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Wu WR, Lee LC, Hung CH, Huang HC. The mediating effect of pregnancy adaptation between family support and maternal-fetal bonding: a cross-sectional study. BMC Nurs 2024; 23:350. [PMID: 38789999 PMCID: PMC11127304 DOI: 10.1186/s12912-024-02009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Establishing a nurturing bond with the unborn child is essential for expectant mothers throughout pregnancy. While the influence of family support and pregnancy adaptation on maternal-fetal bonding is evident, these factors remain unexplored in the early stages of pregnancy. This study aims to elucidate the dynamic interaction between family support, pregnancy adaptation, and maternal-fetal bonding during the first trimester, explicitly investigating the mediating role of pregnancy adaptation. METHOD A cross-sectional design was conducted to recruit expectant mothers between 8 and 12 weeks of gestation without significant complications. RESULTS Family support and pregnancy adaptation emerged as significant predictors of maternal-fetal bonding, and pregnancy adaptation mediated the relationship between family support and maternal-fetal bonding in the first trimester. CONCLUSIONS The study confirms the critical role of family support and pregnancy adaptation in facilitating maternal-fetal bonding during early pregnancy, with pregnancy adaptation fully mediating this relationship. Healthcare providers are encouraged to involve family members in early interventions, focusing on assessing family support and engaging them in education and activities to strengthen the emotional bond between the mother and her unborn child.
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Affiliation(s)
- Wan-Ru Wu
- Department of Nursing, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Li-Chun Lee
- Department of Nursing, Asia University, Taichung, Taiwan
| | | | - Hui-Chuan Huang
- School of Nursing, Taipei Medical University, Taipei, Taiwan.
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Zhu W, Wang F, Cao Y, Wu Q. The Relationships Among Family Functioning, Sleep Quality and Quality of Life in Chinese Community-Dwelling Older Adults with Insomnia: A Structural Equation Model. Clin Gerontol 2024:1-14. [PMID: 38781533 DOI: 10.1080/07317115.2024.2357583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The proportion of individuals with insomnia is increasing, and many older adults have insomnia. This study aimed to explore the relationships between family functioning and quality of life (QOL) among community-dwelling older adults with insomnia, as well as to explore the mediating role of sleep quality in this relationship. METHODS The participants were 225 older adults with insomnia from community health service centers in Chongqing, China. The Family Care Index (APGAR) was used to assess family functioning, the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and the 36-item Short-Form Health Survey (SF-36) was used to assess QOL. RESULTS The results showed that family functioning would be positively associated with QOL (p = .005) and that this relationship would be partially mediated by higher sleep quality (p < .001). CONCLUSIONS Family functioning has a direct effect on QOL and an indirect effect on QOL through the regulation of sleep quality. Maintaining good family functioning is important for improving sleep quality and QOL in older adults with insomnia. CLINICAL IMPLICATIONS Developing family functioning-based assessments and targeted intervention strategies could be beneficial for older adults with insomnia.
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Affiliation(s)
- Wenfen Zhu
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Fangyi Wang
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Yuanyuan Cao
- Department of Psychiatry, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Wu
- School of Nursing, Chongqing Medical University, Chongqing, China
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Wang MW, Chen YM. Assessing family function: older adults vs. care nurses: a cross-sectional comparative study. BMC Public Health 2024; 24:1334. [PMID: 38760759 PMCID: PMC11100032 DOI: 10.1186/s12889-024-18809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND This study aimed to assess family function in home care for older adults. Understanding family dynamics is essential for providing quality care to older adults choosing to age in place. METHODS In a cross-sectional study, 53 patients aged 65 or older receiving home care were evaluated, along with four home care nurses. The General Function of Family Assessment Device (FAD-GF) was used for self-assessment to examine family resources. RESULTS Only 5.7% of older adults reported good family function. Strong correlations were found between assessments by nurses and older adults. Among the six aspects of family function, "problem solving," "communication," "affective responsiveness," and the overall results showed no disparities between the evaluations of older adults and nurses. CONCLUSIONS Home care nurses can effectively assess family function using the FAD-GF, particularly after six months of care. This assessment can help identify family issues and enhance home care quality through nurse training in FAD-GF application.
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Affiliation(s)
- Mei-Wen Wang
- Department of Family Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan R.O.C..
