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Liu S, Zhang W, Zhang K, Wu B. The Association between Intergenerational Support and Self-Rated Health among Chinese Older Adults: Do Resilience and Gender Matter? J Appl Gerontol 2023; 42:111-120. [PMID: 36204775 DOI: 10.1177/07334648221127882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study aims to examine the association between intergenerational support and self-rated health (SRH) levels using data collected from Chinese older adults residing in Honolulu, United States (N = 329). We also investigated the mediating role of resilience and the moderating role of gender in the association. We found that receiving emotional support was significantly and positively associated with better SRH for the whole sample. The positive effect of receiving emotional support on health was significant among older women only. In contrast, the beneficial effect of providing economic support on health was significant among older men only. We found that resilience significantly mediated the positive effect of received emotional support on SRH, and this effect was found for the whole sample and among older women. However, resilience did not mediate the positive effect of the economic support provided on SRH among older men.
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Affiliation(s)
- Sizhe Liu
- Department of Economic Sociology, 12634Shanghai University of Finance and Economics, Shanghai, China
| | - Wei Zhang
- Department of Sociology, 204835University of Hawai'i at Mānoa, Honolulu, USA
| | - Keqing Zhang
- School of English and International Studies, Beijing Foreign Studies University, Beijing, China
| | - Bei Wu
- School of English and International Studies, Beijing Foreign Studies University, Beijing, China.,Rory Meyers College of Nursing, 5894New York University, New York, USA
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Wang X, Bergren S, Dong X. Association Between Social Support and Depression Help-Seeking Behaviors Among U.S. Chinese Older Adults. J Aging Health 2023; 35:83-93. [PMID: 35694797 DOI: 10.1177/08982643221106870] [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] [Indexed: 12/15/2022]
Abstract
Objectives: Depression has become one major mental health concern among Asian older adults. Yet, less is known about the role of social support on depression help-seeking among this population. This study examined the association between positive (i.e., open up to, rely on) and negative (i.e., too many demands, criticism) social support and depression help-seeking among U.S. Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly in Chicago (PINE). Study sample consisted of 994 U.S. Chinese older adults with depressive symptoms. Results: Stepwise logistic regression results indicated that greater positive social support was associated with increased likelihood of both formal and informal help-seeking behaviors, whereas negative support was not a significant predictor. Discussion: Findings highlight the key role of positive social support in influencing U.S. Chinese older adults' depression help-seeking behaviors. Tailored strategies are recommended to better meet the mental health needs of this vulnerable population.
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Affiliation(s)
- Xiaochuan Wang
- School of Social Work, 6243University of Central Florida, Orlando, FL, USA
| | - Stephanie Bergren
- 242612Rutgers University, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
| | - XinQi Dong
- 242612Rutgers University, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, USA
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Cultural attributes of suicidal ideation among older immigrants: a qualitative study. BMC Geriatr 2022; 22:678. [PMID: 35172754 PMCID: PMC8851697 DOI: 10.1186/s12877-021-02628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/24/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Suicide is a large and growing public health problem. Little is known about the attributes of suicidal ideation (SI) in the contexts of immigration. This qualitative study aims to explore immigration- and acculturation-related attributes of SI among older immigrants. METHODS A qualitative semi-structured interview design. Interview were conducted with 57 older Chinese immigrants in Chicago with self-reported SI in the past month. RESULTS In addition to attributes of SI which have been well documented in the literature, we identified immigration- and acculturation-related attributes, including linguistic and cultural barriers of being integrated to the receiving communities, acculturation gaps in intergenerational support, and uselessness. CONCLUSIONS Findings of the study highlight the intersectionality of race, culture, and aging regarding SI, which are essential to improve recognition and understanding of SI among immigrant populations.
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Simon MA, Tom LS, Taylor S, Leung I, Vicencio D. 'There's nothing you can do … it's like that in Chinatown': Chinese immigrant women's perceptions of experiences in Chicago Chinatown healthcare settings. ETHNICITY & HEALTH 2021; 26:893-910. [PMID: 30691290 PMCID: PMC6933085 DOI: 10.1080/13557858.2019.1573973] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 12/24/2018] [Indexed: 06/09/2023]
Abstract
Objectives: Chinese American women living in linguistically isolated communities are among the least likely to utilize healthcare services. Qualitative research methods can help identify health system vulnerability points to improve local healthcare delivery for this population.Design: We conducted 6 focus groups among 56 Chinese-speaking adult women in Chicago's Chinatown between July and August 2014 to explore their perceptions of experiences receiving medical care and interacting with healthcare providers in Chinatown healthcare settings.Results: Health system/clinic infrastructure and patient-provider communications were perceived barriers to care at Chinatown healthcare settings. Chinese participants reported long wait times, difficulty scheduling appointments, and poor front desk customer service. Communication difficulties at Chinatown healthcare settings involved language barriers with non-Chinese-speaking providers, but consideration for healthcare providers, provider demeanor, and reliance on provider recommendation also hindered patient-provider communications.Conclusions: Findings improve understanding of barriers to care experienced by Chinese immigrant women in one urban Chinatown community.
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Affiliation(s)
- Melissa A. Simon
- Departments of Obstetrics & Gynecology and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA
- Robert H. Lurie Comprehensive Cancer Center, Chicago, USA
| | - Laura S. Tom
- Departments of Obstetrics & Gynecology and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Shaneah Taylor
- Departments of Obstetrics & Gynecology and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Ivy Leung
- Chinese American Service League, Chicago, USA
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Liu X, Cao H, Zhu H, Zhang H, Niu K, Tang N, Cui Z, Pan L, Yao C, Gao Q, Wang Z, Sun J, He H, Guo M, Guo C, Liu K, Peng H, Peng W, Sun Y, Xie Y, Li B, Shan G, Zhang L. Association of chronic diseases with depression, anxiety and stress in Chinese general population: The CHCN-BTH cohort study. J Affect Disord 2021; 282:1278-1287. [PMID: 33601707 DOI: 10.1016/j.jad.2021.01.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/26/2023]
Abstract
Background Large-scale epidemiological surveys focusing on characteristic differences in psychological and physical health conditions in Chinese adults are lacking. Objective To investigate the association of noncommunicable chronic diseases (NCDs) with depression, anxiety and stress in the Chinese general population. Methods A total of 13784 participants were recruited from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) from 2017 to 2019. Sociodemographic characteristics, lifestyle and NCDs were assessed via questionnaire. Stress, anxiety and depression were assessed by the Depression-Anxiety-Stress Scale (DASS-21). The relationship of NCDs with psychological symptoms was determined through logistic regression analysis. Results Multivariate logistic regression analysis revealed that the prevalence of stress (OR = 1.640; 95% CI: 1.381-1.949), anxiety (OR = 1.654; 95% CI: 1.490-1.837) and depression (OR = 1.460; 95% CI: 1.286-1.658) symptoms were all significantly higher in patients with NCDs. Multimorbidities were associated with a higher risk of stress (OR = 2.310; 95% CI: 1.820-2.931), anxiety (OR = 2.119; 95% CI: 1.844-2.436) and depression (OR = 2.785; 95% CI: 1.499-2.126) than single NCDs. A course of disease within 1 year or more than 5 years also was associated with a higher risk. Limitations The cross-sectional design could not examine the causal link between psychological symptoms and NCDs. Conclusion Psychological symptoms were more prevalent among individuals with NCDs in the Chinese general population. This study suggests that more attention should be paid to the mental health problems of patients with NCDs.
