Psychological distress and its correlates in older care-dependent persons living at home

Prevalence and predictors of psychological assistance services for older individuals in Turkish society

Background/aim

Due to the high contribution of psychological problems to the decline in the comfortable lifestyle of the older individuals, determining the factors that affect individuals' receiving psychological services and searching for solutions based on these factors is one of the primary concerns of national and international decision-makers. This study aimed to identify the factors that affect older individuals' access to psychological assistance services in Turkey.

Methods

In this study, the Turkish Health Research micro dataset, which was conducted by the Turkish Statistical Institute (TURKSTAT) in 2016 and 2019, was employed. In this dataset, the data of 7,252 older individuals were analyzed. Using binary logistic analysis, the factors that are effective for obtaining psychological assistance for the older individuals were identified.

Results

According to the results of the analysis, factors such as gender, education, general health status, disease status, payment of health expenditures, and body mass index affected older individuals who received psychological assistance.

Conclusion

In recent years, there has been a rise in the availability of psychological assistance services for the older individuals. By identifying factors that increase the likelihood of receiving psychological assistance services, this study is expected to contribute to the creation and regulation of psychological assistance services to prevent possible psychological problems that may occur in old age, minimize the problems experienced by individuals, and promote a more comfortable lifestyle.

The association between sleep quality and psychological distress among older Chinese adults: a moderated mediation model

BACKGROUND

Previous research has found a link between sleep quality and psychological distress. However, the underlying mechanisms of this connection have still not been well explored. The aim of this study was to examine the roles of activities of daily living (ADL), physical activity, and perceived social support in the link between sleep quality and psychological distress among older adults.

METHODS

Three thousand two hundred fifty valid individuals (aged 60 years or above) participated in face-to-face questionnaire-based surveys. Older individuals were assessed using the Pittsburgh Sleep Quality Index, Barthel Index, International Physical Activity Questionnaire, Perceived Social Support Scale, and Depression Anxiety Stress Scale-21. The PROCESS macro developed by Hayes was used to conduct moderated mediation analysis.

RESULTS

In older adults, sleep quality had a substantial direct influence on psychological distress. ADL mediated the association between sleep quality and psychological distress. Physical activity significantly reduced ADL's mediating influence on the relationship between sleep quality and psychological distress. Furthermore, perceived social support moderated the direct relationship between sleep quality and psychological distress, as well as the second half of the mediating effect of the ADL. Moreover, physical activity and perceived social support were preventive factors that might successfully mitigate the detrimental effects of poor sleep quality on ADL and psychological distress.

CONCLUSIONS

The findings contribute to existing understanding by clarifying the fundamental mechanisms that link sleep quality and psychological distress. These results may provide a valuable reference to the Chinese government for improving mental health in older individuals.

Physical Activity and Health Among Native Hawaiian and other Pacific Islander Older Adults

Objectives: Native Hawaiian and other Pacific Islander (NHPI) older adults often experience social disadvantages and poor health outcomes. Physical activity has been associated with better health in other racial groups, but limited studies have examined these associations in NHPI older adults. Methods: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n = 1,045), logistic regression models examined associations between physical activity and memory/psychological distress/self-rated health. Results: Sufficient levels of physical activity were associated with lower odds of memory problems, serious psychological distress, and poor/fair self-rated health. Unfortunately, only half of the sample reported sufficient physical activity and approximately 30% reported none. Also, 78% of the sample was estimated to be overweight/obese, and 29% had diabetes. Discussion: Culturally-appropriate interventions are recommended to increase physical activity in this population, which could also help reduce high rates of overweight/obesity and diabetes.