- College of Public Health, National Taiwan University, Taipei, Taiwan R.O.C..
| | - Ya-Mei Chen
- College of Public Health, National Taiwan University, Taipei, Taiwan R.O.C
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Xiao T, Zhu F, Wang D, Liu X, Xi SJ, Yu Y. Psychometric validation of the Perceived Stress Scale (PSS-10) among family caregivers of people with schizophrenia in China. BMJ Open 2023; 13:e076372. [PMID: 38035751 PMCID: PMC10689371 DOI: 10.1136/bmjopen-2023-076372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND The 10-item Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress that has been validated in various populations, yet with inconsistent results on its factor structure. The present study examines the reliability and validity of the PSS-10 in a population not previously examined: Chinese family caregivers of persons with schizophrenia, with a focus on factor analysis. METHODS A sample of 449 family caregivers of persons with schizophrenia was recruited for psychometric testing of the scale. The factor structure of PSS-10 was tested by randomly dividing the sample into two groups for both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The scale was further tested for internal consistency, test-retest reliability, convergent validity, discriminant validity and concurrent validity. RESULTS EFA extracted two factors: perceived helplessness with six negative phrasing items and perceived efficacy with four positive phrasing items. CFA confirmed the structure of two factors with satisfactory model fit indices. Convergent validity was supported by high standard regression weight (0.78-0.92), average variance extracted (AVE=0.79-0.81) and composite reliability (0.88-0.94), while discriminant validity was confirmed by higher AVE estimates than the squared interconstruct correlations. The PSS-10 showed good internal consistency and test-retest reliability, with Cronbach's alpha of 0.79 and intraclass correlation coefficient of 0.91, respectively. Concurrent validity was demonstrated by its significant positive correlations with stigma, depression and anxiety, as well as significant negative correlations with social support, family functioning and positive caregiving experiences. CONCLUSION The two-factor PSS-10 has good psychometric characteristics assessing the perceived stress of family caregivers of people with schizophrenia. The findings indicate that the PSS-10 can be used to measure perceived stress in future research and practice among caregivers of people with schizophrenia, and potentially, other caregiving samples.
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Affiliation(s)
- Tao Xiao
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Zhu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Dan Wang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Xiang Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shi-Jun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Foshan Center for Disease Control and Prevention, Foshan, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
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Serrano L, Vela E, Martín L. Analysis of the Functioning of Families of Children with Autism Spectrum Disorder: A Psychometric Study of the Family APGAR Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7106. [PMID: 38063536 PMCID: PMC10706771 DOI: 10.3390/ijerph20237106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/06/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023]
Abstract
Normalised family functioning is a predictor of individual well-being. The diagnosis of a family member with autism spectrum disorder (ASD) can alter the ordinary dynamics of family systems, having a variable impact on family functioning. This research employed a non-probability convenience sampling method to gather a sample of 327 families with and without children diagnosed with ASD. This study has dual objectives: to analyse the psychometric properties of the Spanish version of the Family APGAR Scale and to compare family functioning in families with and without a child with ASD. The results reveal several favourable psychometric properties in the application of the APGAR scale within families of children with ASD. The use of the Family APGAR Scale in the selected sample confirms that the functioning of families with children with ASD can be categorized as mildly dysfunctional, attributed to the inherent challenges in caring for and raising a child with ASD. The presence of ASD within family systems presents a challenge to typical family functioning, with significant differences observed between families with and without children with ASD. This underscores the necessity of implementing effective intervention programs based on empirical evidence to improve the quality of life for individuals with ASD and their families.
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Affiliation(s)
- Laura Serrano
- Faculty of Education and Psychology, Universidad Francisco de Vitoria, Majadahonda, 28223 Madrid, Spain; (E.V.); (L.M.)
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Han Y, Xing F, Huang J, Wang M. Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem. Aten Primaria 2023; 55:102679. [PMID: 37295306 PMCID: PMC10272280 DOI: 10.1016/j.aprim.2023.102679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/07/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECT To explore the factors related to health-promoting lifestyles of the elderly based on social-ecosystem theory. DESIGN A cross-sectional survey study was carried out to include 627 elderly people in communities in three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou) from October 2021 to January 2022 for questionnaire survey (601 validly returned cases). VENUE Three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou). PARTICIPANTS 627 elderly people. INTERVENTIONS A cross-sectional survey study. MAIN MEASUREMENTS The questionnaire survey was conducted by using the general demographic data, health promotion life scale, frailty scale, general self-efficacy scale, health engagement scale, General Self-Efficacy Scale, The family Adaptability, Partnership, Growth, Affection, and Resolve scale, and Perceived Social Support Scale. RESULTS The total health promotion lifestyle score for the elderly was 100.20±16.21, which was at the lower limit of the good level, with the highest mean score for nutrition (2.71±0.51) and the lowest mean score for physical activity (2.25±0.56). Stepwise linear regression showed that exercise frequency (95% confidence interval (CI) 1.304-3.885), smoking status (95% CI -4.190 to -1.556), self-efficacy (95% CI 0.071-0.185), health management (95% CI 0.306-0.590), frailty (95% CI -3.327 to -1.162) in the microsystem, marital status (95% CI 0.677-3.660), children's attention to the elderly health (95% CI 4.866-11.305), family care in the mesosystem (95% CI 1.365-4.968), and pre-retirement occupation (95% CI 2.065-3.894), living area (95% CI 0.813-3.912), whether receive community-based chronic disease prevention and management services (95% CI 2.035-8.149), social support (95% CI 1.667-6.493) in the macrosystem were the main factors affecting health promotion of life in the elderly (P<0.05). Hierarchical regression analysis showed the microsystem accounted for 17.2%, the mesosystem accounted for 7.1%, and the macrosystem accounted for 11.4%. CONCLUSION The health promotion lifestyle of the elderly in Hebei Province was at the lower limit of good level. Among them, exercise frequency, children's attention to the elderly health, and pre-retirement occupation played a major role in relation to the health-promoting lifestyle of the elderly. Hence, it needs the joint action of individuals, families, and society to promote the elderly to adopt the health promotion lifestyle and realize healthy aging.
