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Oh JW, Gwon S, Lee S, Son NH. Association of social gatherings and physical exercise with depressive symptoms among middle-aged and older adults during the COVID-19 pandemic. J Psychiatr Res 2024; 178:23-32. [PMID: 39106580 DOI: 10.1016/j.jpsychires.2024.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/28/2024] [Accepted: 07/31/2024] [Indexed: 08/09/2024]
Abstract
Strict social isolation and physical distancing measures implemented during the COVID-19 pandemic had significant implications for the psychological well-being of middle-aged and older adults. This study aimed to investigate factors associated with depressive symptoms during the pandemic period among individuals who reported no significant depressive symptoms before the pandemic. Individuals from the Korean Longitudinal Study of Aging without a previous report of significant depressive symptoms across Waves 6 (2016) and 7 (2018) were investigated for the development of depressive symptoms in Wave 8 (2020). The multivariable logistic regression results revealed that both men and women who participated in social gatherings and physical exercise less than once a week were associated with an increase in the likelihood of depressive symptoms (odds ratio [OR] 2.88; 95% confidence interval [CI] 1.80-4.61 and OR 2.61; 95% CI 1.64-4.15, respectively for men and OR 2.58; 95% CI 1.80-3.70 and OR 1.51; 95% CI 1.02-2.23, respectively for women). In addition, unmarried men (OR 2.38; 95% CI 1.37-4.14) and women with one chronic disease (OR 1.98; 95% CI 1.14-3.43) or two or more chronic diseases (OR 2.28; 95% CI 1.31-3.99) reported a significant increase in the likelihood of depressive symptoms. Regular social gatherings and physical exercise were identified as key factors in mitigating depressive symptoms among middle-aged and older adults. The findings can inform the development of public health strategies that promote regular social interactions and physical activity to enhance the psychological resilience and overall well-being of middle-aged and older adults in the endemic era.
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Affiliation(s)
- Jae Won Oh
- Department of Psychology, The University of Utah Asia Campus, Incheon, Republic of Korea
| | - Sohyeon Gwon
- Department of Statistics, Keimyung University, Daegu, Republic of Korea
| | - San Lee
- Department of Psychiatry and the Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Nak-Hoon Son
- Department of Statistics, Keimyung University, Daegu, Republic of Korea.
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Horgan S, Prorok J, Ellis K, Mullaly L, Cassidy KL, Seitz D, Checkland C. Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:664. [PMID: 38928911 PMCID: PMC11203904 DOI: 10.3390/ijerph21060664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024]
Abstract
This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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Affiliation(s)
- Salinda Horgan
- Departments of Rehabilitation Therapy & Psychiatry, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Jeanette Prorok
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Katie Ellis
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Laura Mullaly
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Keri-Leigh Cassidy
- Department of Psychiatry, Dalhousie University, Dalhousie, NS B3H 2E2, Canada;
| | - Dallas Seitz
- Departments of Psychiatry & Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Claire Checkland
- Canadian Coalition for Seniors’ Mental Health, Markham, ON L3R 9X9, Canada;
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Krahé C, Brown C, Twiddy H, Frank B, Brian E, Nurmikko T, Stancak A, Fallon N. Effects of Lockdown Restrictions and Impact of Anxiety and Depression Symptoms in People With Chronic Pain During the Covid-19 Pandemic: A 13-Wave Longitudinal Study. THE JOURNAL OF PAIN 2024; 25:104437. [PMID: 38029948 DOI: 10.1016/j.jpain.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
In early 2020, countries across the world imposed lockdown restrictions to curb the spread of the Covid-19 coronavirus. Lockdown conditions, including social and physical distancing measures and recommended self-isolation for clinically vulnerable groups, were proposed to disproportionately affect those living with chronic pain, who already report reduced access to social support and increased isolation. Yet, empirical evidence from longitudinal studies tracking the effects of prolonged and fluctuating lockdown conditions, and potential psychological factors mediating the effects of such restrictions on outcomes in chronic pain populations, is lacking. Accordingly, in the present 13-wave longitudinal study, we surveyed pain intensity, pain interference, and tiredness in people with chronic pain over the course of 11 months of the Covid-19 pandemic (April 2020-March 2021). Of N = 431 participants at baseline, average completion rate was ∼50% of time points, and all available data points were included in linear mixed models. We examined the impact of varying levels of lockdown restrictions on these outcomes and investigated whether psychological distress levels mediated effects. We found that a full national lockdown was related to greater pain intensity, and these effects were partially mediated by depressive symptoms. No effects of lockdown level were found for pain interference and tiredness, which were instead predicted by higher levels of depression, anxiety, pain catastrophising, and reduced exercise. Our findings are relevant for improving patient care in current and future crises. Offering remote management options for low mood could be particularly beneficial for this vulnerable population in the event of future implementation of lockdown restrictions. PERSPECTIVE: This longitudinal study demonstrates the impact of Covid-19 lockdown restrictions on people with chronic pain. Findings suggest a complex interaction of psychosocial factors that impacted various aspects of pain experience in patients, which offer the potential to inform clinical strategies for remote medicine and future crises.
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Affiliation(s)
- Charlotte Krahé
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Christopher Brown
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Hannah Twiddy
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Bernhard Frank
- Department of Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Eleanor Brian
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Turo Nurmikko
- Department of Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Andrej Stancak
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Nicholas Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
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Elena MG, Pablo MA. Sociocultural interactions and self-perception of health in older adults from an active participation centre: A qualitative study. Geriatr Nurs 2024; 57:73-79. [PMID: 38598906 DOI: 10.1016/j.gerinurse.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/04/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Promoting healthy ageing is a global priority. Active Participation Centres are potentially key in fostering psychosocial and emotional health, contributing to a fulfilling and active lifestyle for older adults. AIMS The study explores self-perceived health, perceptions of sociocultural participation, emotions that emerged when sociocultural participation, and preferences among older adults engaged in community socio-cultural activities from an Active Participation Centre. METHODS We realised a hermeneutic study; interviews with nine older participants were conducted. Hermeneutic considerations were employed for data analysis. RESULTS Findings reveal the centre's significance as a therapeutic space, positively influencing emotional well-being, fostering social connections, and offering diverse activity preferences. CONCLUSION This study underscores the nuanced interplay between sociocultural engagement and self-perceived health, emphasising the need for holistic approaches to promote well-being among older adults attending Active Participation Centres.
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Affiliation(s)
- Marín-García Elena
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Andalucía, Spain
| | - Martínez-Angulo Pablo
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Andalucía, Spain; Research Group HUM 380 ("Interdisciplinary Research in Discourse Analysis"), Spain.
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Zhang L. Middle-aged and older adults in Aids village: a mixed methods study on talking about death and well-being promotion based on social support theory. Front Psychol 2024; 15:1363047. [PMID: 38572204 PMCID: PMC10987812 DOI: 10.3389/fpsyg.2024.1363047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Will about talking about death bring well-being? This study aims to explore the impact of talking about death on the subjective well-being of the rural middle-aged and older adults in China's "Aids village" from five dimensions: the way of talking about death, the attitude towards talking about death, the objects of talking about death with, the frequency of talking about death and the content of the death talk, and investigate whether social support played a mediating role during this process. Methods A field survey and in-depth interviews were conducted in Wen Lou village (a famous Chinese "Aids village"), and valid questionnaires were completed by the HIV/Aids-affected middle-aged and older adults. A series of linear regression analyses were conducted to detect whether the way of talking about death, the attitude towards talking about death, the objects of talking about death with, the frequency of talking about death and the content of the death talk predict the subjective well-being of the HIV/Aids-affected middle-aged and older adults. An empirical test for mediation effect was performed to examine whether social support played a mediating role during the process. Results It was found that the more frequent the middle-aged and older adults talk about death, the higher level of their subjective well-being is (ΔR2 = 0.056, 0.05 < p < 0.10), and during which process social support played a mediating role. Discussion The author believes that using "talking about death" as a kind of medical intervention, carrying out corresponding life education and death education, and developing a suitable hospice care model, may be a valuable way for the HIV/Aids-affected middle-aged and older adults in the rural area.
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Affiliation(s)
- Lin Zhang
- Department of Journalism and Communication, Shanghai University, Shanghai, China
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Lu Q, Qu L, Xie C, Shu Y, Gao F, Zou M, Fan X, Luo X, Meng J, Xue Y, Cao Y. Relationship between social isolation and glycaemic control of people previously diagnosed with diabetes: secondary analysis from the CHARLS. BMJ Open 2024; 14:e076106. [PMID: 38508640 PMCID: PMC10953297 DOI: 10.1136/bmjopen-2023-076106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 01/29/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES Social isolation may affect diabetes self-management. This study aimed to explore the relations between social isolation and glycaemic control in patients with diabetes and to explore lifestyle differences among individuals with different levels of social isolation. METHODS The relevant data of 665 people previously diagnosed with diabetes included in the China Health and Retirement Longitudinal Study from 2011 to 2015 were extracted and analysed. The study included patient general information, blood glucose, lipids, glycosylated haemoglobin, social isolation index, health-related lifestyle factors and diabetes-related factors. Differences in metabolic abnormalities and modifiable lifestyles were compared among patients with varying levels of social isolation. RESULTS Multiple linear regression analysis demonstrated that among men aged 45-64 years, the high social isolation group had significantly higher glycosylated haemoglobin levels compared with the low isolation group (7.29±1.81 vs 6.59±1.63, p=0.026). A positive correlation was observed between social isolation and blood glucose (β=14.16; 95% CI 2.75 to 25.57; p=0.015) and glycosylated haemoglobin (β=0.35; 95% CI 0.10 to 0.60; p=0.006), indicating that higher social isolation was associated with higher fasting blood glucose and glycosylated haemoglobin levels. However, no significant associations were observed in other age groups. Notably, men aged 45-65 years with high social isolation had higher depression rates (44.10% vs 24.60%, p=0.024), lower engagement in moderate exercise (5.70% vs 23.50%, p=0.019) and shorter 10-minute walks (17.10% vs 36.80%, p=0.027). Differences in other health-related and diabetes-related factors were not statistically significant. CONCLUSION Middle-aged men with diabetes with higher social isolation tend to have higher blood glucose and glycosylated haemoglobin levels. This subset of patients requires targeted attention to provide social support from family and friends for improved glycaemic control. If necessary, education on diabetes should be made available to family members and friends.
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Affiliation(s)
- Qiuping Lu
- Department of Endocrinology, The Sixth Affiliated Hospital ,School of Medicine, South China University of Technology, Foshan City, Guangdong, China
| | - Liyuan Qu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Cuihua Xie
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi Shu
- Department of Endocrinology, The Sixth Affiliated Hospital ,School of Medicine, South China University of Technology, Foshan City, Guangdong, China
| | - Fang Gao
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Mengchen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinzhao Fan
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiangrong Luo
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianfu Meng
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaoming Xue
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Cao
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Bae Y, Pachucki MC. Social isolation and depression as risk factors for weight loss of 5kg or more among older Korean adults. PLoS One 2024; 19:e0299096. [PMID: 38478536 PMCID: PMC10936863 DOI: 10.1371/journal.pone.0299096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
Given a well-known overlapping prevalence of social isolation with loneliness and depression among older adults, this study aimed to contextually investigate the relationship of these constructs with weight loss of more than 5kg in a year, with a special focus on the intersection of living alone and marital dissolution as key dimensions of isolation. The data were obtained from the Korean Longitudinal Study of Aging (KLoSA) from 2006, 2008, 2010, 2012, 2014, 2016, and 2018, with an adult sample of those aged 65 and older (n = 5,481). The study evaluated several critical dimensions of social isolation: living alone, transition to living alone, infrequent social contact with children or friends, and infrequent social participation. These dimensions were examined individually and as a composite scale, along with loneliness and depressive symptoms, to determine their association with weight loss of 5kg or greater among older men and women. Generalized Estimating Equation (GEE) regression models enabled investigation of whether socially isolated men and women tended to lose 5kg or more in weight, given other confounding factors. Surprisingly, the results showed no evidence of such a trend. However, significant associations were found between weight loss and changes in living alone and marital status. For older men, transitioning to living alone without a change in marital status was linked to significant weight loss. For older women, transitioning to living alone following widowhood or divorce was the risk factor. These relationships remained significant even after adjusting for depression and a wide range of covariates. Additional analysis testing a cumulative effect revealed that only depression was a risk factor for being underweight at the last observation. Therefore, to prevent a clinically risky extent of weight loss, health policies for older Koreans should focus on those who transition to living alone, especially due to spousal bereavement or divorce (among women) and separation from living with children (among men).