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Affiliation(s)
- Xiaohui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Han Zhang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, 100076, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, and Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei Province, 050021, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Changqiang Yao
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Zhengfang Wang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, 100076, China
| | - Jixin Sun
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei Province, 050021, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Ming Guo
- Department of Disease Prevention and Control, Dingzhou Center for Disease Prevention and Control, Baoding, Hebei Province, 073099, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Kuo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Hai Peng
- Department of Disease Prevention and Control, Dingzhou Center for Disease Prevention and Control, Baoding, Hebei Province, 073099, China
| | - Wenjuan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yanyan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China..
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Li M, Dong X, Kong D. Social Networks and Depressive Symptoms among Chinese Older Immigrants: Does Quantity, Quality, and Composition of Social Networks Matter? Clin Gerontol 2021; 44:181-191. [PMID: 31322054 PMCID: PMC8626165 DOI: 10.1080/07317115.2019.1642973] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: This study aims to investigate the relationship between quantity, quality, and composition of social networks and depressive symptoms among U.S. Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly (PINE) (N = 3,157), a study of Chinese older adults aged 60 and above in Chicago. We assessed quantitative (network size and volume of contact), qualitative (emotional closeness), and composition (proportion kin, proportion female and proportion coresident) aspects of social networks. Depressive symptoms were measured by the Patient Health Questionnaire-9. Negative binomial and logistic regressions were conducted. Results: Older adults who had three to five network members with strong ties, a medium level of contact, and a high level of emotional closeness were less likely to experience depression than their counterparts. Quantitative and qualitative dimensions of social networks have stronger protective effects than the composition dimension. Conclusions: U.S. Chinese older immigrants with different levels of social network characteristics have different risks of depression, suggesting targeted subpopulation assessments to facilitate the delivery of more appropriate and effective treatment to those most in need. Clinical Implications: Health-care professionals and social service agencies are suggested to develop intervention programs to promote mental health through increasing strong ties and improving the quality of social networks for U.S. Chinese older immigrants.
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Affiliation(s)
- Mengting Li
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey , New Brunswick, USA.,School of Nursing, Rutgers, The State University of New Jersey , New Brunswick, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey , New Brunswick, USA
| | - Dexia Kong
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey , New Brunswick, USA
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Wang J, Kong D, Yu F, Conwell Y, Dong X. Cognitive deficit, physical frailty, hospitalization and emergency department visits in later life. Aging Ment Health 2021; 25:521-527. [PMID: 31805771 PMCID: PMC7272280 DOI: 10.1080/13607863.2019.1699015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To examine the added effect of having both cognitive deficit and physical frailty, compared to having either one only, on hospitalization and emergency department (ED) visits. METHODS Data from a population-based study of 3,157 community-dwelling older (≥60 years) Chinese adults in the U.S. were used. Cognitive deficit was measured by the Mini-Mental State Examination (i.e. education-adjusted score: 16 [illiterate], 19 [primary school], and 23 [≥middle school]). Physical frailty was identified using the Short Performance Physical Battery (0-6 out of 15). The numbers of hospitalizations and ED visits in the previous two years were self-reported. RESULTS In this sample, 12.63% had cognitive deficit alone, 5.95% had physical frailty alone, and 4.26% had both. Compared with participants having neither cognitive deficit nor physical frailty, those having physical frailty alone were 1.5 times as likely to have hospitalizations (Rate Ratio [RR] = 1.52 [1.07, 2.16], p = 0.02) and ED visits (RR = 1.52 [1.07, 2.15], p = 0.02). Having cognitive deficit alone was not significantly related to either outcome. However, having cognitive deficit with existing physical frailty increased the likelihood of both hospitalization (RR = 2.00 [1.36, 2.96], p < 0.001) and ED visits (RR = 2.04 [1.37, 3.03], p < 0.001) to a greater extent than having physical frailty alone. CONCLUSION Having cognitive deficit alone was not significantly related to the likelihood of hospitalizations or ED visits, however having cognitive deficit with existing physical frailty increased the likelihood of both outcomes to a greater degree than having physical frailty alone. This suggests cognitive deficit and physical frailty have synergistic effects on hospitalizations and ED visits.
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Affiliation(s)
| | - Dexia Kong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University
| | - Fang Yu
- School of Nursing, University of Minnesota
| | | | - Xinqi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University
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Baghdadi LR, Alhassan MK, Alotaibi FH, AlSelaim KB, Alzahrani AA, AlMusaeed FF. Anxiety, Depression, and Common Chronic Diseases, and Their Association With Social Determinants in Saudi Primary Care. J Prim Care Community Health 2021; 12:21501327211054987. [PMID: 34814776 PMCID: PMC8673869 DOI: 10.1177/21501327211054987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Patients with chronic diseases can experience psychological conditions, including anxiety and depression. However, the association between chronic diseases and these psychological conditions remains unclear. This study aimed to identify the relationship between anxiety, depression, and common chronic diseases (hypertension, type 2 diabetes, dyslipidemia, and rheumatoid arthritis), and their association with social determinants at an outpatient primary care setting. METHODS The validated hospital anxiety and depression scale was administered electronically to eligible participants. For each condition (anxiety and depression), participants were categorized as normal, borderline abnormal, and abnormal, according to their score out of 21 (≤7 = normal, 8-10 = borderline abnormal, ≥11 = abnormal). The scores and numbers of participants in each category were analyzed and compared with their demographic characteristics and chronic diseases for associations and relationships. RESULTS We recruited 271 participants (mean age of 51.65 + 11.71 years) attending primary care clinics. Of these patients, 17.7% and 8.9% had borderline abnormal and abnormal depression, respectively, and 10.3% and 8.9% of patients had borderline abnormal anxiety and abnormal anxiety. Common social determinants and lifestyle factors were examined. Age, gender, and sugary drinks' consumption significantly increased the odds of hypertension and type 2 diabetes; vigorous physical activity 3 times a week, decreased the odds of developing these chronic diseases. Adjusted regression models showed a statistically significant association between the hospital anxiety and depression scale score for borderline and abnormal anxiety and the presence of type 2 diabetes (OR 3.04 [95% CI 1.13, 8.19], P-value = .03 and OR 4.65 [95% CI 1.63,13.22], P-value <.03, respectively) and dyslipidemia (OR 5.93 [95% CI 1.54, 22.86], P-value = .01, and OR 4.70 [95% CI 0.78, 28.35], P-value = .09, respectively). The odds of developing depression were 4 times higher (P-value .04) in patients with rheumatoid arthritis. CONCLUSION Among patients attending primary care outpatient clinics, anxiety, and depression were significantly associated with type 2 diabetes and rheumatoid arthritis, respectively. Social determinants and lifestyle factors play a major role in the development of common chronic diseases in Saudi Arabia. Primary care physicians should consider the patients' psychological status, sociodemographic status, and lifestyle risks during the management of chronic diseases.
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Chao YY, Zha P, Yang K, Dong X. Association between physical function and perceived stress among U.S. Chinese older adults. AMERICAN JOURNAL OF AGING SCIENCE AND RESEARCH 2020; 1:12-19. [PMID: 33135012 PMCID: PMC7595296 DOI: 10.46439/aging.1.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives Physical function impairment can cause great stress to older adults.