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Affiliation(s)
- Ying Han
- College of Nursing and Rehabilitation, North China University of Science and Technology, China.
| | - Fengmei Xing
- School of Clinical Medicine, North China University of Science and Technology, China
| | - Jiali Huang
- College of Nursing and Rehabilitation, North China University of Science and Technology, China
| | - Mengyi Wang
- College of Nursing and Rehabilitation, North China University of Science and Technology, China
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Zhao T, Xuan K, Liu H, Chen X, Sun L, Chen M, Qin Q, Qu G, Wu Y, Zhang J, Sun Y. The association between family function and sleep disturbances of preschool children in rural areas of China: a cross-sectional study. PSYCHOL HEALTH MED 2023; 28:895-907. [PMID: 35089094 DOI: 10.1080/13548506.2022.2032772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to explore the association between family function and sleep disturbances in preschool children in rural areas of China. Caregivers of preschool children completed sociodemographic questionnaires, the Children's Sleep Habits Questionnaire (CSHQ), the Self-rating Anxiety Scale (SAS) and the Family APGAR scale. Using sleep disturbances in children as the dependent variable, family function and other related factors as independent variables, binary logistic regression analyses were performed to examine associations between family function and sleep disturbances in children. A total of 3,636 caregivers of preschool children were enrolled in our study, and the prevalence of sleep disturbances among their preschool children was 89.4%. In our study, lower family function was associated with higher risk of sleep disturbances among preschool children. After adjusting for age (years), education level of mother, discipline attitudes of father and mother, only child status and caregivers' anxiety, the associations were statistically significant both in families of which caregivers of children are their parents or other relatives. (AOR for parents = 1.487, 95% CI:1.152-1.919, P = 0.002; AOR for other relatives = 1.963, 95% CI:1.302-2.958, P = 0.001). Our study results indicated that family function was associated with sleep disturbances in preschool children, and future high-quality cohort studies are needed to explore this topic in more detail.
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Affiliation(s)
- Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Liang Sun
- Department of Acute Infectious Disease Prevention, Fuyang Center for Disease Control and Prevention, Fuyang, Anhui, China
| | - Mingchun Chen
- Department of HIV/AIDS Prevention, Changfeng Center for Disease Control and Prevention, Changfeng, Anhui, China
| | - Qirong Qin
- Department of Chronic Disease Control/Prevention and Health Management, Maanshan Center for Disease Control and Prevention, Maanshan, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Yile Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.,Department of Neonatology, Anhui Provincial Children's Hospital/Children's Hospital of Anhui Medical University, Hefei, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
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Shabani M, Amini-Tehrani M, Sadri M, Taheri-Kharameh Z, Khaljinia Z, Poorolajal J. Family function, social support and quality of life in community-dwelling older adults: the moderating role of gender. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04297-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Wang Q, Zhao D, Zhou M, Zhao X, Gao Y, Duan J, Cao C, Li P. The Effect of Resilience and Family Support Match on Psychological Distress among Women in the Menopausal Transition Based on Polynomial Regression and Response Surface Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14165. [PMID: 36361043 PMCID: PMC9655886 DOI: 10.3390/ijerph192114165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Menopausal transition (MT) is a natural process in women from reproductive decline to aging. During this period, women present with an increased prevalence of psychological distress. The aim of this study was to investigate how resilience and family support interact to influence psychological distress among women during MT. A convenience sampling method was used to recruit 858 women during MT from Shandong Province. All participants completed the 10-item Connor-Davidson Resilience Scale, the family care degree questionnaire, and the Kessler Psychological Distress Scale. Data were analyzed by using SPSS 24.0. Response surface analysis was used for polynomial regression and response surface analysis. The results of response surface analysis show that in the case of agreement between resilience and family support, the joint effect manifested as a negative curve (inverted U shape) related to the psychological distress of women during MT. In the case of disagreement, the joint effect manifested as a negative curve (inverted U shaped) related to psychological distress. Specifically, with increased variance in the degree of resilience and family support, women experienced less psychological distress. Both resilience and family support play an important role in protecting women from psychological distress, either alone or in combination. Future intervention studies targeting women during MT should consider the coordinated actions of resilience and family support.