Prevalence and Factors Associated with Psychological Distress among Older Adults Admitted to Hospitals After Fall Injuries in Vietnam

Although psychological distress is one of the major health issues among aging populations, little is known about how this challenge affects older patients after falls. A cross-sectional study was conducted in Thai Binh province, Vietnam, to explore the prevalence of psychological distress and associated factors among 405 older patients after falls. The 6-item Kessler Psychological Distress Scale (K6) was used to measure psychological distress. Socio-demographic and clinical characteristics were collected using a structured questionnaire. Multivariate Tobit and Logistic regressions were used to determine factors associated with psychological distress. The prevalence of psychological distress among participants was 26.2%. Patients who were alone or older had a higher likelihood of psychological distress. Patients with a history of falls in the past 12 months were more likely to suffer from psychological distress (OR = 2.87, 95%CI = 1.74; 4.72). Having two and three comorbidities was significantly associated with greater K6 scores and a higher risk of psychological distress. This study underlined a significantly high prevalence of psychological distress among older patients after falls. Providing frequent mental health monitoring, screening, treatment, and facilitating social engagements are important implications to improve the mental health of this population.

Self-evaluated anxiety in the Norwegian population: prevalence and associated factors

Background

Self-evaluations of mental health problems may be a useful complement to diagnostic assessment, but are less frequently used. This study investigated the prevalence of self-evaluated current and lifetime anxiety in the general Norwegian population, and sociodemographic and psychological factors associated with current anxiety.

Methods

A cross-sectional population survey was conducted, using anxiety stated by self-evaluation as outcome. Single and multivariate logistic regression analyses were conducted to examine associations between sociodemographic and psychological variables and anxiety.

Results

One thousand six hundred eighty-four valid responses (34% of the eligible participants) were analysed in this study. One hundred and eleven participants (6.6%) reported current anxiety, while 365 (21.7%) reported lifetime anxiety. Adjusting for sociodemographic and psychological variables, higher age reduced the odds of current anxiety (OR = 0.87, 95% CI = 0.75-0.99), whereas higher levels of neuroticism increased the odds (OR = 2.04, 95% CI = 1.77-2.36).

Conclusions

The study concludes that higher age appears to protect against anxiety, whereas neuroticism appears to increase the odds of experiencing anxiety.

Musculoskeletal pain in Primary Care Physiotherapy: Associations with demographic and general health characteristics

BACKGROUND

Many patients reporting musculoskeletal pain present to Primary Care Physiotherapy with costly comorbid overlapping complaints that remain medically unexplained. These subjective health complaints (SHC) incorporate coexisting multi-site musculoskeletal pain and varied non-musculoskeletal complaints (e.g. anxiety, tiredness). The role of these non-musculoskeletal complaints is acknowledged in spinal musculoskeletal disorders, but less so for peripheral musculoskeletal disorders.

OBJECTIVE

This cross-sectional study explored the relationships between self-reported musculoskeletal pain sites, non-musculoskeletal complaints and disability among people reporting spinal or peripheral musculoskeletal pain.

METHODS

Fifty individuals with spinal musculoskeletal pain and fifty with peripheral musculoskeletal pain provided data on disability, number of musculoskeletal pain sites and non-musculoskeletal complaints. Relationships between these variables were examined for each group using Pearson's correlation coefficient and linear regression analysis.

RESULTS

Participants with spinal musculoskeletal pain recorded significantly more pain sites and non-musculoskeletal complaints than participants with peripheral musculoskeletal pain. However, there was no significant difference in disability between the groups. Non-musculoskeletal complaints were significantly associated with disability (correlation = 0.41, p < 0.01) and number of pain sites (correlation = 0.42, p < 0.01). Number of pain sites and disability were not significantly associated in either group. Participants with spinal musculoskeletal pain reported more tiredness, dizziness, anxiety and sleep problems. Participants reporting dizziness, anxiety, sadness/depression and sleep problems had higher disability.

CONCLUSION

Further studies must confirm the robustness of these associations, to permit comparisons between clinical and general populations and aid identification of causal factors. Considering SHC within individualised management programmes may improve outcomes.

Physical activities impact sense of coherence among community-dwelling older adults

AIM

The objective of the present study was to investigate bidirectional longitudinal relationships between sense of coherence (SOC) and physical activities (PA) among community-dwelling older adults.