The purpose of the study is to investigate the association between
self-reported and directly-observed physical function on perceived stress
among U.S. Chinese older adults. Methods Data were from the Population Study of Chinese Elderly in Chicago
(PINE) of 3,157 Chinese older adults who were 60 and above in the Greater
Chicago Area. Self-reported and directly-observed physical function
measures, and Perceived Stress Scale were used. Results Participants had a mean age of 72.8 ± 8.3 years old (range
60–105). Higher scores of Katz activities of daily living impairments
(odds ratio [OR]=1.77), Lawton instrumental activities of daily living
impartments (OR=1.10, p<0.01), Rosow–Breslau
index of mobility scale (OR=1.39, p<0.05), and Nagi
index of basic physical activities scale (OR=1.19,
p<0.001) were associated with higher levels of
perceived stress. In addition, higher scores of directly-observed physical
function measurements, including chair stand (OR=0.93), tandem stand
(OR=0.71, p<0.05), timed walk (OR=0.73,
p<0.001), and the overall measurement (OR= 0.87,
p<0.01) were associated with lower level of
perceived stress. Discussion Findings suggested that poor physical function was associated with
perceived stress among U.S. Chinese older adults. Longitudinal studies are
needed to obtain a more comprehensive understanding of the pathways between
physical function and perceived stress. Implications for practice Health care professionals could provide personalized physical
activity interventions to encourage older adults to engage in regular
exercise in order to maintain and promote older adults’ physical
function and psychological well-being.
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Affiliation(s)
- Ying-Yu Chao
- Clinical Assistant Professor, Rutgers, the State University of New Jersey, School of Nursing, 180 University Avenue, Newark, NJ 07102-1803, USA
| | - Peijia Zha
- Assistant Professor, Rutgers, the State University of New Jersey, School of Nursing, 180 University Avenue, Newark, NJ 07102-1803, USA
| | - Kyeongra Yang
- Associate Professor, Rutgers, the State University of New Jersey, School of Nursing, 65 Bergen Street, Room 1025E, Newark, NJ 07107, USA
| | - XinQi Dong
- Director, Rutgers Institute for Health, Health Care Policy and Aging Research, 112 Paterson St, New Brunswick, NJ, 08901, USA
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Utilization of Mental Health Services Among Older Chinese Immigrants in New York City. Community Ment Health J 2020; 56:1331-1343. [PMID: 32026216 DOI: 10.1007/s10597-020-00570-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/31/2020] [Indexed: 10/24/2022]
Abstract
Older immigrants are at risk of developing mental illness. This study aims to examine mental health service utilization among older Chinese immigrants, using a mixed-method design. Andersen's Behavioral Model of Health Services Use informed an examination of predictors of mental health services utilization, and semi-structured individual interviews were conducted to illuminate these findings. Participants who were younger, had less than a high school education, and had a higher level of depressive symptoms were more likely to use mental health services. Stressors of psychological distress included breakdown of support system, language barriers, and financial hardships. Factors influencing mental health services use included information from family/friends, referrals from primary care physicians, perceived needs for help, mental health stigma, and culturally competent mental health professionals. Understanding the factors associated with seeking mental health services for older Chinese immigrants could help health care providers to develop early screening programs and culturally sensitive interventions.
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11
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Guo M, Byram E, Dong X. Filial expectation among Chinese immigrants in the United States of America: a cohort comparison. AGEING & SOCIETY 2020; 40:2266-2286. [PMID: 35046615 PMCID: PMC8765011 DOI: 10.1017/s0144686x1900059x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Relying on two unique data-sets on Chinese older immigrants (N = 3,157) and younger immigrants with ageing parents (N = 469) in Chicago, this study compared the level of filial expectation among the two groups and examined the predictors and mental health implications of having high filial expectation among each group. Results of t-tests, logistic regression and negative binominal analyses showed that, regardless of socio-demographic variables, acculturation, physical health and family relations, Chinese adult children had higher filial expectations on themselves than older immigrants' filial expectation on the younger generation. Chinese older immigrants who had less education, lower levels of acculturation, poorer health and closer relationships with children reported higher filial expectation. In the cohort of younger immigrants, high filial expectation was associated with lower income, better health and closer relations with their parents. In addition, having high filial expectation was associated with lower levels of depression and anxiety among the older immigrants, but not among the younger cohort. The results indicated that, whereas Chinese older immigrants seemed to adapt their filial expectation in the new society, the younger cohort still strongly adhere to this traditional family norm. Maintaining strong filial expectation might be a protective factor for older immigrants' mental health. Practice and policy implications of these findings are discussed in the paper.
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Affiliation(s)
- Man Guo
- School of Social Work, University of Iowa, Iowa City, Iowa, USA
| | - Elizabeth Byram
- School of Social Work, University of Iowa, Iowa City, Iowa, USA
| | - Xinqi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey, USA
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12
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Fang CY, Handorf EA, Rao AD, Siu PT, Tseng M. Acculturative Stress and Depressive Symptoms Among Chinese Immigrants: the Role of Gender and Social Support. J Racial Ethn Health Disparities 2020; 8:1130-1138. [PMID: 33000431 DOI: 10.1007/s40615-020-00869-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 09/13/2020] [Indexed: 10/23/2022]
Abstract
The USA has among the largest immigrant population of any country in the world, and over the past few decades, the proportion of Chinese immigrants in the USA has increased significantly. Immigrants may experience substantial acculturative stress as they learn to navigate their new environment, and this stress can contribute to depressive symptoms and poor mental health. Social support can help mitigate the effects of stress on depressive symptoms, but the protective effects of social support have been reported to differ between men and women. Thus, the present study examined associations of acculturative stress and depressive symptoms among Chinese immigrants and explored whether the effects of social support on depressive symptoms varied by gender. Participants included 620 foreign-born Chinese men and women who completed questionnaires on acculturative stress, social support, and depressive symptoms. In nested regression analyses, acculturative stress was positively associated with depressive symptoms among both men and women. However, the interaction of social support and acculturative stress on depressive symptoms was statistically significant among men (β = - 0.89, p < 0.001), but not women (β = - 0.43, p = 0.21). These findings suggest that social support moderates the association of acculturative stress with depressive symptoms, but only among Chinese immigrant men. Future research should explore factors that can enhance resilience and mitigate acculturative stress effects on psychological well-being among Chinese immigrant women.
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Affiliation(s)
- Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.
| | - Elizabeth A Handorf
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA
| | - Ajay D Rao
- Center for Metabolic Disease Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA
| | - Philip T Siu
- Nemours duPont Pediatrics, Media, PA, 19063, USA
| | - Marilyn Tseng
- Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA, 93407, USA
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13
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Chao YY, Li M, Lu SE, Dong X. Elder mistreatment and psychological distress among U.S. Chinese older adults. J Elder Abuse Negl 2020; 32:434-452. [PMID: 32886054 DOI: 10.1080/08946566.2020.1814180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults. METHODS Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed. RESULTS Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression. CONCLUSION AND IMPLICATIONS The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.
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Affiliation(s)
- Ying-Yu Chao
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Mengting Li
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Shou-En Lu
- School of Public Health, Rutgers, the State University of New Jersey , Piscataway, New Jersey, USA
| | - XinQi Dong
- Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
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14
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Anxiety Symptoms, Depressive Symptoms, and Traditional Chinese Medicine Use in U.S. Chinese Older Adults. J Immigr Minor Health 2020; 22:746-753. [PMID: 31586266 PMCID: PMC9943582 DOI: 10.1007/s10903-019-00935-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This study examined the association between anxiety symptoms, depressive symptoms, and Traditional Chinese Medicine (TCM) use among U.S. Chinese older adults. Data was obtained from the Population Study of Chinese Elderly in Chicago (N = 3157; mean age = 72.8). Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS-A). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). TCM modalities included herbal products, acupuncture, massage therapy, Taichi, and other types of TCM. Although not significant, there was a trend indicating that higher levels of anxiety symptoms showed a higher rate of acupuncture use and massage therapy. Older Chinese Americans with depressive symptoms were more likely to use acupuncture and massage therapy; and they were less likely to use other TCM. Future research is needed to identify reasons for TCM use; and how these factors mediate or moderate the relationship between psychiatric symptoms and TCM use.
