Relevance of spirituality and perceived social support to mental health of people with pre-existing mental health disorders during the COVID-19 pandemic: a longitudinal investigation

BACKGROUND

The COVID-19 pandemic and related measures have negatively impacted mental health worldwide. The main objective of the present longitudinal study was to investigate mental health in people living in Tyrol (Austria) and South Tyrol (Italy) during the COVID-19 pandemic and to report the prevalence of psychological distress among individuals with versus those without pre-existing mental health disorders (MHD) in the long-term (summer 2020-winter 2022). Here, we specifically focus on the relevance of spirituality and perceived social support in this regard.

METHODS

161 individuals who had been diagnosed with MHD and 446 reference subjects participated in this online survey. Electronic data capture was conducted using the Computer-based Health Evaluation System and included both sociodemographic and clinical aspects as well as standardized questionnaires on psychological distress, spirituality, and the perception of social support.

RESULTS

The prevalence of psychological distress was significantly higher in individuals with MHD (36.6% vs. 12.3%) and remained unchanged among both groups over time. At baseline, the perception of social support was significantly higher in healthy control subjects, whereas the two groups were comparable in regards of the subjective relevance of faith. Reference subjects indicated significantly higher spiritual well-being in terms of the sense of meaning in life and peacefulness, which mediated in large part the between-group difference of psychological distress at follow-up. Notably, both faith and the perception of social support did not prove to be relevant in this context.

CONCLUSIONS

These findings point to a consistently high prevalence of psychological distress among people suffering from MHD and underscore the prominent role of meaning in life and peacefulness as a protective factor in times of crisis. Therapeutic strategies that specifically target spirituality may have a beneficial impact on mental health.

Religiosity, Aging in the Homeland, and Growing Old in the Diaspora: A Longitudinal Study of Two Cohorts of Indian Older Adults

This article reports a longitudinal study comparing religiosity among two cohorts of Indian older adults-those who age in the homeland of India (AIH cohort) and immigrants (to the USA) or diaspora older adults (DOA). Results indicated that AIH and DOA cohorts' religiosity outcomes were comparable at baseline but there was a statistically significant increase in all outcomes of the DOA cohort at subsequent time points. Women and single older adults in both the cohorts had higher religiosity scores at baseline. Religiosity scores were higher among those in the DOA cohort who migrated following marital disruption (widowhood, divorce) or grandchild birth and lived with adult immigrant children and their families. The immigration process can have an impact on religious orientation of older adults and place is a significant variable impacting religiosity possibly for augmenting the sense of self, acquire social capital and preserve cultural identity in the foreign land.

Mediation analysis of mental health characteristics linking social needs to life satisfaction among immigrants

Background

Life satisfaction contributes to improved long and healthy lives, enhanced biological function, better mental health, and decreased mortality risks. Social needs (e.g., food security, employment, healthcare utilization) are important determinants of mental health and life satisfaction among immigrants. However, there is limited literature on how social needs influence mental health, which, in turn, affects life satisfaction among immigrants. We examined whether mental health influences the mechanisms of the relationship between social needs and life satisfaction among immigrants.

Methods

We used the 2021 cross-sectional National Health Interview Survey data on U.S. immigrants (n = 4320) aged ≥18 years. We conducted weighted mediation analyses with multiple linear regression. Life satisfaction (scores 0-10; ≥1 as higher life satisfaction) was the dependent variable; independent variables were food security, employment, and healthcare utilization; and the mediator, serious psychological distress (SPD: scores 0-24; ≥1 as higher SPD).

Results

The total effect (not accounting for SPD) of food insecurity (vs. secure) on life satisfaction was negative (β = -0.61, p < 0.001); the direct effect (after accounting for SPD) was not statistically significant (β = -0.21, p = 0.153), while the indirect effect (food insecurity's effect explained by SPD) was negative (β = -0.40, p < 0.001). The total (β = 0.32, p < 0.001), direct (β = 0.24, p = 0.004), and indirect (β = 0.09, p = 0.006) effects of being employed (vs. unemployed) on life satisfaction were positive. The total (β = -0.12, p = 0.116) and direct (β = -0.03, p = 0.683) effects of healthcare utilization within the past year (vs. more than a year) on life satisfaction were not statistically significant, whereas the indirect effect was negative (β = -0.09, p < 0.001).

Conclusions

SPD mediates the effect of food security, healthcare utilization, and employment on life satisfaction, suggesting the need to improve social needs and mental health among immigrants.

The chain mediation model of social support and life satisfaction among migrant older adults with children: The role of mental health and sleep quality

INTRODUCTION

Few studies have examined the life satisfaction of migrant older adults with children (MOAC), who emerged due to rapid urbanization and population aging in China. This study aimed to explore the chain mediating effect of mental health and sleep quality on the association between social support and life satisfaction among MOAC in Weifang, China.

METHODS

A cross-sectional study was conducted using multi-stage cluster random sampling, and 613 participants were included. The Social Support Rating Scale, Depression Anxiety Stress Scale, Pittsburgh Sleep Quality Index, and Scale with Life Satisfaction were used to measure the social support, mental health, sleep quality, and life satisfaction of MOAC, respectively. Descriptive statistics, t-tests, and ANOVA were used to explore the relationship between sociodemographic variables and life satisfaction. Pearson's correlation analysis and structural equation modeling (SEM) were conducted to investigate the association between social support, mental health, sleep quality, and life satisfaction.

