerable to physical and mental diseases. Studies show that an elderly person’s health depends on his/her utilization of health knowledge in daily life. Hence, here we investigated the contributing factors of knowledge utilization in the elderly population.
Methods: A qualitative study was conducted through conventional content analysis. Semi-structured in-depth interviews were held with 29 elderly individuals from Tehran. A focus group discussion was conducted (eight elderly individuals), and an expert panel was held with nine experts to complement the results.
Results: Upon data analysis, four categories and seven subcategories were extracted. The main categories included provision of basic needs, maintaining dignity, life satisfaction, and negative feelings toward self and others. The concept of ‘life satisfaction’ held a pivotal role in relation to the other categories.
Conclusion: Life satisfaction was the main category in the utilization of health knowledge among the elderly. Aging should be foreseen and forethought to increase life satisfaction. The followings can be effective in increasing life satisfaction in the elderly: Promoting positive-thinking, placing greater emphasis on spiritualism in life, employment of the elderly, and promoting the culture and tradition of respecting the elderly.
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Yang F, Zhang J, Wang J. Correlates of loneliness in older adults in Shanghai, China: does age matter? BMC Geriatr 2018; 18:300. [PMID: 30509209 PMCID: PMC6278108 DOI: 10.1186/s12877-018-0994-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loneliness is a public health concern with serious health consequences in older adults. Despite a large body of research on the correlates of loneliness, little is known about the age group differences in the correlates. Given that the older adult population is heterogeneous, this study aims to examine the correlates of loneliness in older adults in Shanghai, and to explore how the correlates vary across different age groups. METHODS We used the Shanghai Urban Neighborhood Survey (SUNS) which was conducted in 2016 and 2017. The total sample size of older adults included in the analysis was 2770. Loneliness was measured using the sum of the 6 items derived from the De Jong Gierveld Loneliness Scale. Correlates include demographic variables, health conditions, social factors, and new media use. Regression analysis was used to examine the correlates of loneliness first in the whole sample, and then in the young old (60-79 years old) and the old old (80+ years old) separately. RESULTS The mean of loneliness score was 18.48 (SD = 5.77). The old old reported a higher level of loneliness than the young old. Variables, including age, living arrangement, marital status, education, health, family functioning, volunteering, square dancing, and new media use were found to be significant in the whole sample. Most of the significant correlates observed in the young old were identical to the findings reported for the total sample, with an exception for living arrangement. Self-rated health (SRH) and family functioning were two important correlates for the old old. CONCLUSIONS Correlates of loneliness vary for the young old and the old old. The older adults at higher risk of loneliness deserve more attention and concern. Future interventions should be tailored to the young old and the old old to better help older adults alleviate loneliness and enhance their well-being.
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Affiliation(s)
- Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, 99 Shangda Road, Baoshan District, Shanghai, 200444 China
| | - Junan Zhang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, 99 Shangda Road, Baoshan District, Shanghai, 200444 China
| | - Jianping Wang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, 99 Shangda Road, Baoshan District, Shanghai, 200444 China
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18
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Lee SH, Tsai YF, Wang YW, Chen YJ, Tsai HH. Development and psychometric testing of the triggers of Suicidal Ideation Inventory for assessing older outpatients in primary care settings. Int J Geriatr Psychiatry 2017; 32:1114-1121. [PMID: 27572427 DOI: 10.1002/gps.4574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/06/2016] [Accepted: 08/10/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to develop an instrument for assessing triggers of suicidal ideation among older outpatients and determine its psychometrics. METHOD Participants were recruited from older outpatients of two hospitals in northern Taiwan. The 34-item Triggers of Suicidal Ideation Inventory (TSII) was developed, and its items were validated by experts in two runs of Delphi technique survey. Pre-testing this TSII in 200 older outpatients resulted in a 12-item TSII, with three items not considered triggers but suggesting the need for further psychiatric assessment. The 9-item TSII was examined by criterion validity, construct validity, internal consistency reliability, and test-retest reliability. RESULTS Factor analysis of the final version of TSII yielded a three-factor solution, accounting for 68.75% of the variance. Participants with depressive tendency tended to have higher TSII scores than participants with no depressive tendency (t = 8.62, p < 0.01), indicating good construct validity. TSII scores were significantly and positively correlated with Beck Scale for Suicide Ideation (r = 0.45, p < 0.01) and UCLA Loneliness (r = 0.55, p < 0.01) scores, indicating satisfactory criterion validity. The TSII had Cronbach's α and intraclass correlation coefficient of 0.70 and 0.99, respectively, indicating acceptable internal consistency reliability and excellent test-retest reliability. Receiver operating characteristic analysis revealed an area under the curve of 0.82, indicating excellent ability to detect triggers of suicidal ideation. With a cutoff point of 2, the sensitivity and specificity were 0.76 and 0.69, respectively. CONCLUSIONS The TSII can be completed in 5 min, is perceived as easy to complete, and yielded highly acceptable parameters of validity and reliability. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shwu-Hua Lee
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yi-Wen Wang
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Ying-Jen Chen
- Division of Internal Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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19
