Validation of the abbreviated Lubben Social Network Scale (LSNS-6) and its association with self-rated health amongst older adults in Puerto Rico

Effect of an entry-to-care intervention on diabetes distress in individuals with newly diagnosed type 2 diabetes: a study protocol for a cluster-randomized trial

BACKGROUND

Diabetes distress (DD) affects at least 36% of T2DM patients and is often associated with insufficient support and care. This study examines an intervention that targets DD through enhanced cross-sectoral collaboration and treatment during the first 3 months following diagnosis. The intervention aims to improve care and self-management and to reduce DD.

METHODS AND INTERVENTION

The study is designed as a cluster-randomized trial with the intervention focusing on four key elements of diabetes care: effective cross-sectoral communication and information sharing, systematic care, a "one-stop-shop" health screening and start-up conversation at the municipality, and improving patient insights into own care. This study requires 32 clusters (16/arm) to achieve 80% power and a 5% significance cut-off, with 270 patients required. GP recruitment occurred from May to Dec 2022. Patient recruitment is ongoing from May 2022 to Aug 2023. GPs were randomized 1:1 using computer-generated blocks of six. Participating GPs are located in Southern Denmark and are not participating in other trials. Patients must be 18 + years of age, have a T2DM diagnosis, and be fluent in spoken and written Danish. DD is the primary outcome and will be measured at baseline, at four months, and again at a 12-month follow-up. Secondary outcomes include quality of care, self-management, quality of life, and clinical factors. Tertiary outcomes comprise depression, stress, resilience, sleep quality, and social network quality.

CONCLUSION

This study is among the first clinical trials exploring the development of DD from diagnosis to 12 months post-diagnosis. Many previous interventions did not directly target DD as the primary outcome. This research provides new insights into DD progression in patients newly diagnosed with T2DM and examines an intervention designed to lower DD in early diabetes stages, contributing to a better understanding of the development of DD and how this intervention affects patient well-being.

TRIAL REGISTRATION

ClinicalTrial.gov NCT05571306. Registered on 07 October 2022.

The psychometric properties of the Lubben Social Network Scale (LSNS-6) and its associations with well-being indicators in Hong Kong older adults

OBJECTIVE

Social networks play a vital role in facilitating late-life health and well-being. The current research sought to examine the psychometric properties of the abbreviated Lubben Social Network Scale (LSNS-6) among community-dwelling Hong Kong Chinese older adults and to explore the association between social network and well-being indicators such as life satisfaction, functional social support, loneliness and anxiety.

METHODS

We administered the LSNS-6 scale to 324 older adults (mean = 71.70, SD = 8.58, range: 58-95). We performed confirmatory factor analysis (CFA) to confirm the construct validity. Cronbach's alpha was chosen for internal consistency estimation. Correlational analysis was performed between LSNS-6 scale and other measures to ascertain the convergent validity.

RESULTS

The two-factor model of LSNS-6 indicated an adequate fit. The goodness-of-fit index values for the model were χ2 /df = 2.61, CFI = 0.98, RSMEA = 0.07, SRMR = 0.05. The internal consistency of the scale was α = 0.75. It also demonstrated good construct validity in measuring the social network and acceptable convergent validity to other measures.

CONCLUSIONS

The LSNS-6, according to current findings, can be a valid reference to the social network of Hong Kong older adults, enabling researchers and clinicians to investigate and develop further corresponding remedies for those in need.

Association between oral condition and subjective psychological well-being among older adults attending a university hospital dental clinic: A cross-sectional study

Positive psychological well-being has a favorable impact on survival rates in both healthy and unhealthy populations. Oral health is also associated with psychological well-being, is multidimensional in nature, and includes physical, psychological, emotional, and social domains that are integral to overall health and well-being. This study aimed to identify the associations between individual and environmental characteristics, oral condition and nutritional status in relation to subjective well-being among older adults using the Wilson and Cleary conceptual model. The participants were older adults (age ≥ 60 years) attending a university hospital. Subjective well-being was assessed using the World Health Organization-5 Well-Being Index, oral condition was assessed based on the number of bacteria in the tongue coating, oral wettability, tongue pressure, occlusal force, oral diadochokinesis, and masticatory ability, and subjective swallowing function was assessed using the Eating Assessment Tool, number of remaining teeth, and number of functional teeth. In addition, factors related to well-being, including social networks, life-space mobility, nutritional status, smoking history, drinking history, and medical history were assessed. In the analysis, structural equation modeling was used to investigate the association between oral condition and subjective well-being. Confirmatory factor analysis revealed oral condition as a latent variable, including tongue pressure, oral diadochokinesis /pa/, /ta/, /ka/, occlusal force, masticatory ability, subjective swallowing function, and number of functional teeth. Structural Equation Modeling revealed that oral condition was positively correlated with nutritional status, and nutritional status was positively correlated with the World Health Organization-5 Well-Being Index. These findings suggest that oral condition may influence subjective well-being via nutritional status or social environmental factors.