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Affiliation(s)
- Youngjoon Bae
- Center on Aging and Population Sciences, The University of Texas at Austin, Austin, Texas, United States of America
| | - Mark C. Pachucki
- Department of Sociology, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
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Yang JM, Kim JH, Hwang JE. Effect of intensity of persistent social isolation on mental health in the late middle-aged and older population: results of the Korea Longitudinal Study of Ageing (2006-2020). Psychogeriatrics 2024; 24:391-403. [PMID: 38339804 DOI: 10.1111/psyg.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Social isolation (SI) was recently identified as a significant public health issue in the United States. Consequently, several studies on the association between SI and mental health were conducted. However, few studies have considered the duration and intensity of SI. In the present study, a longitudinal analysis was conducted to determine the effect of the intensity of persistent SI on the mental health status of late middle-aged and older Koreans. METHODS After excluding missing values, data on 6200 participants were analyzed using the group-based trajectory model (GBTM) from the first to fifth Korean Longitudinal Study of Ageing (KLoSA) to categorise the SI trajectory (SIT). The Chi-square test, t-test, analysis of variance, and time-lagged generalised estimation equations were utilised from the fifth to eighth KLoSA to determine the association between SIT and the incidence of cognitive decline (the group with a Korean version Mini-Mental State Examination score of 23 or lower), cognitive function score, and depression score. RESULTS Four SIT groups were identified in the GBTM analysis. These were the non-SIT (21.7%), mild (46.8%), moderate (21.1%), and severe SIT (10.4%) groups. Compared to the non-SIT group, the severe SIT group experienced a greater incidence of cognitive decline (odds ratio = 1.57, P < 0.0001) as well as poorer cognitive function scores (B = -0.63, P < 0.0001) and depression scores (B = 0.90, P < 0.0001). Furthermore, stratified analysis by sex and age showed that mental health status was inversely proportionate to the intensity of SIT, particularly in males and patients, aged 65 years and above. CONCLUSION A close association was observed between SIT and mental health. This finding highlighted the need for policies and institutional measures to reduce the incidence of mental health deterioration among vulnerable groups due to the intensity of SI.
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Affiliation(s)
- Jeong Min Yang
- Department of Public Health, General Graduate School of Dankook University, Cheonan, Republic of Korea
| | - Jae Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
| | - Ji Eun Hwang
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
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Ford SD, Nagamatsu LS. Four weeks of meditation training improves sustained attention in community-dwelling older adults: a proof-of-concept randomized controlled trial. FRONTIERS IN AGING 2024; 5:1322705. [PMID: 38496316 PMCID: PMC10940317 DOI: 10.3389/fragi.2024.1322705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/05/2024] [Indexed: 03/19/2024]
Abstract
Introduction: With our rapidly expanding population of older adults, identifying effective intervention strategies to improve cognitive functioning is an increasing priority. This study sought to examine whether 4 weeks of thrice-weekly meditation training can improve attention in older adults, as well as whether such benefits may extend to other domains of cognition as well as mobility. Methods: Forty-three participants (mean age 68 years) were randomized into either the focused attention meditation group or the music listening control group (Clinicaltrials.gov ID NCT03417635). Participants completed three 20-minute guided group sessions per week for four consecutive weeks. Our primary outcome measure was behavioural performance on the Sustained Attention to Response Task (SART). Secondary and tertiary outcome measures included event-related potentials (ERPs) during the SART task, measures of executive functioning, and measures of mobility. Results: We found that meditation training significantly improved attention, as demonstrated by improved SART accuracy and changes in N2 ERP amplitude and latency. Discussion: These findings suggest that meditation may lead to changes in attention and underlying cognitive processing in older adults, although a full-scale definitive trial is needed. Future research on the long-term benefits with real world applications is warranted.
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Affiliation(s)
- Sabrina D. Ford
- Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Segovia MS, Huseynov S, Palma MA, Nayga RM. The mental burden of stay-at-home order extensions during COVID-19. Sci Rep 2024; 14:4293. [PMID: 38383527 PMCID: PMC10881574 DOI: 10.1038/s41598-024-54059-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024] Open
Abstract
This study evaluates the psychological impact of stay-at-home extension orders during COVID-19 and its relationship with individuals' expectations on the duration of the extensions. An online survey was administered to 1259 US adult residents to measure symptoms of post-traumatic stress disorder (PTSD), anxiety and stress induced by different stay-at-home order extensions using hypothetical length scenarios. We find that individuals exposed to two 2-week order extensions exhibit higher levels of stress and anxiety compared to those exposed to a single 4-week extension. We also find that subjects with longer expected extensions exhibit more signs of psychological damage than those with shorter expected extensions. Furthermore, we find that the negative psychological consequences of providing two shorter extensions is observed only among subjects with extension expectations of four weeks or less. Our results demonstrate that people's expectations affect the level of psychological damage caused by lockdown mandates. Our findings suggest that whenever lockdown extensions are necessary, reduced psychological distress may be possible by implementing a one-time restriction, rather than extending multiple smaller extensions perhaps due to manipulation of personal expectations.
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Affiliation(s)
- Michelle S Segovia
- Department of Applied Economics and Statistics, University of Delaware, 204 Townsend Hall, Newark, DE, 19716, USA.
| | - Samir Huseynov
- Department of Agricultural Economics and Rural Sociology, Auburn University, 202 Comer Hall, Auburn, AL, 36849, USA
| | - Marco A Palma
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX, 77843, USA
| | - Rodolfo M Nayga
- Department of Agricultural Economics, Texas A&M University, 2124 TAMU, College Station, TX, 77843, USA
- Korea University, Seoul, South Korea
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Gilbody S, Littlewood E, McMillan D, Atha L, Bailey D, Baird K, Brady S, Burke L, Chew-Graham CA, Coventry P, Crosland S, Fairhurst C, Henry A, Hollingsworth K, Newbronner E, Ryde E, Shearsmith L, Wang HI, Webster J, Woodhouse R, Clegg A, Dexter-Smith S, Gentry T, Hewitt C, Hill A, Lovell K, Sloan C, Traviss-Turner G, Pratt S, Ekers D. Behavioural activation to mitigate the psychological impacts of COVID-19 restrictions on older people in England and Wales (BASIL+): a pragmatic randomised controlled trial. THE LANCET. HEALTHY LONGEVITY 2024; 5:e97-e107. [PMID: 38310902 PMCID: PMC10834375 DOI: 10.1016/s2666-7568(23)00238-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Older adults were more likely to be socially isolated during the COVID-19 pandemic, with increased risk of depression and loneliness. We aimed to investigate whether a behavioural activation intervention delivered via telephone could mitigate depression and loneliness in at-risk older people during the COVID-19 pandemic. METHODS BASIL+ (Behavioural Activation in Social Isolation) was a pragmatic randomised controlled trial conducted among patients recruited from general practices in England and Wales, and was designed to assess the effectiveness of behavioural activation in mitigating depression and loneliness among older people during the COVID-19 pandemic. Eligible participants were aged 65 years and older, socially isolated, with a score of 5 or higher on the Patient Health Questionnaire-9 (PHQ-9), and had multiple long-term conditions. Participants were allocated in a 1:1 ratio to the intervention (behavioural activation) or control groups by use of simple randomisation without stratification. Behavioural activation was delivered by telephone; participants were offered up to eight weekly sessions with trained BASIL+ Support Workers. Behavioural activation was adapted to maintain social connections and encourage socially reinforcing activities. Participants in the control group received usual care with existing COVID-19 wellbeing resources. The primary clinical outcome was self-reported depression severity, assessed by the PHQ-9, at 3 months. Outcomes were assessed masked to allocation and analysis was by treatment allocation. This trial is registered with the ISRCTN registry (ISRCTN63034289). FINDINGS Between Feb 8, 2021, and Feb 28, 2022, 449 eligible participants were identified and 435 from 26 general practices were recruited and randomly assigned (1:1) to the behavioural activation intervention (n=218) or to the control group (usual care with signposting; n=217). The mean age of participants was 75·7 years (SD 6·7); 270 (62·1%) of 435 participants were female, and 418 (96·1%) were White. Participants in the intervention group attended an average of 5·2 (SD 2·9) of eight remote behavioural activation sessions. The adjusted mean difference in PHQ-9 scores between the control and intervention groups at 3 months was -1·65 (95% CI -2·54 to -0·75, p=0·0003). No adverse events were reported that were attributable to the behavioural activation intervention. INTERPRETATION Behavioural activation is an effective and potentially scalable intervention that can reduce symptoms of depression and emotional loneliness in at-risk groups in the short term. The findings of this trial add to the range of strategies to improve the mental health of older adults with multiple long-term conditions. These results can be helpful to policy makers beyond the pandemic in reducing the global burden of depression and addressing the health impacts of loneliness, particularly in at-risk groups. FUNDING UK National Institute for Health and Care Research.
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Affiliation(s)
- Simon Gilbody
- Department of Health Sciences, University of York, York, UK; Hull York Medical School, University of York, York, UK.
| | - Elizabeth Littlewood
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | - Dean McMillan
- Department of Health Sciences, University of York, York, UK; Hull York Medical School, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | - Lucy Atha
- Department of Health Sciences, University of York, York, UK
| | - Della Bailey
- Department of Health Sciences, University of York, York, UK
| | - Kalpita Baird
- Department of Health Sciences, University of York, York, UK
| | - Samantha Brady
- Department of Health Sciences, University of York, York, UK
| | - Lauren Burke
- Department of Health Sciences, University of York, York, UK
| | | | - Peter Coventry
- Department of Health Sciences, University of York, York, UK; York Environmental Sustainability Institute, University of York, York, UK
| | | | | | - Andrew Henry
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | - Kelly Hollingsworth
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | | | - Eloise Ryde
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | | | - Han-I Wang
- Department of Health Sciences, University of York, York, UK
| | | | | | - Andrew Clegg
- School of Medicine, University of Leeds, Leeds, UK
| | - Sarah Dexter-Smith
- Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
| | | | | | - Andrew Hill
- School of Medicine, University of Leeds, Leeds, UK
| | - Karina Lovell
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Claire Sloan
- Department of Health Sciences, University of York, York, UK
| | | | | | - David Ekers
- Department of Health Sciences, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, Research & Development, Flatts Lane Centre, Middlesbrough, UK
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Haynes A, Tiedemann A, Hewton G, Chenery J, Sherrington C, Merom D, Gilchrist H. "It doesn't feel like exercise": a realist process evaluation of factors that support long-term attendance at dance classes designed for healthy ageing. Front Public Health 2023; 11:1284272. [PMID: 38192566 PMCID: PMC10773813 DOI: 10.3389/fpubh.2023.1284272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Dance can positively impact older people's health and wellbeing across cultures and socioeconomic groups, countering age-related physical, sensorimotor and cognitive decline. Background/objectives The RIPE (Really Is Possible for Everyone) Dance program aims to improve older people's physical, mental, cognitive and social wellbeing by integrating engaging dance sequences with evidence-based fall prevention exercises. We sought to identify what mechanisms support observed long-term participation in this program, including by people living with challenging health conditions. Methods Following a realist evaluation approach, we co-developed and tested program theories iteratively with participant interviewees (n = 20), dance teachers (n = 2) and via observation of a dance class. Initial data were dual-coded and emergent findings were interrogated by the research team. Findings were organised to express Program activities + Context + Mechanism = Process outcomes configurations. Results We identified four program theories comprising 14 mechanisms which explained long-term attendance: 1. RIPE Dance benefits my body and mind (trust in the program, belief in health benefits), 2. RIPE Dance helps me feel good about myself (self-efficacy, pride in achievement, psychological safety, defying expectations, feeling valued), 3. RIPE Dance creates camaraderie (social connection, mutual support, rapport with the teacher), and 4. RIPE Dance is uplifting (raised spirits, fun, synchrony, musical reactivity). Conclusion The RIPE Dance program provides effective and enjoyable 'exercise in disguise' for older people with diverse mobility profiles. Significance/implications This research confirms that participation in dance can contribute significantly to healthy, happy ageing. Findings detail program activities that were most strongly associated with process outcomes, offering guidance for further program development, implementation and scaling up.