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15
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Understanding the neighbourhood environment and the health and wellbeing of older Chinese immigrants: a systematic literature review. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x1900134x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractNeighbourhood environment has a significant impact on the health and wellbeing of older people. In recent years, the increase in older Chinese immigrants globally has attracted a growing amount of research which has investigated the health and wellbeing of these elderly residents. The aim of this study is to provide a systematic literature review of empirical findings on the health and wellbeing of older Chinese immigrants and the ways in which the neighbourhood environment impacts them. A systematic search was conducted using online databases where 52 articles met specific criteria and were subsequently reviewed critically. An inductive approach was undertaken to analyse the data extracted from the selected articles. The review was categorised according to the following themes: neighbourhood social environment, neighbourhood physical environment and place attachment. The findings show that the majority of research has investigated the health status of older immigrants, and in particular, the impacts related to the social environments in which they live. The literature review indicated that there is scope for future studies to investigate the impact of the physical neighbourhood environment on this group of people.
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16
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Jiang L, Sun F, Zhang W, Wu B, Dong X. Health Service Use Among Chinese American Older Adults: Is There a Somatization Effect? J Am Geriatr Soc 2019; 67:S584-S589. [PMID: 31403189 DOI: 10.1111/jgs.15734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES Somatization of depressive symptoms among Chinese American older adults remains understudied. This study aimed to identify whether the relationship between depressive symptoms and use of health services (ie, doctor visits, hospital, and emergency department) could be due to pain and whether acculturation played a role in the relations among depressive symptoms, pain, and health service use. DESIGN AND PARTICIPANTS Secondary data came from the Population Study of Chinese Elderly in Chicago that surveyed 3159 Chinese community-dwelling older adults in the greater Chicago area. The average age was 76.3 years (standard deviation = 8.4); 57.95% were female). Negative binominal models were used to identify the effects of depression and pain on each type of health service use, controlling for sociodemographics and health-related factors (eg, chronic illness). MEASUREMENTS Depressive symptoms were assessed using the Patient Health Questionnaire-9; pain was assessed by self-reported pain severity. Participants were classified into low, moderate, and high acculturation groups based on acculturation scores. RESULTS Depressive symptoms and pain were positively related to health service use on the bivariate level. For groups with both low and high acculturation levels, depression and pain each independently predicted more health service use, whereas for the group with a moderate acculturation level, the effect of somatization was substantialized. CONCLUSION Depression largely influenced health service use independently and partially through pain for older Chinese Americans. The somatization tended to be only salient for the moderate acculturation group, calling for more research attention to the complicated effect of acculturation. J Am Geriatr Soc 67:S584-S589, 2019.
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Affiliation(s)
- Lin Jiang
- Department of Social Work, University of Texas Rio Grande Valley, Edinburg, Texas
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan
| | - Wei Zhang
- Department of Sociology, University of Hawai'i at Manoa, Honolulu, Hawaii
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
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17
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Sun F, Gao X, Gao S, Li Q, Hodge DR. Depressive Symptoms Among Older Chinese Americans: Examining the Role of Acculturation and Family Dynamics. J Gerontol B Psychol Sci Soc Sci 2019; 73:870-879. [PMID: 27048568 DOI: 10.1093/geronb/gbw038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 03/14/2016] [Indexed: 11/12/2022] Open
Abstract
Objectives This study identified the prevalence of depression and tested the influence of acculturation and family dynamics on depressive symptoms, among a community sample of older Chinese Americans. Method Data came from a survey of 385 Chinese Americans aged 55 and older (Mage = 72.4 years, SD = 8.7) living in a large metropolitan area in the American Southwest. The survey was administered in 2013 through face-to-face interviews. Depressive symptoms were assessed with the 12-item Center for Epidemiological Studies Depression scale. Results Approximately 19.5% of the sample reported mild depressive symptoms and an additional 8.5% reported moderate depressive symptoms. Three-step hierarchical regression analyses indicated that smaller family support network size and more family conflict were risk factors for depressive symptoms. The effect of acculturation was not significantly associated with depressive symptoms after controlling for family dynamics. Discussion Family support and conflict play a prominent role in explaining depressive symptoms among Chinese American older adults. The effect of acculturation is minimal when older adults have supportive families and good health. Interventions or services aimed at promoting family harmony for members of this population should be considered.
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Affiliation(s)
- Fei Sun
- School of Social Work, Michigan State University, East Lasing
| | - Xiang Gao
- Department of Sociology, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shuo Gao
- School of Journalism and Mass Communication, Arizona State University, Phoenix
| | - Qilun Li
- School of Social Work, Arizona State University, Phoenix
| | - David R Hodge
- School of Social Work, Arizona State University, Phoenix.,Program for Research on Religion and Urban Civil Program for Research on Religion and Urban Civil, University of Pennsylvania, Philadelphia
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18
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Kong D, Solomon P, Dong X. Depressive Symptoms and Onset of Functional Disability Over 2 Years: A Prospective Cohort Study. J Am Geriatr Soc 2019; 67:S538-S544. [PMID: 31403199 PMCID: PMC9942515 DOI: 10.1111/jgs.15801] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/23/2018] [Accepted: 01/04/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This prospective cohort study examined the relationship between depressive symptoms and onset of functional disability over 2 years among US Chinese older adults, a rapidly growing minority older adult population. DESIGN AND SETTING This study used survey data from 2713 Chinese older adults who completed both baseline (2011-2013) and follow-up (2013-2015) interviews of the Population Study of Chinese Elderly in Chicago. Depressive symptoms were assessed at baseline by the nine-item Patient Health Questionnaire. Functional disability was measured by three validated scales, Katz Index of Independence in Activities of Daily Living (ADLs), the Lawton Instrumental Activities of Daily Living (IADLs) scale, and the Rosow and Breslau mobility scale. Multivariate logistic regression was conducted to examine the relationship between baseline depressive symptoms and the development of functional disability (ADLs, IADLs, mobility) at 2-year follow-up while adjusting for covariates. RESULTS Of the 2713 participants, 5.2% experienced ADL disability onset, 35.6% experienced IADL disability onset, and 23.3% experienced mobility disability onset over 2 years. After adjusting for covariates, the odds of ADL disability onset (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02-1.11), IADL disability onset (OR = 1.05; 95% CI = 1.01-1.09), and mobility disability onset (OR = 1.05; 95% CI = 1.01-1.09) were consistently higher in US Chinese older adults with higher levels of depressive symptoms than their less-depressed counterparts. Other significant risk factors included older age and more chronic physical conditions. CONCLUSION Study findings underscore a significant relationship between depressive symptoms and onset of functional disability. Screening and, subsequently, treating depressive symptoms have the potential to reduce disability among US Chinese older adults. Culturally relevant depressive symptom screening may help identify Chinese older adults who are at greater risks for the development of functional disability. J Am Geriatr Soc 67:S538-S544, 2019.
