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Zhou H, Han D, Zhou H, Ke X, Jiang D. Influencing factors of psychological pain among older people in China: A cross-sectional study. Heliyon 2023; 9:e21141. [PMID: 37916102 PMCID: PMC10616401 DOI: 10.1016/j.heliyon.2023.e21141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
Limited research has focused on the psychological pain among older people and factors associated with psychological distress in older adults also remain to be evaluated. This study aims to examine the status and correlates of psychological pain among older people from urban and rural areas in China. This cross-sectional study analyzed data from 4312 samples which extracted from the dataset of China's Health-Related Quality of Life Survey for Older Adults 2018. Psychological pain was assessed by the Chinese version of the Psychache Scale (PAS). Multiple linear regression models were established to examine the associations between demographic characteristics and psychological pain. The average score of PAS among older people was 41.79 ± 14.52, and the average score of PAS among urban older people was higher than rural ones in this study. For rural older people, age (B ≥ 80 = 2.55), gender (B Female = 1.27), educational level (B Primary school = 1.63; B ≥ Middle school = 0.27), smoking (B yes = 0.83), number of chronic diseases (B ≥ 2 = 3.19) and personal social capital (B BRC = 0.27) were positively related to psychological pain, while family per-capita annual income (B15,000-30,000 = -2.52; B > 30,000 = -3.44), living arrangement (B With spouse = -3.40; B With children = -2.89; B Others = -3.82) and personal social capital (B BOC = -0.36) were negatively associated with psychological pain (p < 0.05). Moreover, for urban older people, gender (B Female = 0.98), current occupation (B With occupation = 1.13) and smoking (B yes = 2.14) were positively related to psychological pain, whereas age (B ≥ 80 = -1.45), family per-capita annual income (B > 30,000 = -3.63), living arrangement (B With spouse = -1.31), BMI (Bnormal = -2.62) and personal social capital (B BOC = -0.16) were negatively associated with psychological pain (p < 0.05). The present study sheds light on the worrying state of psychological pain experienced by Chinese older people. The results suggest that targeted interventions and social support, should be taken to alleviate the psychological pain among older people, especially urban older people.
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Affiliation(s)
- Han Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, 211200, China
| | - Dong Han
- Suqian Hospital of Nanjing Drum Tower Hospital Group, Suqian, 223800, China
| | - Haisen Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, 211200, China
| | - Xinfeng Ke
- School of Public Health, Wuhan University, Wuhan, 430071, China
| | - Dongdong Jiang
- School of Public Health, Wuhan University, Wuhan, 430071, China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China
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Passive Suicidal Ideation in Older Adults from 12 European Countries. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yang Y, Wang R, Zhang D, Su Y, Zang Y. The protective effect of self-esteem on suicidal ideation among nursing home residents with limited social support in China: A cross-sectional study. Nurs Open 2021; 9:2729-2738. [PMID: 34190426 PMCID: PMC9584493 DOI: 10.1002/nop2.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/29/2021] [Accepted: 06/02/2021] [Indexed: 11/20/2022] Open
Abstract
Aim This cross‐sectional study aimed to assess the impact of limited social support and loneliness on suicidal ideation, under the influence of self‐esteem, an important inner resource for quality living. Design An observational cross‐sectional study conducted from September 2018–April 2019. Methods The participants comprised 538 nursing home residents selected by a stratified sampling method from all seven administrative districts in a capital city of eastern China. All the participants completed the survey that constituted the measurement of suicidal ideation, self‐esteem, social support and loneliness. Path analysis was performed using the structural equation modelling method. Results A moderating effect, with satisfactory model fit indices and significant path coefficients, was detected between self‐esteem and suicidal ideation through limited social support and loneliness, revealing the multiple protective mechanisms of this psychological characteristic on the change of suicidal ideation.
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Affiliation(s)
- Yang Yang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Rui Wang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Dan Zhang
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Yonggang Su
- School of Basic Medical Sciences, Shandong University, Jinan, China.,School of Foreign Languages and Literature, Shandong University, Jinan, China
| | - Yuli Zang
- Faculty of Medicine, The Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, China
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Zhao D, Li J, Hao W, Yuan Y, Yu C, Jing Z, Wang Y, Fu P, Zhou C. The relationship between activities of daily living and suicidal ideation among Chinese rural older adults: a multiple mediation model through sleep quality and psychological distress. Aging (Albany NY) 2020; 12:22614-22625. [PMID: 33202378 PMCID: PMC7746386 DOI: 10.18632/aging.103857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022]
Abstract
Few studies clarified the mechanisms underlying the relationship between activities of daily living and suicidal ideation among older adults. This study aimed to explore the multiple mediating roles of sleep quality and psychological distress between this relationship. A total of 3,243 rural older adults were included. Multiple mediation analysis was performed using Mplus 8.3. Activities of daily living was found to directly affect suicidal ideation (β=0.092, 95% CI=0.043−0.140) and through three significantly mediation pathways: (1) the path through sleep quality (β=0.019, 95% CI=0.007−0.031), which accounted for 9.79 % of the total effect; (2) the path through psychological distress (β=0.049, 95% CI=0.036−0.063), which accounted for 25.26 % of the total effect; (3) the path through sleep quality and psychological distress (β=0.034, 95% CI=0.026−0.042), which accounted for 17.53 % of the total effect. The total mediating effect was 52.58%. Attention should be paid to sleep quality and mental health among the Chinese rural older adults with activities of daily living limitation. For early detection and prevention of suicidal ideation, it is necessary to take sleep-based and positive psychological interventions for older adults with activities of daily living limitation.