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Affiliation(s)
- Abby Haynes
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Anne Tiedemann
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Gail Hewton
- Gold Moves Australia and RIPE Dance, Noosa, QLD, Australia
| | | | - Catherine Sherrington
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Dafna Merom
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Heidi Gilchrist
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
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Gerhards SK, Pabst A, Luppa M, Riedel-Heller SG. Depressive and anxiety symptoms during the COVID-19 pandemic in the oldest-old population and the role of psychosocial factors: a multivariate and multi-wave analysis. Front Public Health 2023; 11:1229496. [PMID: 38192565 PMCID: PMC10773748 DOI: 10.3389/fpubh.2023.1229496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024] Open
Abstract
Background Since the oldest-old population was identified as a high-risk group for a severe course of the coronavirus disease and higher mortality, it was assumed that they might be particularly psychologically burdened. The aim of the study is to analyze the development of anxiety and depressive symptoms over the course of the pandemic from 2020 to 2022, as well as psychosocial factors associated with these outcomes. Method We analyzed data of n = 135 participants aged 78 to 97 years old (2020: M = 86.77, SD = 4.54) with three points of measurement from May to June 2020 (t1), March to May 2021 (t2) and November to January 2022 (t3). Besides sociodemographic variables, worries about the Sars-Cov-2 virus, living situation, perceived social support (ESSI), resilience (BRS), anxiety and depressive symptoms (BSI-18) were assessed. We calculated multilevel mixed-effects generalized linear models with a negative binominal distribution to model anxiety and depressive symptoms over time. Results While there is an increase in depressive and anxiety symptoms in the investigated oldest-old individuals in Germany from 2020 to 2021, there is no further increase in symptomatology from 2021 to 2022. Participants of older age reported higher levels of anxiety symptoms. Higher perceived social support was associated with both less depressive and less anxiety symptoms, while resilience was associated with less depressive symptoms only. More worries about the Sars-Cov-2 virus were associated with higher anxiety levels. Conclusion Overall, the oldest-old population appeared to show rather stable mental health after a slight increase in symptomatology within the first year of the pandemic. Social support is an important factor to target in mental health prevention programs for oldest-old individuals in times of future crises such as a pandemic.
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Affiliation(s)
- Sina K. Gerhards
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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Soundararajan A, Lim JX, Ngiam NHW, Tey AJY, Tang AKW, Lim HA, Yow KS, Cheng LJ, Ho J, Nigel Teo QX, Yee WQ, Yoon S, Low LL, Ng KYY. Smartphone ownership, digital literacy, and the mediating role of social connectedness and loneliness in improving the wellbeing of community-dwelling older adults of low socio-economic status in Singapore. PLoS One 2023; 18:e0290557. [PMID: 37647263 PMCID: PMC10468072 DOI: 10.1371/journal.pone.0290557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, safe-distancing measures resulted in many community-dwelling older adults being socially isolated and lonely, with its attending negative impact on wellbeing and quality of life. While digital technology may have mitigated this, older adults of low socioeconomic status (SES) are more likely to be digitally excluded and hence susceptible to the adverse effects of social isolation and loneliness. This study aims to understand the factors that affect digital literacy, smartphone ownership, and willingness to participate in a digital literacy program (DLP), and to test the hypothesized relations between digital literacy, social connectedness, loneliness, wellbeing, and quality of life amongst community dwelling older adults of low SES. MATERIALS AND METHODS A questionnaire assessing digital literacy, social connectedness, wellbeing and quality of life was administered. Socio-demographic variables, pre-existing internet-enabled, and willingness to participate in a home-based DLP was also collected. Logistic regression was used to identify demographic factors associated with digital literacy, smartphone ownership, and willingness to enroll in a DLP. Serial mediation analysis was also performed using a structural equation model framework. RESULTS A total of 302 participants were recruited. Female gender, older age, lower education levels were associated with lower digital literacy. Those who owned a smartphone tended to be younger and better educated. Older adults who were better educated, of Chinese descent (the ethnic majority in Singapore), and who had lower digital literacy, were most willing to enroll in the digital literacy education program. Social-use digital literacy had a positive indirect effect on well-being ([Formula: see text]) and Quality of life ([Formula: see text]), mediated by social connectedness and loneliness. In contrast, instrumental-use digital literacy had a negative indirect effect on well-being ([Formula: see text]) and Quality of life ([Formula: see text]), mediated by social connectedness and loneliness. DISCUSSION The results suggest there are demographic barriers to participation in DLPs and highlight the benefit of focusing on enhancing social-use digital literacy. Further study is needed to evaluate how well specific interventions to improve social-use digital literacy help to reduce social isolation and loneliness, and ultimately improve wellbeing and quality of life.
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Affiliation(s)
- Amrish Soundararajan
- TriGen, Singapore, Singapore
- Department of Family Medicine, National University Health System (NUHS), Singapore, Singapore
| | - Jie Xin Lim
- TriGen, Singapore, Singapore
- Wee Kim Kee School of Communication and Information, Nanyang Technological University, Singapore, Singapore
| | - Nerice Heng Wen Ngiam
- TriGen, Singapore, Singapore
- Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Angeline Jie-Yin Tey
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Department of Respiratory Care & Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Aaron Kai Wen Tang
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Haikel A. Lim
- TriGen, Singapore, Singapore
- Department of Psychiatry, National Health Group, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Ka Shing Yow
- TriGen, Singapore, Singapore
- Department of Internal Medicine, National University Health System, Singapore, Singapore
| | - Ling Jie Cheng
- TriGen, Singapore, Singapore
- Health Systems and Behavioral Sciences Domain, Saw See Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jess Ho
- NTUC Health Co-operative Ltd, Singapore, Singapore
| | - Qun Xuan Nigel Teo
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Wan Qi Yee
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
| | - Lian Leng Low
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Centre for Population Health Research and Implementation, Singapore Health Services, Singapore, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- TriGen, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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15
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Zhang Y, Luo A, Hou L, Chen S, Zhang W, Schwartz A, Clouston SAP. Crisis response during the COVID-19 pandemic: Changes in social contact and social participation of older Americans. PLoS One 2023; 18:e0284935. [PMID: 37498870 PMCID: PMC10374158 DOI: 10.1371/journal.pone.0284935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/11/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE This study aimed to assess changes in social contact with family, friends and healthcare providers, as well as social participation in working, volunteering, religious services and other organized activities, among older adults during the COVID-19 pandemic while examining the role of pre-COVID sociodemographic characteristics or cognitive and physical limitations in changes in social contact and participation. METHODS We conducted secondary data analyses in the National Health and Aging Trends Study (NHATS) COVID-19 questionnaire, collected in 2020 during a period of workplace closures and social distancing guidelines. We linked data to pre-COVID sociodemographic and medical information collected in 2019 before COVID interrupted social life. The frequency of participants' social contact and social participation prior to and during the COVID-19 pandemic, were compared using paired t-tests for summed scores. Multivariate linear regression was used to relate participants' socio-demographic, prior physical and cognitive performance with levels of social contact and participation and with changes reported during the COVID-19 pandemic. RESULTS In total, results from 2,486 eligible participants revealed that COVID-19 was associated with decreased social contact among family and friends (change: -0.62; SE: 0.06; p<0.0001), and social participation among older adults (change: -0.58; SE: 0.02; p<0.0001). Pre-COVID characteristics including older age, lower educational attainment, poorer physical performance, and more chronic conditions were associated with lower social contact and social participation and with how older adults adapted their social lives during the COVID-19 pandemic. DISCUSSION These results emphasize the importance of increasing digital inclusion for older adults in a major crisis.
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Affiliation(s)
- Yun Zhang
- Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
- Pediatric Cardiovascular Clinical Research Core, Pediatric Heart Center, Columbia University Vagelos College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York-Presbyterian, New York, New York, United States of America
| | - Amber Luo
- Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Luke Hou
- Ward Melville High School, Stony Brook, New York, United States of America
| | - Shanquan Chen
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Wei Zhang
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Andrew Schwartz
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Sean A P Clouston
- Program in Public Health and Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
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Eather N, Wade L, Pankowiak A, Eime R. The impact of sports participation on mental health and social outcomes in adults: a systematic review and the 'Mental Health through Sport' conceptual model. Syst Rev 2023; 12:102. [PMID: 37344901 DOI: 10.1186/s13643-023-02264-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/31/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Sport is a subset of physical activity that can be particularly beneficial for short-and-long-term physical and mental health, and social outcomes in adults. This study presents the results of an updated systematic review of the mental health and social outcomes of community and elite-level sport participation for adults. The findings have informed the development of the 'Mental Health through Sport' conceptual model for adults. METHODS Nine electronic databases were searched, with studies published between 2012 and March 2020 screened for inclusion. Eligible qualitative and quantitative studies reported on the relationship between sport participation and mental health and/or social outcomes in adult populations. Risk of bias (ROB) was determined using the Quality Assessment Tool (quantitative studies) or Critical Appraisal Skills Programme (qualitative studies). RESULTS The search strategy located 8528 articles, of which, 29 involving adults 18-84 years were included for analysis. Data was extracted for demographics, methodology, and study outcomes, and results presented according to study design. The evidence indicates that participation in sport (community and elite) is related to better mental health, including improved psychological well-being (for example, higher self-esteem and life satisfaction) and lower psychological ill-being (for example, reduced levels of depression, anxiety, and stress), and improved social outcomes (for example, improved self-control, pro-social behavior, interpersonal communication, and fostering a sense of belonging). Overall, adults participating in team sport had more favorable health outcomes than those participating in individual sport, and those participating in sports more often generally report the greatest benefits; however, some evidence suggests that adults in elite sport may experience higher levels of psychological distress. Low ROB was observed for qualitative studies, but quantitative studies demonstrated inconsistencies in methodological quality. CONCLUSIONS The findings of this review confirm that participation in sport of any form (team or individual) is beneficial for improving mental health and social outcomes amongst adults. Team sports, however, may provide more potent and additional benefits for mental and social outcomes across adulthood. This review also provides preliminary evidence for the Mental Health through Sport model, though further experimental and longitudinal evidence is needed to establish the mechanisms responsible for sports effect on mental health and moderators of intervention effects. Additional qualitative work is also required to gain a better understanding of the relationship between specific elements of the sporting environment and mental health and social outcomes in adult participants.
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Affiliation(s)
- Narelle Eather
- Centre for Active Living and Learning, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
- College of Human and Social Futures, School of Education, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Levi Wade
- Centre for Active Living and Learning, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
- College of Health, Medicine, and Wellbeing, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Aurélie Pankowiak
- Institute for Health and Sport, Victoria University, Ballarat Road, Footscray, VIC, 3011, Australia
| | - Rochelle Eime
- Institute for Health and Sport, Victoria University, Ballarat Road, Footscray, VIC, 3011, Australia
- School of Science, Psychology and Sport, Federation University Australia, University Drive, Mount Helen, VIC, 3350, Australia
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Sargu L, Andrioni F, Popp L, Netedu A, Bularca MC, Otovescu A, Motoi G, Negrilă I, Goian C, Coman C, Chirugu G. The Role of Mass Media in Influencing the Lifestyle of the Elderly during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:1816. [PMID: 37444648 DOI: 10.3390/healthcare11131816] [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: 05/13/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
The elderly represent one of the categories that was most affected by the pandemic period. The purpose of this research was to analyze the ways in which mass media and very often contradictory information flows influenced the lives and personal communications of the Romanian elderly population during the COVID-19 pandemic. In order to conduct the research, we used a mixed-methods approach. For the quantitative research, we gave a questionnaire to the elderly population of Romania, and for the qualitative research, we conducted interviews. Our quantitative sample included 881 retired persons with an age between 55 and 94 years old; the mean age was 71.48 years old with 6.6 years standard deviation. The elderly described the pandemic period using negative words: fear, loneliness, anxiety, disaster; the channel they mostly watched and trusted was the TV; they were aware of the measures they had to take to protect themselves; they missed most of the meetings with the family and the main problems they had were represented by loneliness, the inability to be with their families or the lack of access to medical services. The elderly's mass media consumption during the pandemic was mostly represented by TV consumption; the information spread by mass media was sometimes contradictory; it influenced their behavior and may have generated feelings of anxiety among them.
