Personal mastery, multisystem physiological dysregulation and risk of functional decline in older adults: A prospective study in Taiwan

A Study on the Current Situation and Related Factors of Personal Mastery in Patients with Chronic Heart Failure: A Cross-Sectional Study

Purpose

To explore the status quo and influencing factors of personal mastery in Chinese patients with chronic heart failure, based on the analysis of patient characteristics.

Methods

The sample of the study comprised 249 chronic heart failure patients who visited a university hospital in China. We collected the data using general demographic Information, personal mastery scale, the Simple Coping Style Questionnaire and Minnesota Living With Heart Failure Quality of Life Questionnaire (MLHFQ). SPSS26.0 was used to describe the survey results statistically, and univariate analysis, Pearson correlation analysis and multiple linear regression were used to analyze the influencing factors of personal sense of control.

Results

Chronic heart failure patients' total personal mastery scores were (20.63±4.486), which is in the medium level. Multiple linear regression analysis shows that Age group (β=-1.627, p=0.036), NYHA functional classification (β=-1.563, P<0.001), Positive coping style (β= 0.088, P=0.004) and MLHFQ (β= -0.121 P<0.001) significantly influenced patients' personal mastery (P<0.001).

Conclusion

Our study suggests that the personal mastery of patients with chronic heart failure is at a moderate level in China. Additionally, age group, NYHA functional classification, Positive coping style and MLHFQ emerged as significant influencing factors. Clinical staff should dynamically observe the changes in the level of personal mastery of patients with chronic heart failure, pay more attention to the elderly and patients with poor heart function according to the influencing factors, and encourage active responses to improve the level of personal mastery of patients with heart failure.

Personal mastery and quality of life in patients with atrial fibrillation after radiofrequency ablation: The mediating role of health promoting behavior

BACKGROUND

Improving quality of life is vital for patients with atrial fibrillation (AF) after radiofrequency ablation. Quality of life can be affected not only by personal mastery but also by health promoting behavior as previously studied. However, it remains unclear whether health promoting behavior mediates the relationship between personal mastery and quality of life.

OBJECTIVES

To explore whether health promoting behavior mediates the relationship between personal mastery and quality of life in patients with AF after radiofrequency ablation.

METHODS

A cross-sectional design and convenience sampling were conducted at a tertiary hospital in China. Self-reported questionnaires were used to assess personal mastery, health promoting behavior and quality of life. SPSS and AMOS software were used for statistical analysis.

RESULTS

A total of 202 patients with AF after radiofrequency ablation were enrolled (mean age 58.28 ± 12.70 years). The scores for personal mastery and quality of life were 22.52 ± 2.53 points and 62.58 ± 8.59 points, respectively, indicating a limited level. The health promoting behavior exhibited a moderate level, with scores averaging 103.82 ± 8.47 points. There was a positive correlation between the three variables (all P < 0.05). Health promoting behavior played a partial mediating role in the relationship between personal mastery and quality of life in patients with AF after radiofrequency ablation, accounting for 44.79 % of the total effect.

CONCLUSIONS

In order to improve quality of life and prognosis, it is necessary to consider enhancing personal mastery and increasing patient compliance with health promoting behavior, which are important ways to improve their quality of life.

Social associations and cardiovascular mortality in the United States counties, 2016 to 2020

BACKGROUND

The positive aspects of social interaction on health have been described often, with considerably less attention to their negative aspect. This study aimed to assess the impact of social associations on cardiovascular mortality in the United States.

METHODS

The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) data sets from 2016 to 2020 were used to identify death records due to cardiovascular disease in the United States population aged 15 years and older. The social association rate defined as membership associations per 10,000 population, accessed from the 2020 County Health Rankings data was used as a surrogate for social participation. All United States counties were grouped into quartiles based on their social association rate; Q1 being the lowest quartile of social association, and Q4 the highest quartile. Age-adjusted mortality rate (AAMR) was calculated for each quartile. County health factor rankings for the state of Texas were used to adjust the AAMR for baseline comorbidities of county population, using Gaussian distribution linear regression.

RESULTS

Overall, the AAMR was highest in the 4th social association rate quartile (306.73 [95% CI, 305.72-307.74]) and lowest in the 1st social association rate quartile (266.80 [95% CI, 266.41-267.20]). The mortality rates increased in a linear pattern from lowest to highest social association rate quartiles. After adjustment for the county health factor ranks of Texas, higher social association rate remained associated with a significantly higher AAMR (coefficient 15.84 [95% CI, 12.78-18.89]).