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Chang KS, Tsai WH, Tsai CH, Yeh HI, Chiu PH, Chang YW, Chen HY, Tsai JM, Lee SC. Effects of Health Education Programs for the Elders in Community Care Centers – Evaluated by Health Promotion Behaviors. INT J GERONTOL 2017. [DOI: 10.1016/j.ijge.2017.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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20
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Tsai HJ, Chang FK. Associations of various perceived-stress situations with depressive symptoms in ≥50-year old Taiwanese men and women: Results from the Taiwan Longitudinal Study on Aging. Arch Gerontol Geriatr 2016; 67:113-9. [DOI: 10.1016/j.archger.2016.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 07/16/2016] [Accepted: 07/17/2016] [Indexed: 11/24/2022]
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21
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Wu CC, Chang CM, Hsu TW, Lee CH, Chen JH, Huang CY, Lee CC. The effect of individual and neighborhood socioeconomic status on esophageal cancer survival in working-age patients in Taiwan. Medicine (Baltimore) 2016; 95:e4140. [PMID: 27399129 PMCID: PMC5058858 DOI: 10.1097/md.0000000000004140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Esophageal cancer is the sixth leading cause of cancer mortality. More than 90% of patients with esophageal cancer in Taiwan have squamous cell carcinoma. Survival of such patients is related to socioeconomic status (SES). We studied the association between SES (individual and neighborhood) and the survival of working-age patients with esophageal cancer in Taiwan. A population-based study was conducted of 4097 patients diagnosed with esophageal cancer between 2002 and 2006. Each was traced for 5 years or until death. Individual SES was defined by enrollee job category. Neighborhood SES was based on household income and dichotomized into advantaged or disadvantaged. Multilevel logistic regression was used to compare the survival rates by SES group after adjustment for possible confounding and risk factors. Hospital and neighborhood SES were used as random effects in multilevel logistic regression. In patients younger than 65 years, 5-year overall survival rates were worst for those with low individual SES living in disadvantaged neighborhoods. After adjustment for patient characteristics, esophageal cancer patients with high individual SES had a 39% lower risk of mortality than those with low individual SES (odds ratio 0.61, 95% confidence interval 0.48-0.77). Patients living in disadvantaged areas with high individual SES were more likely to receive surgery than those with low SES (odds ratio 1.45, 95% confidence interval 1.11-1.89). Esophageal cancer patients with low individual SES have the worst 5-year survival, even with a universal healthcare system. Public health, education, and social welfare programs should address the inequality of esophageal cancer survival.
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Affiliation(s)
- Chin-Chia Wu
- Division of Colorectal Surgery
- Cancer Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi
| | - Chun-Ming Chang
- Division of General Surgery, Department of Surgery
- Cancer Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi
- School of Medicine, Tzu Chi University, Hualien
| | - Ta-Wen Hsu
- Division of Colorectal Surgery
- Cancer Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi
- School of Medicine, Tzu Chi University, Hualien
| | - Cheng-Hung Lee
- Division of General Surgery, Department of Surgery
- Cancer Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi
| | - Jian-Han Chen
- Division of General Surgery, Department of Surgery
- Cancer Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi
| | - Chih-Yuan Huang
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi
| | - Ching-Chih Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung
- Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Correspondence: Ching-Chih Lee, No. 386, Dazong 1st Road, Zouying District, Kaohsiung, Taiwan (e-mail: )
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22
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Li YP, Lin SI, Fetzer SJ, Chen CH. The relationships between activity and quality of life for older men and women at different ages in Taiwan. J Women Aging 2015; 26:219-37. [PMID: 24919103 DOI: 10.1080/08952841.2014.888222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women.
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Affiliation(s)
- Yueh-Ping Li
- a Department of Nursing, College of Medicine and Life Science , Chung Hwa University of Medical Technology , Tainan , Taiwan
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23
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Chang CM, Wu CC, Yin WY, Juang SY, Yu CH, Lee CC. Low socioeconomic status is associated with more aggressive end-of-life care for working-age terminal cancer patients. Oncologist 2014; 19:1241-8. [PMID: 25342317 DOI: 10.1634/theoncologist.2014-0152] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The relationship between low socioeconomic status (SES) and aggressiveness of end-of-life (EOL) care in cancer patients of working age (older than 18 years and younger than 65 years) is not clear. We assessed the association between aggressiveness of EOL care and differences in SES among working-age terminal cancer patients from Taiwan between 2009 and 2011. METHODS A total of 32,800 cancer deaths were identified from the Taiwan National Health Insurance Research Database. The indicators of aggressive EOL care (chemotherapy, more than one emergency room [ER] visit or hospital admission, more than 14 days of hospitalization, intensive care unit [ICU] admission, and death in an acute care hospital) in the last month of life were examined. The associations between SES and the indicators were explored. RESULTS Up to 81% of the cancer deaths presented at least one indicator of aggressive EOL care. Those who were aged 35-44 years and male, had low SES, had metastatic malignant disease, lived in urban areas, or were in hospitals with more abundant health care resources were more likely to receive aggressive EOL care. In multilevel logistic regression analyses, high-SES cancer deaths had less chemotherapy (p < .001), fewer ER visits (p < .001), fewer ICU admissions (p < .001), and lower rates of dying in acute hospitals (p < .001) compared with low-SES cancer deaths. CONCLUSION Working-age terminal cancer patients in Taiwan received aggressive EOL care. EOL cancer care was even more aggressive in those with low SES. Public health strategies should continue to focus on low-SES patients to provide them with better EOL cancer care.