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Affiliation(s)
- Lilia Sargu
- Department of Economy and Tourism, Faculty of Economic Sciences, University of European Studies of Moldova, 2069 Chisinau, Moldova
| | - Felicia Andrioni
- Department of Socio-Humanities Sciences, Faculty of Sciences, University of Petrosani, 332006 Petrosani, Romania
| | - Lavinia Popp
- Department of Social Work, Faculty of Sociology and Social Work, University "Babeş-Bolyai"-Reşiţa University Center, 400347 Resita, Romania
| | - Adrian Netedu
- Department of Sociology and Social Work, Faculty of Philosophy and Socio-Political Sciences, Alexandru Ioan Cuza University of Iasi, 700506 Iasi, Romania
| | - Maria Cristina Bularca
- Department of Social Sciences and Communication, Faculty of Sociology and Communication, Transilvania University of Brasov, 500036 Brasov, Romania
| | - Adrian Otovescu
- Department of Communication, Journalism and Education Sciences, Faculty of Letters, University of Craiova, 200585 Craiova, Romania
| | - Gabriela Motoi
- Department of Sociology, Philosophy, and Social Work, Faculty of Social Sciences, University of Craiova, 200585 Craiova, Romania
| | - Ion Negrilă
- Doctoral School of Social and Humanities Sciences, University of Craiova, 200585 Craiova, Romania
| | - Cosmin Goian
- Department of Social Work, Faculty of Sociology and Psychology, West University of Timisoara, 300223 Timisoara, Romania
| | - Claudiu Coman
- Department of Social Sciences and Communication, Faculty of Sociology and Communication, Transilvania University of Brasov, 500036 Brasov, Romania
| | - Gianina Chirugu
- Faculty of Theology, Ovidius University of Constanta, 900527 Constanta, Romania
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Anto A, Asif RO, Basu A, Kanapathipillai D, Salam H, Selim R, Zaman J, Eisingerich AB. Exploring the Impact of Social Media on Anxiety Among University Students in the United Kingdom: Qualitative Study. JMIR Form Res 2023; 7:e43037. [PMID: 37327030 DOI: 10.2196/43037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The rapid surge in social media platforms has significant implications for users' mental health, particularly anxiety. In the case of social media, the impact on mental well-being has been highlighted by multiple stakeholders as a cause for concern. However, there has been limited research into how the association between social media and anxiety arises, specifically among university students-the generation that has seen the introduction and evolution of social media, and currently lives through the medium. Extant systematic literature reviews within this area of research have not yet focused on university students or anxiety, rather predominantly investigating adolescents or generalized mental health symptoms and disorders. Furthermore, there is little to no qualitative data exploring the association between social media and anxiety among university students. OBJECTIVE The purpose of this study is to conduct a systematic literature review of the existing literature and a qualitative study that aims to develop foundational knowledge around the association of social media and anxiety among university students and enhance extant knowledge and theory. METHODS A total of 29 semistructured interviews were conducted, comprising 19 male students (65.5%) and 10 female students (34.5%) with a mean age of 21.5 years. All students were undergraduates from 6 universities across the United Kingdom, with most students studying in London (89.7%). Participants were enrolled through a homogenous purposive sampling technique via social media channels, word of mouth, and university faculties. Recruitment was suspended at the point of data saturation. Participants were eligible for the study if they were university students in the United Kingdom and users of social media. RESULTS Thematic analysis resulted in 8 second-order themes: 3 mediating factors that decrease anxiety levels and 5 factors that increase anxiety levels. Social media decreased anxiety through positive experiences, social connectivity, and escapism. Social media increased anxiety through stress, comparison, fear of missing out, negative experiences, and procrastination. CONCLUSIONS This qualitative study sheds critical light on how university students perceive how social media affects their anxiety levels. Students revealed that social media did impact their anxiety levels and considered it an important factor in their mental health. Thus, it is essential to educate stakeholders, including students, university counselors, and health care professionals, about the potential impact of social media on students' anxiety levels. Since anxiety is a multifactorial condition, pinpointing the main stressors in a person's life, such as social media use, may help manage these patients more effectively. The current research highlights that there are also many benefits to social media, and uncovering these may help in producing more holistic management plans for anxiety, reflective of the students' social media usage.
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Affiliation(s)
- Ailin Anto
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rafey Omar Asif
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Arunima Basu
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | - Haadi Salam
- Faculty of Life Sciences and Medicine, Kings College London, London, United Kingdom
| | - Rania Selim
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Jahed Zaman
- Faculty of Medicine, Imperial College London, London, United Kingdom
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Wittmann FG, Zülke A, Pabst A, Luppa M, Thyrian JR, Kästner A, Hoffmann W, Kaduszkiewicz H, Döhring J, Escales C, Gensichen J, Zöllinger I, Kosilek RP, Wiese B, Oey A, König HH, Brettschneider C, Frese T, Riedel-Heller SG. COVID-19 government measures and their impact on mental health: a cross-sectional study of older primary care patients in Germany. Front Public Health 2023; 11:1141433. [PMID: 37283986 PMCID: PMC10239963 DOI: 10.3389/fpubh.2023.1141433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/09/2023] [Indexed: 06/08/2023] Open
Abstract
Background With the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and social isolation, which constitute risk factors for depressiveness. We aimed to analyse the impact of perceived restriction due to government measures on depressive symptoms and investigated stress as mediator in an at-risk-population in Germany. Methods Data were collected in April 2020 from the population of the AgeWell.de-study, including individuals with a Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score ≥9, using the depression subscale of the Brief Symptom Inventory (BSI-18) and the Perceived Stress Scale (PSS-4). Feeling restricted due to COVID-19 government measures was surveyed with a standardized questionnaire. Stepwise multivariate regressions using zero-inflated negative binomial models were applied to analyse depressive symptoms, followed by a general structural equation model to assess stress as mediator. Analysis were controlled for sociodemographic factors as well as social support. Results We analysed data from 810 older adults (mean age = 69.9, SD = 5). Feeling restricted due to COVID-19 government measures was linked to increased depressiveness (b = 0.19; p < 0.001). The association was no longer significant when adding stress and covariates (b = 0.04; p = 0.43), while stress was linked to increased depressive symptoms (b = 0.22; p < 0.001). A final model confirms the assumption that the feeling of restriction is mediated by stress (total effect: b = 0.26; p < 0.001). Conclusion We found evidence that feeling restricted due to COVID-19 government measures is associated with higher levels of depressive symptoms in older adults at increased risk for dementia. The association is mediated by perceived stress. Furthermore, social support was significantly associated with less depressive symptoms. Thus, it is of high relevance to consider possible adverse effects of government measures related to COVID-19 on mental health of older people.
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Affiliation(s)
- Felix G. Wittmann
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Andrea Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Jochen René Thyrian
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
- Faculty V: School of Life Sciences, University of Siegen, Siegen, Germany
| | - Anika Kästner
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | | | - Juliane Döhring
- Institute of General Practice, University of Kiel, Kiel, Germany
| | | | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Isabel Zöllinger
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Robert Philipp Kosilek
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany
| | - Birgitt Wiese
- Hannover Medical School, Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover, Germany
| | - Anke Oey
- Hannover Medical School, Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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20
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Badawy A, Solberg M, Obstfelder AU, Alnes RE. Together, at a distance: experiences with a novel technology for social contact among older people and their relatives in Norway during the COVID-19 pandemic. BMC Geriatr 2023; 23:218. [PMID: 37024822 PMCID: PMC10078031 DOI: 10.1186/s12877-023-03869-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND The recognition that people are social beings is fundamental for person-centered care. During the COVID-19 pandemic, the lives of older people were restricted in ways that dramatically reduced their opportunities for face-to-face contact. Limited contact with family members due to social distancing raised concerns about the well-being of older people. In Norway, interactive technologies were therefore introduced to older people to help them maintain social contact while practicing physical distancing. OBJECTIVES This study was designed to examine how older people and their relatives experienced the use of technology-mediated communication through KOMP, a tablet-like device for supporting social contact in care facilities and homes during the pandemic. METHODS We adopted an open phenomenological approach inspired by Kvale and Brinkmann (2009) to explore how the use of KOMP became meaningful during the pandemic. The study was based on individual interviews with 4 residents in care facilities and 13 relatives. RESULTS The lived experiences of using KOMP among older people and their relatives revealed that adopting digital communication helped older people, and their families mitigate social distancing and maintain relationships with each other, despite the restrictions imposed by the government. Virtual involvement through KOMP afforded meaningful interconnections in the social lives of the users and their distant family members, thereby supporting their roles as parents and grandparents despite the distance, and promoting cross-generational connections among family members. Digital meetings also provided opportunities for older people and their relatives to enjoy each other's presence in favored places, by conveying a homely atmosphere, for instance. These virtual encounters did not rely exclusively on talk as the only means of communication. CONCLUSION This study suggests that communicating via KOMP was a meaningful activity for the participants. Technologies for social contact can, to some extent, facilitate person-centered care for older people in care facilities and their private homes, despite circumstances requiring social distancing.
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Affiliation(s)
- Abeer Badawy
- Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Larsgårdsvegen 2, Ålesund, 6009, Norway.
| | - Mads Solberg
- Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Larsgårdsvegen 2, Ålesund, 6009, Norway
| | - Aud Uhlen Obstfelder
- Center for Care Research, Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Teknologivegen 22, Gjøvik, 2815, Norway
| | - Rigmor Einang Alnes
- Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Larsgårdsvegen 2, Ålesund, 6009, Norway
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21
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Cannon I, Robinson-Barella A, McLellan G, Ramsay SE. From Drugs to Dry Mouth: A Systematic Review Exploring Oral and Psychological Health Conditions Associated with Dry Mouth in Older Adults with Polypharmacy. Drugs Aging 2023; 40:307-316. [PMID: 36943673 DOI: 10.1007/s40266-023-01017-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Approximately 60% of older adults complain of dry mouth, which may be associated with polypharmacy, common in this population. Existing studies have reported treatment approaches to dry mouth but do not address long-term preventative measures that would more positively benefit the health and well-being of older adults. OBJECTIVE We aimed to explore the consequences of dry mouth, associated with polypharmacy, on the physical and psychological health of older adults in order to establish the importance of preventing dry mouth. METHODS This systematic review was conducted of studies reporting health conditions of dry mouth, in relation to polypharmacy in older adults (aged ≥ 65 years). MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched using keywords such as 'polypharmacy', 'dry mouth', 'oral health' and 'quality of life' (PROSPERO: CRD42021288945). Joanna Briggs Institute critical appraisal tools were used to assess study quality. RESULTS Of the 6852 citations screened, nine studies (cross-sectional, n = 8; longitudinal, n = 1) were included that comprised 37,459 participants (mean age range 68.5-85.0 years). Studies were published between 2005 and 2019. Because of the heterogeneity of reported study outcomes, a narrative synthesis was undertaken. The health conditions identified in this review were categorised as 'physical' or 'psychological'. The main physical health conditions reported in the studies related to dental health, such as tooth loss, and functional impairments, such as swallowing difficulties. An increase in the number of medicines taken, from 0 to 5, decreased the number of natural teeth remaining from 16 (standard deviation [SD] ± 9) to 12 (SD ± 8), respectively. Additionally, the number of dental complications increased from 1 (SD ± 2) to 2 (SD ± 2) as the number of medicines increased from 1 to ≥ 3. There was a paucity of studies (n = 2) that investigated psychological health conditions of dry mouth among older adults, with depression identified as a significant issue among older adults with dry mouth (where the reported prevalence was as high as 64%). An additional six psychological health conditions were identified: self-consciousness, feeling tense, difficulty relaxing, irritability, difficulty completing tasks and feeling less satisfied in life. CONCLUSIONS High levels of physical health conditions of dry mouth are observed in older adults and, to a lesser extent, psychological health conditions. These conditions can negatively affect quality of life. There remains a need to prevent dry mouth and the adverse health conditions associated with it in older adults. The modifiable nature of polypharmacy could be targeted to minimise, and potentially prevent, dry mouth. The optimisation of medication regimes to effectively treat chronic conditions, but also limit the likelihood of dry mouth, is a practical approach. Dry mouth prevention should be a priority and polypharmacy can pave the way for prevention strategies, avoiding the need to treat dry mouth.
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Affiliation(s)
- India Cannon
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Anna Robinson-Barella
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian McLellan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Sheena E Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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22
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Meredith SJ, Roberts H, Grocott MPW, Jack S, Murphy J, Varkonyi-Sepp J, Bates A, Lim SER. Frail2Fit study protocol: a feasibility and acceptability study of a virtual multimodal intervention delivered by volunteers to improve functional outcomes in older adults with frailty after discharge from hospital. BMJ Open 2023; 13:e069533. [PMID: 36927597 PMCID: PMC10030662 DOI: 10.1136/bmjopen-2022-069533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Physical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. In response to the COVID-19 pandemic, healthcare has increasingly turned to virtual modes of delivery and there is interest in the use of trained volunteers to deliver PA and nutrition interventions. We aim to evaluate the feasibility and acceptability of training hospital volunteers to deliver an online intervention, comprising exercise, behaviour change and nutrition support, to older people with frailty after discharge from hospital. METHODS We will use a quasi-experimental mixed methods approach. Hospital volunteers (n=6) will be trained to deliver an online, 3-month, multimodal intervention to frail (Clinical Frailty Scale ≥5) adults ≥65 years (n=30) after discharge from hospital. Feasibility will be assessed by determining the number of volunteers recruited, trained and retained at the end of the study; the proportion of intervention sessions delivered; participant recruitment, retention and adherence to the intervention. To determine the acceptability of the intervention, interviews will be conducted among a purposive sample of older adults, and volunteers. Secondary outcomes will include physical function, appetite, well-being, quality of life, anxiety and depression, self-efficacy for managing chronic disease and PA. Outcomes will be measured at baseline, 3 months and 6 months. ANALYSIS Descriptive statistics will be used to describe feasibility and adherence to the intervention. Secondary outcomes at baseline will be compared at 3 and 6 months. Interviews will be transcribed verbatim and analysed using thematic analysis. ETHICS AND DISSEMINATION Health Research Authority ethical approval was obtained on 30 May 2022 (reference: 22/WA/0155). Results will be disseminated through peer-reviewed journal articles, volunteer organisations, National Health Service communication systems and social media platforms. A toolkit will be developed to facilitate roll out of volunteer training. TRIAL REGISTRATION NUMBER NCT05384730.