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Affiliation(s)
- Dexia Kong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
| | - Phyllis Solomon
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
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19
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Dong X, Kong D, Mendhe D, Bergren SM. Leveraging Technology to Improve Health Disparity Research: Trilingual Data Collection Using Tablets. J Am Geriatr Soc 2019; 67:S479-S485. [PMID: 31403198 PMCID: PMC9867908 DOI: 10.1111/jgs.16097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/23/2019] [Accepted: 07/08/2019] [Indexed: 01/26/2023]
Abstract
Survey research is an essential component of epidemiological research to understand the health of older adults. However, there are several limitations to conventional data collection methods that may serve as barriers for recruitment and retention of research participants, especially from minority populations. With recent technological advancements, our research team developed an innovative data collection and management system to address linguistic and cultural barriers, data quality, data security, and data preparation issues. This platform has been utilized in the Population Study of Chinese Elderly in Chicago since 2011. Future use and improvement of this system will facilitate research among minority older adults and increase research participation and representativeness to ultimately understand and improve the health and well-being of diverse populations. J Am Geriatr Soc 67:S479-S485, 2019.
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Affiliation(s)
- XinQi Dong
- Institute for Health, Health Care Policy, and Aging ResearchRutgers University New Brunswick New Jersey
| | - Dexia Kong
- Institute for Health, Health Care Policy, and Aging ResearchRutgers University New Brunswick New Jersey
| | - Dinesh Mendhe
- Institute for Health, Health Care Policy, and Aging ResearchRutgers University New Brunswick New Jersey
| | - Stephanie M. Bergren
- Institute for Health, Health Care Policy, and Aging ResearchRutgers University New Brunswick New Jersey
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20
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Simon MA, Tom LS, Leung I, Taylor S, Wong E, Vicencio DP, Dong X. Chinese Immigrant Women's Attitudes and Beliefs About Family Involvement in Women's Health and Healthcare: A Qualitative Study in Chicago's Chinatown. Health Equity 2018; 2:182-192. [PMID: 30283866 PMCID: PMC6110181 DOI: 10.1089/heq.2017.0062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: Healthcare utilization and health-seeking behaviors of Chinese American immigrant women may be influenced by longstanding cultural perspectives of family roles and relationships. An understanding of Chinese immigrant women's perceptions of family social support in health and how these beliefs manifest in healthcare utilization and help-seeking behaviors is critical to the development of culturally appropriate health interventions. Focusing on a sample of Chinese women in Chicago's Chinatown, this qualitative study seeks to describe women's attitudes and beliefs about spouse and adult children's involvement in women's health and healthcare. Methods: We conducted six focus groups among 56 Chinese-speaking adult women in Chicago's Chinatown between July and August 2014. Focus groups were transcribed, coded, and analyzed for emergent themes. Results: Women reported that their adult children supported their health and healthcare utilization by helping them overcome language and transportation barriers, making and supporting decisions, and providing informational and instrumental support related to diet and nutrition. Women viewed these supports with mixed expectations of filial piety, alongside preferences to limit dependency and help-seeking because of concern and emotional distress regarding burdening adult children. Women's expectations of the spouse involvement in their healthcare were low and were shaped by avoidance of family conflict. Conclusion: Findings inform opportunities for the development of culturally appropriate interventions to enhance Chinese immigrant women's health and healthcare. These include patient navigation/community health worker programs to promote self-management of healthcare and family-centered strategies for enhancing family social support structures and reducing family conflict.
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Affiliation(s)
- Melissa A Simon
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
| | - Laura S Tom
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ivy Leung
- Chinese American Service League, Chicago, Illinois
| | - Shaneah Taylor
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Esther Wong
- Chinese American Service League, Chicago, Illinois
| | | | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunsiwck, New Jersey
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21
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Chao YY, Katigbak C, Zhang NJ, Dong X. Association Between Perceived Social Support and Depressive Symptoms Among Community-Dwelling Older Chinese Americans. Gerontol Geriatr Med 2018; 4:2333721418778194. [PMID: 30035199 PMCID: PMC6050614 DOI: 10.1177/2333721418778194] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 02/23/2018] [Accepted: 01/04/2018] [Indexed: 11/16/2022] Open
Abstract
Purpose: This study examined the association between social support and depressive symptoms among U.S. Chinese older adults. Methods: Data were from the Population Study of Chinese Elderly in Chicago (PINE) study. Independent variables were positive and negative perceived social support (PSS). Dependent variable was depressive symptoms. Multinomial logistic regression analyses were performed. Results: A total of participants were 3,157 Chinese older adults with the mean age of 72.8 years (range 60-105 years). After controlling for confounding factors, Chinese older adults with higher positive PSS were 12% (odds ratio [OR] = 0.88, 95% confidence interval [CI] = [0.85, 0.92]) and 18% (OR = 0.82, 95% CI = [0.79, 0.86]) less likely to report mild and moderate-severe depressive symptoms, respectively, compared to reporting minimal depressive symptoms; On the contrary, Chinese older adults with higher negative PSS were 34% (OR = 1.34, 95% CI = [1.24, 1.46]) and 38% (OR = 1.38, 95% CI = [1.26, 1.52]) more likely to report mild and moderate-severe depressive symptoms, respectively. Discussion: The study findings corroborate previous research that social support is significantly associated with depressive symptoms. Our findings reinforce the importance of developing strategies to utilize positive social support and limit negative support in practice for the depressed older adults. Further studies should be conducted to better understand the associations between different dimensions of social support and depression among U.S. Chinese older adults.
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Affiliation(s)
- Ying-Yu Chao
- Rutgers, The State University of New Jersey, Newark, NJ, USA
| | | | | | - XinQi Dong
- Rush University Medical Center, Chicago, IL, USA
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22
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Hei A, Dong X. Neighborhood Disorder Is Associated With Greater Risk for Self-Neglect Among Chinese American Older Adults: Findings From PINE Study. Gerontol Geriatr Med 2018; 4:2333721418778185. [PMID: 30035195 PMCID: PMC6050619 DOI: 10.1177/2333721418778185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 12/21/2017] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aims to examine the association between neighborhood disorder with self-neglect among a community-dwelling Chinese American older population. Method: Data were extracted from the Population Study of Chinese Elderly (PINE), a cross-sectional study of 3,157 participants living in the greater Chicago area. Self-neglect was assessed with systematic observations of participants’ personal and home environment. Neighborhood disorder was measured through eight questions. Logistic regression was used to examine the association between neighborhood disorder and self-neglect. Results: After adjusting for potential confounding factors, every one point higher in neighborhood disorder score was significantly associated with greater risk for overall self-neglect (odds ratio [OR] = 1.13, [1.11, 1.16]), mild self-neglect (OR = 1.14, [1.11, 1.17]), and moderate/severe self-neglect (OR = 1.12, [1.09, 1.16]). Regarding the phenotypes of self-neglect, every one point higher in neighborhood disorder score was significantly associated with greater risk for hoarding (OR = 1.17, [1.14, 1.20]), personal hygiene (OR = 1.15, [1.12, 1.19]), house in need of repair (OR = 1.12, [1.10, 1.15]), unsanitary conditions (OR = 1.12, [1.09, 1.15]), and inadequate utilities (OR = 1.10, [1.05, 1.15]). Discussion: This study underscores the significant association between disordered neighborhood and greater risk of self-neglect among Chinese American older adults. Improving neighborhood disorder problems could benefit for elder self-neglect prevention.