RESULTS

The mean total SWLS score was 27.87±5.58. SEM analysis demonstrated that social support had a positive effect on life satisfaction (β= 0.197). Mental health and sleep quality partially mediated the association between social support and life satisfaction (95% CI: 0.083-0.193), and the mediating effect accounted for 39.198% of the total effect.

CONCLUSION

Life satisfaction was relatively high, and mental health and sleep quality partially mediated the association between social support and life satisfaction. Policy suggestions were provided based on these results.

The Association of Social Support, Depression, and Loneliness with Health-Related Quality of Life in Over 50 Years Adults: Ardakan Cohort Study on Ageing (ACSA)

BACKGROUND AND AIM

Social factors play a crucial role in the quality of life of + 50 adults. This study aimed to investigate the association between social support, depression, and loneliness and the health-related quality of life in + 50 adults of Ardakan.

METHODS

This was a cross-sectional study from the first phase of Ardakan Cohort Study on Aging (ACSA) in 2019. Health-Related Quality of Life (HRQoL, SF-16), Duke Social Support Index (DSSI), and Center for Epidemiologic Studies Depression Scale (CES-D10) were used to assess the variables of interest. Multivariable linear regression was used to model the associated factors with the score of the SF-16 tool in two dimensions; physical (PCS) and mental (MCS).

FINDINGS

A total of 5197 over 50 years individuals included in this study; The mean age was 62.2 ± 7.3 years old, and 52% were male. The mean score for PCS and MCS subscales was 45.6 (95% CI 45.4 to 45.9) and 49.3 (95% CI 49.0 to 49.5), respectively. Adjusted for other variables, having less feeling level of loneliness, and not having depressive symptoms were related to better PCS and MCS scores.

CONCLUSION

The HRQoL for the mental aspect of HRQoL was better than the physical in elder populations. Also, much more focus should be paid to older adults who experience inadequate social support, higher levels of loneliness, and depressive symptoms.

Social Support and Commitment to Life and Living: Bidirectional Associations in Late Life over Time

OBJECTIVES

This study aims to enhance the understanding of longitudinal associations between two important facets of well-being in late life: social support and commitment to life and living (CTL).

METHODS

Structured home interviews were conducted with 824 Israelis ≥75 years of age, with three annual data collection timepoints. We hypothesized and tested a cross-lagged, longitudinal structural equation model (SEM) in which CTL and social support were assumed to predict each other over time, covarying for previously reported CTL and social support.

RESULTS

Social support has a positive, contemporaneous effect, predicting commitment to living at T1 and T3, while CTL predicts social support the following year (i.e., T1-T2 & T2-T3). Satisfaction with relationships significantly contributes to measurement of both latent constructs at each point of data collection.

DISCUSSION

Commitment to life and living and social support are intertwined phenomena. Whereas social support has a concomitant effect on CTL, the effect of CTL on social support emerges over time. This suggests that greater social support fosters greater CTL, leading older adults to nurture social networks and relationships; the effect of which is greater social support in the future. The implications of these results warrant further research over longer periods and across cultures.

The Indirect Relationship Between Spiritual Experiences and Subjective Wellbeing Through Hope? A Sample of Chilean Students

Spirituality and religiousness are important factors for adolescents wellbeing. Little is known about the mechanisms underlying the positive relationship between spirituality as well as religiousness and subjective wellbeing. This study aimed to verify, whether, in a sample of Chilean students, religiousness is indirectly related to hope through spiritual experiences, and whether spiritual experiences are indirectly related to subjective wellbeing via hope. The sample consisted of 177 Chilean students and the following measures were applied: the Daily Spiritual Experiences Scale, the Herth Hope Index, the Satisfaction With Life Scale, the Positive and Negative Affect Schedule, and one item measuring the frequencies of prayer and Mass attendance. According to obtained results religiousness was indirectly, positively related to hope through spiritual experiences. In turn spiritual experiences were indirectly, positively related to subjective wellbeing through hope. Conducted research confirmed the beneficial role of religious practices, spiritual experiences, and hope for Chilean students' subjective wellbeing and the presence of mechanisms underlying the relationships between religiousness as well as spirituality and subjective wellbeing.

Association between self-reported oral health and life satisfaction among China's migrant elderly following children: The mediating effect of social support

Purpose

Focusing on the life satisfaction of the migrant elderly following children (MEFC) is of great theoretical and practical significance. We aimed to examine the effect of self-reported oral health on life satisfaction among the MEFC in Weifang, China, and to further explore the mediating role of social support on the relationship between self-reported oral health and life satisfaction.

Methods

We conducted a cross-sectional survey for 613 participants using multi-stage random sampling in Weifang, China, in August 2021. The Social Support Rating Scale was used to assess social support for the MEFC. We used the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI) to evaluate self-reported oral health. We assessed life satisfaction for the MEFC via the Satisfaction with Life Scale. The data were scrutinized through descriptive analysis, a chi-square test, a t-test, Pearson correlation analysis, and structural equation modeling (SEM).

Results

The mean GOHAI, social support, and life satisfaction scores were 54.95 ± 6.649, 38.89 ± 6.629, and 27.87 ± 5.584, respectively. SEM analysis indicated that the self-reported oral health of the MEFC exerts a positive effect on life satisfaction and social support, and social support has a positive and direct effect on life satisfaction. Social support partially mediates the association between self-reported oral health and life satisfaction (95% confidence interval: 0.023-0.107, P < 0.001), with its mediating effect accounting for 27.86% of the total effect.