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Affiliation(s)
- Chun-Ming Chang
- School of Medicine, Tzu Chi University, Hualian, Taiwan, Republic of China; Department of Surgery, Center for Clinical Epidemiology and Biostatistics, and Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, Republic of China
| | - Chin-Chia Wu
- School of Medicine, Tzu Chi University, Hualian, Taiwan, Republic of China; Department of Surgery, Center for Clinical Epidemiology and Biostatistics, and Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, Republic of China
| | - Wen-Yao Yin
- School of Medicine, Tzu Chi University, Hualian, Taiwan, Republic of China; Department of Surgery, Center for Clinical Epidemiology and Biostatistics, and Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, Republic of China
| | - Shiun-Yang Juang
- School of Medicine, Tzu Chi University, Hualian, Taiwan, Republic of China; Department of Surgery, Center for Clinical Epidemiology and Biostatistics, and Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, Republic of China
| | - Chia-Hui Yu
- School of Medicine, Tzu Chi University, Hualian, Taiwan, Republic of China; Department of Surgery, Center for Clinical Epidemiology and Biostatistics, and Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, Republic of China
| | - Ching-Chih Lee
- School of Medicine, Tzu Chi University, Hualian, Taiwan, Republic of China; Department of Surgery, Center for Clinical Epidemiology and Biostatistics, and Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, Republic of China
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Explanation of Loneliness in the Elderly and Comparison With Psychosocial Development Theory: A Quantitative Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2014. [DOI: 10.20286/jech-010230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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25
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Chen Y, Hicks A, While AE. Loneliness and social support of older people living alone in a county of Shanghai, China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:429-438. [PMID: 24621394 DOI: 10.1111/hsc.12099] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 06/03/2023]
Abstract
China has an ageing population with the number of older people living alone increasing. Living alone may increase the risk of loneliness of older people, especially for those in China where collectivism and filial piety are emphasised. Social support may fill the need for social contacts, thereby alleviating loneliness. However, little is known about loneliness and social support of older people living alone in China. This study investigated loneliness and social support of older people living alone, by conducting a cross-sectional questionnaire survey with a stratified random cluster sample of 521 community-dwelling older people living alone in a county of Shanghai. Data were collected from November 2011 to March 2012. The instruments used included the UCLA Loneliness Scale version 3 and the Social Support Rate Scale. The participants reported a moderate level of loneliness. Their overall social support level was low compared with the Chinese norm. Children were the major source of objective and subjective support. Of the participants, 53.9% (n = 281) and 47.6% (n = 248) asked for help and confided when they were in trouble, but 84.1% (n = 438) never or rarely attended social activities. The level of loneliness and social support differed among the participants with different sociodemographic characteristics. There were negative correlations between loneliness and overall social support and its three dimensions. The findings suggest that there is a need to provide more social support to older people living alone to decrease their feelings of loneliness. Potential interventions include encouraging more frequent contacts from children, the development of one-to-one 'befriending' and group activity programmes together with identification of vulnerable subgroups.
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Affiliation(s)
- Yu Chen
- School of Nursing, Fudan University, Shanghai, China
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26
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Tsai AC, Chi SH, Wang JY. Association of perceived stress with depressive symptoms in older Taiwanese: Results of a population-based study. Geriatr Gerontol Int 2014; 15:535-43. [DOI: 10.1111/ggi.12307] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Alan C Tsai
- Department of Healthcare Administration; Asia University; Taichung Taiwan
- Department of Health Services Management; School of Public Health; China Medical University; Taichung Taiwan
| | - Shu-Huang Chi
- Department of Healthcare Administration; Asia University; Taichung Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration; Asia University; Taichung Taiwan
- Center for Health Policy and Management Research; Asia University; Taichung Taiwan
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27
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Chen Y, Hicks A, While AE. Loneliness and social support of older people in China: a systematic literature review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:113-123. [PMID: 23714357 DOI: 10.1111/hsc.12051] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/05/2013] [Indexed: 06/02/2023]
Abstract
Loneliness is a serious problem for older people, which can be alleviated by social support. The dramatic population ageing together with social and economic change in China increases the likelihood of loneliness and the availability of different sources of social support of older people. The aim of this review was to identify the prevalence of loneliness and its related factors and sources of social support of older people in China. Electronic literature searches were conducted in September 2011 using Web of Science, PsycINFO, MEDLINE, PubMed, CINAHL, China Academic Journal and VIP Database for Chinese Technical Periodicals. Twenty-six papers were identified and reviewed. The prevalence of loneliness varied across the studies, reflecting the different measurements and samples. Marital status, gender, age, educational level, economic level, living arrangements, health status and social support were significant factors related to loneliness. The family was the most important source of social support followed by friends. The receipt of family support improved subjective well-being and mental health, but the effects of support from friends were inconsistent. Chinese older people received relatively little support from neighbours, governmental or other social organisations. Further well-designed studies are needed to identify additional factors related to loneliness and to understand the support from friends, neighbours, formal organisations and other sources.
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Affiliation(s)
- Yu Chen
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
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Wu CC, Hsu TW, Chang CM, Yu CH, Wang YF, Lee CC. The effect of individual and neighborhood socioeconomic status on gastric cancer survival. PLoS One 2014; 9:e89655. [PMID: 24586941 PMCID: PMC3934911 DOI: 10.1371/journal.pone.0089655] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 01/26/2014] [Indexed: 01/26/2023] Open
Abstract
PURPOSE Gastric cancer is a leading cause of death, particularly in the developing world. The literature reports individual socioeconomic status (SES) or neighborhood SES as related to survival, but the effect of both has not been studied. This study investigated the effect of individual and neighborhood SES simultaneously on mortality in gastric cancer patients in Taiwan. MATERIALS AND METHODS A study was conducted of 3,396 patients diagnosed with gastric cancer between 2002 and 2006. Each patient was followed for five years or until death. Individual SES was defined by income-related insurance premium (low, moderate, and high). Neighborhood SES was based on household income dichotomized into advantaged and disadvantaged areas. Multilevel logistic regression model was used to compare survival rates by SES group after adjusting for possible confounding factors. RESULTS In patients younger than 65 years, 5-year overall survival rates were lowest for those with low individual SES. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score), gastric cancer patients with high individual SES had 68% risk reduction of mortality (adjusted odds ratio [OR] of mortality, 0.32; 95% confidence interval [CI], 0.17-0.61). Patients aged 65 and above had no statistically significant difference in mortality rates by individual SES group. Different neighborhood SES did not statistically differ in the survival rates. CONCLUSION Gastric cancer patients aged less than 65 years old with low individual SES have higher risk of mortality, even under an universal healthcare system. Public health strategies, education and welfare policies should seek to correct the inequality in gastric cancer survival, especially in those with lower individual SES.