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23
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Liu Q, Cai H, Yang LH, Xiang YB, Yang G, Li H, Gao YT, Zheng W, Susser E, Shu XO. Depressive symptoms and their association with social determinants and chronic diseases in middle-aged and elderly Chinese people. Sci Rep 2018; 8:3841. [PMID: 29497126 PMCID: PMC5832867 DOI: 10.1038/s41598-018-22175-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 02/19/2018] [Indexed: 11/12/2022] Open
Abstract
Depression is one of the most prevalent mental disorders worldwide. Little information is available regarding association of depressive symptoms (DS) with cancer and chronic diseases among middle-aged and elderly Chinese in a population-based setting. In this study we evaluated the prevalence and examined correlates of DS in two population-based cohort studies. Included in the analyses were 103,595 people with a mean age of 61.8 years at the DS assessment. The prevalence of DS was 2.4% in men and 5.6% in women. We found elderly participants, those with lower BMI, or chronic diseases were more likely to experience DS. Having a history of stroke (odds ratio (OR) = 2.2 in men and 1.8 in women), cancer (OR = 3.3 in men and 1.9 in women), or Parkinson's disease (OR = 3.1 in men and 2.7 in women) was associated with high DS. In women, high income and high education levels were inversely related to DS. Being a single woman, long-term or heavy female smoker was associated with high prevalence of DS. High BMI was correlated with low prevalence of depression in men. Our data suggests a low prevalence of DS among middle-aged and elderly people in Shanghai, China. Age, education, income, marital status, smoking, BMI, and certain health conditions were associated with DS.
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Affiliation(s)
- Qiaolan Liu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, United States
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, United States.
| | - Lawrence H Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, United States
| | - Yong-Bing Xiang
- Department of Epidemiology, Cancer Institute of Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Honglan Li
- Department of Epidemiology, Cancer Institute of Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Yu-Tang Gao
- Department of Epidemiology, Cancer Institute of Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, United States
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, United States
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24
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Li M, Dong X. The Association Between Filial Piety and Depressive Symptoms Among U.S. Chinese Older Adults. Gerontol Geriatr Med 2018; 4:2333721418778167. [PMID: 30014005 PMCID: PMC6041996 DOI: 10.1177/2333721418778167] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/10/2017] [Accepted: 02/05/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Depressive symptoms are detrimental to the overall health and well-being of older adults. This study aimed to examine the association between filial piety and depressive symptoms among U.S. Chinese older adults. Method: Data were derived from the Population Study of Chinese Elderly in Chicago (PINE), a community-engaged, population-based epidemiological study of U.S. Chinese older adults aged 60 years and above in the Greater Chicago area. The Patient Health Questionnaire-9 (PHQ-9) was adopted to measure depressive symptoms. Six domains of filial piety were evaluated, involving respect, happiness, care, greeting, obedience, and financial support. Regression analyses were performed. Results: After adjusting for age, sex, education, annual personal income, marital status, living arrangement, number of children, years in the United States, years in the community and medical comorbidities, every one point lower in filial piety expectation score was associated with increased risk of depressive symptoms (RR [rate ratio] = .96, .95-.98). And every one point lower in filial piety receipt score was associated with increased risk of depressive symptoms (RR = .94, .93-.95). Discussion: This study provides insights to research on filial piety and depressive symptoms by examining expectation and perceived receipt of filial piety. Future studies are needed to investigate the association between filial discrepancy and depressive symptoms.
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25
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Chen Y, Peng Y, Ma X, Dong X. Conscientiousness Moderates the Relationship Between Perceived Stress and Depressive Symptoms Among U.S. Chinese Older Adults. J Gerontol A Biol Sci Med Sci 2017; 72:S108-S112. [PMID: 28575254 DOI: 10.1093/gerona/glw172] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 08/09/2016] [Indexed: 11/14/2022] Open
Abstract
Background The present study examined whether individuals' personality traits, Neuroticism and Conscientiousness, moderated the relationship between perceived stress and depressive symptoms among U.S. Chinese older adults. Methods Data analysis was based on the Population Study of Chinese Elderly in Chicago (PINE). Three thousand one hundred and fifty-nine Chinese adults aged 60 years and older participated in the PINE study. They completed scales that assessed their personality (ie, Neuroticism and Conscientiousness of the NEO Five-Factor Inventory), perceived stress (the Chinese Perceived Stress Scale), and depressive symptoms (the Patient Health Questionnaire). Results Perceived stress was positively related to depressive symptoms among U.S. Chinese older adults. No moderation effects were found for Neuroticism. Conscientiousness significantly moderated the perceived stress-depressive symptom relationship. The positive relationship between perceived stress and depressive symptoms was weaker for people who were higher in Conscientiousness than those who were lower in Conscientiousness. Conclusion Conscientiousness mitigated the stress-depressive symptom relationship among U.S. Chinese older adults. Future research is needed to identify the psychological and sociocultural profiles of individuals who show stress resilience and those who are vulnerable. Social services and psychological interventions are needed to promote health and well-being among U.S. Chinese older adults.
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Affiliation(s)
- Yiwei Chen
- Department of Psychology, Bowling Green State University, Ohio
| | - Yisheng Peng
- Department of Psychology, Bowling Green State University, Ohio
| | - Xiaodong Ma
- Psychology Department, University of Houston-Clear Lake, Texas
| | - Xinqi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
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26
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Dong X, Li M, Hua Y. The Association Between Filial Discrepancy and Depressive Symptoms: Findings From a Community-Dwelling Chinese Aging Population. J Gerontol A Biol Sci Med Sci 2017; 72:S63-S68. [PMID: 28575269 DOI: 10.1093/gerona/glx040] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 02/23/2017] [Indexed: 11/13/2022] Open
Abstract
Background The relationship between filial piety and depressive symptoms has been widely discussed, but limited research focused on the gap between filial expectations and filial receipt. This study aims to investigate the association between filial discrepancy and depressive symptoms. Methods Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of U.S. Chinese older adults aged 60 and older in the greater Chicago area. Depressive symptoms were measured by the Patient Health Questionnaire-9. Overall filial discrepancy was evaluated by filial receipt minus expectations. Levels of overall filial discrepancy divided older adults into four groups based on the medium value of filial expectations and receipt. Logistic regression analyses were performed. Results Older adults with greater filial receipt than expectations were more likely to have lower risk of depressive symptoms (odds ratio [OR], 0.95 [0.92-0.97]). The group with high expectations and low receipt has the highest risk of depressive symptoms among the four groups (OR, 1.51 [1.07-2.13]). Greater receipt than expectations in care (OR, 0.83 [0.76-0.92]), make happy (OR, 0.77 [0.69-0.86]), greet (OR, 0.88 [0.79-0.97]), obey (OR, 0.76 [0.68-0.86]), and financial support (OR, 0.80 [0.71-0.89]) was associated with lower risk of depressive symptoms. Conclusions This study goes beyond previous research by examining the association between filial discrepancy domains and depressive symptoms. Cultural relevancy of health interventions is important in the context of Chinese communities. Health care professionals are suggested to be aware of the depressive symptoms of U.S. Chinese older adults with high filial expectations and low receipt.