Conclusion

The mean score of life satisfaction was 27.87 ± 5.584 among the MEFC in Weifang, China, suggesting relatively high life satisfaction. Our findings underscore an empirical association between self-reported oral health and life satisfaction and imply that social support mediates this relationship.

Experiences of Sleep Problems Among Older Korean Immigrants

Despite poor sleep among older adults, little is known about the sleep habits of older immigrants living in the United States. The current pragmatic qualitative descriptive study explored sleep among older Korean immigrants, using a focus group with six participants and individual phone interviews with 22 Korean immigrants aged ≥60 years. Transcripts were coded to identify underlying themes. Several thematic categories were identified under six domains: daytime function, getting ready for bed, falling asleep, awakenings during sleep, going back to sleep, and seeking advice from peers. Unhealthy sleep behaviors were found during daytime and bedtime, particularly among those who were retired/unemployed or living alone. Seeking advice from peers was common but none of the advice helped participants sleep. Sleep education programs in Korean-speaking communities can be used to target those who are socially isolated and may benefit older Korean immigrants with sleep difficulties. [Research in Gerontological Nursing, 15(4), 193-202.].

Coping repertoires and psychological well-being of Chinese older immigrants in the United States

OBJECTIVES

This study examines (1) the overall structures of multifaceted coping resources, that is, coping repertoires, among Chinese older immigrants in the United States, (2) the optimal coping repertoire that is associated with best psychological outcomes of these older immigrants, and (3) the most effective coping repertoire in different adversities.

METHOD

Using data from 2,923 Chinese older immigrants in Chicago, Latent Class Analysis (LCA) was performed to identify the overall coping repertoires of U.S. Chinese older adults. Negative binomial and logistic regressions were used to examine associations between coping repertoires and depression and Quality of Life (QoL), respectively. We further tested whether coping repertories moderate the relationships between adversities in health, economic, and social domains, and the two psychological outcomes.

RESULTS

LCA revealed four types of coping repertories: low-resource (43%), spouse-oriented (32%), community-oriented (15%), and multi-source coping (10%). Overall, Chinese older immigrants who had the multi-source coping repertoire reported the best psychological outcomes. The community-oriented and multi-source coping repertories had significantly stronger buffering effects on psychological well-being among individuals with IADL difficulties or low acculturation. However, spouse-oriented coping intensified the association between ADL difficulties and depression, and community-oriented coping intensified the association between poorer subjective health and lower quality of life.

CONCLUSION

This study revealed overall low coping repertories of Chinese older immigrants, suggesting the most optimal coping repertories should consist of both intrinsic and extrinsic coping sources. The findings further show that relying on limited sources might be harmful to older immigrants' mental health.

Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Objectives

The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.

Methods

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.

Results

One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.

Conclusion

Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.

Social Determinants of Mental Health Among Karen Refugees from Burma

Extant literature has documented a higher level of mental health issues among refugee populations compared with that of the general population. Mental health problems may significantly decrease refugees' quality of life and interfere with a successful transition to their country of resettlement. Using the social determinants of mental health framework, we examined factors affecting psychological distress among Karen refugees from Burma residing in a mid-size city in a northeastern state in the United States. A total of 201 participants completed face-to-face interviews conducted in the Karen language. Results showed that trauma and religious participation were positively associated and education and health status were negatively associated with psychological distress. The findings of this study reiterate the importance of trauma and health conditions to mental health and suggest potential points of interventions among the resettled Karen refugees.

Examining Social Relationships among Older Muslim Immigrants Living in Canada: A Narrative Inquiry

Social connectedness and engagement are particularly important among groups who are at risk of experiencing social isolation, such as immigrant older adults. The objective of our study was to understand the social relationships of aging Muslim Lebanese immigrants living in Canada by exploring their lives in their ethnic and wider communities. This study used a life course perspective and adopted a constructivist narrative inquiry to understand the diverse lived experiences of four older adults who immigrated to Canada during early adulthood. Participants engaged in a narrative interview and follow-up session in which they storied their lived experiences. Findings describe one core theme, cultivating social relationships through family, friends, and community interdependence, and three related sub-themes: (1) navigating and creating family interdependence and planting new roots; (2) family interdependence in later life: the important role of grandchildren; and (3) cultivating ethnic and local interdependence to support aging in place. The participants’ stories provided an understanding of how culture, religion, aging, family, and immigration experiences interrelated throughout their life course and shaped their social relationships during later life. This study sheds new insight on the importance of culturally tailored activities and awareness about the social needs of immigrant older adults.

An Analysis of the Relationship Between Religiosity and Psychological Well-Being in Chilean Older People Using Structural Equation Modeling

Using a representative sample, we explored the relationship of organizational (ORA), non-organizational (NORA), and intrinsic religiosity (IR) with depressive and anxious symptomatology and loneliness in Chilean older people, and examined mediating mechanisms. Structural Equation Modeling showed a direct effect between ORA and reduced depressive symptomatology and between IR and anxious symptomatology; for indirect effects, the relationship between ORA and depressive and anxious symptomatology was mediated by friends' social support network, while that between IR and the three outcomes studied was mediated by the family support network and resilience. NORA was not associated with any of the outcomes or mediating variables.

