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Huang S, Wang J, Zhang Y, Qiu Y, Wang H, Yu X, Wang Z, Lv X. Co-occurrence of depressive and anxious symptoms and their influence on self-rated health: a national representative survey among Chinese older adults. Aging Ment Health 2024:1-10. [PMID: 38745442 DOI: 10.1080/13607863.2024.2348613] [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: 09/22/2023] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES The prevalence of the co-occurrence of depressive and anxious symptoms (CO) and their influence on perceived overall health were not clear in community dwelling Chinese older adults. The aims of the study were to investigate the prevalence of CO and to explore its influence on self-rated health (SRH). METHOD This study included 12301 individuals aged ≥65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative survey of older adults in mainland China. Participants received face-to-face interviews and assessments of depressive symptoms and anxious symptoms via 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), respectively. SRH was measured by self-reported. A logistic regression model was used to examine the association between CO and SRH after adjusting for confounding variables. RESULTS The average age was 83.4 (SD: 11.0) years and there were 6576 (53.5%) females. The age- and sex-standardized prevalence of depressive symptoms only (DSO) was 38.6%, anxious symptoms only (ASO) was 1.5%, and CO was 10.8%. Compared with those without depressive and anxious symptoms, the older adults with DSO or ASO were more likely to have significant influence on SRH. And particularly, CO was likely to produce the greatest decrement in the level of SRH. CONCLUSION CO was not rare in Chinese older adults nationwide. The older adults having CO had increased risk for lower level of SRH than having DSO or ASO. More attention should be given to CO among the older adults.
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Affiliation(s)
- Sicheng Huang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Jing Wang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Yunjing Zhang
- School of Public Health, Peking University, Beijing, China
| | - Yujia Qiu
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Huali Wang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Xin Yu
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Zhijiang Wang
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
| | - Xiaozhen Lv
- NHC Key Laboratory of Mental Health, Peking University Institute of Mental Health Sixth Hospital, Beijing, China
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Salman A, Lee YH. Spiritual practices and effects of spiritual well-being and depression on elders' self-perceived health. Appl Nurs Res 2019; 48:68-74. [PMID: 31266611 DOI: 10.1016/j.apnr.2019.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/18/2019] [Accepted: 05/27/2019] [Indexed: 01/17/2023]
Abstract
As the population is quickly ageing, strategies for helping elders to maintain and promote good health and well-being are urgently needed. Self-perceived health is a powerful predictor of mortality, physical morbidity, and disability among elderly people. Delivering culturally competent care is necessary for taking care of elders. Self-perceived health is a powerful predictor of mortality, physical morbidity, and disability among elderly people. Spiritual well-being has been found particularly important for older adults' overall health. This descriptive, correlational and predictive study used data that was collected from a convenience sample (N = 150) to examine the effects of spiritual well-being on the relationship between depression and self-perceived health, and to describe spiritual practices commonly used by Taiwanese elders. Findings from this study revealed that spiritual well-being was positively correlated with self-perceived health, negatively associated with depression, and significantly mediated the relationship between depression and self-perceived health. Relaxation and exercise were the most commonly used spiritual practices by Taiwanese elders. Findings from this study support the important role of spiritual well-being in elders' health and add to the body of knowledge about the spiritual practices used by Taiwanese elders. Nurses and health care providers should deliver culturally appropriate spiritual care to enhance spiritual well-being for elders to maintain good health for diverse elder population.
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Affiliation(s)
- Ali Salman
- Department of Nursing, Faculty of Health Studies, Brandon University, Manitoba R7A 6A9, Canada.
| | - Yi-Hui Lee
- College of Nursing and Health, Wright State University-Miami Valley, 3640 Colonel Glenn Hwy., Dayton, OH 45435-0001, USA.