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Gallardo-Peralta LP, Sanchez-Moreno E, Herrera S. Aging and Family Relationships among Aymara, Mapuche and Non-Indigenous People: Exploring How Social Support, Family Functioning, and Self-Perceived Health Are Related to Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159247. [PMID: 35954611 PMCID: PMC9368255 DOI: 10.3390/ijerph19159247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022]
Abstract
Family relationships play a central role in wellbeing among older adults in Chile. Based on the theory of social production functions, this study examined the relationship between perceived social support from children, partners and relatives, family functioning, self-perceived health and quality of life (QoL) among Chilean older adults. The study used a multi-ethnic sample of Chilean older adults living in rural areas in the regions of Arica and Parinacota (north) and Araucanía (south). A model was analyzed that emphasizes relationships differentiated by the source of support, family functioning and self-perceived health in the explanation of QoL. The results obtained from the structural equation modelling (SEM) analysis showed the existence of indirect relationships of social support from children, partners and other family members via family functioning, while self-perceived health was directly associated with QoL. The findings indicate that family functioning is a main variable in the contrasted model, in addition to confirming the importance of distinguishing the role of the various sources of support. Research is needed to examine in detail intergenerational relationships and other relationships with family members who are significant in the wellbeing of older adults. This research corroborates that family relationships have a specificity that needs to be addressed in gerontological social intervention, as well as continuing along the lines of strengthening or improving existing family ties (more quality) over the quantity of social relationships.
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Affiliation(s)
- Lorena Patricia Gallardo-Peralta
- Dirección de Investigación, Postgrado y Transferencia Tecnológica, Universidad de Tarapacá, Arica 1000000, Chile
- Department of Social Work and Social Services, Universidad Complutense de Madrid, 28223 Madrid, Spain
- Correspondence:
| | - Esteban Sanchez-Moreno
- Institute for Research in Development and Cooperation (IUDC-UCM), Universidad Complutense de Madrid, 28015 Madrid, Spain;
| | - Soledad Herrera
- Institute of Sociology, Pontifical Catholic University of Chile, Santiago 7820436, Chile;
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Zhang R, Zhang Z, Peng Y, Zhai S, Zhou J, Chen J. The multi-subject cooperation mechanism of home care for the disabled elderly in Beijing: a qualitative research. BMC PRIMARY CARE 2022; 23:186. [PMID: 35883031 PMCID: PMC9327313 DOI: 10.1186/s12875-022-01777-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/17/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Currently, population aging has been an obstacle and the spotlight for all countries. Compared with developed countries, problems caused by China's aging population are more prominent. Beijing, as a typical example, is characterized by advanced age and high disability rate, making this capital city scramble to take control of this severe problem. The main types of care for the disabled elderly are classified as home care, institutional care, and community care. With the obvious shortage of senior care institutions, most disabled elderly people are prone to choose home care. This kind of elderly care model is in line with the traditional Chinese concept and it can save the social cost of the disabled elderly to the greatest extent. However, home care for the disabled elderly is facing bumps from the whole society, such as lack of professional medical care, social support and humanistic care, and the care resources provided by a single subject cannot meet the needs of the disabled elderly. OBJECTIVE Based on the demands of the disabled elderly and their families, this study aims to explore the current status of home care service, look for what kind of care is more suitable for the disabled elderly, and try to find an appropriate elderly care mechanism which could meet the diverse needs of the disabled elderly. METHODS A total of 118 disabled elderly people and their primary caregivers were selected from four districts of Beijing by using multi-stage stratified proportional sampling method. A one-to-one and semi-structured in-depth qualitative interview were conducted in the study to find out the health status of the disabled elderly, the relationship between the disabled elderly and their primary caregivers, and utilization of elderly care resources, etc. The views of the interviewees were analyzed through the thematic framework method. All the methods were carried out in accordance with relevant guidelines and regulations. RESULTS The results showed that the average age of 118 disabled elderly is 81.38 ± 9.82 years; 86 (72.9%) are severe disability; 105 (89.0%)are plagued by chronic diseases; the average duration of disability is 5.63 ± 5.25 years; most of disabled elderly have 2 children, but the primary caregiver are their own partner (42, 35.6%), and there is an uneven sharing of responsibilities among the disabled elderly's offspring in the process of home care. The disabled elderly enjoy medical care services, rehabilitation training, daily health care, psychological and other demands. However, the disabled elderly and their families in Beijing face a significant financial burden, as well as physical and psychological issues. The care services provided by the government, family doctors, family members and social organizations fall far short of satisfying the diverse care needs of the disabled elderly. CONCLUSIONS In order to effectively provide home care services for the disabled elderly, it is therefore necessary to establish a coordination mechanism of multiple subjects and give full play to the responsibilities of each subject. This study proposes a strengthening path for the common cooperation of multiple subjects, which taking specific responsibilities and participating in the home care for the disabled elderly: (1) The government should give full play to the top-level leading responsibilities and effectively implement people-oriented measures to the disabled elderly. (2) Family doctors strengthen their responsibilities as health gatekeepers and promote continuous health management of the disabled elderly. (3) Family members assume the main responsibility and provide a full range of basic care services. (4) Social forces promote supplementary responsibilities of public welfare and expand the connotation of personalized care services. (5) The disabled elderly should shoulder appropriate personal responsibility and actively cooperate with other subjects.
