Spousal collaboration mediates the relation between self-rated health and depressive symptoms of Chinese older couples: an actor-partner interdependence approach

BACKGROUND

Dyadic coping resources have been considered a potential explanatory mechanism of spousal interdependence in health, but the mediation of spousal collaboration for the relationship between self-rated health and depressive symptoms has yet to be examined. This study aimed to investigate the within- (actor effect) and between-partner effects of self-rated health on depressive symptoms in community-dwelling older couples facing physical functioning limitations and to examine the role of spousal collaboration in mediating the actor and cross-partner effects of self-rated health on depressive symptoms.

METHOD

Data from 185 community-dwelling older Chinese married couples were analyzed using the actor-partner interdependence mediation model (APIMeM). Couples were interviewed through trained research assistants using the 5-item common dyadic coping subscale of the Dyadic Coping Inventory (DCI), the Visual Analog Scale (VAS) of the QoL questionnaire EQ-5D and the Patient Health Questionnaire-9 (PHQ-9).

RESULTS

Husbands' self-rated health had an actor effect on their own depressive symptoms and a partner effect on their wives' depressive symptoms. Wives' self-rated health had an actor effect on their own depressive symptoms. The actor effects between self-rated health and depressive symptoms were partially mediated by their own perception of spousal collaboration. Furthermore, husbands' self-rated health not only affects wives' depressive symptoms directly but also indirectly by influencing wives' perceptions of spousal collaboration.

DISCUSSION

The findings from this study underscored the importance of viewing couples' coping processes from a dyadic and gender-specific perspective, since more (perceived) collaborative efforts have beneficial effects on both partners' mental health outcomes.

Dyadic Associations Between Grandparent-Grandchild Familial Values and Successful Aging: Mediating Role of Quality of Life

The current study aimed to determine the reciprocal associations between the familial values and successful aging of grandparents and grandchildren and the extent to which quality of life accounts for these reciprocal associations. Data was collected from 270 grandparent-grandchild pairs living together. Actor-Partner Independence Model indicated that familial values of both grandparents and grandchildren showed significant associations with their own successful aging (actor effects), whereas familial values of grandchildren showed significant associations with the successful aging of grandparents (partner effects). Grandchildren's quality of life mediated the actor and partner effects of familial values on the successful aging of grandchildren; whereas grandparents' quality of life only mediated the actor effect of familial values on the successful aging of grandparents. These findings showed the interdependence of grandparents and grandchildren while emphasizing the importance of grandparents-grandchildren familial values and quality of life in enhancing successful aging.

Grandparenting and subjective well-being in China: The moderating effects of residential location, gender, age, and income

Grandparenting is a social determinant of older adults' subjective well-being (SWB) worldwide, and is receiving increasing scholarly attention. Grandparenting is particularly prevalent in China because of the increasing number of women in the labor force, shortages of daycare services, and intergenerational bonds. Based on three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study (n = 14,846), we used pooled ordinary least squares (POLS) regression to examine the association between grandparenting and Chinese older adults' SWB and the moderating effects of residential location (rural/urban), gender, age, and income. We measured SWB by four outcomes: self-rated health, life satisfaction, depressive symptoms, and cognitive function. Our findings indicate that intensive grandparenting is positively associated with older adults' life satisfaction. Older adults providing a low-to-high intensity of grandparenting have better cognitive function than non-caregivers. Among caregivers, a moderate level of grandparenting is associated with better cognitive function. Residential location, age, and income are significant moderators. For example, high-intensity grandparenting is positively associated with rural grandparents' but not urban grandparents' life satisfaction. Although younger grandparents have better self-rated health, higher life satisfaction, and fewer depressive symptoms than their older counterparts if they provide grandparenting care, grandparenting is more beneficial for older grandparents' cognitive function. Both low and high intensities of grandparenting are positively related to self-rated health and cognitive function for grandparents with lower incomes. Overall, the findings of this study indicate how grandparenting is related to the SWB of older people in China in different social groups and of people living in different locations.