Psychosocial and Sociodemographic Determinants Related to Chronic Diseases in Immigrants Residing in Spain

The aim of the study is to analyze the effect of the psychosocial determinants of satisfaction with social support, resilience and satisfaction with life, and the sociodemographic determinants of age, gender and length of residence on chronic diseases in immigrants living in Spain. The sample was composed of 1131 immigrants from Africa, Eastern Europe, Latin America and Asia. 47.1% were men and 52.9% were women. Most relevant results point to age as the sociodemographic variable with the highest predictive effect in the six chronic diseases analyzed. Gender, in this case female, predicts arthrosis, chronic back pain and migraine, whereas length of residence was only significant in the case of chronic allergies. Regarding psychosocial variables, resilience is a good predictor of hypertension, chronic allergies and arthrosis. However, satisfaction with social support appears to be the best predictor for chronic back pain in the regression equation, satisfaction with life being a significant variable in migraine, arthrosis, allergies and high cholesterol. Results are notably relevant for the design of preventive health programs in immigrants, as well as in ensuring their appropriate access to the health system so that their chronic diseases can be diagnosed. Given the relevance and incidence of the chronic diseases analyzed in immigrants, preventive strategies should be improved to tackle chronic diseases that can have a serious impact on immigrants' health.

Spirituality and religiousness as predictors of life satisfaction among Peruvian citizens during the COVID-19 pandemic

The objective of this study was to determine if religiousness and spirituality predict life satisfaction among Peruvian citizens during the COVID-19 pandemic. This is a non-experimental, predictive and cross-sectional study with a sample of 734 people of both sexes (39.5% males and 60.5% females) between 17-75 years of age (M = 32.05). To measure the variables, the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) and the Satisfaction with Life Scale (SWLS) were used. A multiple regression analysis was performed to determine the variables that best predict life satisfaction, finding that the spirituality variable explains 10.7 % of the total variance of the life satisfaction variable. In summary, a positive and significant correlation between spirituality and life satisfaction is identified (r = .328, p < .01).

Managing social support needs in older age for childless Malaysians living in poverty

OBJECTIVE

To explore how older people manage social support needs when they are childless and living in poverty in the Malaysian context where social policy emphasises family as the primary provider of social support.

METHODS

Semi-structured interviews were completed with a purposive sample of 34 childless and older Malaysians living in poverty in Kuala Lumpur, Malaysia. A thematic content analysis focused on their reports of managing social support needs.

RESULTS

Key strategies were using existing resources, developing new networks and adjusting expectations. Agency played a vital role in avoiding institutional care.

CONCLUSIONS

This paper adds to research on childlessness in older age in varied policy and cultural contexts. It challenges assumptions about families providing social support and argues for policies to recognise older people as an individual unit rather than as part of a family to prolong independent living in the community.

Factors Influencing the Quality of Life of Empty Nesters: Empirical Evidence from Southwest China

Quality of life is a widely accepted concept based on the notion that people’s lives have been subject to rapid development and industrialization. This study aims to explore the impact of different factors on the quality of life of empty nesters in Southwest China. The main factors explored are resilience and social supports (SS), highlighted here from different perspectives. Moreover, the correlations between other variables and quality of life are shown here. This study experimented with a hierarchical multiple regression model from survey data with 3583 valid responses. It argued that both resilience and social supports, including family members and friends, are significantly correlated with the Chinese empty nesters’ quality of life. Family support and friend support play a significant mediating role in the association between resilience and quality of life. However, neither government nor nongovernmental support significantly influences the quality of life. Therefore, the hypothetical recommendations of this study have been partially confirmed. The findings of this study provide a more comprehensive understanding of the overall mental and physical health of Chinese empty nesters.

Associations of the related factors of depression, social support and social participation in kyungro-dang among older adults in South Korea: A structural equation modelling analysis

AIM

This study aimed to investigate the correlations between depression, social support and social participation among older adults in farming villages and identify their associations with the use of senior leisure and welfare facilities, called kyungro-dang, so as to provide foundational data for promoting community care in rural farming communities.

DESIGN

A cross-sectional design was used to identify kyungro-dang use among the 156 participants-older adults aged 65.

METHODS

Data were analysed using descriptive statistics, Pearson's correlation analysis, factor analysis and structural equation modelling.

RESULTS

Older adults with high social support and social participation tended to use kyungro-dang less. Our findings contribute foundational data to promote community care through kyungro-dang. Ministry of Health and Welfare (MoHW) plans to enforce to "Comprehensive community care plan" through kyungro-dang in rural area. The result of this study shows the relation between Kyungro-dang and social support, social participation, depression. This study recommends that MoHW in Korea focuses on enhance social support and social participation to gather before policy implications.

The effect of perceived social support on psychological distress and life satisfaction among Nepalese migrants in Japan

BACKGROUND

The world is becoming individualized due to modernization. International migration is one of the factors that lead to family dissociation and a lack of social support. Social support is viewed as a crucial factor that contributes to psychological well-being and satisfaction with life among migrants. However, very little is known about the impacts of social support on psychological distress and satisfaction with life among migrants. Therefore, we conducted this study to assess the association of perceived social support with psychological distress and satisfaction with life among Nepalese migrants, and we evaluated the factors associated with receiving social support.

METHODS

This was a cross-sectional study conducted with a convenience sample of Nepalese migrants (N = 249) living in Tokyo. Self-administered online questionnaires were distributed using social networks and chain referral methods. The measures included the Multidimensional Scale of Perceived Social Support, the General Health Questionnaire, and Satisfaction with Life Scale. Descriptive analysis, Pearson's correlation analysis, and multiple linear regression analyses were performed using SPSS ver. 25.