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Affiliation(s)
- Xinqi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Mengting Li
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Yingxiao Hua
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
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27
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Dong X, Bergren SM. The Associations and Correlations Between Self-reported Health and Neighborhood Cohesion and Disorder in a Community-dwelling U.S. Chinese Population. THE GERONTOLOGIST 2017; 57:679-695. [PMID: 27038465 PMCID: PMC5881676 DOI: 10.1093/geront/gnw050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 12/21/2015] [Indexed: 01/24/2023] Open
Abstract
Purpose of the Study Characteristics of neighborhood have been found to be associated with physical and psychological health status of older adults, especially in relationship to social dynamics like cohesion and disorder. This study aims to examine correlations and associations between sociodemographic characteristics, self-reported health status, cohesion, and disorder among Chinese older adults in the greater Chicago area. Design and Methods The Population Study of Chinese Elderly in Chicago is a cross-sectional, population-based study with community-dwelling Chinese older adults aged 60 and older, recruited through a community-based participatory research approach. Cohesion was measured through six questions; disorder was measured through eight questions. Correlation and regression analyses were conducted using SAS. Results Among 3,158 participants enrolled in the study, 92.3% reported any neighborhood cohesion; 69.8% reported any neighborhood disorder. After controlling for age, sex, education, income, marital status, living arrangement, number of children, years in the community, years in the United States, country of origin, language preference, and location, a higher level of cohesion is associated with higher quality of life (odds ratio [OR]: 1.25, 95% confidence interval [CI]: 1.13, 1.39) and a higher level of disorder is associated with lower overall health status (OR: 0.97, 95% CI: 0.95, 0.99) and lower quality of life (OR: 0.96, 95% CI: 0.95, 0.98). Implications Our findings suggest that neighborhood cohesion and neighborhood disorder are correlated to the health of U.S. Chinese older adults. Future longitudinal research should examine the relationship between community characteristics, both structural and social, and health-related outcomes.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Stephanie M. Bergren
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
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Dong X, Bergren S, Simon MA. Cross-Sectional and Longitudinal Association Between Trust in Physician and Depressive Symptoms Among U.S. Community-Dwelling Chinese Older Adults. J Gerontol A Biol Sci Med Sci 2017; 72:S125-S130. [PMID: 28575268 PMCID: PMC5861912 DOI: 10.1093/gerona/glx036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/22/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Depression is a major public health concern among older adults and health care professionals play a vital role in screening and treatment. However, this process may be impeded by issues like lack of trust in physician (TIP). This study aims to examine the cross-sectional and longitudinal relationships between TIP and depressive symptoms among Chinese older adults in the Chicago area. METHODS Data were collected through the Population Study of Chinese Elderly (PINE), a longitudinal cohort study of Chinese older adults in the greater Chicago area. A total of 2,713 Chinese older adults completed both waves of data collection. TIP was measured through the Trust in Physician scale from Anderson and Dedrick (Anderson LA, Dedrick RF. Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990;67(3 Pt 2):1091-1100. doi:10.2466/pr0.1990.67.3f.1091) (range: 11-55). Depressive symptoms were measured through Patient Health Questionnaire-9. RESULTS Every one point higher in TIP is associated with being 2% less likely to have any depressive symptoms (odds ratio [OR] 0.98, 0.97-0.99) in cross-sectional analysis. Longitudinally, every one-point increase in TIP score was associated with a 2% lower risk of depressive symptoms at Wave 2 (OR 0.98, 0.97-0.99). Improved TIP over 2 years was associated with 25% decreased risk of having any depressive symptoms at Wave 2 (OR 0.75, 0.63-0.89). Additionally, highest tertile of TIP change was associated with a 31% decreased risk of any depressive symptoms compared to lowest tertile (OR 0.68, 0.55-0.84). DISCUSSION Improved TIP over 2 years is associated with less risk of experiencing depressive symptoms. Future research should examine possible pathways and routes of intervention to improve mental health among older adults.
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Affiliation(s)
- XinQi Dong
- Chinese Health, Aging, and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Stephanie Bergren
- Chinese Health, Aging, and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Melissa A Simon
- Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Dong X. Advancing Community and Health Equity: Health and Wellbeing of U.S. Chinese Populations. J Gerontol A Biol Sci Med Sci 2017; 72:S1-S4. [DOI: 10.1093/gerona/glx049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dong X, Chen R. Gender differences in the experience of loneliness in U.S. Chinese older adults. J Women Aging 2016; 29:115-125. [DOI: 10.1080/08952841.2015.1080534] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jang Y, Huang YC, Yoon H, Lin S. Correlates of Self-Rated Health and Self-Rated Mental Health in Older Chinese Americans. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:309-315. [PMID: 27104949 DOI: 10.1080/19371918.2015.1137515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The present study examined the factors associated with self-rated health (SRH) and self-rated mental health (SRMH) in a sample of 108 older Chinese Americans (MeanAge = 70.6, SD = 7.70). SRH and SRMH were highly associated with each other. In the multiple regression models, chronic conditions and functional disability emerged as significant predictors of poor SRH and SRMH. However, the significance of depressive symptoms was only obtained in the model of SRMH. The findings reflect the body-mind connection among older Chinese Americans and provide implications for integrative health promotion efforts.
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Affiliation(s)
- Yuri Jang
- a School of Social Work, The University of Texas at Austin , Austin , Texas , USA
| | - Ya-Ching Huang
- b School of Nursing, The University of Texas at Austin , Austin , Texas , USA
| | - Hyunwoo Yoon
- a School of Social Work, The University of Texas at Austin , Austin , Texas , USA
| | - Shumin Lin
- c Language Teaching and Research Center and Graduate Institute of Teaching English to Speakers of Other Languages, National Chiao Tung University , Hsinchu , Taiwan
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Chang ES, Simon MA, Dong X. Using community-based participatory research to address Chinese older women's health needs: Toward sustainability. J Women Aging 2016; 28:276-84. [PMID: 27310870 PMCID: PMC4940891 DOI: 10.1080/08952841.2014.950511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although community-based participatory research (CBPR) has been recognized as a useful approach for eliminating health disparities, less attention is given to how CBPR projects may address gender inequalities in health for immigrant older women. The goal of this article is to share culturally sensitive strategies and lessons learned from the PINE study—a population-based study of U.S. Chinese older adults that was strictly guided by the CBPR approach. Working with Chinese older women requires trust, respect, and understanding of their unique historical, social, and cultural positions. We also discuss implications for developing impact-driven research partnerships that meet the needs of this vulnerable population.
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Affiliation(s)
- E-Shien Chang
- a Department of Internal Medicine , Rush University Medical Center , Chicago , Illinois , USA
| | - Melissa A Simon
- b Department of Obstetrics/Gynecology, Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA
| | - XinQi Dong
- a Department of Internal Medicine , Rush University Medical Center , Chicago , Illinois , USA
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Dong X, Bergren SM, Chang ES. Traditional Chinese Medicine Use and Health in Community-Dwelling Chinese-American Older Adults in Chicago. J Am Geriatr Soc 2015; 63:2588-2595. [PMID: 26662921 PMCID: PMC9869288 DOI: 10.1111/jgs.13828] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Chinese people have practiced traditional Chinese medicine (TCM) for thousands of years, but there is a paucity of research regarding TCM use in Chinese older adult immigrants in the United States. This study aims to provide an overall estimate of TCM use for Chinese older adults in the United States and to examine associations between sociodemographic characteristics, health measures, and TCM use. Data were collected through the Population Study of Chinese Elderly in Chicago, a community-based participant research study that surveyed 3,158 Chinese older adults aged 60 and older. TCM use was measured using an eight-item scale that examined eight kinds of TCM. Seventy-six percent of participants reported any use of TCM within the past year. After adjusting for potential confounding factors, health status was associated with greater use of acupuncture (odds ratio (OR) = 1.33, 95% confidence interval (CI) = 1.06-1.68) and massage therapy (OR = 1.53, 95% CI = 1.21-1.93), and quality of life was associated with less use of prescribed herbal products (OR 0.69, 95% CI = 0.55-0.87), tai chi (OR = 0.62, 95% CI = 0.50-0.78), and other traditional medicine (OR = 0.47, 95% CI = 0.40-0.56). These findings call for further investigation of TCM use by Chinese older adults, especially those with poor health and those with better quality of life. In the clinical setting, physicians should have awareness of TCM when treating Chinese older adults and look toward possible integration with Western medicine for more culturally appropriate, patient-centered care.