Intergenerational relationship quality and activity profiles among older adults in China

Currently, very few studies have comprehensively investigated how intergenerational relationship quality (IRQ) between older parents and adult children is related to older adults' activity engagement. To fill this gap, this study endeavoured to examine the associations between IRQ and older adults' activity profiles, not only considering the overall IRQ but also different dimensions of IRQ. We also aimed to reveal the different roles of IRQ with son(s) and with daughter(s). This study made use of survey data collected in Yibin City, Sichuan Province of China in 2018 (N = 4,211). We adopted hierarchical cluster analysis to identify activity profiles, and performed multinomial logistic regressions to assess the association between IRQ and the profiles. We identified five activity profiles among older adults: "caregiving-oriented", "employment-oriented", "social withdrawal", "diverse engagement" and "physically active". Those with greater IRQ were more likely to be "caregiving-oriented" and have "diverse engagement" relative to "social withdrawal". It also showed that structural-associational solidarity and affectual closeness were more predictive of the activity profiles, compared to consensual-normative solidarity and intergenerational conflict. Children's gender plays an important role in the relationship between IRQ and activity engagement profiles. Good intergenerational relationships might not narrow down older adults' activity domains, and instead might actually promote their participation in diverse domains. Promoting structural-associational solidarity and affectual closeness was likely to reduce social withdrawal among older adults in China.

Using the intergenerational solidarity framework to understand the grandparent-grandchild relationship: a scoping review

Intergenerational interactions and exchange are major components of grandparenting, and the present study sought to examine how the intergenerational solidarity framework has been used to investigate grandparenting practices across the lifespan and in different cultures. This framework is widely used across cultures and provides a basis to discuss the future of grandparenting research, considering cultural intermingling and changes in society. Following PRISMA-ScR guidelines, we searched three databases (PsycInfo, PubMed, and Web of Science). Finally, 42 empirical studies that met the inclusion criteria were included in this scoping review. They were published between 1991 and 2020 and assessed intergenerational solidarity between grandparents and their grandchildren. Our findings show that research on grandparenting based on the intergenerational solidarity framework has increased in the last 30 years, and that this model provides a comprehensive approach to studying grandparenting across the lifespan in different cultures. The present study identified cross-cultural differences in the prevalence of the types of intergenerational solidarity. Affectual solidarity was shown to be the most studied dimension of intergenerational solidarity in North America, Europe and Israel, while normative solidarity was the most represented in Asian studies. The only Australian study investigated affectual and functional solidarity. This model is thus suitable for studying grandparenting, but further studies are needed to investigate changes in intergenerational solidarity between grandparents and their grandchildren at different stages of development and account for cultural specificities.

The impact of social capital and mental health on medication adherence among older people living with HIV (PLWH)

Background

The number of older people living with HIV (PLWH) is increasing. Although there are many studies affecting medication adherence, research on the impact of social capital and mental health on medication adherence in this particular population is limited.

Method

Data were collected from an ongoing observational prospective cohort study, starting from November 2018, among older PLWH in Sichuan province, China. Five hundred twenty-one participants were interviewed. Social capital consists of the individual and family (IF) scale, and the community and society (CS) scale. The presence of probable depression and probable anxiety were assessed using the CES-D-10 and GAD-7 scales. Adherence was defined as taking ≥80% of prescribed HIV medication in 4 days prior to the interview. Two sets of Firth’ penalized regression analyses were used to estimate the association between social capital, mental health, and medication adherence.

Results

The prevalence of non-adherence was 18.2% (95/521) among older PLWH in this study. After adjusting for significant factors, the CS social capital (OR: 0.92, 95%CI:0.85–0.99, p < 0.05) and probable anxiety (OR:1.73, 95%CI:1.07–2.80, p < 0.05) were associated with non-adherence.

Conclusion

This study highlighted that the effects of social capital and mental health on older PLWH’s adherence, which implied that the need to develop interventions to concern for mental health and enhance CS social capital to help the older PLWH better manage HIV medication adherence.

