Moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being among elderly Malays

The Impact of Spiritual Well-Being on the Quality of Life of Cancer Patients: A Cross-Sectional Study

BACKGROUND

Quality of life is a multidimensional concept that involves physical, social, emotional, and functional well-being. Spirituality represents a potentially influential factor in the quality of life. This study aimed to evaluate the quality of life and spirituality among cancer patients.

METHODS

A cross-sectional study was carried out on 354 cancer patients in Palestine. A self-administered questionnaire was used for data collection. The questionnaire was made up of 4 sections: sociodemographic factors, clinical data, FACT-G, and FACIT-sp.

RESULTS

A total of 354 cancer patients with a mean age of 46.4 ± 15.3 years were enrolled in the study. The spiritual well-being of patients reported in this study was measured by using the median FACIT-Sp total score, and it was 35 (IQR: 29-42). The quality of life of patients was measured using the median of the FACT-G total score, and it was 63 (IQR: 52-85). The FACT-G score was significantly variable based on several factors including age, marital status, cancer type, presence of metastasis, presence of treatment side effects, and the period since diagnosis (P-value < .05). The FACIT-Sp total score had a significantly strong positive relationship with FACT-G total score (r = .705, P < .001). Moreover, moderate to strong significant correlations were found between spirituality and quality of life subscales.

CONCLUSIONS

Quality of life among cancer patients is affected by their basic and clinical characteristics and is highly correlated with their spirituality level. Thus, addressing palliative support through spiritual care besides primary clinical treatment is of great importance to improve the quality of life among cancer patients.

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

Objectives

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

Methods

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

Results

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

Conclusion

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

Religiousness and Quality of Life Among Older Adults of Different Ethnic Groups in Malaysia: A Five-Year Follow-up Study

Research has shown that religion is associated with a better quality of life (QoL). This study aims to examine ethnic differences in the association between religion and the QoL of older adults in a predominantly Muslim population within a multicultural setting. Two-wave data of 3,810 participants consisting of mostly Muslims and older adults aged ≥ 55 years were collected as part of the community health surveys conducted in 2013 and 2018 in the South East Asia Community Observatory (SEACO). Both cross-sectional analyses of baseline data and prospective analyses of longitudinal data were conducted. The associations between religiosity and quality of life were mainly positive in the cross-sectional analysis. In the two-wave analysis, religious importance was negatively associated with QoL among the Malays (B = - 1.103, SE B = 0.029, p < .001) and the Chinese (B = - 0.160, SE B = 0.043, p < .001), and a belief in a higher power control was associated with better QoL among the Malays (B = 0.051, SE B = 0.022, p < .005) and poorer QoL domains among the Indians (physical health: B = - 5.412, SE B = 1.382, p < .001; psychological: B = - 3.325, SE B = 1.42, p < .001; social relationship: B = - 5.548, SE B = 1.616, p < .001; environment: B = - 2.586, SE B = 1.288; p < .05). Our study's mixed results suggest that religiosity is positively associated with quality of life in cross-sectional analyses. However, in longitudinal analyses, the results are different. Conclusions with regard to causality based on cross-sectional analyses may be misleading. Health promotion programs should continue to examine the effect of religiousness on health outcomes over time among aging populations across different ethnic groups.

Religiosity and Attitudes towards Health, Disease, Death and the Use of Stimulants among Jehovah's Witnesses

Religiosity is considered as one of the many factors shaping an individual's health consciousness. The aim of the study is an analysis of the correlation between the religiosity of Jehovah's Witnesses and their attitudes towards health and disease. A cross-sectional study was performed on the convenience sample of 171 Jehovah's Witnesses from eastern Poland with the use of two research tools: the author's questionnaire, focusing on attitudes towards health, disease, death and the use of stimulants, and the Duke University Religion Index (DUREL). The research involved 99 females (57.9%) and 72 males (42.1%), with an average age of 37.25 (SD = 12.59) years. On average, they have been a Jehovah's Witness for 29.21 (SD = 13.22) years and are characterised by a high ratio of organisational religious activity (ORA) (M = 5.60; SD = 0.62) and intrinsic religiosity (IR) (M = 4.81; SD = 0.37). Those who had never smoked before becoming one of Jehovah's Witnesses had a higher IR (Z = -2.822; p = 0.005), similarly to those respondents who smoked cigarettes before they became Jehovah's Witnesses (Z = -2.977; p = 0.003) and those who did not abuse alcohol before they became Jehovah's Witnesses (Z= -1.974; p = 0.048). Jehovah's Witnesses are a group characterised by a high degree of consistency when it comes to religiosity, attitudes regarding health and disease and health behaviours. This means that they follow the teachings of their religion with regard to health issues. Knowledge about the association between religiosity and health behaviours is important to provide effective health education, health promotion and development of health prevention policy, specifically when dealing with more religious groups of clients.

