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Sasaki Y, Shobugawa Y, Nozaki I, Takagi D, Nagamine Y, Shirakura Y, Lwin KT, Zin PE, Bo TZ, Sone T, Win HH. Association between Internet use and depressive symptoms among older adults in two regions of Myanmar: a cross-sectional study. BMC Geriatr 2024; 24:145. [PMID: 38342899 PMCID: PMC10860261 DOI: 10.1186/s12877-024-04729-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/19/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Internet use has both positive and negative effects on mental health. However, few studies have examined the association between internet use and mental health among older adults in developing countries. This study aimed to investigate the association between Internet use and depressive symptoms among older adults in two regions of Myanmar. METHODS Data based on a visit to 1,200 older adults in urban and rural Myanmar were obtained through stratified random sampling using the cross-sectional baseline survey of the longitudinal study titled "Healthy and Active Aging in Myanmar." Our analysis included 1,186 participants. The dependent variable was depressive symptoms, and the 15-item version of the Geriatric Depression Scale (GDS) was used as a continuous variable; the higher the score, the more likely a person was to be depressed. Internet use (one of the questions about household property ownership) was used as an independent variable. After confirming the absence of multicollinearity, we adjusted for age, gender, educational background, activities of daily living, residential area, and frequency of meeting friends, and stratified by subjective economic status (above or below average). We also examined the interaction between internet use and subjective economic status. A linear regression analysis was performed. RESULTS Among the 1,186 participants included in the analysis (women: 59.5%; median age: 68 years old), 202 (17.0%) were Internet users (95% Confidential Interval [CI]: 0.15, 0.19), and they had significantly lower GDS scores than the participants who did not use the Internet (B: -1.59, 95% CI: -2.04, -1.13).GDS showed a negative association with Internet use even in the multivariate analysis (B: -0.95, 95% CI: -1.41, -0.50). However, the interaction term for GDS between Internet use and subjective economic status was not significantly associated (B: 0.43, 95% CI: -1.11, 1.98). CONCLUSIONS Internet use and depressive symptoms were associated especially among the older adults. However, there were no significant interaction between Internet use and subjective economic status for GDS.
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Affiliation(s)
- Yuri Sasaki
- Department of Public Health Policy, National Institute of Public Health, Wako City, 351-0197, Japan.
| | - Yugo Shobugawa
- Niigata University Graduate School of Medical and Dental Sciences, Niigata City, 951-8510, Japan
| | - Ikuma Nozaki
- National Center for Global Health and Medicine, Bureau of International Health Cooperation, Tokyo, 162-8655, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Yuiko Nagamine
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, 113-8510, Japan
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
| | - Yuki Shirakura
- Niigata University Graduate School of Medical and Dental Sciences, Niigata City, 951-8510, Japan
| | - Kay Thi Lwin
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, 245, Myanmar
| | - Poe Ei Zin
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, 245, Myanmar
| | - Thae Zarchi Bo
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, 245, Myanmar
| | - Tomofumi Sone
- National Institute of Public Health, Wako City, 351-0197, Japan
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, 245, Myanmar
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Nagamine Y, Shobugawa Y, Sasaki Y, Takagi D, Fujiwara T, Khin YP, Nozaki I, Shirakura Y, Kay Thi L, Poe Ei Z, Thae Z, Win HH. Associations between socioeconomic status and adherence to hypertension treatment among older adults in urban and rural areas in Myanmar: a cross-sectional study using baseline data from the JAGES in Myanmar prospective cohort study. BMJ Open 2023; 13:e065370. [PMID: 36653052 PMCID: PMC9853216 DOI: 10.1136/bmjopen-2022-065370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/09/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES This study aims to investigate whether there is a differential association between socioeconomic status (SES) and adherence to hypertension medication among older adults in rural and urban areas in Myanmar and assess what type of SES is associated with a difference. DESIGN Cross-sectional study using baseline data from the Japan Gerontological Evaluation Study in Myanmar