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Affiliation(s)
- Chin-Chia Wu
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Cancer center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Ta-Wen Hsu
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Cancer center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Chun-Ming Chang
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Cancer center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Chia-Hui Yu
- Department of Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Cancer center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Center for Clinical Epidemiology and Biostatistics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- Department of Education, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Cancer center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- * E-mail:
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PARK, BONG-GIL, 송인석. The Relationship between Stress and Suicidal Ideation for Old Adult Living Alone -Multiple Mediator Effects of Self-criticism and Feelings of Loneliness, and the Moderating Effects of Social Support -. ACTA ACUST UNITED AC 2014. [DOI: 10.20970/kasw.2014.66.1.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tsai KY, Chung TC, Lee CC, Chou YM, Su CY, Shen SP, Lin CH, Chou FHC. Is low individual socioeconomic status (SES) in high-SES areas the same as low individual SES in low-SES areas: a 10-year follow-up schizophrenia study. Soc Psychiatry Psychiatr Epidemiol 2014; 49:89-96. [PMID: 23728232 DOI: 10.1007/s00127-013-0716-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study investigates the relationship between individual and neighborhood socioeconomic status (SES) and mortality among patients with schizophrenia. METHODS A study population was identified from the National Health Insurance Research Database (NHIRD) prior to the end of 1999 that included 60,402 patients with schizophrenia. Each patient was tracked until death or to the end of 2009. Individual SESs were defined by enrollee category. Neighborhood SES was defined by enrollee category (as a proxy for occupation) and education, which were classified according to the conventions of Hollingshead. Neighborhoods were also grouped into advantaged and disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rate between the different SES groups after adjusting for possible confounding factors and risk factors. RESULTS During the 10-year follow-up period, the mortality rates among high, moderate, and low individual SES groups were 12.22, 14.75, and 18.48%, respectively (P < 0.001). Schizophrenia patients with low individual SESs in disadvantaged neighborhoods had a risk of death that was 18-22% higher than that of those with high individual SES in advantaged neighborhoods. The analysis of the combined effect of individual SES and neighborhood SES revealed that the death rates were highest among those with low individual SES and low neighborhood SES (P < 0.001). CONCLUSIONS Schizophrenia patients with low individual SES in disadvantaged neighborhoods have the highest risk of mortality despite a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.
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Affiliation(s)
- Kuan-Yi Tsai
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, 130, Kai-Syuan 2nd Rd, Lingya District, Kaohsiung City, Taiwan
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The association of socioeconomic status and access to low-volume service providers in breast cancer. PLoS One 2013; 8:e81801. [PMID: 24312589 PMCID: PMC3846901 DOI: 10.1371/journal.pone.0081801] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 10/16/2013] [Indexed: 11/27/2022] Open
Abstract
Background No large-scale study has explored the combined effect of patients’ individual and neighborhood socioeconomic status (SES) on their access to a low-volume provider for breast cancer surgery. The purpose of this study was to explore under a nationwide universal health insurance system whether breast cancer patients from a lower individual and neighborhood SES are disproportionately receiving breast cancer surgery from low-volume providers. Methods 5,750 patients who underwent breast cancer surgery in 2006 were identified from the Taiwan National Health Insurance Research Database. The Cox proportional hazards model was used to compare the access to a low-volume provider between the different individual and neighborhood SES groups after adjusting for possible confounding and risk factors. Hosmer-Lemeshow goodness-of-fit statistic was used to determine how well the model fit the data. Results Univariate analysis data shows that patients in disadvantaged neighborhood were more likely to receive breast cancer surgery at low-volume hospitals; and lower-SES patients were more likely to receive surgery from low-volume surgeons. In multivariate analysis, after adjusting for patient characteristics, the odds ratios of moderate- and low-SES patients in disadvantaged neighborhood receiving surgery at low-volume hospitals was 1.47 (95% confidence interval=1.19-1.81) and 1.31 (95% confidence interval=1.05-1.64) respectively compared with high-SES patients in advantaged neighborhood. Moderate- and low-SES patients from either advantaged or disadvantaged neighborhood had an odds ratios ranging from 1.51 to 1.80 (p<0.001) to receiving surgery from low-volume surgeons. In Hosmer-Lemeshow goodness-of-fit test, p>0.05 that shows the model has a good fit. Conclusions In this population-based cross-sectional study, even under a nationwide universal health insurance system, disparities in access to healthcare existed. Breast cancer patients from a lower individual and neighborhood SES are more likely to receive breast cancer surgery from low-volume providers. The authorities and public health policies should keep focusing on these vulnerable groups.