RESULTS

The mean (SD) age of the respondents was 31.8 years old (7.3). The family, friends, and significant others subscales of the multidimensional scale of perceived social support were negatively correlated with psychological distress (p<0.01). The family subscale was positively correlated with satisfaction with life (p<0.05), and the friend and significant others subscales were positively correlated with satisfaction with life (p<0.01). Social support from the family was significantly and negatively associated with the type of visa (Beta = -0.160, p = 0.049), and marital status was negatively associated with support from significant others (Beta = -0.175, p = 0.024).

CONCLUSION

Social support from family, friends, and significant others was found to be influential in decreasing psychological distress and increasing satisfaction with life among Nepalese migrants in Tokyo. Strengthing social support system through the expansion of interpersonal network may help minimize the psychological distress.

Religion, Religious Heterogeneity, and Intimate Partner Violence Among Korean Immigrant Women

This study examined the role of religious affiliations and frequency of religious service attendance-such as church, Bible studies, and temples-as well as religious heterogeneity between couples on intimate partner violence (IPV) among Korean immigrant women in the United States. Through a case-control design, this study compared 64 Korean immigrant IPV victims with 63 Korean immigrant non-IPV victims. This study's findings reveal that for Korean immigrant women, a high frequency of religious service attendance was associated with higher IPV victimization, while their partners' high religious service attendance was associated with lower IPV victimization. When women's partners were religious compared with when they were not religious, they were less likely to perpetrate IPV even when the partners' alcohol consumption frequency increased. Also, when there was a gap between couples regarding frequency of religious attendance, IPV victimization increased. This discussion concludes by suggesting some policy implications based on these findings.

Discovering Grace at the Table? Prayers at Mealtime, Marital Status, and Life Satisfaction in Later Life

This study examines the effects of prayers at mealtime on change in life satisfaction among older U.S. adults. In addition, it assesses the ways that marital status conditions these psychological effects of prayers at mealtime. Using two waves of longitudinal data from the Religion, Aging, and Health Survey (2001-2004), a representative sampling of adults aged 65 and older, the analyses reveal that the frequency of prayers at mealtime is associated with an increase in life satisfaction over time. Further, the positive effects of prayers at mealtime on change in life satisfaction are greater for nonmarried older adults than their married counterparts. The findings in the study reinforce claims of the beneficial effects of religion on mental well-being in later life. Moreover, they elaborate on the resource substitution thesis by showing that religion provides greater psychological benefits for older adults who do not have alternative resources for well-being-a marital partner.

Religious Struggle and Life Satisfaction Among Adult Christians: Self-esteem as a Mediator

The religious dimension of life represents an important source of human strength, meaning, and coping for many people. However, the religious life is not always "smooth and easy" and can be associated with weak personal adjustment, poorer psychological well-being, and lower satisfaction. Yet, besides the direct relationship between these variables, some researchers postulate the existence of an indirect association that has not been fully explained by various psychosocial mediators. The aim of the present study was to verify whether self-esteem could be a potential mediator between religious strain and life satisfaction. The sample consisted of 607 adult Christians (49.6% women) aged between 18 and 79. We used the Religious Comfort and Strain Scale, the Satisfaction with Life Scale, and the Rosenberg Self-Esteem Scale. Consistent with our hypotheses, life satisfaction positively correlated with religious comfort and was negatively associated with fear/guilt, negative emotions toward God, and negative social interactions surrounding religion. The same pattern of results was shown in the case of self-esteem. Moreover, the outcomes obtained from bootstrap sampling (5000) with a 95% confidence interval indicated a significant role of self-esteem as a mediator in all of the relationships between: (1) religious comfort and life satisfaction; (2) fear/guilt and life satisfaction; (3) negative emotions toward God and life satisfaction; and (4) negative social interactions surrounding religion and life satisfaction.

The association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity: a gender perspective in Malaysia

BACKGROUND

Little is known about gender differences in the relationship between religious orientation and life satisfaction in older adults living with chronic disease(s). Therefore, the purpose of this article was to examine the moderating effect of gender on the association between religious orientation and life satisfaction in older adults living with morbidity and multimorbidity.

METHODS

The study involved 1790 community-dwelling older adults aged 60 and above living with at least one chronic medical condition. The Satisfaction with Life Scale and Revised Intrinsic/Extrinsic Religious Orientation Scale were used to measure life satisfaction and religious orientation. Moderated hierarchical multiple regression was used to test the moderation effect.

RESULTS

Results showed that while intrinsic religiosity was positively associated with life satisfaction, extrinsic religiosity was found to have a negative relationship with life satisfaction. Gender moderated the association between intrinsic religiosity and life satisfaction.

CONCLUSIONS

The findings suggested that the positive impact of intrinsic religiosity on life satisfaction was stronger in older women living with morbidity and multimorbidity. Healthcare practitioners can help disadvantaged older women in identifying their religious values and practices to improve their subjective wellbeing.

What Can Buffer the Impact of Social Support on Chinese Older Adults' Life Satisfaction?

This study aims to test the moderating effects of home health care, home-help service, and older adults' attitudes toward aging on the relationship between social support and life satisfaction among Chinese older adults. The study used a sample of 5,578 Chinese home-dwelling older adults. Multiple linear regression analyses were performed to test the hypothesized effects along with gender and Hukou type differences. The results show that home health care significantly buffers the impact of social support on life satisfaction, and this buffering effect remains same across gender groups and Hukou groups. The findings of the study provide unique and contemporary theoretical and practical implications.