prospective cohort study. A multistage random sampling method was applied in each region. SETTING An urban and a rural area in Myanmar. PARTICIPANTS A total of 1200 older adults over 60 years old in Myanmar were randomly selected in 2018 (600 each from rural and urban areas). Of them, 573 had hypertension and were eligible for the analysis (urban: 317, rural: 256). OUTCOME Adherence to hypertension medication (yes/no) is the outcome of interest. Three types of SES (wealth, education and current employment status) were the independent variables. RESULTS We found that 21.5% of urban residents and 48.4% of rural residents were non-adherent in the study population. Poisson regression modelling stratified by area was performed to estimate the prevalence ratios (PRs) of not following treatment instructions. Demographic information and complications of hypertension were adjusted for in all models as possible confounders. In terms of SES, middle level of wealth compared with low level was significantly associated with poor adherence (PR 2.68, 95% CI 1.28 to 5.59) in the urban area, but education and employment status did not show similar associations. Lower education compared with middle/high school or higher was significantly associated with poor adherence in the rural area (no school: PR 3.22, 1.37-7.58; monastic: 3.42, 1.16-5.07; primary school: 2.41, 1.18-4.95), but wealth and income did not show similar associations. CONCLUSIONS SES and adherence to hypertension medication were differently associated among older adults in rural and urban areas in Myanmar. To ensure healthcare access to hypertension treatment for every citizen, the differential association between SES and adherence in urban/rural areas needs to be recognised.
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Affiliation(s)
- Yuiko Nagamine
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
- Department of Social Preventive Medical Sciences, Chiba University Center for Preventive Medical Sciences, Chiba, Japan
| | - Yugo Shobugawa
- Department of Active Ageing, Niigata University, Niigata, Japan
| | - Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Wako, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, The University of Tokyo, Bunkyo-ku, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Yu Par Khin
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Ikuma Nozaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Shirakura
- Department of Active Ageing, Niigata University, Niigata, Japan
| | - Lwin Kay Thi
- Department of Preventive and Social Medicine, University of Medicine, Magway, Myanmar
| | - Zin Poe Ei
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Yangon, Myanmar
| | - Zarchibo Thae
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Yangon, Myanmar
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Yangon, Myanmar
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Rosenberg M, Tomioka S, Barber SL. Research to inform health systems' responses to rapid population ageing: a collection of studies funded by the WHO Centre for Health Development in Kobe, Japan. Health Res Policy Syst 2022; 20:128. [PMID: 36443868 PMCID: PMC9706822 DOI: 10.1186/s12961-022-00917-z] [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: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
Population ageing is a global phenomenon that has profound implications for all aspects of health systems development. Research is needed to understand and improve the health system response to this demographic shift, especially in low- and middle-income countries where the change is happening rapidly. This Supplement was organized by the WHO Centre for Health Development in Kobe, Japan (WHO Kobe Centre) whose mission is to promote innovation and research for equitable and sustainable universal health coverage considering the impacts of population ageing. The Supplement features 10 papers all based on studies that were funded by the WHO Kobe Centre in recent years. The studies involve a diverse set of 10 countries in the Asia Pacific (Cambodia, Japan, the Lao People's Democratic Republic, Malaysia, Mongolia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam); address various aspects of the health system including service delivery, workforce development and financing; and utilize a wide range of research methods, including economic modelling, household surveys and intervention evaluations. This introductory article offers a brief description of each study's methods, key findings and implications. Collectively, the studies demonstrate the potential contribution that health systems research can make toward addressing the challenges of ensuring sustainable universal health coverage even while countries undergo rapid population ageing.