Perspectives of ESCAPE-Pain Programme for Older People With Knee Osteoarthritis in the Community Setting

Background: Functional limitationscommonly affect patients with knee osteoarthritis (OA) which reduces quality of life. The Enabling Self-management and Coping with Arthritic Pain using Exercise (ESCAPE-pain) is an evidence-based programme identified to be suitable for adaptation for the Malaysian health care system. It is important to understand the acceptance from a sociocultural context of the ESCAPE-pain programme from the perspectives of patients with knee OA and healthcare professionals. This qualitative study aims to explore the perspectives of stakeholders to inform the adaptation of the ESCAPE-pain programme into the Malaysian health care system. Method: Semi-structured interviews using interview guides were conducted with 18 patients with knee OA and 14 healthcare professionals including nurses, physiotherapists, occupational therapists, medical doctors, and orthopedic surgeons. The data were transcribed and analyzed using framework analysis. Results: The findings show that patients and healthcare professionals positively accept the programme into their daily living activities and recommend some modifications related to the Malaysian context. This study also highlights strategies to adopt when providing ESCAPE-pain to patients with knee OA. Conclusion: The findings reveal how sociocultural considerations could facilitate uptake and engagement with the ESCAPE-pain programme for home exercise among patients with knee osteoarthritis. These findings may benefit t patients with knee OA in the Malaysian healthcare system, although future research is recommended.

Perceived Health and Life Satisfaction of Elderly People: Testing the Moderating Effects of Social Support, Attitudes Toward Aging, and Senior Privilege

As health declines with age, it is critical to explore moderators that could buffer the impact of declining health on life satisfaction of elderly people. This study aims to test the moderating effects of social support, attitudes toward aging, and senior privilege on the relationship between perceived health and life satisfaction among elderly people. The study used a sample of 5809 Chinese elderly people. Multiple regression analyses were performed to test the moderating effects of the study variables along with gender difference. The results show that social support and attitudes toward aging do not moderate the relationship between perceived health and life satisfaction; senior privilege however, amplifies the impact of perceived health on life satisfaction for female elderly people. The findings recommend personalized provision of senior privilege based on health status and types of diseases, rather than only based on age; and suggest tailored female-oriented social services such as psychological counseling and humanistic care.

Education Moderates the Relationship Between Spirituality with Quality of Life and Stress Among Malay Muslim Women with Breast Cancer

The purpose of this study was to investigate the relationship between spirituality with quality of life and stress of Malay Muslim breast cancer patients in Malaysia. In addition, the moderating role of education on this relationship was examined. Participants consisted of 145 conveniently selected Malay breast cancer patients. The results indicated that the more spiritual respondents reported a higher level of quality of life and lower level of stress. Moreover, education weakened the relationship between spirituality with quality of life and stress.

Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults

OBJECTIVES

Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function.

METHOD

The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0).

RESULTS

Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics.

CONCLUSION

Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.

Sex differences in stroke: a socioeconomic perspective

BACKGROUND

A number of studies have explored the issue of sex differences in stroke from biomedical perspective; however, there are still large gaps in the existing knowledge. The purpose of this study was to assess whether the differences in socioeconomic status and living conditions between men and women may explain the part of the sex differences in incidence and outcomes of stroke.

METHODS

All stroke participants aged ≥60 years admitted in Vaseie Hospital in Sabzevar, Iran, from March 21, 2013, until March 20, 2014, were included in this study. Computerized tomography and magnetic resonance imaging were used to confirm stroke. A series of χ2 tests were performed and Statistical Program for Social Sciences, Version 21.0, was used to investigate the potential differences between older men and women in stroke incidence and outcomes.