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Affiliation(s)
- Dan Zhao
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jie Li
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Wenting Hao
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yemin Yuan
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Caiting Yu
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Zhengyue Jing
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yi Wang
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Peipei Fu
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chengchao Zhou
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China.,NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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Ying Y, Huang L, Shen L, Zhou C, Zhu X, Yin Z. Rehabilitation psychological experience of the elderly within 6 months of initial disability: a qualitative study. Disabil Rehabil 2020; 44:2332-2339. [PMID: 33053306 DOI: 10.1080/09638288.2020.1833091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To explore the rehabilitation psychological experience of the Chinese elderly within 6 months of initial disability, understand and analyse their real feelings and thoughts to help caregivers in providing support. MATERIALS AND METHODS We adopted the descriptive phenomenology method to purposefully select elderly with initial disability within 6 months from neurorehabilitation departments of 2 hospitals in China, who were able to cooperate with researchers to conduct interviews. The data were collected from semi-structured interviews and analysed using Colaizzi's analysis method. RESULTS fifteen participants with an average age of 73.7(±9.0) years and an average disability time of 3.2 (±1.5) months were interviewed. Four themes were identified: (1) the discomfort of losing the sense of self; (2) feeling trapped over unmet needs; (3) ambivalence towards rehabilitation; (4) expectations and hopelessness for the future. Traditional Chinese thoughts such as family concepts played an important role in the generation of complex emotions. CONCLUSION The elderly had the desire and motivation to recover and return to the families and society. However, due to personal, family and social factors, they still felt ambivalence towards rehabilitation, self-worth and life, which hindered rehabilitation. Therefore, carers should focus on the elderly's psychological states, taking corresponding measures to satisfy their complex demands and motivate long-term recovery.IMPLICATIONS FOR REHABILITATIONChinese elderly with initial disability often had a strong sense of ambivalence towards self-worth, rehabilitation and life, among which the influence of the traditional Chinese family concept counts.Health care personnel should improve the positive coping ability of the elderly to promote their harmonious coexistence with disability, rebuild their personal values, develop their rehabilitation potential.Health care departments need to provide support to the elderly and their families to maximize the positive role of the family in the rehabilitation process of the elderly.In order to alleviate the discomfort of disabled elderly in rehabilitation and enhance compliance, there is a need to improve the hard environment (rehabilitation technologies, etc.) and soft environment (rehabilitation concept and service quality, etc.).
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Affiliation(s)
- Yisha Ying
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Lili Huang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Lu Shen
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chunchun Zhou
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Xiaohui Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Zhiqin Yin
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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Yang Y, Wang S, Hu B, Hao J, Hu R, Zhou Y, Mao Z. Do Older Adults with Parent(s) Alive Experience Higher Psychological Pain and Suicidal Ideation? A Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6399. [PMID: 32887427 PMCID: PMC7504437 DOI: 10.3390/ijerph17176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022]
Abstract
Elderly mental health promotion is an important task in the current "Healthy China Action". This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China's Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.
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Affiliation(s)
- Ying Yang
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Shizhen Wang
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Borui Hu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Jinwei Hao
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Runhu Hu
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
| | - Yinling Zhou
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, Wuhan 430071, China; (Y.Y.); (S.W.); (B.H.); (J.H.); (R.H.)
- Global Health Institute, Wuhan University, Wuhan 430071, China
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Zhu J, Xu L, Sun L, Li J, Qin W, Ding G, Wang Q, Zhang J, Xie S, Yu Z. Chronic Disease, Disability, Psychological Distress and Suicide Ideation among Rural Elderly: Results from a Population Survey in Shandong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1604. [PMID: 30060593 PMCID: PMC6121389 DOI: 10.3390/ijerph15081604] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 12/12/2022]
Abstract
Objective: Suicide is a major public health and social problem in contemporary societies. Previous studies showed that the older the seniors were, the more likely it was that they would experience disability, chronic disease, or both. The objective of this study was to examine the joint effects of chronic disease and physical disability on suicide ideation while controlling for psychological distress among the rural elderly living in Shandong Province, China. Method: A total of 5514 rural elderly individuals (60+) living in Shandong Province, China were included in this study. Suicidal ideation was assessed by using questions from the National Comorbidity Survey (NCS). Multiple logistic analyses were performed to examine the factors associated with suicide ideation. A path analysis was conducted to test the direct and indirect effects of chronic disease and of activity of daily living (ADL) limitation on suicide ideation while controlling for psychological distress. Results: The prevalence of suicide ideation among the rural elderly in Shandong, China was 11.0%. Psychological distress had the strongest direct (β = 0.392) and total effect (β = 0.392), chronic disease (β = -0.034; β = -0.063) had both direct and indirect impacts, and ADL (β = 0.091) had indirect impacts on suicide ideation. Psychological distress was a mediator between chronic disease, ADL limitation, and suicide ideation. Conclusions: Psychological distress was the greatest influencing factor of suicide ideation among the rural elderly, followed by chronic disease and disability. Effective intervention measures should be taken to facilitate the early detection of psychological distress in clinical practice among the rural elderly.
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Affiliation(s)
- Jing Zhu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Lingzhong Xu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Long Sun
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Jiajia Li
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Wenzhe Qin
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Gan Ding
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Qian Wang
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Jiao Zhang
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Su Xie
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Zihang Yu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
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