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Affiliation(s)
- Megumi Rosenberg
- WHO Centre for Health Development (WHO Kobe Centre), 1-5-1 Wakinohama-Kaigandori, Chuo-ku, Kobe, 651-0073, Japan.
| | - Shinichi Tomioka
- WHO Centre for Health Development (WHO Kobe Centre), 1-5-1 Wakinohama-Kaigandori, Chuo-ku, Kobe, 651-0073, Japan
| | - Sarah Louise Barber
- WHO Centre for Health Development (WHO Kobe Centre), 1-5-1 Wakinohama-Kaigandori, Chuo-ku, Kobe, 651-0073, Japan
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Aung MN, Moolphate S, Aung TNN, Koyanagi Y, Kurusattra A, Chantaraksa S, Supakankunti S, Yuasa M. Effectiveness of a community-integrated intermediary care (CIIC) service model to enhance family-based long-term care for Thai older adults in Chiang Mai, Thailand: a cluster-randomized controlled trial TCTR20190412004. Health Res Policy Syst 2022; 20:110. [PMID: 36443788 PMCID: PMC9706835 DOI: 10.1186/s12961-022-00911-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Populations around the world are ageing faster, with the majority living in low- and middle-income countries where health and social care are yet to be universal and inclusive for the ageing population. This community-integrated intermediary care (CIIC) model is a novel prevention-based, long-term care model enhancing the family-based care system traditionally practised in Thailand and neighbouring Asian countries, and many low-and middle-income countries globally. This study assessed the effectiveness of the CIIC model in Chiang Mai, Thailand. METHODS The two-arm parallel intervention study was designed as a cluster-randomized controlled trial. The study population at randomization and analysis was 2788 participants: 1509 in six intervention clusters and 1279 in six control clusters. The research protocol was approved by the WHO Research Ethics Review Committee (WHO/ERC ID; ERC.0003064). The CIIC service intervention model is a combination of formal care and informal care in a subdistrict setting consisting of three components: (1) care prevention delivered as community group exercise and home exercise; (2) care capacity-building of the family caregiver; and (3) community respite service. The primary outcome was family caregivers' burden at 6-month follow-up, and secondary outcome was activities of daily living. Analysis applied the intention-to-treat approach using cluster-level analysis via STATA 16 SE. RESULTS Baseline characteristics did not differ between the two arms. Loss of follow up was 3.7%. Mean age of the participants was 69.53 years. Women constituted 60%. The COVID-19 pandemic caused delayed implementation. The proportion of families with reduced caregiver burden at 6-month follow-up was higher among the intervention clusters (mean 39.4%) than control clusters (mean 28.62%). The intervention clusters experienced less functional decline and fewer people with depression. CONCLUSIONS When communities are integrated for preventing care, and families are empowered for giving care, it is possible to secure universal access to health and social care for the older persons, with basic resources mobilized from communities. This study had shown the CIIC model as an effective and potential step to the realization of universal health and long-term care coverage being inclusive of ageing populations in Thailand and globally. TRIAL REGISTRATION This trial was registered at the Thailand Clinical Trial Registry-Trial registration number TCTR20190412004, https://www.thaiclinicaltrials.org/.
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Affiliation(s)
- Myo Nyein Aung
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan.
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, Japan.
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan.
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand.
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai, 50300, Thailand
| | - Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Yuka Koyanagi
- Department of Judo Therapy, Faculty of Medical and Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, 135-0063, Japan
| | - Akrapon Kurusattra
- Department of Health Service Support, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Sutatip Chantaraksa
- Department of Health Service Support, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Siripen Supakankunti
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
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Nozaki I, Shobugawa Y, Sasaki Y, Takagi D, Nagamine Y, Zin PE, Bo TZ, Nyunt TW, Oo MZ, Lwin KT, Win HH. Unmet needs for hypertension diagnosis among older adults in Myanmar: secondary analysis of a multistage sampling study. Health Res Policy Syst 2022; 20:114. [DOI: 10.1186/s12961-022-00918-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
Abstract
Background
Hypertension is a major cause of morbidity among older adults. We investigated older adults’ access to health services in Myanmar by focusing on unmet needs in diagnosing hypertension. This study aims to identify factors associated with the unmet needs for hypertension diagnosis in the study areas of Myanmar.