RESULTS

A total of 159 incident stroke cases were documented during 1 year. The annual rate of stroke was statistically significantly higher in elderly women than in elderly men (401 vs 357 per 100,000; P<0.001). Female elderly participants had significantly lower socioeconomic status, poorer living conditions, and higher lifetime history of depression, hypertension, and diabetes mellitus than their male counterparts.

CONCLUSION

The findings from this study showed that elderly women are more adversely affected by stroke in terms of incidence and outcomes of stroke than elderly men. The most noticeable result is that sex differences in socioeconomic status and living conditions may result in increased incidence of stroke and poorer outcomes in elderly women. Therefore, it is imperative to identify vulnerable elderly women and provide them appropriate treatment and services.

Flourishing in later life

OBJECTIVE

Flourishing is a relatively new concept in positive psychology that considers hedonic and eudaimonic aspects of well-being. The current study aims to identify the prevalence and socio-demographic and health factors associated with flourishing among older Malaysians.

METHODS

The sample for this study consisting of 2202 community-dwelling older Malaysians was obtained from a national survey entitled "Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly", conducted from May 2013 to April 2014. Data analyses were conducted using the IBM SPSS Version 22.0 and AMOS Version 22.0.

RESULTS

The average age of the respondents was 69.05 (SD=6.24) years. Descriptive results showed that 50.1% of the respondents were flourishing in life, 36.3% were languishing, 8.4% were struggling, and 5.2% were floundering in life. The results of Multiple logistic regression analysis revealed that gender, employment status, level of education, having living children, and chronic medical conditions are significantly associated with flourishing. However, age, marital status, living alone, and economic status did not have much impact on flourishing.

CONCLUSION

To the best of our knowledge, the current study is one of the first studies that conceptualizes and assesses flourishing among older adults in Malaysia. The findings from the present study make important contributions to the existing literature on well-being. It is suggested that health and social care professionals working with older adults adopt a comprehensive approach to identify and propel non-flourishing people toward flourishing in life.

Aging in Multi-ethnic Malaysia

Multiethnic Malaysia provides a unique case study of divergence in population aging of different sociocultural subgroups within a country. Malaysia represents 3 major ethnicities in Asia-the Malay, Chinese, and Indian. The 3 ethnic groups are at different stages of population aging, as they have undergone demographic transition at different pace amidst rapid social and economic changes. Between 1991 and 2010, the Malaysian population aged 60 and over has more than doubled from about 1 million to 2.2 million, and this is projected to rise to about 7 million or 17.6% of the projected population of 40 million by 2040. In 2010, the aging index ranged from 22.8% among the Bumiputera (Malays and other indigenous groups), to 31.4% among the Indians and 55.0% among the Chinese. Population aging provides great challenges for Malaysia's social and economic development. The increasing prevalence of noncommunicable diseases in older adults, coupled with the erosion of the traditional family support system has increased demands on health care services with an overwhelming need for multidisciplinary and specialized geriatric care. Following the adoption of the National Policy for the Elderly in 1995, issues of population aging have gained increasing attention, especially among researchers. There is an urgent need to increase public awareness, develop infrastructure, as well as support action oriented research that will directly translate to comprehensive and cohesive social strategies, policies, and legislation to protect not just the current older Malaysians but the future of all Malaysians.

Gastritis May Boost Odds of Dementia

INTRODUCTION

Given the high prevalence of dementia and its devastating consequences, identifying risk factors for dementia is a public health priority. The present study aims to assess whether gastritis increases the odds of dementia.

METHODOLOGY

The data for this study, consisting of 2926 community-dwelling older adults, were obtained from the National survey entitled "Mental Health and Quality of Life of Older Malaysians." Dementia was diagnosed using the Geriatric Mental State-Automated Geriatric Examination for Computer-Assisted Taxonomy.

RESULTS

Prevalence of dementia was considerably higher among older adults with gastritis (29.5%) compared to those without gastritis (13.2%). After adjusting for age, gender, marital status, educational attainment, hypertension, stroke, and diabetes, gastritis was significantly associated with more than twice odds of dementia (adjusted odds ratio = 2.42, P < .001, 95% confidence interval = 1.68-3.49).

CONCLUSIONS

The findings from this population-based observational study showing evidence that gastritis may increase the risk of dementia provide avenue for further inquiries into dementia.