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Affiliation(s)
- Samantha Jane Meredith
- Academic Geriatric Medicine, University of Southampton Faculty of Medicine, Southampton, Hampshire, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
| | - Helen Roberts
- Academic Geriatric Medicine, University of Southampton Faculty of Medicine, Southampton, Hampshire, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
| | - Michael P W Grocott
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
- Clinical and Experimental Science, University of Southampton, Southampton, UK
| | - Sandy Jack
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
- Clinical and Experimental Science, University of Southampton, Southampton, UK
| | - Jane Murphy
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Judit Varkonyi-Sepp
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
- Clinical and Experimental Science, University of Southampton, Southampton, UK
- Clinical Health Psychology Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andrew Bates
- Clinical and Experimental Science, University of Southampton, Southampton, UK
- Nursing, Midwifery, and Health, University of Southampton, Southampton, UK
| | - Stephen Eu Ruen Lim
- Academic Geriatric Medicine, University of Southampton Faculty of Medicine, Southampton, Hampshire, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton / University of Southampton, Southampton, UK
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23
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Mistry SK, Ali AM, Yadav UN, Huda MN, Khanam F, Kundu S, Khan JR, Hossain MB, Anwar A, Ghimire S. Change in prevalence over time and factors associated with depression among Bangladeshi older adults during the COVID-19 pandemic. Psychogeriatrics 2023; 23:230-242. [PMID: 36584687 DOI: 10.1111/psyg.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/12/2022] [Accepted: 12/15/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Globally, the COVID-19 pandemic seriously affected both physical and mental health conditions. This study aims to assess changes in the prevalence of depression among older adults during the COVID-19 pandemic in Bangladesh and explore the correlates of depression in pooled data. METHODS This study followed a repeated cross-sectional design and was conducted through telephone interviews on two successive occasions during the COVID-19 pandemic (October 2020 and September 2021) among 2077 (1032 in 2020-survey and 1045 in 2021-survey) older Bangladeshi adults aged 60 years and above. Depression was measured using the 15-item Geriatric Depression Scale (GDS-15). The binary logistic regression model was used to identify the factors associated with depression in pooled data. RESULTS A significant increase in the prevalence of depression was noted in the 2021 survey compared to the 2020 survey (47.2% versus 40.3%; adjusted odds ratio (aOR): 1.40, 95% confidence interval (CI): 1.11-1.75). Depression was significantly higher among participants without a partner (aOR 1.92, 95% CI 1.45-2.53), with a monthly family income of <5000 BDT (aOR: 2.65, 95% CI 1.82-3.86) or 5000-10 000 BDT (aOR: 1.30, 95% CI 1.03-1.65), living alone (aOR 2.24, 95% CI 1.40-3.61), feeling isolated (aOR 3.15, 95% CI 2.49-3.98), with poor memory/concentration (aOR 2.02, 95% CI 1.58-2.57), with non-communicable chronic conditions (aOR 1.34, 95% CI 1.06-1.69), overwhelmed by COVID-19 (aOR 1.54, 95% CI 1.18-2.00), having difficulty earning (aOR 1.49, 95% CI 1.15-1.92) or obtaining food (aOR 1.56, 95% CI 1.17-2.09) during COVID-19 pandemic, communicating less frequently (aOR 1.35, 95% CI 1.07-1.70) and needing extra care (aOR 2.28, 95% CI 1.75-2.96) during the pandemic. CONCLUSIONS Policymakers and public health practitioners should provide immediate mental health support initiatives for this vulnerable population during the COVID-19 pandemic and beyond. Policymakers should also invest in creating safe places to practise mindful eating, exercise, or other refuelling activities as a means of preventing and managing depression.
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Affiliation(s)
- Sabuj K Mistry
- ARCED Foundation, Dhaka, Bangladesh.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.,BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | | | - Uday N Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.,National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Md Nazmul Huda
- ARCED Foundation, Dhaka, Bangladesh.,School of Medicine, Western Sydney University, Campbeltown, Australia
| | - Fouzia Khanam
- Department of Public Health, North South University, Dhaka, Bangladesh
| | - Satyajit Kundu
- Global Health Institute, North South University, Dhaka, Bangladesh.,School of Public Health, Southeast University, Nanjing, China
| | - Jahidur R Khan
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Md Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Afsana Anwar
- Health and Nutrition, Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV), Cox's Bazar, Bangladesh
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Centre, Miami University, Oxford, Ohio, USA
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24
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Littlewood E, McMillan D, Chew Graham C, Bailey D, Gascoyne S, Sloane C, Burke L, Coventry P, Crosland S, Fairhurst C, Henry A, Hewitt C, Baird K, Ryde E, Shearsmith L, Traviss-Turner G, Woodhouse R, Webster J, Meader N, Churchill R, Eddy E, Heron P, Hicklin N, Shafran R, Almeida O, Clegg A, Gentry T, Hill A, Lovell K, Dexter-Smith S, Ekers D, Gilbody S. Can we mitigate the psychological impacts of social isolation using behavioural activation? Long-term results of the UK BASIL urgent public health COVID-19 pilot randomised controlled trial and living systematic review. EVIDENCE-BASED MENTAL HEALTH 2022; 25:e49-e57. [PMID: 36223980 PMCID: PMC9811092 DOI: 10.1136/ebmental-2022-300530] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Behavioural and cognitive interventions remain credible approaches in addressing loneliness and depression. There was a need to rapidly generate and assimilate trial-based data during COVID-19. OBJECTIVES We undertook a parallel pilot RCT of behavioural activation (a brief behavioural intervention) for depression and loneliness (Behavioural Activation in Social Isolation, the BASIL-C19 trial ISRCTN94091479). We also assimilate these data in a living systematic review (PROSPERO CRD42021298788) of cognitive and/or behavioural interventions. METHODS Participants (≥65 years) with long-term conditions were computer randomised to behavioural activation (n=47) versus care as usual (n=49). Primary outcome was PHQ-9. Secondary outcomes included loneliness (De Jong Scale). Data from the BASIL-C19 trial were included in a metanalysis of depression and loneliness. FINDINGS The 12 months adjusted mean difference for PHQ-9 was -0.70 (95% CI -2.61 to 1.20) and for loneliness was -0.39 (95% CI -1.43 to 0.65).The BASIL-C19 living systematic review (12 trials) found short-term reductions in depression (standardised mean difference (SMD)=-0.31, 95% CI -0.51 to -0.11) and loneliness (SMD=-0.48, 95% CI -0.70 to -0.27). There were few long-term trials, but there was evidence of some benefit (loneliness SMD=-0.20, 95% CI -0.40 to -0.01; depression SMD=-0.20, 95% CI -0.47 to 0.07). DISCUSSION We delivered a pilot trial of a behavioural intervention targeting loneliness and depression; achieving long-term follow-up. Living meta-analysis provides strong evidence of short-term benefit for loneliness and depression for cognitive and/or behavioural approaches. A fully powered BASIL trial is underway. CLINICAL IMPLICATIONS Scalable behavioural and cognitive approaches should be considered as population-level strategies for depression and loneliness on the basis of a living systematic review.
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Affiliation(s)
| | - Dean McMillan
- Health Sciences, University of York, York, UK
- Centre for Health and Population Science, Hull York Medical School, Hull, UK
| | | | | | | | | | | | - Peter Coventry
- Health Sciences, University of York, York, UK
- York Environmental Sustainability Institute, University of York, York, UK
| | | | | | | | | | | | - Eloise Ryde
- Health Sciences, University of York, York, UK
- Research and Development Unit, Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | | | | | | | - Judith Webster
- Research and Development Unit, Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - Nick Meader
- Faculty of Medical Sciences, University of Newcastle, Newcastle upon Tyne, UK
| | - Rachel Churchill
- Cochrane Common Mental Disorders Group, University of York, York, UK
| | - Elizabeth Eddy
- Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Paul Heron
- Health Sciences, University of York, York, UK
| | - Nisha Hicklin
- Department of Psychology, Royal Holloway University of London, Egham, UK
| | - Roz Shafran
- PPP, University College London Institute of Child Health, London, UK
- Paediatric Psychology Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Osvaldo Almeida
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Clegg
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Tom Gentry
- Health and Care Policy, Age UK, London, UK
| | - Andrew Hill
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, UK
| | - Sarah Dexter-Smith
- Research and Development Unit, Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - David Ekers
- Health Sciences, University of York, York, UK
- Research and Development Unit, Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - Simon Gilbody
- Health Sciences, University of York, York, UK
- Centre for Health and Population Sciences, Hull York Medical School, York, UK
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25
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Sundarakumar JS, Menesgere AL, Hameed SKS, Ravindranath V. Depression and anxiety during the first and second waves of the COVID‐19 pandemic in two large, prospective, aging cohorts in rural and urban India. Health Sci Rep 2022; 5:e901. [DOI: 10.1002/hsr2.901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
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26
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Park NS, Jang Y, Yoon JW, Chung S, Chiriboga DA. Relationship of social isolation with mental distress among older Korean Americans: The moderating role of social cohesion. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4909-e4919. [PMID: 35770341 DOI: 10.1111/hsc.13903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/31/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
Social isolation has been associated with poor mental health outcomes, particularly for older immigrants who do not have a protective social environment. The purpose of this study was to investigate the relationship of social isolation (living alone, marginal family ties and marginal friend ties) with mental distress and to examine the moderating role of social cohesion (family cohesion and community cohesion). We hypothesised that social isolation and social cohesion would be directly associated with mental distress and that social cohesion would buffer the influence of social isolation on mental distress. Data were drawn from the Study of Older Korean Americans (SOKA), which included 2150 older Korean Americans aged 60 or over in multiple areas, collected during 2017-2018. A series of hierarchical regression models of mental distress examined the direct and interactive role of social isolation and social cohesion. Approximately one-third of the sample lived alone, 20% had marginal family ties and 27% had marginal friend ties. All three indicators of social isolation had a significant direct effect on mental health; however, living alone lost its statistical significance with the inclusion of social cohesion variables. Both indicators of family and community cohesion were significantly associated with lower levels of mental distress. In addition, family cohesion buffered the negative effects of marginal ties to family and friends on mental distress. The significant role of a positive social environment must be considered when addressing the needs of older immigrants who are socially isolated.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jung Won Yoon
- Department of Library and Information Science, Jeonbuk National University, Jeonju-si, South Korea
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - David A Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, Florida, USA
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27
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Matteucci I. Sport, physical activity and social health in older adults. Caring with technology in the COVID-19 pandemic. INTERNATIONAL REVIEW FOR THE SOCIOLOGY OF SPORT 2022; 57:960-979. [PMID: 36065458 PMCID: PMC9301356 DOI: 10.1177/10126902211045675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this paper was to photograph this precise moment in history, focusing on the situation of older adults during the COVID-19 health emergency in Northern Italy. In particular, we analysed the relationship between social networks and social support, sport and recreational activity, and the use of communications technologies in December 2020. We investigated and discussed such use of technologies, wondering if and how it helped to compensate for the diminishment in social health, usually gained trough social interactions and the practice of sport and physical activity. We examined how reduction of mobility, social distancing and isolation measures imposed by the government to reduce the spread of COVID-19, affected the living conditions of the older adults, in particular their social health, and the level of sport and physical activity they were engaged in. We collected data through interviews with the subjects, assessing their social networks, the perceived social support provided by their family members, friends and caregivers, and the level of sport and physical activity they were engaged in. Moreover, we analysed the impact of technological communications devices, which were employed to help older adults to maintain their relationships with the outside world and to preserve their active life. The interview questions were formulated based on the Lubben Social Network Scale-Revised (LSNS-R), the short version of the Social Support List (SSL12-I) for the elderly and the Physical Activity Scale for the Elderly (PASE). A relationship was found between the social health related to physical activity of the older adults subjects during the COVID-19 emergency and the use of communications technologies, which played a role in mitigating the impact of the crisis on their social health by helping them to keep physically and socially active.
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Affiliation(s)
- Ivana Matteucci
- Ivana Matteucci, Department of
Communication Science, Humanistic and International Studies (DISCUI), Carlo Bo
University of Urbino, Urbino, Italy.