Methods
This is a secondary data analysis of the survey which is a cross-sectional study conducted with older adults (aged ≥ 60 years) in the Yangon and Bago regions of Myanmar. Objective indicators of health were collected, including blood pressure, height and weight. The diagnosis of hypertension was considered an unmet need when a participant’s blood pressure measurement met the diagnostic criteria for hypertension but the disease had not yet been diagnosed. Bivariate and multivariate analyses using logistic regression were performed to identify factors associated with the unmet need for hypertension diagnosis. Factors related to lifestyle habits and medical-seeking behaviour were selected and put into the multivariate model.
Results
Data from 1200 people, 600 from each of the two regions, were analysed. Altogether 483 (40.3%) participants were male, 530 (44.2%) were aged ≥ 70 years, and 857 were diagnosed with hypertension based on their measured blood pressure or diagnostic history, or both, which is a 71.4% prevalence of hypertension. Moreover, 240 (20.0%) participants had never been diagnosed with hypertension. In the multivariate analysis, these unmet needs for hypertension diagnosis were significantly associated with male sex (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.05–2.05), residence in the Bago region (OR 1.64, 95% CI 1.09–2.45) and better self-rated health (OR 1.70, 95% CI 1.24–2.33), but not with education, category on the wealth index or living arrangement.
Conclusions
There are barriers to accessing health services for hypertension diagnosis, as evidenced by the regional disparities found in this study, and charitable clinics may decrease the financial barrier to this diagnosis.
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Rojo-Perez F, Rodriguez-Rodriguez V, Molina-Martinez MA, Fernandez-Mayoralas G, Sanchez-Gonzalez D, Rojo-Abuin JM, Ayala A, Rodriguez-Blazquez C, Calderon-Larrañaga A, Ribeiro O, Forjaz MJ. Active ageing profiles among older adults in Spain: A Multivariate analysis based on SHARE study. PLoS One 2022; 17:e0272549. [PMID: 35925982 PMCID: PMC9352065 DOI: 10.1371/journal.pone.0272549] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age. METHODS A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA). RESULTS Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life. DISCUSSION AND CONCLUSIONS The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle.
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Affiliation(s)
- Fermina Rojo-Perez
- Grupo de Investigacion sobre Envejecimiento (GIE), IEGD, CSIC, Madrid, España
| | | | - Maria-Angeles Molina-Martinez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), Madrid, España
| | | | - Diego Sanchez-Gonzalez
- Departamento de Geografía, Universidad Nacional de Educación a Distancia (UNED), Madrid, España
| | | | - Alba Ayala
- Departamento de Estadística, Universidad Carlos III de Madrid (UC3M), Madrid, España
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health (ISCIII), Madrid, España
| | - Amaia Calderon-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet & Stockholm University, Solna, Sweden
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology of the University of Aveiro, Aveiro, Portugal
| | - Maria-João Forjaz
- National Centre of Epidemiology and REDISSEC, Carlos III Institute of Health (ISCIII), Madrid, España
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Sasaki Y, Shobugawa Y, Nozaki I, Takagi D, Nagamine Y, Funato M, Chihara Y, Shirakura Y, Lwin KT, Zin PE, Bo TZ, Sone T, Win HH. Association between Happiness and Economic Status among Older Adults in Two Myanmar Regions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3216. [PMID: 35328904 PMCID: PMC8951419 DOI: 10.3390/ijerph19063216] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/04/2022]
Abstract
Few studies have examined whether objective or subjective economic status (ES) has a greater association with the happiness of older adults, despite concerns regarding the growing economic cost of morbidity and their functional dependence in developing countries with aging populations. Thus, this study examined whether objective/subjective ES was associated with happiness in older adults in two Myanmar regions. A multistage random sampling procedure and face-to-face interviews were conducted in the urban and rural areas of Myanmar. The happiness of 1200 participants aged >60 years was evaluated using a single happiness score ranging from 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective ES, was calculated from 17 household asset items, such as radio, washing machines, and television. Subjective ES was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” Responses ranged from “very difficult” to “very comfortable”. Both low objective and subjective ES were negatively associated with happiness, after adjusting for confounding variables and stratification by region (urban and rural areas). Although objective and subjective ES had similar associations with happiness in urban areas, subjective ES had a stronger association in rural areas.