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Affiliation(s)
- Ruyi Zhang
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Zhiying Zhang
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Yingchun Peng
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China.
| | - Shaoqi Zhai
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Jiaojiao Zhou
- Fengtai District, Xiluoyuan Community Health Service Center, Beijing, 100077, China
| | - Jingjing Chen
- Huairou District, Liulimiao Community Health Service Center, Beijing, 101400, China
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Karimi Z, Taheri-Kharameh Z, Sharififard F. Cultural Adaption and Psychometric Analysis of Family APGAR Scale in Iranian Older People. Korean J Fam Med 2022; 43:141-146. [PMID: 35320900 PMCID: PMC8943237 DOI: 10.4082/kjfm.21.0028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background Family function is a necessary factor that influences older people’s health. The Family APGAR has been widely used to study family functions. However, there has been no Persian version of this instrument to assess family function in older people. The aim of this study was to determine the psychometric properties of the Persian version of the Family APGAR Scale to evaluate the perception of family functions. Methods The “forward-backward” procedure was applied to translate the scale from English into Persian. The translated version was checked in terms of validity and reliability, with a sample of 281 older people selected from retirement centers. The factor structure of the scale was also tested using a confirmatory factor analysis. To test reliability, internal consistency and test–retest analyses were performed. Results The results of the confirmatory factor analysis indicated a good structural model. Criterion-related validity was strongly supported by the pattern of association between the APGAR Scale and the social support survey. Cronbach’s α of the scale was 0.88 and test–retest reliability ranged from 0.96 to 0.98, indicating a good range of reliability. Conclusion The findings of this study suggest that the Iranian version of the Family APGAR is a valid and reliable scale to evaluate family functions in health intervention programs.
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Affiliation(s)
- Zeinab Karimi
- Faculty of Health, Qom University of Medical Sciences, Qom, Iran
| | - Zahra Taheri-Kharameh
- Spiritual Health Research Center, Qom University of Medical Sciences, Qom, Iran
- School of Paramedical Sciences, Qom University of Medical Sciences, Qom, Iran
- Corresponding Author: Zahra Taheri Kharame Tel: +98-253-3209123, Fax: +98-25-32858464, E-mail:
| | - Fatemeh Sharififard
- School of Paramedical Sciences, Qom University of Medical Sciences, Qom, Iran
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Wang W, Guo X, Kang L, Zhang N, Ma S, Cheng J, Fang L, Liu Z. The Influence of Family-Related Factors on Suicide in Major Depression Patients. Front Psychiatry 2022; 13:919610. [PMID: 35845470 PMCID: PMC9283679 DOI: 10.3389/fpsyt.2022.919610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To explore the influence of family-related factors on suicide-related behaviors of patients with major depression disorder, and to provide scientific evidence for effective preventive measures. METHODS A total of 852 outpatients at Renmin Hospital of Wuhan University were enrolled in this cross-sectional study from April 2019 to January 2021. The general demographic information and family-related information of the patients were collected via a general information questionnaire, the Family Assessment Device, the Egna Minnen av Barndoms Uppfostran, and the Childhood Trauma Questionnaire. RESULTS Participants without suicide-related behaviors accounted for 10.45% of the total sample, those with suicidal ideation accounted for 47.54%, those with suicidal plans accounted for 24.77% and with suicidal attempts for 17.25%. Patients with major depression disorder who have lower education level, who were separated from their parents, who have severely impaired family function, who experienced childhood abuse, and whose parents adopted apathetic and severe child-rearing styles had a higher risk of suicide-related behaviors. In the multivariate regression model, degree of major depression disorder, education and child-rearing style were independent risk factors for suicide-related behaviors. CONCLUSION Patients with major depression disorder who have been separated from their parents, have severely impaired family function, were abused in childhood or have been exposed to improper childrearing styles have a greater risk of suicide. Family-related factors play a predictive role in suicide in patients with major depression disorder. More attention should be paid to family-related factors to reduce the occurrence of suicidal ideation and attempt.