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Tsai AC, Chi SH, Wang JY. The association of perceived stress with depressive symptoms in older Taiwanese-Result of a longitudinal national cohort study. Prev Med 2013; 57:646-51. [PMID: 23988493 DOI: 10.1016/j.ypmed.2013.08.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 07/09/2013] [Accepted: 08/17/2013] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the impact of perceived-stress over one's own health, financial condition, job, and conflict with family members, and family members' problems on depressive symptoms in older adults. METHODS We analyzed datasets of the Taiwan Longitudinal Survey on Aging, and used self-reported stress in 2003 and 2007 to represent long-term stress conditions in 4854 ≥ 50-year old persons. The impact of long-term stress on depressive status (evaluated with CES-D10, score range 0-30) was determined with multivariate logistic regression analysis. Persons with proxy interviews, incomplete CES-D data, or cognitive impairment were excluded. RESULTS Perceived-health stress had stronger impacts on depressive symptoms than most other stress situations. Job-related stress showed no impact. Other stress situations showed modest associations in the middle-aged and young-olds. Ongoing stress had stronger impacts than past stress. Excluding health and job stresses, the impact generally decreased with aging. The association with clinically relevant depression generally followed that with depressive symptoms. CONCLUSION All perceived stresses are not equal in their impacts on subsequent depressive symptoms. Perceived-health stress has stronger impacts under most conditions. Better understanding of the associations of various stressors with depressive symptoms could enhance planning of effective strategies to reduce the risk of depression in older persons.
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Affiliation(s)
- Alan C Tsai
- Department of Healthcare Administration, Asia University, Wu-feng, Taichung, Taiwan; Center for Health Policy and Management Research, Asia University, Wu-feng, Taichung, Taiwan; Department of Health Services Management, School of Public Health, China Medical University, Taichung, Taiwan.
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Jeon GS, Jang SN, Kim DS, Cho SI. Widowhood and Depressive Symptoms Among Korean Elders: The Role of Social Ties. J Gerontol B Psychol Sci Soc Sci 2013; 68:963-73. [DOI: 10.1093/geronb/gbt084] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liu H, Xiao Q, Cai Y, Li S. The quality of life and mortality risk of elderly people in rural China: the role of family support. Asia Pac J Public Health 2013; 27:NP2232-45. [PMID: 23355053 DOI: 10.1177/1010539512472362] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The number of elderly in China's population is projected to grow well beyond the capacity of the nation's social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This article examines the short-term, mid-term, and long-term effects of family support on elderly well-being in rural China, using 4-wave panel data on 1456 persons aged 60 and older in the Chaohu region of China. Findings showed that compared with living alone, being coresident with others lowered the mortality risk of several chronic diseases, but being coresident with adult children increased the mortality risk of cardiovascular diseases, though it was associated with a higher quality of life in the short and middle terms. Children's educational attainment and financial support increased the quality of life except for an increased risk of new incidence of cardiovascular disease in the middle term.
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Wang H, Chen K, Pan Y, Jing F, Liu H. Associations and impact factors between living arrangements and functional disability among older Chinese adults. PLoS One 2013; 8:e53879. [PMID: 23342030 PMCID: PMC3544765 DOI: 10.1371/journal.pone.0053879] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 12/05/2012] [Indexed: 11/21/2022] Open
Abstract
Objectives To examine the association of living arrangements with functional disability among older persons and explore the mediation of impact factors on the relationship. Design Cross-sectional analysis using data from Healthy Aging study in Zhejiang Province. Participants Analyzed sample was drawn from a representative rural population of older persons in Wuyi County, Zhejiang Province, including 1542 participants aged 60 and over in the second wave of the study. Measurements Living arrangements, background, functional disability, self-rated health, number of diseases, along with contemporaneous circumstances including income, social support (physical assistance and emotional support). Instrument was Activities of Daily Living (ADL) scale, including Basic Activities Daily Living (BADL) and Instrumental Activities of Daily Living (IADL). Results Living arrangements were significantly associated with BADL, IADL and ADL disability. Married persons living with or without children were more advantaged on all three dimensions of functional disability. Unmarried older adults living with children only had the worst functional status, even after controlling for background, social support, income and health status variables (compared with the unmarried living alone, ß for BADL: −1.262, ß for IADL: −2.112, ß for ADL: −3.388; compared with the married living with children only, ß for BADL: −1.166, ß for IADL: −2.723, ß for ADL: −3.902). In addition, older adults without difficulty in receiving emotional support, in excellent health and with advanced age had significantly better BADL, IADL and ADL function. However, a statistically significant association between physical assistance and functional disability was not found. Conclusion Functional disabilities vary by living arrangements with different patterns and other factors. Our results highlight the association of unmarried elders living with children only and functioning decline comparing with other types. Our study implies policy makers should pay closer attention to unmarried elders living with children in community. Community service especially emotional support such as psychological counseling is important social support and should be improved.
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Affiliation(s)
- Hui Wang
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - Kun Chen
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China
- * E-mail:
| | - Yifeng Pan
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China
| | - Fangyuan Jing
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China
| | - He Liu
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China
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Lu LC, Hsieh PL. Frontline healthcare providers’ views of depression and its prevention in older adults. J Clin Nurs 2012; 22:1663-71. [DOI: 10.1111/j.1365-2702.2012.04276.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chang CM, Su YC, Lai NS, Huang KY, Chien SH, Chang YH, Lian WC, Hsu TW, Lee CC. The combined effect of individual and neighborhood socioeconomic status on cancer survival rates. PLoS One 2012; 7:e44325. [PMID: 22957007 PMCID: PMC3431308 DOI: 10.1371/journal.pone.0044325] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 08/01/2012] [Indexed: 01/22/2023] Open
Abstract
Background This population-based study investigated the relationship between individual and neighborhood socioeconomic status (SES) and mortality rates for major cancers in Taiwan. Methods A population-based follow-up study was conducted with 20,488 cancer patients diagnosed in 2002. Each patient was traced to death or for 5 years. The individual income-related insurance payment amount was used as a proxy measure of individual SES for patients. Neighborhood SES was defined by income, and neighborhoods were grouped as living in advantaged or disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rates between the different SES groups after adjusting for possible confounding and risk factors. Results After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence), tumor extent, treatment modalities (operation and adjuvant therapy), and hospital characteristics (ownership and teaching level), colorectal cancer, and head and neck cancer patients under 65 years old with low individual SES in disadvantaged neighborhoods conferred a 1.5 to 2-fold higher risk of mortality, compared with patients with high individual SES in advantaged neighborhoods. A cross-level interaction effect was found in lung cancer and breast cancer. Lung cancer and breast cancer patients less than 65 years old with low SES in advantaged neighborhoods carried the highest risk of mortality. Prostate cancer patients aged 65 and above with low SES in disadvantaged neighborhoods incurred the highest risk of mortality. There was no association between SES and mortality for cervical cancer and pancreatic cancer. Conclusions Our findings indicate that cancer patients with low individual SES have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.