METHODS

Self-administered questionnaires were sent to 508 community-dwelling adults aged 65-85 years who expressed their intention to participate in our surveys including cognitive function tests and physical performance tests. Of these, 427 people responded to the baseline survey, and 223 of them participated in the follow-up survey 1 year later. Finally, the number of eligible respondents who had no missing values in all data was 179 (valid response rate: 35.2%). We used the 13-item five-point version of the Sense of Coherence Scale to assess SOC variables, and the Physical Activity Scale for the Elderly to assess PA variables. A structural equation modeling method was used to analyze bidirectional longitudinal relationships between SOC and PA. Cross-lagged effects and synchronous effects models were applied to analyze these relationships. Demographic variables (age, sex, education, living arrangements, medical histories, employment status), cognitive function and physical performance were used as control variables.

RESULTS

Leisure-time PA had a cross-lagged effect (β = 0.117, P < 0.05) and a synchronous effect (β = 0.217, P < 0.001) on SOC. In contrast, no significant effect of SOC on any type of PA was observed in either the cross-lagged effects model or the synchronous effects model.

CONCLUSIONS

Leisure-time PA might contribute to enhancing SOC in community-dwelling older adults. Geriatr Gerontol Int 2017; 17: 2208-2215.

Sense of Coherence among Older Adult Residents of Long-Term Care Facilities in Taiwan: A Cross-Sectional Analysis

Background

Growing evidence shows that sense of coherence (SOC) is related to health promotion. Knowledge of SOC among older adults in Taiwan is limited. The present study aimed to investigate SOC status and its relationship to personal and environmental factors among older adult residents of long-term care facilities (LTCFs) in northeastern Taiwan.

Methods

This cross-sectional study was performed in Yilan, Taiwan. With face-to-face interviews, we obtained data from 104 LTCF residents (aged 65 years and older) using the Chinese version of Antonovsky's short 13-item SOC scale. We also collected the information on personal characteristics, physical and social environmental resources. Multiple linear regression was used to analyze factors potentially influencing SOC.

Results

Of the participants, the mean score (±standard deviation) of SOC was 58.3 (±8.8), while scores on SOC subscales (comprehensibility, manageability, and meaningfulness) were 23.4 ±4.5, 17.9 ±3.8, and 17.0 ±3.2, respectively. Education level, activities of daily living and number of LTCF staff were found to be independently associated with SOC status after adjusting for demographic characteristics, health status, and environmental resources. In addition, interactions between personal and environmental factors had a crucial influence on SOC status.

Conclusions

Participants in this study had relatively low SOC scores compared to their counterparts in Western countries. In addition to personal factors, environmental factors can play a significant role in SOC status among older adult LTCF residents. Comprehensive evaluation of SOC status should consider person-environment interaction effects.

Mediating effect of self-control in relation to depression, stress, and activities of daily living in community residents with stroke

[Purpose] This study aimed to determine whether self-control mediates the relation between depression, stress, and activities of daily living in community residents with stroke. [Subjects and Methods] This study is a secondary analysis of data from 108 community-dwelling stroke patients in Korea. Data were collected through self-reporting questionnaires, including the Korean version of the Center for Epidemiological Studies Depression Scale, Korean version of the Brief Encounter Psychosocial Instrument, and the modified Barthel index. The path model was tested to investigate causal relations between variables, obtain maximum-likelihood estimates of model parameters, and provide goodness-of-fit indices. [Results] The proposed path model showed good fit to the data. Depression and stress have a significant direct effect on self-control and a significant indirect effect on activities of daily living through self-control. Depression and stress accounted for 28.0% of the variance in self-control. Depression, stress, and self-control accounted for 8.4% of the variance in explaining activities of daily living. [Conclusion] The level of self-control is an important indicator of activities of daily living in stroke patients. We suggest that interventions such as enhancement of confidence in one’s self-control ability could be effective in improving the physical activity of stroke patients with depressive mood and stress.

Older people with incurable cancer: Existential meaning-making from a life-span perspective

OBJECTIVE

An increasing number of older people in Western countries are living with incurable cancer, receiving palliative care from specialized healthcare contexts. The aim of our article was to understand how they experience the existential meaning-making function in daily living from a life-span perspective.