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Affiliation(s)
- Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Guo
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nan Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Cheng
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Fang
- Department of Psychiatry, Jingmen No. 2 People's Hospital, Jingmen, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Zhang M, Zhang W, Liu Y, Wu M, Zhou J, Mao Z. Relationship between Family Function, Anxiety, and Quality of Life for Older Adults with Hypertension in Low-Income Communities. Int J Hypertens 2021; 2021:5547190. [PMID: 34616569 PMCID: PMC8490058 DOI: 10.1155/2021/5547190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 09/14/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Effective functional family was beneficial for older adults' health, which may affect the quality of life (QoL) in hypertension patients. This study aimed to clarify the association between family function, anxiety, and QoL for older adults with hypertension in low-income communities. METHODS A questionnaire survey was conducted on 363 older adults with hypertension in low-income communities in Wuhan from September 2019 to November 2019. The relationships among the variables were examined by Pearson's correlation analysis. Predictor effects were tested using hierarchical multiple regressions, controlling for demographic characteristics. The structural equation model (SEM) was used to test the mediation effects of anxiety on the pathway from family function to QoL. RESULTS Family function was negatively correlated with the self-rating anxiety scale (SAS) score and positively correlated with the mental component score (MCS), but had no influence on the physical component score (PCS). Both PCS and MCS were negatively correlated with SAS. Anxiety was the negative predictor of MCS and PCS. Family function was the positive predictor of MCS, but had no influence on PCS. The path model indicated that anxiety significantly mediated the link between family function and QoL (R 2 = 32.8%), but only partially. CONCLUSION A significant correlation between anxiety, family function, and QoL was found. Anxiety had a partial mediating effect on the relationship between family function and QoL. Further research should focus on increasing the level of family function and reducing the perceived anxiety of older adults with hypertension to improve their QoL level.
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Affiliation(s)
- Meng Zhang
- Nursing Department, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenyan Zhang
- Nursing Department, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Liu
- Nursing Department, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meiliyang Wu
- Nursing Department, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin Zhou
- Hanshui Bridge Street Community Health Center, Qiaokou District, Wuhan, China
| | - Zhongmin Mao
- Gutian Street Community Health Center, Qiaokou District, Wuhan, China
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Ghasemi M, Arab M, Mangolian Shahrbabaki P. Relationship Between Caregiver Burden and Family Functioning in Family Caregivers of Older Adults With Heart Failure. J Gerontol Nurs 2020; 46:25-33. [PMID: 32453437 DOI: 10.3928/00989134-20200511-04] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/16/2020] [Indexed: 11/20/2022]
Abstract
Caregivers of individuals with heart failure are at high risk for diminished quality of life because of the energy involved in providing necessary care. Caring for someone with chronic heart failure can affect caregivers' physical, psychological, and social health, collectively referred to as the burden of care, and may also affect family functioning. The current cross-sectional study aimed to investigate the relationship between caregiver burden and family functioning in caregivers of older adults with heart failure in southeastern Iran using the Zarit Burden Inventory and the Family Assessment Device based on the McMaster Model of Family Functioning. The Pearson correlation coefficient, independent t test, and analysis of variance were used to determine relationships among variables. Results showed a significant correlation between burden of care and total score of family functioning. Therefore, it is necessary to take measures to reduce burden of care for caregivers through education and support programs and to improve their family functioning and quality of life. [Journal of Gerontological Nursing, 46(6), 25-33.].
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Yu Y, Liu ZW, Li TX, Zhou W, Xi SJ, Xiao SY, Tebes JK. A comparison of psychometric properties of two common measures of caregiving burden: the family burden interview schedule (FBIS-24) and the Zarit caregiver burden interview (ZBI-22). Health Qual Life Outcomes 2020; 18:94. [PMID: 32252766 PMCID: PMC7137330 DOI: 10.1186/s12955-020-01335-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/19/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The Family Burden Interview Schedule (FBIS-24) and the Zarit Caregiver Burden Interview (ZBI-22) are among the most widely used measures for assessing caregiving burden, but their psychometric performances have not been compared in the same study of caregivers of people living with schizophrenia (PLS). This is important because the measures assess overlapping constructs- the FBIS-24 assesses objective burden (e.g., completion of manual tasks) and the ZBI-22 assesses subjective burden (e.g., perceived distress, stigma). This study seeks to fill this gap by comparing the reliability and validity of the FBIS-24 and the ZBI-22 in a Chinese community sample of caregivers of PLS. Methods A Cross-sectional stud was conducted in a community-based mental health service program in Central South part of China. A total of 327 primary family caregivers of PLS completed face-to-face interviews of the FBIS-24, the ZBI-22, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Family Adaptation, Partnership, Growth, Affection and Resolve Index scale (APGAR), and PLS were assessed using the Global Assessment of Function scale (GAF). Results Our findings show that both the FBIS-24 and ZBI-22 have comparable psychometric performance in terms of the internal consistency, convergent validity and known group’s validity. Conclusion Both the FBIS-24 and the ZBI-22 are psychometrically sound measures of caregiving burden but the choice of which measure to use will depend on the research question.