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Kirkevold M, Kildal Bragstad L, Bronken BA, Kvigne K, Martinsen R, Gabrielsen Hjelle E, Kitzmüller G, Mangset M, Angel S, Aadal L, Eriksen S, Wyller TB, Sveen U. Promoting psychosocial well-being following stroke: study protocol for a randomized, controlled trial. BMC Psychol 2018; 6:12. [PMID: 29615136 PMCID: PMC5883408 DOI: 10.1186/s40359-018-0223-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 03/11/2018] [Indexed: 11/25/2022] Open
Abstract
Background Stroke is a major public health threat globally. Psychosocial well-being may be affected following stroke. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent. Approximately one third report depressive symptoms and 20% report anxiety during the first months or years after the stroke. Psychosocial difficulties may impact significantly on long-term functioning and quality of life, reduce the effects of rehabilitation services and lead to higher mortality rates. The aim of the study is to evaluate the effect of a previously developed and feasibility tested dialogue-based psychosocial intervention aimed at promoting psychosocial well-being and coping following stroke among stroke survivors with and without aphasia. Methods The study will be conducted as a multicenter, randomized, single blind controlled trial with one intervention and one control arm. It will include a total of 330 stroke survivors randomly allocated into either an intervention group (dialogue-based intervention to promote psychosocial well-being) or a control group (usual care). Participants in the intervention group will receive eight individual sessions of supported dialogues in their homes during the first six months following an acute stroke. The primary outcome measure will be psychosocial well-being measured by the General Health Questionnaire (GHQ). Secondary outcome measures will be quality of life (SAQoL), sense of coherence (SOC), and depression (Yale). Process evaluation will be conducted in a longitudinal mixed methods study by individual qualitative interviews with 15–20 participants in the intervention and control groups, focus group interviews with the intervention personnel and data collectors, and a comprehensive analysis of implementation fidelity. Discussion The intervention described in this study protocol is based on thorough development and feasibility work, guided by the UK medical research council framework for developing and testing complex interventions. It combines classical effectiveness evaluation with a thorough process evaluation. The results from this study may inform the development of further trials aimed at promoting psychosocial well-being following stroke as well as inform the psychosocial follow up of stroke patients living at home. Trial registration NCT02338869; registered 10/04/2014 (On-going trial).
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Affiliation(s)
- Marit Kirkevold
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway.
| | - Line Kildal Bragstad
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway
| | - Berit A Bronken
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Kari Kvigne
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Ellen Gabrielsen Hjelle
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway
| | - Gabriele Kitzmüller
- Faculty of Health UIT, The Arctic University of Norway, Campus, Narvik, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, P.O box 4956, Nydalen, 0424, Oslo, Norway
| | - Sanne Angel
- Institute of Public Health, Aarhus University, Hoegh-Guldbergs Gade 6 A, 8000, Aarhus, Denmark
| | - Lena Aadal
- Hammel Neurorehabilitation and Research Centre, Voldbyvej 15 8450, Hammel, Denmark
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), P. O. Box 2136, 3103, Tønsberg, Norway
| | - Torgeir B Wyller
- Institute of Clinical Medicine, University of Oslo, and Department. of Geriatric Medicine, Oslo University Hospital, P.O box 4956 Nydalen, 0424, Oslo, Norway
| | - Unni Sveen
- Dept. of Geriatric Medicine, and Dept. of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O box 4956 Nydalen, 0424, Oslo, Norway
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Isaac V, McLachlan CS, Baune BT, Huang CT, Wu CY. Poor Self-Rated Health Influences Hospital Service Use in Hospitalized Inpatients With Chronic Conditions in Taiwan. Medicine (Baltimore) 2015; 94:e1477. [PMID: 26356706 PMCID: PMC4616650 DOI: 10.1097/md.0000000000001477] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Our aim was to investigate the association between self-rated health (SRH) and use of hospital services (ie, medical outpatient department, emergency department, and general ward. admissions). Cross-sectional study data were collected from 230 consecutive patients admitted to medical departments of a 2000-bed academic medical center in Taiwan using standardized operating procedures for data collection of SRH (ie, a single-item question inquiring overall perceived health status), medical disorders, depressive symptoms, and combined service utilization over a 1-year period (ie, number of visits to outpatient department, number of visits to emergency department, and number of hospitalizations). Electronic medical records were retrieved, with self-reported external medical visits added to in-hospital frequencies of service use to provide better estimation of health service utilization. Fifty-two percent of study patients rated their health as poor or very poor. Poor SRH was associated with more visits to medical outpatient department, emergency department, and hospital admission. Multivariate logistic regression demonstrated an independent association between poor SRH and services utilization after adjustment for age, gender, hypertension, diabetes, metastatic cancer, number of chronic illness, life-threatening event, life-time suicidal ideation, and depression. SRH may be a useful research tool to model medical service use for inpatients with chronic conditions.
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Affiliation(s)
- Vivian Isaac
- From the Rural Clinical School, University of New South Wales, Sydney, Australia (VI, CSM); Department of Psychiatry, School of Medicine, University of Adelaide, Adelaide, Australia (BTB); Departments of Internal Medicine and Traumatology, National Taiwan University Hospital, Taipei, Taiwan (C-TH); and Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan (C-YW)
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Schuler BR. Health Perceptions and Quality of Life among Low-Income Adults. HEALTH & SOCIAL WORK 2015; 40:225-232. [PMID: 26285362 DOI: 10.1093/hsw/hlv045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Marginalized populations may be predisposed to poor health outcomes due to health dis parities. Although much of the research on health and quality of life is from the perspective of the impact of clinical diagnosis, there is a need for more diverse inquiries and recognition of the individuals' perceptions and preferences. The present study examined the importance of an individual's perception of his or her current health in predicting quality of life over and beyond the presence of physical or mental health conditions. The sample included 150 low-income adults, of which 84.7 percent were African American and 15.4 percent were of another minority race or ethnicity. Participants had an average monthly income of $703. Having a better perception of health was significantly associated with increased quality of life scores. Subjective perceptions of current health were a better predictor of quality of life than the presence of a serious physical or mental health condition. The article ends with a discussion of appropriate interventions to improve health perceptions in similar populations predisposed to poor health outcomes.
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Bruvik FK, Ulstein ID, Ranhoff AH, Engedal K. The effect of coping on the burden in family carers of persons with dementia. Aging Ment Health 2014; 17:973-8. [PMID: 23614391 DOI: 10.1080/13607863.2013.790928] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study explores the association between coping, measured by the extent of locus of control, and the burden of care on family carers of persons with dementia (PWD). METHOD Two hundred thirty PWD living at home and their family carers were recruited from 20 Norwegian municipalities. The carers' burden was assessed by the Relatives' Stress Scale (RSS) and coping by the Locus of Control Behaviour Scale. The PWD were assessed by the Neuropsychiatric Inventory (NPI-Q), the Physical Self-Maintenance Scale (PSMS), the Instrumental Activities of Daily Living (IADL) scale, and the Mini Mental Status Examination (MMSE). RESULTS Locus of control (LoC) was found to be the most important factor associated with the burden on carers of PWD, even when we had controlled for the PWD variables, such as the NPI-Q score. The LoC and the carer's use of hours per day to assist the PWD were the only two variables the carers found that affected the extent of the burden. The NPI-Q was the most important variable in the PWD that affected the burden on the carers. CONCLUSION Carers who believe that what happens to them is the consequence of their own actions are likely to be less burdened than carers not expecting to have control. This finding gives a possibility to identify carers with a high risk of burden.