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Affiliation(s)
- Chun-Ming Chang
- Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Yu-Chieh Su
- School of Medicine, Tzu Chi University, Hualian, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- Cancer Center, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | - Ning-Sheng Lai
- School of Medicine, Tzu Chi University, Hualian, Taiwan
- Division of Rheumatology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | - Kuang-Yung Huang
- School of Medicine, Tzu Chi University, Hualian, Taiwan
- Division of Rheumatology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | - Sou-Hsin Chien
- Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Yu-Han Chang
- Department of Medical Research, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | - Wei-Cheng Lian
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
| | - Ta-Wen Hsu
- Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Ching-Chih Lee
- School of Medicine, Tzu Chi University, Hualian, Taiwan
- Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- Center for Clinical Epidemiology and Biostatistics, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
- Community Medicine Research Center and the Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Leisure activity, mobility limitation and stress as modifiable risk factors for depressive symptoms in the elderly: Results of a national longitudinal study. Arch Gerontol Geriatr 2012; 54:e221-9. [DOI: 10.1016/j.archger.2011.06.014] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 06/12/2011] [Accepted: 06/13/2011] [Indexed: 01/25/2023]
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Li YP, Lin SI, Chen CH. Gender differences in the relationship of social activity and quality of life in community-dwelling Taiwanese elders. J Women Aging 2012; 23:305-20. [PMID: 22014220 DOI: 10.1080/08952841.2011.611052] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
This study explores the gender differences in the relationship between social activity and quality of life (QOL). A cross-sectional survey of 220 community-dwelling elderly people was conducted in southern Taiwan. Social activity was classified into six categories. The brief version of the World Health Organization QOL (WHOQOL-BREF) was used to measure QOL. Findings revealed that the associations of six types of social activities with QOL were weaker among women than men. The regression analyses further showed that for women, only religious activity was positively related to total QOL, while for men only involvement in formal group activity was positively related to total QOL.
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Affiliation(s)
- Yueh-Ping Li
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lee CC, Chien SH, Hung SK, Yang WZ, Su YC. Effect of individual and neighborhood socioeconomic status on oral cancer survival. Oral Oncol 2011; 48:253-61. [PMID: 22041306 DOI: 10.1016/j.oraloncology.2011.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 10/04/2011] [Accepted: 10/04/2011] [Indexed: 11/25/2022]
Abstract
This population-based study investigated the relationship between individual and neighborhood socioeconomic status (SES) and oral cancer mortality. A population-based follow-up study was conducted of 3607 oral cancer patients (predominantly male) who were diagnosed between 2004 and 2005. Each patient was traced to death or for 2 years. Individual SES was defined by enrollee category. Neighborhood SES was defined by income, and numbers of doctors, and neighborhoods were grouped into advantaged and disadvantaged areas. The Cox proportional hazards model was used to compare the death-free survival rate between the different SES groups after adjusting for possible confounding and risk factors. In oral cancer patients aged below 65 years, death rates among those with low SES were highest in disadvantaged neighborhoods. After adjusting for patient characteristics (age, gender, Charlson Comorbidity Index Score, urbanization, and area of residence), tumor extent, treatment modalities (operation, adjuvant therapy), hospital characteristics (ownership, teaching level, caseload), and year of diagnosis, oral cancer patients with low individual SES in disadvantaged neighborhoods conferred a 1.46- to 1.64-fold higher risk for death, compared with patients with high individual SES in advantaged neighborhoods. No statistically significant difference was found in risk of death between different SES groups in patients aged 65 and above. Our findings indicate that oral cancer patients with low individual SES have the highest risk of mortality even under a universal health-care system. Public health strategies and welfare policies must continue to focus on this vulnerable group.
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Affiliation(s)
- Ching-Chih Lee
- Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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Chiao CY, Schepp KG. The impact of foreign caregiving on depression among older people in Taiwan: model testing. J Adv Nurs 2011; 68:1090-9. [PMID: 21851382 DOI: 10.1111/j.1365-2648.2011.05814.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This article is a report of a study of predicting the factors that influence depression in the older people in Taiwan. Background. In 1991, Taiwan opened the labour market to foreign caregivers for the older people who needed long-term care. With the differences in language, culture and lifestyle between foreign caregivers and older people in Taiwan, it was hypothesized that the older people would not be able to relate to them, and therefore become depressed. METHODS The data were collected from 116 Taiwanese older people from July to September, 2005. Path analysis using multiple regression analyses was conducted to estimate the direct and indirect effects of caregiving communication, activities of daily living, income and social support on depression among older people in Taiwan. To evaluate the hypotheses for this research, bi-variate linear regression and multiple regression analyses were used. RESULTS/FINDINGS The results indicated that the level of activities of daily living (β = -0·201, P = 0·010), care-giving communication (β = -0·272, P = 0·002) income (β = -0·305, P = 0·000) and social support (β = -0·276, P = 0·002) were the predictors of depression in older people in Taiwan. Social support was a mediating factor for caregiving communication and depression. Furthermore, foreign caregiver care was not correlated with depression among older people in Taiwan. CONCLUSIONS The findings influence the public awareness of depression in older people, and provide the foundational information to influence the policy makers of Taiwan to evaluate the foreign caregiver policy.