Caring as curing: Grandparenting and depressive symptoms in China

Research on grandparenting (i.e., caring for grandchildren) and mental health in Asian contexts has been limited, despite the rapid growth of older adults who take care of grandchildren. This study aims to investigate how grandparenting influences depressive symptoms in China. Using the China Health and Retirement Longitudinal Study (2011-2015, N = 4354), we conducted fixed effects regression models to examine the association between various types of grandparenting and depressive symptoms among older adults between the ages of 45 and 80. The results show that for grandparents, providing care to their grandchildren in skipped-generation households (i.e., grandparent-grandchildren families without adult children) is associated with a lower level of depressive symptoms compared to providing no care, after controlling for socioeconomic status, health behaviors, social support, and basic demographic characteristics. Other types of care (i.e., multigenerational household grandparenting, and part-time and full-time noncoresident grandparenting) are not significantly linked to caregiving grandparents' depressive symptoms. Overall, our findings suggest that sociocultural contexts need to be considered in explaining the different mental health implications of grandparenting.

Community Social Capital, Family Social Capital, and Self-Rated Health among Older Rural Chinese Adults: Empirical Evidence from Rural Northeastern China

This study investigated the relationships among community social capital, family social capital, and self-rated health of older adults in rural China. Data came from a community survey in Jilin Province, China, in 2019. Using a quota sampling method, 458 respondents aged 60 years or older were recruited. Two-step structural equation modeling was adopted to examine the proposed hypotheses. The relationships between community-based structural social capital, family social capital and self-rated health were statistically significant, whereas the relationship between community-based cognitive social capital and self-rated health was statistically nonsignificant. In order to enhance healthy aging, social capital policies and interventions should be developed to promote not only family social capital indicators (e.g., quality of family relationship and support) but also older adults' structural social capital indicators (e.g., social participation and volunteering) in rural Chinese contexts.

Grandparents - Grandchildren Relationship in Iran, 2017

Introduction:

With the continuing growth of aged populations, it is imperative to find ways to maintain and improve the quality of life in old age. It has been documented that grandparents-grandchildren relationship is significantly contributed to quality of life of older adults. This study was conducted to identify the status and associated factors of grandparents-grandchildren relationship in a sample of Iran.

Methods:

This cross-sectional study was conducted on 377 community dwelling older adults 60 years and over living in Kashan, Iran. A multistage proportional random sampling technique was applied to obtain the sample. The grandparent -grandchildren relationship was measured by a researcher-developed 16-item scale. The data were analyzed using SPSS version 23 and AMOS 23.

Results:

The mean age of the respondents was 70.42(SD = 8.20) years. About 62% of the respondents were female and 60.7% were married. The average score of grandparents-grandchild relationship was 67.60(SD = 12.47). The multiple linear regression analysis revealed a significant model (F _{(11, 365)} = 19.05, P < 0.001), where information communication technology of grandparents, geographical distance between grandparents and grandchildren, and the quality of relationship between grandparents and parents of grandchildren were the most important predictors of the grandparents-grandchildren relationship.

Conclusion:

The findings from the current study showed that status of grandparents-grandchildren relationship is moderate to high and influenced by some factors. It is, therefore, suggested that policymakers pay more attention to strengthening grandparent-grandchild relationship by providing educational programs for families and encouraging the elderly to learn and use information communication technology.

Multidimensional Intergenerational Instrumental Support and Self-Rated Health Among Older Adults in Rural China: Trajectories and Correlated Change Over 11 Years

OBJECTIVES

This study investigated the dynamic relationship between multidimensional intergenerational instrumental support and health over time. This approach is of theoretical, methodological, and practical significance in gerontological research.

METHOD

Data came from The Well-Being of Older People in Anhui Province in 2001, 2003, 2006, 2009, and 2012. Of the 1,636 participants at baseline, a working sample of 1,557 older adults was used. Trajectories and correlated change were estimated using parallel latent growth curve modeling with maximum likelihood estimation.

RESULTS

"Received household-chore help" decreased over time, whereas "received personal-care help" increased over time. "Provided household-chore help" and "provided personal-care help" increased and then decreased over time. Increasing receipt of "household-chore help" and "personal-care help" were associated with faster decline in health over time.

DISCUSSION

Findings suggest distinctive patterns of changes for different dimensions of intergenerational instrumental support and their relationship with changes in perception of health over time in later life.

Does social capital influence preferences for aging in place? Evidence from urban China

OBJECTIVE

This study investigated the relationships between social capital and preferences for aging in place among older urban adults in eastern China.