The Moderating Roles of Intrinsic and Extrinsic Religiosity on the Relationship between Social Networks and Flourishing: A Study on Community-Dwelling Widowed Older Adults in Malaysia

Widowhood affects the social networks and well-being of older adults. Religion might moderate the relationship between a stressor and well-being. This study aimed to identify the moderating roles of intrinsic and extrinsic religiosity on the relationship between social networks and flourishing among widowed older people and whether this relationship varied across gender. This study involved 655 community-dwelling widowed older Malaysians from Wave 1 (2012-2013) of "Identifying Psychosocial Risks and Quantifying the Economic Costs of Age-Related Cognitive Decline among Older Malaysians" in Peninsula Malaysia. The moderated hierarchical multiple linear regression analysis was conducted to examine the moderating roles of religiosity. Results showed that the moderating effect of religiosity on the relationship between social networks and flourishing was only observed for extrinsic religiosity, not intrinsic religiosity. In terms of gender differences, extrinsic religiosity moderated the relationship between social networks, flourishing only among widows but not widowers. Widows with low levels of extrinsic religiosity should join activities or programs that could expand their social networks to promote higher well-being despite widowhood.

Psychological sense of community, self-rated health and quality of life among older adults in Puerto Rico two years after Hurricane María

Older adults who experience natural disasters are at risk for immediate and longer-term negative health outcomes and diminished quality of life (QOL), in part due to disruptions to social relationships and protections. We use a risk and resilience framework to examine the protective effects of psychological sense of community (PSOC) on self-rated health (SRH) and QOL for older adults in Puerto Rico 2 years after the devastation of Hurricane María in 2017. Between September 2019 and January 2020, we conducted face-to-face interviews with a nonprobability sample of 154 community-dwelling adults aged 60+ in Puerto Rico. Controlling for covariates, we used multivariate regression to examine the association of PSOC and key social risk factors (mental health, social isolation, and loneliness) with SRH and QOL. Higher levels of PSOC were significantly associated with better SRH and QOL. Regarding risks, worse mental health was significantly associated with lower QOL and SRH, loneliness was significantly related to worse QOL, and social isolation was significantly associated with better SRH and better QOL. PSOC was a protective factor for older adults, suggesting that prevention and intervention efforts should focus on building and sustaining older adults' sense of community in the longer-term wake of natural disasters.

Sensor-Based Assessment of Social Isolation and Loneliness in Older Adults: A Survey

Social isolation (SI) and loneliness are 'invisible enemies'. They affect older people's health and quality of life and have significant impact on aged care resources. While in-person screening tools for SI and loneliness exist, staff shortages and psycho-social challenges fed by stereotypes are significant barriers to their implementation in routine care. Autonomous sensor-based approaches can be used to overcome these challenges by enabling unobtrusive and privacy-preserving assessments of SI and loneliness. This paper presents a comprehensive overview of sensor-based tools to assess social isolation and loneliness through a structured critical review of the relevant literature. The aim of this survey is to identify, categorise, and synthesise studies in which sensing technologies have been used to measure activity and behavioural markers of SI and loneliness in older adults. This survey identified a number of feasibility studies using ambient sensors for measuring SI and loneliness activity markers. Time spent out of home and time spent in different parts of the home were found to show strong associations with SI and loneliness scores derived from standard instruments. This survey found a lack of long-term, in-depth studies in this area with older populations. Specifically, research gaps on the use of wearable and smart phone sensors in this population were identified, including the need for co-design that is important for effective adoption and practical implementation of sensor-based SI and loneliness assessment in older adults.