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Affiliation(s)
- XinQi Dong
- Chinese Health, Aging and Policy Program; Rush Institute for Healthy Aging; Rush University Medical Center; Chicago Illinois
| | - Stephanie M. Bergren
- Chinese Health, Aging and Policy Program; Rush Institute for Healthy Aging; Rush University Medical Center; Chicago Illinois
| | - E-Shien Chang
- Chinese Health, Aging and Policy Program; Rush Institute for Healthy Aging; Rush University Medical Center; Chicago Illinois
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Dong X, Zhang M. Religiosity among U.S Chinese Older Adults in Greater Chicago Area-Findings from the PINE Study. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2015; 27:323-342. [PMID: 27087800 PMCID: PMC4827333 DOI: 10.1080/15528030.2015.1065540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Religiosity influences health and well-being. We assessed religiosity among U.S. Chinese older adults. METHODS Data were drawn from the PINE study based on 3,159 community-dwelling U.S. Chinese older adults aged 60+ in the greater Chicago area. Two items retrieved from Duke University Religion Index (DUREL) were used to assess the frequency of participating in religious activities, and a separate item was used to assess the importance of religion. RESULTS Overall, 35.4% of participants perceived religion to be important. This study correlated the higher frequency of participation in religious observances with older age groups of the sample, being female, having a higher income, being unmarried, longer duration of residency in the U.S., and not having been born in Mainland China. Higher frequency of participating in organized religious services was correlated with better quality of life. CONCLUSIONS Religion is important among U.S Chinese older adults. Future longitudinal research is needed to explore aging and religiosity.
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Affiliation(s)
- XinQi Dong
- Chinese Health, Aging and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center
| | - Manrui Zhang
- Chinese Health, Aging and Policy Program, Rush Institute for Healthy Aging, Rush University Medical Center
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Roepke-Buehler SK, Simon M, Dong X. Association Between Depressive Symptoms, Multiple Dimensions of Depression, and Elder Abuse: A Cross-Sectional, Population-Based Analysis of Older Adults in Urban Chicago. J Aging Health 2015; 27:1003-25. [PMID: 25804901 PMCID: PMC9950795 DOI: 10.1177/0898264315571106] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Depression is conceptualized as both a risk factor for and a consequence of elder abuse; however, current research is equivocal. This study examined associations between elder abuse and dimensions of depressive symptoms in older adults. METHOD Participants were 10,419 older adults enrolled in theChicago Health and Aging Project (CHAP), a population-based study of older adults. Regression was used to determine the relationships between depressive symptoms, depression dimensions, and abuse variables. RESULTS Depressive symptoms were consistently associated with elder abuse. Participants in the highest tertile of depressive symptoms were twice as likely to have confirmed abuse with a perpetrator (odds ratio = 2.07, 95% confidence interval = [1.21, 3.52], p = .008). Elder abuse subtypes and depression dimensions were differentially associated. DISCUSSION These findings highlight the importance of routine depression screening in older adults as a component of abuse prevention and intervention. They also provide profiles of depressive symptoms that may more accurately characterize risk for specific types of abuse.
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Dong X, Chen R, Wu B, Zhang NJ, Mui ACYS, Chi I. Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the USA. Gerontology 2015; 62:71-80. [PMID: 26336817 DOI: 10.1159/000437420] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/07/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Elder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation. OBJECTIVES To examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. METHODS Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). RESULTS Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52-4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62-3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. CONCLUSION As the largest epidemiological study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Ill., USA
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Kim HJ, Park E, Storr CL, Tran K, Juon HS. Depression among Asian-American Adults in the Community: Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0127760. [PMID: 26029911 PMCID: PMC4452590 DOI: 10.1371/journal.pone.0127760] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 04/20/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES In this systematic review, we provide an overview of the literature on depression among Asian-Americans and explore the possible variations in depression prevalence estimates by methodological and demographic factors. METHODS Six databases were used to identify studies reporting a prevalence estimate for depression in Asian-American adults in non-clinical settings. Meta-analysis was used to calculate pooled estimates of rates of depression by assessment type. Statistical heterogeneity was assessed for subgroup analyses by gender, age, ethnicity, and other participant characteristics. RESULTS A total of 58 studies met the review criteria (n = 21.731 Asian-American adults). Heterogeneity across the studies was considerably high. The prevalence of major depression assessed via standardized clinical interviews ranged between 4.5% and 11.3%. Meta-analyses revealed comparable estimated prevalence rates of depression as measured by the Center for Epidemiologic Studies Depression Scale (35.6%, 95% CI 27.6%-43.7%) and the Geriatric Depression Scale (33.1%, 95% CI 14.9%-51.3%). Estimates varied by Asian racial/ethnic group and other participant characteristics. Estimates of depression among special populations, which included maternity, caregivers, and homosexuals, were significantly higher than estimates obtained from other samples (58.8% vs 29.3%, p = .003). Estimates of depression among Korean and Filipino-Americans were similar (33.3%-34.4%); however, the estimates were twice as high as those for Chinese-Americans (15.7%; p = .012 for Korean, p = .049 for Filipino). CONCLUSION There appears to be wide variability in the prevalence rates of depression among Asian-Americans in the US. Practitioners and researchers who serve Asian-American adults need to be sensitive to the potential diversity of the expression of depression and treatment-seeking across Asian-American subgroups. Public health policies to increase Asian-American access to mental health care, including increased screening, are necessary. Further work is needed to determine whether strategies to reduce depression among specific Asian racial/ethnic groups is warranted.
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Affiliation(s)
- Hee Jun Kim
- School of Nursing, University of Maryland, Baltimore, Maryland, United States of America
| | - EunMi Park
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, United States of America
| | - Katherine Tran
- Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Hee-Soon Juon
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States of America
- * E-mail:
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Chen R, Dong X. The Prevalence and Correlates of Gambling Participation among Community-Dwelling Chinese Older Adults in the U.S. AIMS MEDICAL SCIENCE 2015. [DOI: 10.3934/medsci.2015.2.90] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Chen R, Dong XQ. Elder Mistreatment and its Subtypes across Different Sociodemographic and Socioeconomic Groups among U.S. Chinese Community-Dwelling Older Adults. JOURNAL OF GERIATRIC MEDICINE AND GERONTOLOGY 2015; 1. [PMID: 26973979 PMCID: PMC4786076 DOI: 10.23937/2469-5858/1510001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives To examine the risk of overall elder mistreatment (EM) and its subtypes in each sociodemographic and socioeconomic group based on different definitional criteria. Methods In person interviews were conducted with 3,159 Chinese older adults in the Greater Chicago Area from 2011 to 2013. Psychological mistreatment, physical mistreatment, sexual abuse, caregiver neglect, and financial exploitation were measured using definitional approaches from the least strict to the strictest criteria. Results Physical, psychological mistreatment, and financial exploitation were closely correlated with each other, but caregiver neglect was not correlated with any other types of mistreatment. The risk of EM and its subtypes across sociodemographic groups differed by types and definitions of mistreatment. Discussion Future longitudinal studies are needed to quantity the risk and protective factors associated with EM and its subtypes with consideration of definitional issues in Chinese aging populations.
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Affiliation(s)
- Ruijia Chen
- Rush Institute for Healthy Aging, Rush University Medical Center, USA
| | - Xin Qi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, USA
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