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Affiliation(s)
- Yu Yu
- Hospital Evaluation Office, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.,Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
| | - Zi-Wei Liu
- School of Medicine, Hunan Normal University, 371 Tongzhi Road, Changsha, Hunan, 410013, China
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Wei Zhou
- Hospital Administration Institute, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China
| | - Shi-Jun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Shui-Yuan Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
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Barbosa da Silva A, Queiroz de Souza I, da Silva IK, Borges Lopes Tavares da Silva M, Oliveira Dos Santos AC. Factors Associated with Frailty Syndrome in Older Adults. J Nutr Health Aging 2020; 24:218-222. [PMID: 32003414 DOI: 10.1007/s12603-020-1310-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Frailty is a common geriatric syndrome, characterized by a decrease in energy reserve and stress resistance, resulting in an accumulated decline of multiple physiological systems and greater vulnerability. Frailty syndrome has a multifactorial etiology involving a biological basis associated with sociobehavioral factors. We verify the association of frailty syndrome with family functionality level, nutritional status and medication adherence in older adults. DESIGN Observational and analytical study. SETTING AND PARTICIPANTS Conducted at ambulatory the university hospital, with patients aged 60 years or older. MEASUREMENTS Cognitive function was measured using the Mini-Mental State Examination (MMSE); nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and Body Mass Index, BMI; the 5-item FRAIL scale was used for frailty screening; family functioning was assessed using the Family APGAR Index, which evaluates Adaptability, Partnership, Growth, Affection, and Resolve; Self-reported medication adherence was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8). RESULTS The study involved 308 older adults, with a mean age of 70.40 years, There was an association between frailty and highly dysfunctional family with an OR of 5.9 (95% CI 1.9-18.5)(p<0.05), nutritional risk assessed by BMI, where low weight presented an OR of 2.5 (95% CI 1.1-5.8) and obesity an OR of 2.8 (95% CI 1.1-7.0)(P <0.05) and a nutritional risk assessed by MNA with an OR 6.3(95% CI 1.9-20.4) and low medication adherence with an OR of 8.9 (95% CI, 3.6-21.6)(P = 0.01). CONCLUSION Frailty syndrome is associated with high levels of family dysfunction, nutritional risk and poor medication adherence amongst older people.
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Affiliation(s)
- A Barbosa da Silva
- Alessandra Barbosa da Silva, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife - PE, Brasil, CEP 50100-130, E-mail: ; Phone number +558131833311
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Cao R, Jia C, Ma Z, Niu L, Zhou L. Disability in Daily Living Activities, Family Dysfunction, and Late-Life Suicide in Rural China: A Case-Control Psychological Autopsy Study. Front Psychiatry 2019; 10:827. [PMID: 31798474 PMCID: PMC6863879 DOI: 10.3389/fpsyt.2019.00827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Although late-life suicide in rural China is a matter of concern, research is scarce addressing the association between capability of daily living activities, family function, and late-life suicide. We conducted this psychological autopsy study to explore associations between disability in daily living activities, family dysfunction, and late-life suicide in rural China. Methods: Using a 1:1 matched case-control design, we collected data from 242 elderly suicide cases and 242 living community controls in rural China using the psychological autopsy method. We used Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID), Activities of Daily Living Scale (ADL), and Family Adaptive, Partnership, Growth, Affection and Resolve scale (APGAR) to assess the presence of mental disorders, capability of daily living activities, and family function, respectively. Results: Compared with the living controls, suicide cases presented more severe impairment in capability of daily living activities and poorer family function. After controlling for all other factors, capability of daily living activities and family function remained in the final model. The results of the multivariate analysis also show that the presence of a mental disorder, lower levels of social support, and increased number of life events in the last year were significantly associated with elevated suicide risk. Conclusions: Disability in daily living activities and family dysfunction are associated with elevated risk of late-life suicide in rural China. It is warranted to design programs, including family interventions, peer-support groups, and community programs, to help the rural elderly improve activities of daily living and obtain the social support they need to prevent suicidal behaviors.