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Affiliation(s)
- Chia-Yi Chiao
- College of Nursing, Chung-Shan Medical University, Taichung, Taiwan.
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Abstract
BACKGROUND Koreans typically work long hours. We herein analyze the relationship between the level of working hours and extent of stress complaints. METHODS We analyzed stress complaints with respect to hours worked per week, as reported by 7,075 subjects, using data from the 2006 First Korean Working Conditions Survey. Subjects were categorized as those working fewer than 40 hr per week (short working hours, SWH); those working 40-47 hr per week (intermediate working hours, IWH); those working 48-59 hr per week (long working hours, LWH); or those working at least 60 hr per week (very long working hours, VLWH). RESULTS Male subjects with IWH had an odds ratio (OR) of 0.74 for stress complaints compared to subjects with SWH (95% CI 0.53-1.04), whereas OR = 0.72 (95% CI 0.52-1.02) for stress complaints among females, comparing IWH and SWH. Males with LWH had OR = 1.15 (95% CI 0.82-1.60) for stress complaints compared to subjects with SWH, whereas the OR for females for stress complaints was 1.11 (95% CI 0.79-1.55). Male subjects with VLWH had OR = 1.72 (95% CI 1.24-2.41) for stress complaints compare to those with SWH, whereas for the female workers the OR was 1.35 (95% CI 0.93-1.98). CONCLUSION Among males, VLWH are associated with a significant increase in stress, compared with SWH.
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Affiliation(s)
- Jungsun Park
- Department of Occupational Health, Korea Occupational Safety and Health Agency, Inchon, South Korea.
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Chiang KJ, Chu H, Chang HJ, Chung MH, Chen CH, Chiou HY, Chou KR. The effects of reminiscence therapy on psychological well-being, depression, and loneliness among the institutionalized aged. Int J Geriatr Psychiatry 2010; 25:380-8. [PMID: 19697299 DOI: 10.1002/gps.2350] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To examine the effects of reminiscence therapy on psychological well-being, depression, and loneliness among institutionalized elderly people. METHODS In an experimental study design, 92 institutionalized elderly people aged 65 years and over were recruited and randomly assigned to two groups. Those participants in the experimental group received reminiscence therapy eight times during 2 months to examine the effects of this therapy on their psychological well-being. RESULTS After providing the reminiscence therapy to the elderly in the experimental group, a significant positive short-term effect (3 months follow-up) on depression, psychological well-being, and loneliness, as compared to those in the comparison group was found. CONCLUSIONS Reminiscence therapy in this study sample improved socialization, induced feelings of accomplishment in participants, and assisted to ameliorate depression.
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Affiliation(s)
- Kai-Jo Chiang
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
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Psychological Health of Primary Caregivers of Home-Based Older Adults With Dementia in India, Taiwan, and the United States. TOPICS IN GERIATRIC REHABILITATION 2010. [DOI: 10.1097/tgr.0b013e3181cd689e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hsu MC, Moyle W, Creedy D, Venturato L, Ouyang WC, Tsay SL. Use of antidepressants and complementary and alternative medicine among outpatients with depression in Taiwan. Arch Psychiatr Nurs 2009; 23:75-85. [PMID: 19216991 DOI: 10.1016/j.apnu.2008.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 01/24/2008] [Accepted: 03/29/2008] [Indexed: 10/21/2022]
Abstract
Understanding use of complementary and alternative medicine (CAM) and antidepressants during patient's recovery for depression is important to enhance their psychological functioning and promote positive health care outcomes. This study investigated the use of antidepressant treatment and CAM in outpatients with depression 1 month after discharge from psychiatric hospitalization. Telephone surveys were conducted. Of the 201 participants, 50.2% reported using CAM 1 month after discharge. Nearly 41% (n = 82) used a combination of both antidepressant treatment and CAM after hospital discharge. The most commonly used CAMs were spiritual healing, relaxation techniques, and herbal medicine. Symptom relief was the top reason participants used CAM for depression. A number of factors were associated with higher odds of using CAM. CAM is often considered as a valued component of holistic care plan after discharge. It is important for nurses to identify the CAM approaches patients are using so that this information can assist in the education of patients and family about the benefits of contemporary treatments for depression, possible interactions when combining treatments, and the CAM and conventional medicine that can be helpful to relieve depression symptoms and psychological distress.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, Taiwan, R.O.C
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Abstract
ABSTRACTThis paper reports a study of the risk factors for social and emotional loneliness among older people in Ireland. Using the ‘Social and Emotional Scale for Adults’, the social and emotional dimensions of loneliness were measured. Emotional loneliness was conceptualised as having elements of both family loneliness and romantic loneliness. The data were collected through a national telephone survey of loneliness in older people conducted in 2004 that completed interviews with 683 people aged 65 or more years. It was found that levels of social and family loneliness were low, but that romantic loneliness was relatively high. Predictors for social loneliness were identified as greater age, poorer health, living in a rural area, and lack of contact with friends. Living in a rural setting, gender (male), having a lower income, being widowed, no access to transport, infrequent contact with children and relatives and caring for a spouse or relative at home were significant predictors of family loneliness. Romantic loneliness was predicted by marital status, in particular being widowed. Never having married or being divorced or separated were also significant predictors for romantic loneliness. The findings indicate that loneliness for older people is variable, multi-dimensional and experienced differently according to life events, with, for example, the death of a partner being followed by the experience of emotional loneliness, or the loss of friends or declining health leading to social loneliness.