Living arrangements and life satisfaction: mediation by social support and meaning in life

BACKGROUND

Living arrangements have impact on life satisfaction among older adults. However, the mechanism how it works has received less attention. This study aims to examine the mediating role of meaning in life and social support in the relationship between living arrangements and life satisfaction.

METHODS

A total of 215 older adults from nine nursing homes and three communities were included in this study. The Social Support Rating Scale, Meaning in Life Questionnaire and Life Satisfaction Index A were adopted. Data were analyzed with Hayes' s bias-corrected bootstrapping method.

RESULTS

Both social support and presence of meaning in life had positive correlations with life satisfaction (p<0.001), and they were significant mediators between living arrangements and life satisfaction (p<0.01).

CONCLUSION

To improve the life satisfaction of nursing home residents, more emphasis should be placed on encouraging residents to seek or maintain a meaningful life and creating a more positive climate of social support.

“We Are Like Any Other People, but We Don’t Cry Much Because Nobody Listens”: The Need to Strengthen Aging Policies and Service Provision for Minorities in Canada

Background and Objectives

This study explores the aging experiences and needs of immigrant Muslim communities in an urban center in Alberta, Canada. Over one million Muslims live in Canada, with the majority being immigrants and visible minorities. Aging-focused policies and services have yet to address the needs of this population as larger cohorts begin to enter older age.

Research Design and Methods

A community-based participatory research approach was adopted with a community advisory committee co-leading all aspects of the research process. Sixty-seven older adults and stakeholders from diverse ethnocultural immigrant Muslim communities participated in either individual interviews or one of the seven focus groups (2017–2018). Data were transcribed verbatim and thematically analyzed with a focus on factors that support or hinder positive aging experiences in this population.

Results

Participants not only described the benefits of growing old in Canada but also identified unique challenges stemming from their social positioning as religious minorities, immigrants, and older adults. We highlight these experiences in three themes: (a) aging while living across places, (b) negotiating access to aging-supportive resources in a time of scarcity, and (c) re-envisioning Islamic approaches to eldercare.

Discussion and Implications

Immigrant Muslim communities report inequities experienced by older community members. There is a need for an in-depth analysis of the ways aging and migration policies intersect to influence the resources that immigrant minorities have access to as they grow old in Canada.

Protective Factors and Processes Fostering Resilience and Buffering Psychosocial Distress among Later-Life Egyptian Immigrants

This qualitative study explores and describes the protective factors and processes that foster resilience and buffer psychosocial distress among later-life Egyptian immigrants post immigration to the US. Open-ended structured interviews were conducted with (30) later-life Egyptian immigrants who came to the United States after turning 60 years of age. Thematic analysis was used to analyze patterns within the data. The findings of this study reveal that the availability and utilization of psychosocial resources - due to opportunities embedded in their sociocultural context and coping strategies embedded in their individual strengths and cultural or religious beliefs - play a pivotal role in buffering the losses and acculturative stressors triggered by transitioning to a new environment. The findings of this study can be used to inform psychosocial and therapeutic interventions and guide the development of appropriate social work programs and services for later-life Egyptian immigrants in particular and older Arabic-speaking immigrants in general.

Social Support and Life Satisfaction of Ethnic Minority Elderly in China

Previous studies indicate that Han and ethnic minority groups in China are not homogeneous. However, little research has examined potential heterogeneity in the association between social support and life satisfaction across Han and ethnic minority elderly. Based on data from the 2014 China Longitudinal Aging Social Survey, this study uses ordered logit models with interaction terms to examine the relationship between social support and the life satisfaction of ethnic minority elderly and of elderly Han Chinese. We find that support from families and friends has a stronger association with the life satisfaction of ethnic minority elderly than their Han peers. For ethnic minority elderly, the patterns of family support varied according to rural or urban residence, with family support being less important to the life satisfaction of ethnic minority elderly living in urban communities than in rural areas. Our findings suggest that social policy should take this heterogeneity between ethnic groups into account.

Older people's satisfaction with and utilisation patterns of the Old Age Allowance in Nepal

OBJECTIVE

The Old Age Allowance in Nepal aims to support the welfare of older people, to improve their social and economic status and to encourage independence. The aim of this study was to assess satisfaction with and utilisation patterns of the Old Age Allowance among older people in Nepal.

METHODS

A cross-sectional, quantitative study was conducted in Chitwan, Nepal. Face-to-face interviews were carried out with 232 older people asking about demographics, and satisfaction and utilisation of Old Age Allowance.

RESULTS

Seventy-two per cent of older people expressed satisfaction with the Old Age Allowance. The highest satisfaction level (81.9%) was associated with the satisfaction scale construct of contribution to religious practices. Satisfaction with the allowance was associated with family relationships and dissatisfaction with higher expectations of allowance. The allowance was predominantly utilised for personal expenditure (91.4%), followed by health and medicine (75.0%).

CONCLUSION

The Old Age Allowance is a necessary and important contribution to keeping older people connected with family and community.