METHOD

Some 21 participants (12 men and 9 women), aged 70-88, were interviewed in a semistructured framework. They were recruited from somatic hospitals in southeastern Norway. We applied the model of selective optimization with compensation (SOC) from life-span developmental psychology in a deductive manner to explore the participants' life-oriented adaptive strategies. A meaning component was added to the SOC model.

RESULTS

The participants experienced the existential meaning-making function on two levels. On a superordinate level, it was an important component for interpreting and coordinating the adaptive strategies of SOC for reaching the most important goals in daily living. The existential meaning-making framework provided for a comprehensive understanding of resilience, allowing for both restoration and growth components to be identified. The second level was related to strategy, in that the existential meaning-making function was involved in a complex interaction with behavioral resources and resilience, leading to continuation of goals and more realistic goal adjustments. A few experienced existential meaning-making dysfunction.

SIGNIFICANCE OF RESULTS

The modified SOC model was seen as applicable for palliative care in specialized healthcare contexts. Employing the existential meaning-making framework with its complementary understanding of resilience as growth potential to the SOC model's restoration potential can help older people to identify how they make meaning and how this influences their adaptation process to being incurably sick.

Psychometric properties of the Swedish version of the Self-Transcendence Scale among very old people

BACKGROUND AND PURPOSE

This study tested the psychometric properties of a Swedish version of the Self-Transcendence Scale (STS).

METHODS

Cohen's weighted kappa, agreement, absolute reliability, relative reliability, and internal consistency were calculated, and the underlying structure of the STS was established by exploratory factor analysis. There were 2 samples available: 1 including 194 people aged 85-103 years and a convenience sample of 60 people aged 21-69 years.

RESULTS

Weighted kappa values ranged from .40 to .89. The intraclass correlation coefficient for the original STS was .763, and the least significant change between repeated tests was 6.25 points.

CONCLUSION

The revised STS was found to have satisfactory psychometric properties, and 2 of the 4 underlying dimensions in Reed's self-transcendence theory were supported.

Inner strength in relation to perceived physical and mental health among the oldest old people with chronic illness

OBJECTIVES

The aim of this study was to examine inner strength, defined as connectedness, firmness, flexibility, and creativity, and its relation to mental and physical health in a sample of the oldest old chronically ill women and men living at home.

METHODS

A sample of 79 older women and 41 men in the age range of 80-101 years old (mean = 87.5) participated in this study. Inner strength measured by Resilience Scale, Sense of Coherence Scale (SOC), Purpose in Life Test (PIL), and Self-Transcendence Test (STS) was viewed in relation to mental and physical health (SF-36 Health Survey).

RESULTS

Experiencing connectedness, firmness, flexibility, and creativity were equal for women and men. SOC, PIL, and STS showed moderate inner strength. Medium and low resilience made the participants feel vulnerable. A significant correlation was observed between the variables for inner strength and mental health for women, men, and the total sample. STS was associated with mental and physical health for the total sample and for women.

CONCLUSIONS

Although the oldest old women and men were vulnerable, they had inner strength. Encouraging participation using the inner strength of the oldest old can contribute to strengthen their experiences of independence, integrity, and enjoying life.

An investigation of the role nurses play in Norwegian home care

Registered nurses' (RNs') role in Norwegian home care services exists in a state of flux owing to the early discharge of patients from hospitals, more time-consuming and complex care for young patients, and a growing number of older care recipients. The aim of this study was to investigate the RN role through an integrative research review, with a focus on nursing activities and competence. This study found that RNs and assistant nurses often perform the same tasks, providing assistance with personal hygiene, medication and wound management. The change towards more medicalized and complex home care entails that requirements pertaining to RNs' competence, the allocation of RNs' time and skills to those in most need of nursing care, and the assignment of assistant nurses to lower care levels activities must be delineated. Norwegian home care must examine how care activities can be better allocated between RNs, social educators, assistant nurses, and informal care-givers.