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Chen F, Short SE. Household Context and Subjective Well-Being Among the Oldest Old in China. JOURNAL OF FAMILY ISSUES 2008; 29:1379-1403. [PMID: 19554216 PMCID: PMC2701306 DOI: 10.1177/0192513x07313602] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This article investigates the importance of household context to subjective well-being among the oldest old (aged 80 years and older) in China. Using data from the Chinese Longitudinal Healthy Longevity Survey, the authors find that living arrangements have strong implications for elderly emotional health. First, living alone is associated with lower subjective well-being. Second, coresidence with immediate family (spouse or children) is associated with positive subjective well-being. Third, compared to living with a son, the traditionally dominant type of living arrangement, coresidence with a daughter appears positively linked to the emotional health of the oldest old. Results highlight the importance of family and cultural context to subjective well-being of the oldest old. They also suggest that the gendered nature of caregiving merits further attention in China and other patrilineal societies.
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Sicotte M, Alvarado BE, León EM, Zunzunegui MV. Social networks and depressive symptoms among elderly women and men in Havana, Cuba. Aging Ment Health 2008; 12:193-201. [PMID: 18389399 DOI: 10.1080/13607860701616358] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To examine the main and the stress-buffering effects of social networks on depressive symptoms among elderly Cuban men and women living in La Havana. METHOD Information was gathered from a representative sample of the elderly population in Havana (n = 1905), as part of the SABE (Salud, Bienestary Enuejecimiento) study. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. The structure and function of social networks were studied. Gender-specific multivariate logistic regressions were fitted to test the main (independent of stressors) and the stress-buffering effects (in the presence of financial strain or disabilities) on depressive symptoms. RESULTS Social ties were associated with a lower prevalence of depressive symptoms in women and men independently of the presence of stressors. Women who were or had been married, lived in an extended family, and enjoyed balanced exchanges with relatives and children reported low prevalence of depressive symptoms. Men were less likely to report depressive symptoms if they were currently married, and did not live alone. Social networks buffered the effect of financial strain on depression, but not in the event of disability. CONCLUSION In Cuba, networks centered on children and extended family were associated with low frequency of depressive symptoms, ruling contrary to common findings in developed societies. These living arrangements have an important role in buffering the impact of financial strain on depressive symptoms.
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Affiliation(s)
- Maryline Sicotte
- Groupe de Recherche Interdisciplinaire en Santé, Université de Montréal, Québec, Canada.
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Gersten O. Neuroendocrine biomarkers, social relations, and the cumulative costs of stress in Taiwan. Soc Sci Med 2007; 66:507-19; discussion 520-35. [PMID: 18022742 DOI: 10.1016/j.socscimed.2007.09.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Indexed: 11/19/2022]
Abstract
Allostatic load (AL) is thought to represent the physiological toll that builds up over the life course as a consequence of the body's response to stress. An important aim of this paper is to test this widely held-but little investigated-understanding of what AL represents. More specifically, using the Social Environment and Biomarkers of Aging Study (SEBAS), a nationally representative survey of Taiwan conducted in year 2000, this paper scrutinizes the connection between stressful life histories and neuroendocrine allostatic load (NAL). Stressful life histories are operationalized through the use of two sets of indicators: one set makes use of respondents' subjective interpretations of various life domains and the other makes use of non-subjective data about conditions that are expected to be stressful (e.g., widowhood, living alone, and low education). NAL is an index of four neuroendocrine biomarkers (cortisol, dehydroepiandrosterone sulfate (DHEAS), epinephrine, and norepinephrine) collected in blood and urine samples under resting, basal states. The major findings of this paper are twofold. First, there is little evidence to support the hypothesis that baseline levels of the neuroendocrine markers stem from stressful life histories. Second, report of current stress (among women only) is positively correlated with higher NAL levels. Taken together, these findings question whether the neuroendocrine markers of the AL construct reflect long-term processes over the life course. Indeed, evidence here suggests that the neuroendocrine markers may reflect the exact opposite-a transient state at the time of the study.
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Jeon GS, Jang SN, Rhee SJ, Kawachi I, Cho SI. Gender differences in correlates of mental health among elderly Koreans. J Gerontol B Psychol Sci Soc Sci 2007; 62:S323-9. [PMID: 17906176 DOI: 10.1093/geronb/62.5.s323] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE . This study examined the differential impact of social roles and socioeconomic resources on the mental health of Korean men and women aged 65 years or older. METHODS The study sample was a weighted population of 930 people (905 survey samples) aged 65 years or older who had responded to the health behavior survey of the 2001 Korean National Health and Nutrition Examination Survey. RESULTS We observed striking gender differences in the correlates of poor mental health. Living alone was significantly associated with depressive symptoms and suicidal ideation in men but not in women. Living in a multigenerational family without a spouse and having a lower household income were significantly associated with poor mental health in both men and women. DISCUSSION We discuss the intriguing evidence of gender differences in the correlates of mental health within the context of traditional Asian society and suggest further research on social components of gender differences in mental health across diverse cultures.
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Affiliation(s)
- Gyeong-Suk Jeon
- Graduate School of Public Health, Seoul National University, Jongno-gu, Seoul, Republic of Korea
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