Cohort comparisons: emotional well-being among adolescents and older adults

Background

There are several negative stereotypes about older adults that have negatively influenced people’s attitude about aging. The present study compared emotional well-being between older adults and adolescents.

Methods

Data for this study came from 1,403 community-dwelling elderly persons and 1,190 secondary school students and were obtained from two national cross-sectional surveys. Emotional well-being was measured using the World Health Organization-Five Well-Being Index. Data analysis was conducted using a multivariate analysis of covariance with SPSS software version 20 (IBM Corporation, Armonk, NY, USA).

Results

Elderly people significantly scored higher levels of emotional well-being (mean, 62.3; standard deviation, 22.55) than younger people (mean, 57.9; standard deviation, 18.46; t, 5.32; P≤0.001). The findings from the multivariate analysis of covariance revealed a significant difference between older adults and younger people in emotional well-being [F_{(3, 2587)}=120.21; P≤0.001; η²=0.122] after controlling for sex.

Conclusion

Contrary to negative stereotypes about aging, our findings show a higher level of emotional well-being among older adults compared with younger people.

The impact of giving support to others on older adults' perceived health status

BACKGROUND

Social support that may contribute to the physical and mental health of older adults is widely studied. However, much of the existing research has focused on the impact of receiving support; the effects of giving support have largely been neglected. Using the biopsychosocial perspective, this study aimed to examine the independent impact of giving support to others on older adults' perceived health status.

METHODS

Data for this study were obtained from a nationwide community-based cross-sectional survey entitled 'Determinants of Wellness among Older Malaysians: A Health Promotion Perspective', which was conducted in 2010. To assess the unique effects of giving support on perceived health status, above and beyond other possible known factors, a four-step hierarchical regression model using SPSS was used to test the hypothesis.

RESULTS

The findings from the analysis revealed that giving support to others was a significant positive predictor of older adults' perceived health status after receiving support, demographic variables and chronic medical conditions were considered. Further results showed that giving support to others had almost twice the effect on perceived health status (β = 0.11, P < 0.001) as receiving support (β = 0.06, P < 0.05).

CONCLUSION

The findings from this study underscore the need to develop programmes that encourage older adults' participation in productive activities such as caring for and helping others and volunteering.

Dyadic effects of attitude toward aging on psychological well-being of older Malaysian couples: an actor-partner interdependence model

BACKGROUND

There is a growing body of literature indicating that attitudes toward aging significantly affect older adults' psychological well-being. However, there is a paucity of scientific investigations examining the role of older adults' attitudes toward aging on their spouses' psychological well-being. Therefore, the present study aimed to examine the dyadic effects of attitude toward aging on the psychological well-being of older couples.

METHODS

Data for the present study, consisting of 300 couples aged 50 years and older, were drawn from a community-based survey entitled "Poverty among Elderly Women: Case Study of Amanah Ikhtiar" conducted in Peninsular Malaysia. An actor-partner interdependence model using AMOS version 20 (Europress Software, Cheshire, UK) was used to analyze the dyadic data.

RESULTS

The mean ages of the husbands and wives in this sample were 60.37 years (±6.55) and 56.33 years (±5.32), respectively. Interdependence analyses revealed significant association between older adults' attitudes toward aging and the attitudes of their spouses (intraclass correlation =0.59; P<0.001), and similar interdependence was found for psychological well-being (intraclass correlation =0.57; P<0.001). The findings from AMOS revealed that the proposed model fits the data (CMIN/degrees of freedom =3.23; goodness-of-fit index =0.90; confirmatory fit index =0.91; root mean square error of approximation =0.08). Results of the actor-partner independence model indicated that older adults' psychological well-being is significantly predicted by their spouses' attitudes toward aging, both among older men (critical ratio =2.92; P<0.01) and women (critical ratio =2.70; P<0.01). Husbands' and wives' own reports of their attitudes toward aging were significantly correlated with their own and their spouses' psychological well-being.

CONCLUSION

The findings from this study supported the proposed Spousal Attitude-Well-Being Model, where older adults' attitudes toward aging significantly affected their own and their spouses' psychological well-being. The theoretical and practical implications of the findings are discussed.

Theories and measures of elder abuse

Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope.