Formal and informal social participation and elder mistreatment in a national sample of older adults

Cannabis use, social support and social engagement among working-age adults in rural America

Objective

Cannabis use has been linked to physical, psychological, and behavioral changes. Although research indicates separately that informal social support and formal social engagement - which are correlated measures - serve as protective factors in cannabis use, much of this research focuses on youth and more urban samples, limiting our understanding of if these findings are true for rural populations where social support and social engagement are particularly important for health and health behaviors. To fill the research gap, this study examines the effects of informal social support (tangible support and emotional support) and formal social engagement on cannabis use among rural working-age adults.

Methods

This research analyzed 1,122 observations from a cross-sectional online survey conducted in 2022 of working-age adults (18-64) from rural America. Multilevel logistic regression models were used to predict cannabis use in the past 12 months using informal social support (tangible support and emotional support) and formal social engagement and other sociodemographic covariates and state legalization status.

Results

Multilevel logistic modeling indicates that low emotional support and low formal social engagement are associated with a higher odds of reporting cannabis use in the past 12 months among rural working-age adults, net of other sociodemographic variables and state legalization status.

Conclusions

The study suggests that emotional support and social engagement may contribute to cannabis use prevention among rural working-age adults. These findings should inform future research as well as the development of tailored health interventions targeting rural working-age adults.

Elder Mistreatment Experienced by Older Caregiving Adults: Results from a National Community-Based Sample

BACKGROUND

With an aging population, older adults are increasingly serving as caregivers to others, which may increase their risk of adverse interpersonal experiences.

OBJECTIVE

To investigate the prevalence and types of elder mistreatment experienced by older caregiving adults.

DESIGN

Cross-sectional analysis PARTICIPANTS: National sample of community-dwelling US adults over age 60 in 2015-2016.

MAIN MEASURES

Caregiving (assisting another adult with day-to-day activities) was assessed by interviewer-administered questionnaires. Experience of elder mistreatment was assessed by participant-reported questionnaire in three domains: emotional, physical, and financial. Multivariable logistic regression models examined associations between caregiving status and each domain of elder mistreatment, adjusting for age, race, ethnicity, gender, education, marital status, concomitant care-receiving status, overall physical and mental health, and cognitive function. Additional logistic regression models examined associations between being the primary caregiver (rather than a secondary caregiver) and each domain of mistreatment among older caregivers.

KEY RESULTS

Of the 1898 participants over age 60 (including 1062 women and 836 men, 83% non-Hispanic white, and 64% married or partnered), 14% reported serving as caregivers for other adults, including 8% who considered themselves to be the primary caregiver. Among these older caregivers, 38% reported experiencing emotional, 32% financial, and 6% physical mistreatment after age 60. In multivariable models, caregiving was associated with experiencing both emotional mistreatment (AOR 1.61, 95% CI 1.15-2.25) and financial mistreatment (AOR 1.72, 95% CI 1.18-2.50). In analyses confined to caregiving older adults, those who served as primary rather than secondary caregivers for other adults had an over two-fold increased odds of emotional mistreatment (AOR 2.17, 95% CI 1.07, 4.41).

CONCLUSION

In this national cohort of older community-dwelling adults, caregiving was independently associated with experiencing emotional and financial mistreatment after age 60. Findings suggest that efforts to prevent or mitigate elder mistreatment should put more emphasis on vulnerable older caregivers.

Association between Social Participation and Remaining Teeth and Urban-Rural Difference among Older Adults in China

Oral health is an important part of older adults' general health. The study examined the association between social participation (formal and informal) and remaining teeth and the urban-rural difference based on a national survey of older adults in China. The data of older adults were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and analyzed. A total of 11,948 respondents were ultimately involved, including 6836 urban respondents and 5112 rural respondents. Informal social participation and formal social participation were used to assess social participation. The number of remaining natural teeth was measured. Social participation was significantly associated with remaining teeth among older adults, after adjusting for confounders, a one-level increase in the informal social participation was associated with a decrease in natural teeth by 0.152 (95% CI = -0.274; -0.030) and a one-level increase in the formal social participation was associated with a decrease in natural teeth by 0.370 (95% CI = -0.585; -0.156). In addition, the association between social participation (formal and informal) and remaining teeth was observed among urban older adults, but not rural older adults. A high level of social participation may effectively decrease the risk of oral-health problems for the Chinese older adults. The findings suggest recommendations for an older adults-targeted policy and the practice of oral-health promotion. However, the urban-rural difference should be taken into full consideration in social-participation-driven oral-health promotion interventions.

Abuse and neglect of older people in health facilities from the perspective of nursing professionals: A cross-sectional study from Croatia

BACKGROUND

Abuse and neglect of older people represent a salient public health issue that remains understudied in the current literature. However, most studies have focused on estimating the prevalence of mistreatment of older people, while litter priority has been put on healthcare professionals and their role in addressing this problem.

OBJECTIVES

The aim of this paper was to determine nurses' perceptions of neglect and abuse of older persons within health facilities in Croatia.

METHODS

A cross-sectional survey with convenience sampling approach was conducted on 632 nursing professionals between 26 March and 26 April 2020. Participation was voluntary and anonymous. A questionnaire from Drennan et al. (NCPOP, University College Dublin, Dublin, 2012), previously adapted by Neuberg et al. (Arch Ind Hyg Toxicol, 68, 2017, 190), was used as a survey instrument. Descriptive and inferential statistics has been used, as well as multivariable methods (reliability analysis). Significance was set at p < .05 (two-tailed).

RESULTS

Abuse/neglect of older people was observed by 13.8% to 57.4% of nursing professionals, depending on the incident type. The most prevalent incidents observed were ignoring the call of an older person (57.4%), shouting at an older person in anger (41.1%) and force-feeding an older person (34.5%), while the least prevalent incidents observed were denial of food or some privileges as a form of punishment (13.8%). Male nursing professionals reported observing various forms of abuse significantly more often than their female counterparts (p = .038), without statistically significant age-related differences. Furthermore, mistreatment of older people was much more frequently observed in nursing homes (p = .013), with suboptimal the ratio of caregivers and care recipients, as well as by nursing professionals who work in shifts (p = .012). Reliability analysis demonstrated a satisfactory level of internal consistency for the used questionnaire.

CONCLUSIONS

This study reinforces neglect and abuse of older people as a growing public health problem and puts the emphasis on its perception; hence, there is a need for systematic and continuous training of nursing professionals on preventing, identifying and responding to such mistreatment, with the aim of enhancing the quality of life in this vulnerable group.

IMPLICATIONS FOR PRACTICE

This study contributes to the growing body of research on the quality of evidence-based nursing care of older people, most notably from providers' perspective - with direct implications for policy, practice, research and training.

Elder mistreatment and life satisfaction of older adults: mediating roles of emotional closeness with children and loneliness

Elder mistreatment is a risk factor in the life satisfaction of older adults, yet understanding of its underlying mechanisms remains limited. This study investigates the mediating role of emotional closeness and loneliness in the association between elder mistreatment and life satisfaction. A sample of 8,717 Chinese older adults is obtained from the 2018 China Longitudinal Aging Social Survey. Results reveal that emotional mistreatment has a negative effect on the life satisfaction of older adults. Moreover, emotional mistreatment is associated with a low level of emotional closeness and a high degree of loneliness, which further decreases life satisfaction. However, emotional closeness with children did not significantly mediate the association between physical mistreatment and life satisfaction. This study advances the comprehension of the influencing path on how elder mistreatment affects the life satisfaction of older adults. Implications for policy and intervention programs are discussed.