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Helvik AS, Selbæk G, Engedal K. Cognitive decline one year after hospitalization in older adults without dementia. Dement Geriatr Cogn Disord 2013; 34:198-205. [PMID: 23128048 DOI: 10.1159/000343932] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS We studied cognitive functioning 1 year after hospitalization (T2) in patients at least 65 years old without cognitive impairment at baseline (T1). METHODS Cognition was assessed using the Mini-Mental State Examination (MMSE) at both time points. We included 211 (114 women) patients with a mean age of 78.3 (SD 7.0) years and an MMSE score of 24 and above. RESULTS At T2, 69 (32.7%) patients had an MMSE score below 24. In participants with MMSE 24-26 at T1, cognitive decline was related to impaired physical self-maintenance, a decline in the performance of the instrumental activities of daily living, impaired hearing and less reading ability. In participants with MMSE 27-30, cognitive decline was associated with higher comorbidity (Charlson Index) and impaired physical self-maintenance and hearing. CONCLUSION A reduced functioning level and increased comorbidity predicted a decline in cognitive functioning.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Helvik AS, Engedal K, Selbæk G. Perceived health among the medically hospitalized elderly: a one-year follow-up study. Scand J Public Health 2013; 41:421-8. [PMID: 23474953 DOI: 10.1177/1403494813480278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM To examine perceived health of elderly medically hospitalized patients 1 year after hospitalization, and to explore factors associated with the perceived health at follow-up. METHODS A one-year follow-up study included 363 (175 men) elderly previously medical inpatients with age range 65-98 (mean 80.2, SD 7.5) years. Information was collected at baseline and follow-up, where perceived health--the dependent variable--was measured by one self-report item. The independent variables were assessed by the Hospital Anxiety and Depression scale (HAD), the Mini-Mental State Examination (MMSE), Lawton and Brody's scales for physical self-maintenance and performance of the instrumental activities of daily living (PSMS and I-ADL). RESULTS The proportion of elderly people assessing their health as good at baseline was 43.3% (n = 157) and at 12 months 41.3% (n = 150). Of those with poor health at baseline, 34% (n = 70) experienced good health at 12 months. In the analysis controlling for physical health, perceived health, physical and instrumental functioning, and depression at baseline, an increase in the level of physical and instrumental functioning and reduced symptom level of depression were independently associated with good perceived health at 12 months. CONCLUSIONS Improvement in performing the activities of daily living and a reduction of depressive symptoms are important factors for the perception of health one year after hospitalization. The rehabilitation of medically ill elderly patients could be the means of achieving this improvement.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Helvik AS, Engedal K, Selbæk G. Change in sense of coherence (SOC) and symptoms of depression among old non-demented persons 12 months after hospitalization. Arch Gerontol Geriatr 2013; 56:314-20. [DOI: 10.1016/j.archger.2012.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 10/16/2012] [Accepted: 10/17/2012] [Indexed: 11/29/2022]
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Helvik AS, Engedal K, Selbæk G. Three-year mortality in previously hospitalized older patients from rural areas--the importance of co-morbidity and self-reported poor health. BMC Geriatr 2013; 13:17. [PMID: 23419167 PMCID: PMC3600034 DOI: 10.1186/1471-2318-13-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 02/14/2013] [Indexed: 11/13/2022] Open
Abstract
Background The risk factors for mortality after hospitalization in older persons are not fully understood. The aim of the present study was to examine the three-year (1,096 days) mortality in previously hospitalized older patients from rural areas, and to explore how objectively and self-reported health indicators at baseline were associated with mortality. Methods The study included 484 (241 men) medical inpatients with age range 65–101 (mean 80.7, SD 7.4) years. Baseline information included the following health measures: the Charlson Index, the Mini-Mental-State Examination, Lawton and Brody’s scales for physical self-maintenance and the instrumental activities of daily living, the Hospital Anxiety and Depression scale, self-reported health (one item), and perceived social functioning (one item) and assistance in living at discharge. Results In all, 172 (35.5%) of those patients included had died within the three years of the follow-up period. Three-year mortality was associated with a high score at baseline on the Charlson Index (HR 1.73, 95%CI 1.09-2.74) and poor self-reported health (HR 1.52, 95%CI 1.03-2.25) in a Cox regression analysis adjusted for age, gender, other objectively measured health indicators, and perceived impaired social functioning. Conclusion In a study of older adults admitted to a general hospital for a wide variety of disorders, we found co-morbidity (as measured with the Charlson Index) and poor self-reported health associated with three-year mortality in analysis adjusting for age, gender, and other health-related indicators. The results suggest that self-reported health is a measure that should be included in future studies.
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Affiliation(s)
- Anne-Sofie Helvik
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Postboks 8905, Trondheim NO-7491, Norway.
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