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Affiliation(s)
- Rifang Cao
- Department of Medical Affairs,The Seventh People's Hospital of Hangzhou, Hangzhou, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Lu Niu
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Liang Zhou
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
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Hai S, Wang H, Cao L, Liu P, Zhou J, Yang Y, Dong B. Association between sarcopenia with lifestyle and family function among community-dwelling Chinese aged 60 years and older. BMC Geriatr 2017; 17:187. [PMID: 28821239 PMCID: PMC5563006 DOI: 10.1186/s12877-017-0587-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 08/14/2017] [Indexed: 02/05/2023] Open
Abstract
Background Sarcopenia is defined as the age-related decline in skeletal muscle mass and function. The risk factors and causes of sarcopenia must be identified to develop prevention and treatment strategies for this syndrome. Our aim was to examine the association between sarcopenia with lifestyle and family function among community-dwelling Chinese people aged 60 years and older. Methods We conducted this study to evaluate sarcopenia among 834 community-dwelling Chinese individuals aged ≥60 years using the Asian Working Group for Sarcopenia (AWGS) criteria. The sociodemographic characteristics, food consumption patterns, habits of smoking, and alcohol consumption of the participants were collected using a general questionnaire, whereas physical activity was assessed using the International Physical Activity Questionnaire (IPAQ; long-form version). Family function was assessed using the Family APGAR scale. In addition, the association of sarcopenia with lifestyle and family function was examined using univariate and multivariate analyses. Results The total prevalence rate of sarcopenia was 10.6%. Female participants with sarcopenia had a lower frequency per week of nut consumption than those without sarcopenia (p < 0.05), whereas, for male participants, the differences in food consumption patterns of those with sarcopenia versus those without sarcopenia were not significant. Among the participants, the mean Family APGAR score was 8 (standard deviation [SD] = 0.92). For both sexes, participants with sarcopenia had lower family function scores than those without sarcopenia. In the multivariate model, after adjustment for all covariates, frequency per week of nut consumption (adjusted OR 0.724, 95% CI 0.532–0.985, P < 0.05) and Family APGAR score (adjusted OR 0.683, 95% CI 0.496–0.940, P = 0.019) were statistically significantly associated with sarcopenia. The relationship between other lifestyle habits and sarcopenia was not significant. Conclusion There was significant association between sarcopenia with intake of nuts and family function. Further studies should evaluate if adequate intake of nuts and a well-functioning family may be effective in lowering the risk of sarcopenia.
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Affiliation(s)
- Shan Hai
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Hui Wang
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Li Cao
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Ping Liu
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Jianghua Zhou
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Ying Yang
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China
| | - Birong Dong
- Department of Geriatrics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, NO, 610041, China.
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Prazeres F, Santiago L. Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: a multicentre cross-sectional study. Health Qual Life Outcomes 2016; 14:156. [PMID: 27835995 PMCID: PMC5106778 DOI: 10.1186/s12955-016-0559-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 11/04/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Multimorbidity has a high prevalence in the primary care context and it is frequently associated with worse health-related quality of life (HRQoL). Few studies evaluated the variables that could have a potential effect on HRQoL of primary care patients with multimorbidity. The purpose of this study, the first of its kind ever undertaken in Portugal, is to analyse the relationship between multimorbidity, health-related quality of life, perceived family support and unmet health needs in adult patients attending primary care. METHODS Multicentre, cross-sectional survey conducted among primary care patients with multimorbidity. It included 521 participants (64.1 % females) who met the inclusion criteria. HRQoL was evaluated using the Portuguese Short Form-12 Health Status Questionnaire. The Portuguese Family APGAR was used to measure the perceived family support. A patients' unmet health needs questionnaire was used. The unmet needs for medical, surgical and dental care; prescription medications; mental healthcare or counselling; and eyeglasses or other technical aid was assessed. Descriptive and multivariate analyses were performed. RESULTS The sample had an overall average of 4.5 chronic health problems. Increased multimorbidity levels were linked to worse health-related quality of life, particularly the physical health. Some variables were confirmed as playing a role on health-related quality of life. Male patients with high monthly incomes and highly functional families had better physical and mental health. High levels of education and the presence of asthma were also associated with better physical health. Contrariwise, elderly patients with high levels of multimorbidity and with osteoarthritis had lower physical health. The majority of the patients did not have unmet health needs. When health needs were stated they were mostly for generalist medical care, dental care, and eyeglasses/other technical aid. Financial insufficiency was the primary reason for not fulfilling their health needs. CONCLUSION To improve the quality of life of multimorbid patients, within primary care practices and health delivery systems, one should take into special account the sex of the patient, the perceived family support and the self-perceived economic status because of their relationship with both physical and mental health. Limitations and recommendations are discussed.
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Affiliation(s)
- Filipe Prazeres
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, 6200-506, Portugal.
- Centro de Saúde de Aveiro, Aveiro, 3810-000, Portugal.
| | - Luiz Santiago
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, 6200-506, Portugal
- USF Topázio, Coimbra, 3020-171, Portugal
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