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28
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Brugiavini A, Di Novi C, Orso CE. Visiting parents in times of COVID-19: The impact of parent-adult child contacts on the psychological health of the elderly. ECONOMICS AND HUMAN BIOLOGY 2022; 46:101152. [PMID: 35700656 PMCID: PMC9172389 DOI: 10.1016/j.ehb.2022.101152] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/20/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Using the 8th wave of the SHARE and the SHARE Corona Survey, we investigated whether the disruption of parent-adult child contacts due to social distancing restrictions increased the symptoms of depression among old age individuals during the first wave of the COVID-19 pandemic. We model the relationship between the disruption of parent-adult child contacts and the mental health of the elderly using a recursive simultaneous equation model for binary variables. Our findings show that the likelihood of disruption of parent-adult child contacts was higher with adult children who do not live with or close to their parents (i.e., in the same household or in the same building) for whom contact disruption increases about 15 %. The duration of restrictions to movement and lockdowns also has a positive and significant effect on parent-child contact disruption: an additional week of lockdown significantly increases the probability of parent-child contact disruption, by about 1.5 %. The interventions deemed essential to reduce the spread of the pandemic, such as the "stay-at-home" order, necessarily disrupted personal parent-child contacts and the social processes that facilitate psychological well-being, increasing the probability of suffering from a deepening depressed mood by about 17 % for elderly parents.
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Affiliation(s)
- Agar Brugiavini
- Department of Economics, Ca' Foscari University of Venice, Italy
| | - Cinzia Di Novi
- European Commission, Joint Research Centre (JRC), Ispra, Italy.
| | - Cristina Elisa Orso
- Department of Law, Economics, and Cultures, Insubria University, Como, Italy
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29
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Owens OL, Beer JM. Human Factors and Ergonomics Considerations for Aging-in-Place Part 2: The Intersection of Environment and Technology. ERGONOMICS IN DESIGN 2022. [DOI: 10.1177/10648046221096021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article is part 2 of a two-part series focused on aging-in-place. Aging-in-place is a term that has been increasingly used over the past 40 years to describe the process of remaining in one’s home. In attempt to advance the discussion on the future of aging-in-place, this feature series provides an overview of the grand challenges to aging-in-place with an emphasis on human factors and ergonomics considerations. Part 2 will discuss a variety of ways to conceptualize “place” and describe the need for integrated technology within the home and beyond.
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Affiliation(s)
- Otis L. Owens
- College of Social Work, University of South Carolina, Columbia, SC, USA
- Institute of Gerontology, University of Georgia, Athens, GA, USA
| | - Jenay M. Beer
- College of Social Work, University of South Carolina, Columbia, SC, USA
- Institute of Gerontology, University of Georgia, Athens, GA, USA
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30
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Associations of face-to-face and non-face-to-face social isolation with all-cause and cause-specific mortality: 13-year follow-up of the Guangzhou Biobank Cohort study. BMC Med 2022; 20:178. [PMID: 35501792 PMCID: PMC9059436 DOI: 10.1186/s12916-022-02368-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/06/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although social isolation has been associated with a higher mortality risk, little is known about the potential different impacts of face-to-face and non-face-to-face isolation on mortality. We examined the prospective associations of four types of social isolation, including face-to-face isolation with co-inhabitants and non-co-inhabitants, non-face-to-face isolation, and club/organization isolation, with all-cause and cause-specific mortality separately. METHODS This prospective cohort study included 30,430 adults in Guangzhou Biobank Cohort Study (GBCS), who were recruited during 2003-2008 and followed up till Dec 2019. RESULTS During an average of 13.2 years of follow-up, 4933 deaths occurred during 396,466 person-years. Participants who lived alone had higher risks of all-cause (adjusted hazard ratio (AHR) 1.24; 95% confidence interval (CI) 1.04-1.49) and cardiovascular disease (CVD) (1.61; 1.20-2.03) mortality than those who had ≥ 3 co-habitant contact after adjustment for thirteen potential confounders. Compared with those who had ≥ 1 time/month non-co-inhabitant contact, those without such contact had higher risks of all-cause (1.60; 1.20-2.00) and CVD (1.91; 1.20-2.62) mortality. The corresponding AHR (95% CI) in participants without telephone/mail contact were 1.27 (1.14-1.42) for all-cause, 1.30 (1.08-1.56) for CVD, and 1.37 (1.12-1.67) for other-cause mortality. However, no association of club/organization contact with the above mortality and no association of all four types of isolation with cancer mortality were found. CONCLUSIONS In this cohort study, face-to-face and non-face-to-face isolation were both positively associated with all-cause, CVD-, and other-cause (but not cancer) mortality. Our finding suggests a need to promote non-face-to-face contact among middle-aged and older adults.
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Khaing NEE, Lim CS, Soon SP, Oh HC. Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:283-291. [PMID: 35658151 DOI: 10.47102/annals-acadmedsg.202219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has affected almost all populations, with frontline workers experiencing a higher risk of mental health effects compared to other groups. Although there are several research studies focusing on the mental health effects of the pandemic on healthcare workers, there is little research about its impact on workers in outsourced hospital essential services. This study aims to examine the prevalence and correlates of psychological distress and coronavirus anxiety among staff working in 3 outsourced hospital essential services-housekeeping, porter service and maintenance services. METHODS A cross-sectional study was conducted among outsourced hospital essential services workers in a tertiary hospital. Data on demographics, medical history, lifestyle factors, psychosocial factors and mental well-being were collected using self-administered questionnaires. Robust logistic regression was used to determine risk factors associated with psychological distress and dysfunctional anxiety related to COVID-19. RESULTS A total of 246 hospital essential services workers participated in the study. The prevalence of psychological distress was 24.7%, and dysfunctional anxiety related to COVID-19 was 13.4%. Social support and workplace support were found to be independently associated with a lower risk of psychological distress, and social connectivity was associated with a lower risk of dysfunctional anxiety related to COVID-19. CONCLUSION These findings highlight the crucial roles of communities and workplaces in combating the mental health consequences of the pandemic. Public health programmes that aim to tackle the emerging mental health crisis in hospital essential services workers should incorporate strategies to address psychosocial factors, in addition to traditional self-care approaches.
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Ekoh PC, George EO, Agbawodikeizu PU, Ezulike CD, Okoye UO, Nnebe I. “Further Distance and Silence among Kin”: Social Impact of COVID-19 on Older People in Rural Southeastern Nigeria. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2022. [DOI: 10.1080/15350770.2022.2070572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Prince Chiagozie Ekoh
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
| | | | | | - Chigozie Donatus Ezulike
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
- Department of Social and Behavioural Science City, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Ikechukwu Nnebe
- Department of Social Work, University of Nigeria, Nsukka, Nigeria
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O'Campo P, Stergiopoulos V, Davis O, Lachaud J, Nisenbaum R, Dunn JR, Ahmed N, Tsemberis S. Health and social outcomes in the Housing First model: Testing the theory of change. EClinicalMedicine 2022; 47:101387. [PMID: 35497057 PMCID: PMC9046122 DOI: 10.1016/j.eclinm.2022.101387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Homelessness continues to grow globally. The Housing First (HF) model offers immediate access to housing and support services without preconditions and has a growing body of evidence documenting its effectiveness at ending homelessness. HF has a robust theory of change that hypothesizes how unique program components (i.e., immediate access to housing, separation of services from housing, client choice, etc.) drive positive social and health changes over time. We advance the understanding of how HF causes client improvement by empirically testing this program's theory of change. METHODS Using a unique longitudinal quantitative data from the large Canadian At Home/Chez Soi Housing First trial we used path analysis to test the theory of change for Quality of Life, Crisis related events or service utilization, and Recovery. Program pathways and health and social outcomes were measured at enrolment, 6-, 12- and 24-months post-enrolment. FINDINGS Most hypothesized pathways were confirmed with path analysis. Confirmed pathways for two outcomes- Quality of Life (QOL) and Recovery - were similar. Health and social consultations at enrolment, health status at 6- and 12-months post enrolment, and social connectedness at 12-months were important predictors of the 24-month outcomes of Quality of Life and Recovery, but not for Crisis related events or service utilization. INTERPRETATION This analysis directly responds to recent calls for more empirical evidence about intervention mechanisms. Ensuring linkages to health and social service consultations for clients, supporting clients' engagement with family and community, and enabling clients to improve or maintain good health will drive better longer term client outcomes within Housing First. FUNDING Funding Mental Health Commission of Canada.
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Affiliation(s)
- Patricia O'Campo
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
- Corresponding author at: MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada.
| | - Vicky Stergiopoulos
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Center for Addiction and Mental Health, 1001, 1025, 1051 Queen Street West, Toronto, ON M6J 1H4, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
| | - Owen Davis
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - James Lachaud
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada
| | - James R. Dunn
- Department of Health, Aging and Society, McMaster University, 1280 Main St West, Hamilton, ON L8S 4L8, Canada
| | - Naveed Ahmed
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Sam Tsemberis
- Pathways Housing First Institute, 1328 2nd Street, Santa Monica, CA 90403, United States
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Marr NS, Zainal NH, Newman MG. Focus on and venting of negative emotion mediates the 18-year bi-directional relations between major depressive disorder and generalized anxiety disorder diagnoses. J Affect Disord 2022; 303:10-17. [PMID: 35065091 PMCID: PMC8917061 DOI: 10.1016/j.jad.2022.01.079] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Myriad emotion regulation and coping theories have proposed that avoidant/emotion-oriented coping is a cause and consequence of anxiety and depression. However, few studies have investigated potential mechanisms underlying the prospective anxiety-depression disorder relation. The current study examined various coping strategies (i.e., denial, focus on and venting of emotion (FOAVE), and behavioral disengagement) as potential longitudinal mediators between generalized anxiety disorder (GAD) and major depressive disorder (MDD). METHODS In a nationally representative sample of adults (N = 3,294), MDD and GAD were assessed at Time 1 (T1) and Time 3 (T3) (Composite International Diagnostic Interview - Short-Form), and avoidant coping strategies (denial, behavioral disengagement, and FOAVE) were measured at Time 2 (T2) (Coping Questionnaire). Assessments occurred over 18 years, each spaced approximately 9 years apart. Structural equation modeling mediation analyses examined whether T1 MDD predicted T3 GAD (and vice versa), and if T2 avoidant coping mediated these relations, above and beyond baseline comorbidity. RESULTS FOAVE mediated the T1 MDD-T3 GAD association, and vice versa. Presence of T1 MDD and GAD predicted more T2 FOAVE, and greater T2 FOAVE forecasted T3 MDD and GAD, accounting for 16-21% of the longitudinal MDD-GAD relations. However, behavioral disengagement and denial did not mediate the prospective MDD-GAD relations. Also, T1 MDD and GAD forecasted greater T2 behavioral disengagement. CONCLUSIONS The use of FOAVE, may be a mechanism by which MDD earlier in life may lead to GAD 18 years later, and vice versa. Theoretical and potential clinical implications are discussed.
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Valera L, López Barreda R. Bioethics and COVID-19: Considering the Social Determinants of Health. Front Med (Lausanne) 2022; 9:824791. [PMID: 35391891 PMCID: PMC8980461 DOI: 10.3389/fmed.2022.824791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
In this paper, we focus on a novel bioethical approach concerning the ethical implications of the Social Determinants of Health (SDs) in the time of COVID-19, offering a fresh interpretation of our agency and responsibility in the current pandemic era. Our interpretation is grounded on the idea that our health basically depends on factors that go beyond our organism. In this sense, we stress the radical importance of circumstances to ethically assess an action, in the current pandemic context. Moreover, due the centrality of the SDs in our bioethical assessments-that implies that our health does not exclusively depend on our choices, behaviors, and lifestyle-we can affirm that we are not entirely responsible for our wellness or diseases. As health depends on economic, social, cultural, and environmental factors, we argue that the analysis of personal responsibility facing personal health status should receive further consideration. In this sense, following the "social connection model," we stress the importance of the concept of "shared responsibility" in collective decisions: if we make many decisions collectively, we are also collectively responsible of these decisions. Furthermore, to responsibly tackle the social inequalities that are the underlying cause of disparities in health outcomes, we propose two main strategies based on the Capability Approach: 1. empowering the individuals, especially the most vulnerable ones; and 2. designing preventive policies and interventions that provides an opportunity to address the disparities moving forward. This will help us going beyond the "individualistic medical ethics paradigm" and integrating our concept of health with social factors (e.g., the SDs), based on a more relational and interdependent anthropological thought.
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Affiliation(s)
- Luca Valera
- Bioethics Centre, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
- Department of Philosophy, Universidad de Valladolid, Valladolid, Spain
| | - Rodrigo López Barreda
- Bioethics Centre, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
- Department of Anesthesiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
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Chai X. How Has the Nationwide Public Health Emergency of the COVID-19 Pandemic Affected Older Chinese Adults' Health Literacy, Health Behaviors and Practices, and Social Connectedness? Qualitative Evidence From Urban China. Front Public Health 2022; 9:774675. [PMID: 35356089 PMCID: PMC8960051 DOI: 10.3389/fpubh.2021.774675] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022] Open
Abstract
Older Chinese adults' daily lives have been affected significantly during the outbreak phase of the COVID-19 pandemic since January 2020. They were confronted with activity restrictions due to strict pandemic prevention. The older population also had to get accustomed to widely-used modern technologies in community management, such as health codes and WeChat groups. By late 2021, mainland China had reduced the prevalence of COVID-19, and people's daily lives had primarily returned to pre-pandemic normality. Under China's systematic health management during the pandemic, older Chinese adults' responses to this nationwide public health emergency may have influenced their health in the long run. However, it remains unclear what specific health changes or improvements have occurred. Such a void in the literature is worrying, given that older adults are at high health risks due to the pandemic which, might still be with humankind for a while. Thus, it is of necessity to explore and report their health changes after this official, large-scale health intervention. In this study, 17 adults aged 55 and above were recruited as interviewees. All interviewees reside in a community located in Q district, N city of the People's Republic of China. According to the findings, many interviewees now have better literacy in health risk prevention. Information and Communication Technologies (ICTs) play a significant role in getting access to health information. Specifically, television, WeChat chatting groups, and TikTok could be valuable information sources for older adults. As for the understanding and evaluation of health information, although older participants can distinguish COVID-19 rumors, they may sometimes feel confused about the underlying scientific logic. Regarding changes in health behaviors and practices, many older adults can integrate health information and knowledge into their daily lives. Additionally, although interviewees can keep important social connections, not all of them are familiar with using new ICTs, such as online chatting group, for social participation and engagement. The empirical evidence suggests that both the communities and the local governments can offer specific training programs to older residents for the sake of enhancing their health literacy, health behaviors and practices, and social connectedness during and after the pandemic.
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Jeetoo J, Jaunky VC. An Empirical Analysis of Income Elasticity of Out-of-Pocket Healthcare Expenditure in Mauritius. Healthcare (Basel) 2022; 10:101. [PMID: 35052265 PMCID: PMC8775967 DOI: 10.3390/healthcare10010101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/07/2021] [Accepted: 12/30/2021] [Indexed: 11/25/2022] Open
Abstract
A free universal healthcare provision exists in Mauritius. Yet the share of out-of-pocket healthcare expenditure out of total household expenditure has been growing over time. This study estimates income elasticity of out-of-pocket healthcare expenditure using Mauritian household data within an Engel curve framework. In the absence of longitudinal data on out-of-pocket healthcare expenditure patterns, the study proposes the application of the pseudo-panel approach using cross-sectional Household Budget Survey waves from 1996/97 to 2017. Income elasticity of out-of-pocket healthcare expenditure is estimated to be 0.938, which is just below unity. This implies that out-of-pocket healthcare demand is not considered to be a luxury, but a necessity in Mauritius. In order to see the differences in income elasticities by income groups, separate regressions are estimated for each income quartile over different years. The results indicate that income elasticities of out-of-pocket healthcare expenditure vary non-monotonically.
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Affiliation(s)
- Jamiil Jeetoo
- Department of Economics and Statistics, Open University of Mauritius, Reduit 80837, Mauritius;
| | - Vishal Chandr Jaunky
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, SE-971 87 Lulea, Sweden
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Kremers EM, Janssen JHM, Nieuwboer MS, Olde Rikkert MGM, Peeters GMEE(G. The psychosocial adaptability of independently living older adults to COVID-19 related social isolation in the Netherlands: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e67-e74. [PMID: 34028124 PMCID: PMC8239797 DOI: 10.1111/hsc.13436] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/19/2021] [Accepted: 04/18/2021] [Indexed: 05/25/2023]
Abstract
Since coronavirus disease 2019 (COVID-19) entered the Netherlands, the older adults (aged 70 or above) were recommended to isolate themselves, resulting in less social contact and possibly increased loneliness. The aim of this qualitative study was to explore independently living older adults' perceptions of social and emotional well-being during the COVID-19-related self-isolation, and their motivation to expand their social network in the future. Semi-structured phone interviews were held with 20 community-dwelling adults (age range 56-87; 55% female) between April and June 2020 in the Netherlands. The interviews were audio recorded and transcribed verbatim. Open coding process was applied to identify categories and themes. Participants said to use more digital technologies to maintain contacts and adapt to the government measurements. Most participants missed the lack of social contacts, while some participants had no problems with the reduced social contacts. The emotional well-being of most participants did not change. Some participants felt unpleasant or mentioned that the mood of other people had changed. Participants were not motivated to expand their social network because of existing strong networks. The relatively vital community-dwelling older adults in this study were able to adapt to the government recommendations for self-isolation with limited negative impact on their socio-emotional well-being.
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Affiliation(s)
- Evi M. Kremers
- Department of Geriatric MedicineRadboud Institute of Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Jeroen H. M. Janssen
- Department of Geriatric MedicineRadboud Institute of Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Minke S. Nieuwboer
- Department of Geriatric MedicineRadboud Institute of Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
- Radboudumc Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Marcel G. M. Olde Rikkert
- Radboudumc Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
- Department of Geriatric MedicineDonders Institute for Brain, Cognition and BehaviourRadboud University Medical CenterNijmegenThe Netherlands
| | - G. M. E. E. (Geeske) Peeters
- Department of Geriatric MedicineRadboud Institute of Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
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Alam MS, Sultana R, Haque MA. Vulnerabilities of older adults and mitigation measures to address COVID-19 outbreak in Bangladesh: A review. SOCIAL SCIENCES & HUMANITIES OPEN 2022; 6:100336. [PMID: 36124099 PMCID: PMC9474424 DOI: 10.1016/j.ssaho.2022.100336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/27/2022]
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Experiencing the Unprecedented COVID-19 Lockdown: Abu Dhabi Older Adults' Challenges and Concerns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413427. [PMID: 34949034 PMCID: PMC8705884 DOI: 10.3390/ijerph182413427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022]
Abstract
This study focused on older adults (60+ years old) of both genders in Abu Dhabi during the COVID-19 pandemic before vaccines were made available (age ranged from 60 years to 75 years). They faced more strict rules of movement restriction and isolation that might have resulted in certain psychological feelings and social reactions. The main objective was to understand Abu Dhabi older adults’ psychological feelings during the pandemic and to identify their main concerns and challenges considering the various COVID-19-related policies and restrictions. The psychological feelings focused on fear, loneliness, sadness, irritability, emotional exhaustion, depressive symptoms, sleeping disorders, overeating, and excessive screen use. The objectives also included the changes in the psychological feelings concerning time. Other objectives covered better understanding the differences in (some activities) compared to the other age categories. Data were gathered through an online survey of community members from February to July 2020 as part of government initiatives (Department of Community Development). Responses were collected from 574 older adults in Abu Dhabi (60.1% male and 39.9% female). The analysis mainly used descriptive analysis, t-tests, analysis of variance (ANOVA), and simple trend analysis. For all tests, a p-value less than 0.05 was used for significance. The results pointed to the significant rise in feelings related to excessive screen use, fear, loneliness, and stress. The most significant concerns were related to more restrictions being imposed and not being able to see the grandchildren.The impact of new technologies on their quality of life was significantly reflected by respondents. The influence of the pandemic on older adults’ health and weight was also investigated. Analysis of variance, t-tests, and regression analysis with relevant tests were employed. The relevant results showed that some negative psychological feelings were common among older adults during the pandemic. However, the psychological feelings did not portray significant changes with time, except for sleeping disorders and overeating. Overall, older adults scored significantly different from other age groups on many challenges, concerns, and views regarding new technologies during the pandemic. No significant differences were observed regarding gender and marital status for the challenges and concerns. The research summarizes some policy guidance while noting some limitations of this study and future research directions.
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Mental health, substance use, and suicidal ideation among unpaid caregivers of adults in the United States during the COVID-19 pandemic: Relationships to age, race/ethnicity, employment, and caregiver intensity. J Affect Disord 2021; 295:1259-1268. [PMID: 34706440 PMCID: PMC8413485 DOI: 10.1016/j.jad.2021.08.130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/30/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unpaid caregivers of adults play critical roles in health care systems by providing care to older adults and those with chronic conditions. The COVID-19 pandemic has heightened caregiving needs, forcing some into caregiving roles and disrupting others. We sought to estimate the prevalence of and identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation amongst unpaid caregivers of adults versus non-caregivers. METHODS During June 24-30, 2020, surveys were administered to U.S. adults. Quota sampling and survey weighting were implemented to improve sample representativeness of age, gender, and race/ethnicity. RESULTS Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys and 5,011 (92.6%) met screening criteria and were analyzed, including 1,362 (27.2%) caregivers. Caregivers had higher adverse mental health symptom prevalences than non-caregivers, including suicidal ideation (33.4% vs 3.7%, p < 0.0001). Symptoms were more common among caregivers who were young vs older adults (e.g., aged 18-24 vs ≥65 years, aPR 2.75, 95% CI 1.95-3.88, p < 0.0001) and with moderate and high vs low Caregiver Intensity Index scores (2.31, 1.65-3.23; 2.81, 2.00-3.94; both p < 0.0001). LIMITATIONS Self-report data may be subject to recall, response, and social desirability biases; unpaid caregivers were self-identified; child caregiving roles were not assessed; and internet-based survey samples might not fully represent the U.S. CONCLUSIONS Caregivers experienced disproportionately high levels of adverse mental health symptoms. Younger caregivers and those with higher caregiving intensity were disproportionately affected. Increased visibility of and access to mental health care resources are urgently needed to address mental health challenges of caregiving.
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Cipolletta S, Gris F. Older People's Lived Perspectives of Social Isolation during the First Wave of the COVID-19 Pandemic in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11832. [PMID: 34831586 PMCID: PMC8618043 DOI: 10.3390/ijerph182211832] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 02/06/2023]
Abstract
The aim of the present study is to understand the experiences of isolation and strategies used to cope with it among older people living at home during the first wave of the COVID-19 pandemic. More specifically, the roles of media and online technologies were also explored. Semistructured interviews were conducted via telephone between March and April 2020 with 30 people aged 72-94 years old living in Northern Italy. The thematic analysis identified six thematic areas: changes in daily life, emotions, social networks, exploited resources and strategies, use of media, and view of the future. Older people faced the emergency in heterogeneous ways; some were able to take advantage of their own residual resources and of social support, whereas in other cases, isolation exacerbated existing weaknesses. Technology and media were useful for reducing loneliness and fostering social contacts, but people with age-related impairments or low digital literacy presented many difficulties in approaching new technologies. Moreover, the overabundance of information could also increase anxiety and feelings of threat. Given the impact of social isolation on older people's well-being, it is critical to identify and strengthen personal resources and social support strategies that may help older people cope with the restrictions imposed by the COVID-19 pandemic.
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Affiliation(s)
- Sabrina Cipolletta
- Department of General Psychology, University of Padua, 35131 Padua, Italy;
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Köverová M, Ráczová B, Kováčová Holevová B. Predictors of Anxiety, Stress, and Concern of COVID-19 Infection in Older Adults During the First and the Second Waves of the COVID-19 Pandemic in Slovakia. Gerontol Geriatr Med 2021; 7:23337214211047642. [PMID: 34660848 PMCID: PMC8511907 DOI: 10.1177/23337214211047642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This cross-sectional online study examined the role of socio-demographic and psychological characteristics in predicting anxiety, stress, and concern of coronavirus (COVID-19) infection in older adults during the first and second waves of the COVID-19 pandemic in Slovakia. METHODS Six hundred and seven older adults (Sample 1) and 156 older adults (Sample 2) participated in the study during the first and second waves of the COVID-19 pandemic, respectively. The older adults completed a battery of validated instruments for anxiety, stress, concern of COVID-19 infection (outcome variables), satisfaction with health, perceived danger of COVID-19, loneliness, intolerance of uncertainty (IU), optimism, powerlessness, and coping self-efficacy (predictor variables). The data were analyzed using multiple linear regression. RESULTS The older adults in both samples experienced moderate levels of anxiety, stress, and concern of COVID-19 infection. The greatest amount of variability in anxiety and stress was explained by powerlessness, IU, optimism, and coping self-efficacy. Concern of COVID-19 infection was best predicted by the perceived danger of COVID-19. CONCLUSION The findings contribute to the existing knowledge about the mental health of older adults during the COVID-19 pandemic and highlight the role of the psychological predictors of anxiety, stress, and concern of COVID-19 infection during both waves.