Health, faith and therapeutic landscapes: Places of worship as Black, Asian and Minority Ethnic (BAME) public health settings in the United Kingdom

Within the United Kingdom, there is evidence that faith-based affiliations, ideas, actors and organisations play a role in public health (PH) that has been neither properly recognised nor integrated into mainstream health systems (November, 2014). Discourses on faith and improving health outcomes have been particularly focused on 'seldom heard' groups, including 'Black, Asian and Minority Ethnic' (BAME) communities (November, 2014; Jain, 2014; Burton et al., 2017; Muhammad, 2018). In this paper we first present findings from a qualitative scoping study carried out in the UK cities of Leeds and Bradford, between 2014 and 2015, which examined Places of Worship (PWs) as BAME PH settings. We carried out 19 semi-structured interviews with purposively selected respondents, and three focus groups. Second, we develop a theory that originates from one in the sub-discipline of 'health geography' concerned with 'therapeutic landscapes', applying it to our research findings on PWs as BAME PH settings. The paper argues for the recentring of religion and faith settings back into the therapeutic landscapes literature, reflecting evidence that faith-based affiliations, ideas, actors and organisations are relevant to the pursuit of health and wellbeing. We also contend that a therapeutic landscapes framework provides a way of making the health relevance of PWs visible to both health practitioners and to members of PWs. We argue that PWs act as therapeutic places (i.e. specific transformative sacred sites) as well as therapeutic spaces (i.e. settings that provide adjuncts to formal PH promotion services), and are often part of therapeutic networks included in 'kinship groups and networks of care provided by family, friends, therapists and other agents of support' (Smyth, 2005: 490). This approach allows us to see how influences on health behaviour are not just confined to biomedical settings, but that the 'healing process works itself out in places (or situations, locales, settings and milieus)' (Gesler, 1992: 743).

The Effect of Religious Involvement on Life Satisfaction among Korean Christians: Focused on the Mediating Effect of Spiritual Well-Being and Self-Esteem

The present study examined the relationship between two categories of religious involvement, namely religious belief and religious behavior, and life satisfaction among Korean Christians (N = 278) with spiritual well-being and self-esteem as potential mediators in this relationship by using structural equation modeling (SEM). The results supported the full mediated structural model and indicated that religious belief had a significant indirect effect on life satisfaction through the mediators, spiritual well-being and self-esteem. Religious behavior did not have an indirect or direct effect on life satisfaction among Korean Christians. The significance, implications, and limitations of the study were discussed.

Social networks, health promoting-behavior, and health-related quality of life in older Korean adults

In this cross-sectional, descriptive study, we compared the sociodemographic characteristics, social networks, health-promoting behavior, and the health-related quality of life of older Korean adults living in South Korea to those of older Korean adult immigrants living in the USA. A total of 354 older adults, aged 65 years or older, participated. Data were collected through self-directed questionnaires, and analyzed using a two way analysis of variance, t-tests, χ² -tests, and Pearson's correlation coefficient. The association between four sociodemographic characteristics and health-related quality of life was significantly different between the two groups. For the older Korean adults living in South Korea, positive correlations existed between a measure of their social networks and both health-promoting behavior and health-related quality of life. For the older Korean immigrants, the findings revealed a positive correlation only between social networks and health-promoting behavior. The study findings support the important association social networks can have with health-related quality of life, and their possible relationship to health-promoting behaviors of older Korean adults. We suggest that health policy-makers and healthcare providers develop comprehensive programs that are designed to improve older adults' social networks.

Factors related to quality of life among older adults in Bangladesh: A cross sectional survey

This cross-sectional design study aimed to describe quality of life and examine factors related to quality of life among older adults in Bangladesh. Convenience sampling was used to recruit 280 older adults from ten villages in two southern districts. The results demonstrate that the majority of the participants reported an overall moderate score of quality of life. Moreover, participants' sleep problems, depression, religiosity, and activities of daily living were negatively correlated with quality of life whereas social support and health service availability were positively correlated with quality of life. Implementing intervention programs upon the significant related factors to improve older adults' quality of life is recommended.

Expanding the Happiness Paradox: Ethnoracial Disparities in Life Satisfaction Among Older Immigrants in the United States

OBJECTIVE

This study investigated nativity disparities in life satisfaction among ethnoracial groups of older adults in the United States and the factors associated with such disparities.

METHOD

Cross-sectional data from 7,348 respondents aged 60 and older from the 2012/2014 waves of the Health and Retirement Study (HRS) were used to estimate linear regression models.

RESULTS

Older immigrants experienced higher levels of life satisfaction than comparable native-born individuals. This "happiness advantage" was particularly salient for Hispanic immigrants, who reported the highest levels of life satisfaction of all groups included in the study. With increasing education, life satisfaction increased for White and "Other Race" groups, regardless of nativity. However, for both Black groups and native-born Hispanics, higher levels of education were associated with lower life satisfaction.

DISCUSSION

Findings suggest that the "happiness paradox" may not only be a matter of Hispanic ethnicity, but that it may also extend to immigrants from other ethnoracial backgrounds.

Spirit or Fleeting Apparition? Why Spirituality's Link with Social Support Might Be Incrementally Invalid

Previously published path models apparently confirm the belief-as-benefit perspective that spirituality boosts well-being via social support. The broad acceptance of such findings has motivated recommendations that clinical psychologists and psychiatrists routinely assess their patients' spiritual status. Skeptics retort that past findings are statistically confounded and that numinous beliefs and well-being are unrelated. A multivariate regression analysis testing whether spirituality explains variance in social support after personality traits are simultaneously included is reported. Although spirituality displays a significant positive correlation and partial correlation (after controlling for socio-demographics) with social support, regression analysis specifying agreeableness and conscientiousness-individual differences related to both spirituality and social support-as predictors renders spirituality nonsignificant. In summary, spirituality's correlation with social support appears spurious; demonstrating the hazards of relying on simple associations and highlighting the urgent need for researchers to utilize statistical methods capable of establishing cause and parsing effects across rival theoretical explanations.