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Affiliation(s)
- Yuri Sasaki
- Department of International Health and Collaboration, National Institute of Public Health, Wako City 351-0197, Japan
| | - Yugo Shobugawa
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata City 951-8510, Japan; (Y.S.); (Y.C.); (Y.S.)
| | - Ikuma Nozaki
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan;
| | - Daisuke Takagi
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Yuiko Nagamine
- Department of Family Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Masafumi Funato
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Yuki Chihara
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata City 951-8510, Japan; (Y.S.); (Y.C.); (Y.S.)
| | - Yuki Shirakura
- Graduate School of Medical and Dental Sciences, Niigata University, Niigata City 951-8510, Japan; (Y.S.); (Y.C.); (Y.S.)
| | - Kay Thi Lwin
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
| | - Poe Ei Zin
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
| | - Thae Zarchi Bo
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
| | - Tomofumi Sone
- National Institute of Public Health, Wako City 351-0197, Japan;
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon 245, Myanmar; (K.T.L.); (P.E.Z.); (T.Z.B.); (H.H.W.)
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Khin ET, Aung MN, Ueno S, Ahmad I, Latt TS, Moolphate S, Yuasa M. Social Support between Diabetes Patients and Non-Diabetes Persons in Yangon, Myanmar: A Study Applying ENRICHD Social Support Instrument. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147302. [PMID: 34299754 PMCID: PMC8303506 DOI: 10.3390/ijerph18147302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/28/2022]
Abstract
Diabetes patients, due to the chorionic nature of the disease, need complex and long-term care for control and prevention of complications. The patients themselves find it difficult to adopt appropriate disease management after diagnosis and they need social support from family, friends, and their environment, especially in lower- and middle-income countries where medical service is limited, and they need self-care of disease and lifestyle modification. In Myanmar, however, the study for social support among diabetes patients is still limited. Therefore, we conducted a case-control study to investigate the social support among diabetes patients and the association between socioeconomic factors in Yangon, which has the highest prevalence of diabetes in Myanmar. Social support between diabetes patients who came to diabetes special clinics and non-diabetes community control was assessed by applying transculturally translated ENRICHD Social Support Instrument (ESSI). Among the diabetes patients’ group, more than 70% had high perceived social support, specifically higher level of informational and emotional social support. Robust multiple regression models revealed significant positive associations between total social support and independent variables: p value < 0.001 for monthly household income and being married, and p value < 0.05 for household number and frequency of having meals together with family. These findings suggest that perceived social support among patients with diabetes may be mainly affected by the patients’ family conditions, such as household income and living with a spouse, in Myanmar culture.
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Affiliation(s)
- Ei Thinzar Khin
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Correspondence: ; Tel.: +81-33813-3111
| | - Satomi Ueno
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of Nursing, Seisen Jogakuin College, Nagano 381-0085, Japan
| | - Ishtiaq Ahmad
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Tint Swe Latt
- Myanmar Diabetes Association (MMDA), Yangon 11211, Myanmar;
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai 50300, Thailand;
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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Sasaki Y, Shobugawa Y, Nozaki I, Takagi D, Nagamine Y, Funato M, Chihara Y, Shirakura Y, Lwin KT, Zin PE, Bo TZ, Sone T, Win HH. Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar. PLoS One 2021; 16:e0245489. [PMID: 33507963 PMCID: PMC7842968 DOI: 10.1371/journal.pone.0245489] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/03/2021] [Indexed: 12/20/2022] Open
Abstract
Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.
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Affiliation(s)
- Yuri Sasaki
- National Institute of Public Health, Wako, Japan
- * E-mail:
| | - Yugo Shobugawa
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ikuma Nozaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Masafumi Funato
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Yuki Chihara
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuki Shirakura
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Poe Ei Zin
- University of Medicine 1, Yangon, Myanmar
| | | | | | - Hla Hla Win
- University of Medicine 1, Yangon, Myanmar
- University of Public Health, Yangon, Myanmar
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