METHOD

Quota sampling was used to recruit 456 respondents aged 60 and older from Gusu District, Suzhou City, in 2015. Random-effects logistic regression was used to test the proposed model.

RESULTS

Respondents who had better quality family social capital, a higher level of social trust, and more organization memberships were more likely to choose to live in local communities, even after we controlled for individual characteristics.

DISCUSSION

The findings highlight the important role of both family and community social capital in influencing preferences for aging in place among older adults in urban China. This is particularly important for developing long-term care systems for older adults living in naturally occurring retirement communities.

Social Capital and Life Satisfaction across Older Rural Chinese Groups: Does Age Matter?

This study examined the age difference in the relationship between social capital in the form of cognitive (trust, family support) and structural aspects (social membership, activity frequency) and life satisfaction of older Chinese people in a rural area. Data were collected from 398 elders in the rural area of China by quota sampling. Hierarchical regression analysis was used to realize the objective. Trust and family support were significantly positively associated with life satisfaction, whereas social membership was strongly negatively associated with life satisfaction. Activity frequency did not show any significance in relationship with life satisfaction. Age difference existed in the associations of trust and activity frequency with life satisfaction. Age difference in the relationship of trust and activity frequency with life satisfaction of elderly Chinese people in the rural area did exist. It is recommended that the measure be refined and programs and services be provided according to the hierarchical needs of older adults in different age groups.

To Share or Not to Share: A Cross-Sectional Study on Health Information Sharing and Its Determinants Among Chinese Rural Chronic Patients

To examine the determinants of the health information sharing among rural Chinese chronic patients. Two large population-based surveys in rural China were carried out from July 2011 to April 2012. Data used in this study were second hand and sorted out from the two previous databases. A binary logistic regression analysis was employed to discover the impact of demographic characteristics, level of health literacy, and other factors on respondents' health information sharing behavior. Among the total 1,324 participants, 63.6% share health information with others. Among all significant predictors, those who acquire health information via family and friends are 6.0 times the odds of sharing health information than those who do not. Participants who have more than six household members, with middle and high levels of health knowledge, and who are moderately involved in discussions or settlements of village affairs are also more likely to share health information. The reliance on interpersonal communication channels for health information, household size, the patients' preexisting health knowledge, and their activity in village affairs are crucial determinants for health information sharing among rural chronic patients. A more sophisticated model needs to be established to reveal the complex processes of health information communication.

Is occupation a good predictor of self-rated health in China?

Background

China’s rapidly changing economic landscape has led to widening social inequalities. Occupational status in terms of occupational type and prestige may reflect these socio-structural shifts of social position and be more predictive of self-rated health status than income and education, which may only reflect more gradual acquisitions of social status over time. The goals of this study were to understand the role of occupational status in predicting self-rated health, which is well known to be associated with long-term mortality, as well as compare the occupational status to the other major socioeconomic indicators of income and education.

Methods

Data from the 2010 baseline surveys of the China Family Panel Studies, which utilized multi-stage probability sampling with implicit stratification was used. Logistic regression was used to examine the relationship of various socioeconomic indicators (i.e. occupational status, income, and education) with self-rated health as the primary outcome of interest. A series of models considered the associations of occupational category or occupational prestige with self-rated health.

Results

The final sample consisted of 14,367 employed adults aged 18–60, which was nationally representative of working adults in China. We found that occupation was not a major predictor of self-rated health in China when age, ethnicity, location, marital status, physical and mental health status were controlled for, with the exception of women working in lower grade management and professional jobs (OR = 1.82, 95% CI: 1.03–3.22). In comparison, income followed by education exhibited greater association with self-rated health. The highest income group had the least probability to report poor health (In men: OR = 0.30, 95% CI: 0.21–0.43. In women: OR = 0.44, 95% CI: 0.26–0.73). People educated with junior high school had better self-rated health than those with primary and below education level (In men: OR = 0.62, 95% CI: 0.50–0.75. In women: OR = 0.53, 95% CI: 0.42–0.68). Income, education and occupation were correlated with each other.

Conclusions

Within the context of rapid societal changes in China, income and its implications for greater healthcare access and benefits had the greatest association with self-rated health followed by education. Occupational status was not associated. Occupational categories and prestige should be better adapted to reflect China’s unique sociopolitical and historical context.