Efficacy of a Church-Based, Culturally Tailored Program to Promote Completion of Advance Directives Among Asian Americans

Having an Advance Directive (AD) can help to guide medical decision-making. Asian Americans (AA) are less likely than White Americans to complete an AD. This pilot study investigated the feasibility and efficacy of a church-based intervention to increase knowledge and behavior change related to AD among Chinese and Vietnamese Americans. This study utilized a single group pre- and post-intervention design with 174 participants from 4 churches. Domain assessed: demographics; AD-related knowledge, beliefs, attitudes, and intentions; AD completion; and conversations with a healthcare proxy. Data were analyzed using Chi square and multiple logistic regression techniques. We observed significant increases in participants' AD-related knowledge, intentions, and a gain in supportive beliefs and attitudes about AD, resulting in 71.8 % AD completion, and 25.0 % having had a proxy conversation. Providing culturally-tailored intervention and step-by-step guidance can help to achieve significant changes in AD related knowledge and behavior in AA church goers.

Life satisfaction of migrants, stayers and returnees: reaping the fruits of migration in old age?

This paper evaluates the effects of migration on life satisfaction in later life. We compare the life satisfaction of older migrants with that of non-migrants and return migrants of a similar age and originating from the same regions in Turkey. Turks constitute one of the largest migrant groups in Europe, and the growing population of older Turkish migrants display greater risks of loneliness and material disadvantage compared to native-born populations in Europe. However, compared to their non-migrant peers from the country of origin, older migrants may experience gains from migration that are reflected in their life satisfaction. Using the 2000 Families Study, a large survey of Turkish migrants from the peak labour migration period and their non-migrant comparators, we investigate whether life satisfaction of migrants and stayers differs and the possible causes of any differences. We find that both migrants and return migrants experience higher life satisfaction in old age than stayers. However, the gap cannot be explained by the classical determinants of life satisfaction such as income, health, partner and friends, or religiosity, nor by the better outcomes of the migrants’ children. We discuss possible reasons for this migration satisfaction advantage.

A Case Study of Exploring Older Chinese Immigrants' Social Support within a Chinese Church Community in the United States

The number of older Chinese immigrants living in the United States is increasing steadily. They are faced with challenges to meet their needs for social support and are unlikely to turn to formal services. This case study utilizes an ecological framework to analyze social support among Chinese immigrants age 65 year and older within a Christian Chinese church community, and to explore the ways in which a Chinese church functions as the source of social support for older Chinese immigrants. Seven months of participant observation and ten face-to-face, in-depth interviews were conducted with 65+ Chinese adults who attended one Chinese church in the Southern United State and included questions concerning patterns of support and personal relationships within the church. Findings revealed that gender, living arrangements, working experiences, ability to drive, and English language skills were related to support the older Chinese immigrants sought, received, and provided. Although the Chinese church can be a viable source of supplementary support, some participants in this study felt the support they received from the church was insufficient, particularly in terms of emotional support. Therefore, suggestions are outlined that may assist Chinese churches to be more proactive in better understanding and providing services that meet the different needs and desires of older Chinese immigrants.

Religion, Self-Rated Health, and Mortality

Existing research, mostly based on the data from the United States, suggests that religiosity contributes to better health and longevity. This article explores the association between religiosity and self-rated health across 59 countries and shows that the positive association between religiosity and self-rated health is an exception found in a relatively small number of countries. Consistent with the person–culture fit literature, Study 1 shows that in countries in which religiosity represents a social norm (i.e., it is common and socially desirable), religious individuals report better subjective health than nonreligious individuals. Study 2 demonstrates that even within the United States, the association of religiosity with self-rated health as well as with reduced mortality largely depends on the regional level of religiosity, suggesting that the health and longevity benefits of religiosity are restricted to highly religious regions.

Religion, spirituality, social support and quality of life: measurement and predictors CASP-12(v2) amongst older Ethiopians living in Addis Ababa

OBJECTIVES

As African populations begin to age developing accurate measures of quality of life (QoL) in later life for use on the continent is becoming imperative. This study evaluates the measurement and predictors of QoL amongst older Ethiopians.

METHOD

The data come from a multi-stage cluster sample of 214 people aged 55 and over living in Addis Ababa, Ethiopia. QoL was measured using the CASP-12(v2). Confirmatory factor analysis (CFA) was used to test the properties of the scale. The relationships between social support, religiosity/spirituality and socio-demographic factors on QoL were tested with linear regression analyses.

RESULTS

The CASP subscales exhibited good internal reliability and the CFA provides reasonable support for an 11-item 4-factor model (CFI, 0.954; RMSEA 0.075). Multivariate regression analyses suggest that both religiousness/spirituality and social support have positive relationships with QoL.

CONCLUSION

Older people in Africa can often be socially isolated, marginalised and in extreme poverty. Yet few studies have looked at QoL more generally and there is no accepted gold standard measurement of QoL. Yet such a development would allow researchers to directly compare QoL and the determinants of QoL amongst older Africans and those elsewhere. The results show that a modified 11-item CASP is a meaningful measure of QoL for use with older Ethiopians. Both religiousness/spirituality and social support are positively associated with QoL and might be important buffers against deprivation.