CONCLUSIONS

Our study reported higher cardiovascular AAMR with higher social associations in the United States, with similar results after adjustment for County Health Rankings in the state of Texas.

Influence of personal mastery on mobility disability among older adults: A systematic review

PURPOSE

Personal mastery is a psychological resource recognized as a domain of quality of life that helps individuals cope with life strains. Despite its relevance, there is a lack surrounding the relationship between mobility disability and personal mastery. This study aimed to investigate the influence of personal mastery on mobility disability among older adults and identify the mechanisms that underlie this influence.

METHODS

A systematic review was conducted by searching four databases (i.e., PubMed, Scopus, ScienceDirect, and the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information) using combinations of the following words: mastery, personal mastery, self-control, mobility, disability, older adults, older people, and aging. We summarized and analyzed the findings of cross-sectional and longitudinal/prospective studies.

RESULTS

Twenty-one studies were included. There was high heterogeneity in how the studies had assessed mobility disability. Although a majority of the studies had used the Pearlin's Self-Mastery Scale (PSMS) to assess personal mastery, there were variations in the number of response anchors and scoring strategies that were used. Nevertheless, findings revealed that personal mastery influences mobility disability by acting as a protective resource against adverse outcomes among older adults. The authors of the reviewed articles had provided physiological and behavioral explanations for their findings.

CONCLUSIONS

Higher level of personal mastery can protect older adults from mobility disability, because it confers a sense of personal control, which in turn promotes positive physiological functioning and health behaviors. This knowledge contributes to the maintenance of physical functioning in old age.

Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study

BACKGROUND

Obesity has been associated with increased physical limitations among older adults, although few studies have adjusted for important covariates. There is limited information about the relationship between apolipoprotein E (APOE) polymorphisms and physical limitations, and the findings have been inconsistent.

PURPOSE

This study examined the longitudinal associations of obesity and APOE ε4 with difficulties in activities of daily living (ADLs) over a 6-year follow-up period controlling for multiple covariates.

METHODS

Data were analyzed from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66). Body mass index (BMI) was used to define obesity at a baseline, and the APOE genotype was classified into an APOE ε4 carrier and non-carrier status. The combination of basic and instrumental activities of daily living (ADLs and IADLs) was used to define impaired ADLs.

RESULTS

APOE ε4 carriers had greater difficulties in combined ADLs (incident rate ratio; IRR = 1.87, 95 % CI = 1.40-2.51) than non-carriers. Obese but not overweight adults had greater difficulties in activities of daily living (IRR = 1.59, 95 % CI = 1.20-2.10) compared with the normal/underweight group. Obese older adults without APOE ε4 had greater subsequent difficulties in ADLs than non-obese non-carriers. Among APOE ε4 carriers, obesity was not a significant risk factor for the development of impaired ADLs in older adults, indicating an interaction between genotype and obesity.

CONCLUSIONS

The interaction between genotype and obesity phenotype adds new information about the determinants of physical impairment.

Association of received social support with depressive symptoms among older males and females in Singapore: Is personal mastery an inconsistent mediator?

RATIONALE

Personal mastery has been shown to be a mediator of the relationship between perceived social support and depressive symptoms. Less is known about its role in the context of received social support. While there is some evidence that received social support may improve one's sense of personal mastery, other studies highlight that received social support may induce dependence and lower one's sense of personal mastery. In addition, less is known about structural factors such as gender that may alter this relationship.

OBJECTIVE

To examine gender differences in how personal mastery mediates the relationship between received social support and depressive symptoms.

METHODS

Using data from a nationally representative study of community dwelling older adults in Singapore, we test the hypothesis that personal mastery is an inconsistent mediator of the received social support-depressive symptoms association using mediation analysis and that gender is associated with this inconsistent mediation.

RESULTS

We find support for our hypothesis of personal mastery as an inconsistent mediator, and observe both the direct and indirect effects of received social support on depressive symptoms to be stronger in females than in males.

CONCLUSION

Depressive symptoms for females may be more sensitive to received social support than males, which may be due to gendered pathways and expectations of support. This study highlights the need to further examine both the beneficial and detrimental effects of received social support on psychological health in tandem, considering the effect of mediating variables such as personal mastery to understand its nuanced pathways.