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Affiliation(s)
- Miroslava Köverová
- Faculty of Arts, Pavol Jozef Šafárik University in Košice, Košice, Slovakia
| | - Beáta Ráczová
- Faculty of Arts, Pavol Jozef Šafárik University in Košice, Košice, Slovakia
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Mental Health and Social Connectedness Across the Adult Lifespan in the Context of the COVID-19 Pandemic. Can J Aging 2021. [DOI: 10.1017/s0714980821000477] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
AbstractThe coronavirus disease (COVID-19) pandemic has had profound consequences on collective mental health and well-being, and yet, older adults appear better off than younger adults. The current study examined mental health impacts of the pandemic across adult age groups in a large sample (n = 5,320) of Canadians using multiple hierarchical regression analyses. Results suggest older adults are experiencing better mental health and more social connectedness relative to younger adults. Loneliness predicted negative mental health outcomes across all age groups, while the negative association between social support and mental health was only significant at average and high levels of loneliness in the 65–69 age group. Results point towards differential mental health impacts of the pandemic across adult age groups and indicate that loneliness and social support may be key intervention targets during the COVID-19 pandemic. Future research should further examine mechanisms of resiliency among older Canadian adults during the pandemic.
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Gilbody S, Littlewood E, McMillan D, Chew-Graham CA, Bailey D, Gascoyne S, Sloan C, Burke L, Coventry P, Crosland S, Fairhurst C, Henry A, Hewitt C, Joshi K, Ryde E, Shearsmith L, Traviss-Turner G, Woodhouse R, Clegg A, Gentry T, Hill AJ, Lovell K, Dexter Smith S, Webster J, Ekers D. Behavioural activation to prevent depression and loneliness among socially isolated older people with long-term conditions: The BASIL COVID-19 pilot randomised controlled trial. PLoS Med 2021; 18:e1003779. [PMID: 34637450 PMCID: PMC8509874 DOI: 10.1371/journal.pmed.1003779] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/20/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Older adults, including those with long-term conditions (LTCs), are vulnerable to social isolation. They are likely to have become more socially isolated during the Coronavirus Disease 2019 (COVID-19) pandemic, often due to advice to "shield" to protect them from infection. This places them at particular risk of depression and loneliness. There is a need for brief scalable psychosocial interventions to mitigate the psychological impacts of social isolation. Behavioural activation (BA) is a credible candidate intervention, but a trial is needed. METHODS AND FINDINGS We undertook an external pilot parallel randomised trial (ISRCTN94091479) designed to test recruitment, retention and engagement with, and the acceptability and preliminary effects of the intervention. Participants aged ≥65 years with 2 or more LTCs were recruited in primary care and randomised by computer and with concealed allocation between June and October 2020. BA was offered to intervention participants (n = 47), and control participants received usual primary care (n = 49). Assessment of outcome was made blind to treatment allocation. The primary outcome was depression severity (measured using the Patient Health Questionnaire 9 (PHQ-9)). We also measured health-related quality of life (measured by the Short Form (SF)-12v2 mental component scale (MCS) and physical component scale (PCS)), anxiety (measured by the Generalised Anxiety Disorder 7 (GAD-7)), perceived social and emotional loneliness (measured by the De Jong Gierveld Scale: 11-item loneliness scale). Outcome was measured at 1 and 3 months. The mean age of participants was aged 74 years (standard deviation (SD) 5.5) and they were mostly White (n = 92, 95.8%), and approximately two-thirds of the sample were female (n = 59, 61.5%). Remote recruitment was possible, and 45/47 (95.7%) randomised to the intervention completed 1 or more sessions (median 6 sessions) out of 8. A total of 90 (93.8%) completed the 1-month follow-up, and 86 (89.6%) completed the 3-month follow-up, with similar rates for control (1 month: 45/49 and 3 months 44/49) and intervention (1 month: 45/47and 3 months: 42/47) follow-up. Between-group comparisons were made using a confidence interval (CI) approach, and by adjusting for the covariate of interest at baseline. At 1 month (the primary clinical outcome point), the median number of completed sessions for people receiving the BA intervention was 3, and almost all participants were still receiving the BA intervention. The between-group comparison for the primary clinical outcome at 1 month was an adjusted between-group mean difference of -0.50 PHQ-9 points (95% CI -2.01 to 1.01), but only a small number of participants had completed the intervention at this point. At 3 months, the PHQ-9 adjusted mean difference (AMD) was 0.19 (95% CI -1.36 to 1.75). When we examined loneliness, the adjusted between-group difference in the De Jong Gierveld Loneliness Scale at 1 month was 0.28 (95% CI -0.51 to 1.06) and at 3 months -0.87 (95% CI -1.56 to -0.18), suggesting evidence of benefit of the intervention at this time point. For anxiety, the GAD adjusted between-group difference at 1 month was 0.20 (-1.33, 1.73) and at 3 months 0.31 (-1.08, 1.70). For the SF-12 (physical component score), the adjusted between-group difference at 1 month was 0.34 (-4.17, 4.85) and at 3 months 0.11 (-4.46, 4.67). For the SF-12 (mental component score), the adjusted between-group difference at 1 month was 1.91 (-2.64, 5.15) and at 3 months 1.26 (-2.64, 5.15). Participants who withdrew had minimal depressive symptoms at entry. There were no adverse events. The Behavioural Activation in Social Isolation (BASIL) study had 2 main limitations. First, we found that the intervention was still being delivered at the prespecified primary outcome point, and this fed into the design of the main trial where a primary outcome of 3 months is now collected. Second, this was a pilot trial and was not designed to test between-group differences with high levels of statistical power. Type 2 errors are likely to have occurred, and a larger trial is now underway to test for robust effects and replicate signals of effectiveness in important secondary outcomes such as loneliness. CONCLUSIONS In this study, we observed that BA is a credible intervention to mitigate the psychological impacts of COVID-19 isolation for older adults. We demonstrated that it is feasible to undertake a trial of BA. The intervention can be delivered remotely and at scale, but should be reserved for older adults with evidence of depressive symptoms. The significant reduction in loneliness is unlikely to be a chance finding, and replication will be explored in a fully powered randomised controlled trial (RCT). TRIAL REGISTRATION ISRCTN94091479.
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Affiliation(s)
- Simon Gilbody
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
| | | | - Dean McMillan
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, University of York, York, United Kingdom
| | | | - Della Bailey
- Department of Health Sciences, University of York, York, United Kingdom
| | - Samantha Gascoyne
- Department of Health Sciences, University of York, York, United Kingdom
| | - Claire Sloan
- Department of Health Sciences, University of York, York, United Kingdom
| | - Lauren Burke
- Department of Health Sciences, University of York, York, United Kingdom
| | - Peter Coventry
- Department of Health Sciences, University of York, York, United Kingdom
| | - Suzanne Crosland
- Department of Health Sciences, University of York, York, United Kingdom
| | | | - Andrew Henry
- Department of Health Sciences, University of York, York, United Kingdom
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | - Catherine Hewitt
- Department of Health Sciences, University of York, York, United Kingdom
| | - Kalpita Joshi
- Department of Health Sciences, University of York, York, United Kingdom
| | - Eloise Ryde
- Department of Health Sciences, University of York, York, United Kingdom
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | - Leanne Shearsmith
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | | | - Rebecca Woodhouse
- Department of Health Sciences, University of York, York, United Kingdom
| | - Andrew Clegg
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | | | - Andrew J. Hill
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Karina Lovell
- Division of Nursing, Midwifery & Social Work, University of Manchester, Manchester, United Kingdom
| | - Sarah Dexter Smith
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
| | | | - David Ekers
- Department of Health Sciences, University of York, York, United Kingdom
- Tees, Esk and Wear Valleys NHS FT, Research & Development, Flatts Lane Centre, Middlesbrough, United Kingdom
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Lund B, Ma J. Exploring information seeking of rural older adults during the COVID-19 pandemic. ASLIB J INFORM MANAG 2021. [DOI: 10.1108/ajim-04-2021-0118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study investigates the impact of the COVID-19 pandemic on the types and sources of information sought by older adults along with their motivations in the Midwestern United States.Design/methodology/approachInterviews were conducted with 30 older adults residing in rural communities around the Midwestern United States during late-summer (July/August) 2020, using a protocol based on Dervin's Sense-Making Methodology. The resulting data was analyzed using standard content analysis procedures, guided by the theoretical frameworks based on Dervin's Sense-Making and Williamson's Ecological Model of Information Behavior. Implications of COVID-19 for the normative behaviors described in these models are discussed.FindingsFindings show that older adults were concerned primarily with health and political information during this period, but that this information was not necessarily sought only to address an informational need, but also to satisfy the need to maintain social and emotional connections in coping with isolation and loneliness. Sources of information that allowed for social interaction with people were favored. Wider personal networks (community members) were strained by the social distancing measures and closures. These findings have theoretical and practical implications for considering the impact of social restrictions on information seeking behaviors of older adults in a time of crisis.Originality/valueThis study is the first, known to the authors, that applied the two adopted theoretical frameworks to explore information seeking behaviors of older adults during the COVID-19 pandemic.
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Kyriazis M, Mikellides G, Pantelidakis H, Polycarpou M, Panayiotou B. COVID-19 Isolation and Risk of Death in Cyprus Elderly People. Front Med (Lausanne) 2021; 8:717692. [PMID: 34409055 PMCID: PMC8365165 DOI: 10.3389/fmed.2021.717692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/12/2021] [Indexed: 11/25/2022] Open
Abstract
Social isolation is associated with a higher risk of morbidity and death in older people. The quarantine and social distancing measures due to Covid-19 imposed in most countries and particularly in Cyprus, aim to isolate individuals from direct contact with others. This has resulted in vulnerable older people being isolated at their places of residence for several months, while the recommendations for continuing lockdowns do not appear to be ending. The risk of death from causes other than those related to Covid-19 increases in such individuals and it is due to the effects of social isolation. We estimate that in the next years, there will be a significant increase in the death numbers of such older people in Cyprus. The health authorities must develop a program of support for these older individuals to include medical, social, physical, and psychological elements. Examples of such support are given here.
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Affiliation(s)
| | | | | | | | - Barnabas Panayiotou
- Postgraduate School of Medicine, Keele University, Stoke-on-Trent, Staffordshire, United Kingdom
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Johnstone J, Duncan D. Coronavirus: the 7th C affecting the 6Cs. A focus on compassion, care and touch. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:928-933. [PMID: 34379479 DOI: 10.12968/bjon.2021.30.15.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The C0VID-19 pandemic has challenged everyone in society, from children who are no longer able to attend school and nursery to adults trying to juggle working at home and vulnerable members of society who have needed to self-isolate. NHS staff and key workers also need to juggle their family situations and many will have to adapt their practice and ways of working to address the demands placed on the NHS during this time. The current pandemic has altered the nature of services being provided to patients, and staff are now wearing personal protective equipment, with many being redeployed to ward areas. This article considers the 6Cs of nursing and the challenges faced by staff during the COVID-19 pandemic, with a primary focus on care and compassion. The vital role that touch has in the care of the patient and family is also considered.
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Affiliation(s)
| | - Debbie Duncan
- Lecturer in Nursing, Queen's University Belfast, Northern Ireland
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Lund BD, Maurya SK. How older adults in the USA and India seek information during the COVID-19 pandemic: A comparative study of information behavior. IFLA JOURNAL-INTERNATIONAL FEDERATION OF LIBRARY ASSOCIATIONS 2021. [DOI: 10.1177/03400352211024675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 2020 COVID-19 pandemic introduced significant information challenges for older adults worldwide. Given the widespread disparities in information infrastructure and access between developing and developed countries, the challenges presented during this period may be even more grave in the developing world. This interview study examines how older adults (age 65+) in two countries—the USA and India—experienced information needs, sources, and barriers. The results indicate distinct experiences among the two populations, with individuals in the USA expressing more diverse needs, while Indian respondents focused on the impact of COVID-19. The American respondents also indicated much greater use of Internet resources compared to the Indian respondents, who used television and print resources more frequently. Far more Indian respondents reported significant challenges finding information to satisfy their information needs. The findings of this study have important ramifications for the design of intervention, education, and support for the information-related needs of older adults worldwide.
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Affiliation(s)
- Brady D. Lund
- School of Library and Information Management, Emporia State University, Kansas, USA
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50
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Aihara Y, Kiyoshi M. Depressive symptoms in community-dwelling older adults in Japan before and during the COVID-19 pandemic. Int J Geriatr Psychiatry 2021; 36:1122-1123. [PMID: 33931892 PMCID: PMC8207021 DOI: 10.1002/gps.5558] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoko Aihara
- Faculty of RehabilitationKobe Gakuin UniversityKobeHyogoJapan
| | - Maeda Kiyoshi
- Faculty of RehabilitationKobe Gakuin UniversityKobeHyogoJapan
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