Social participation is an important health behaviour for health and quality of life among chronically ill older Chinese people

The impact of social activities on mental health among older adults in China

Background

Understand the current situation of social activities among older adults and its impact on mental health, providing policy basis and intervention measures to improve the mental health of the older adult.

Method

Collect relevant data from 8,181 older adults aged ≥ 60 years old from the 2020 China Health and Retirement Longitudinal Study (CHARLS), constructing an analysis framework for social activities of older adults in China from three aspects: participation in social activities, number of social activities, frequency of social activities, and describe them, then analyzing the impact of social activities on their mental health using OLS and 2SLS regression models. This study also discusses the impact of eight social activities on the mental health of older adult people through subgroup.

Result

Among 8,181 older adults aged 60 and above, 3,808 participated in social activities (56.24%), average number of social activities is 0.71, and average frequency of social activities is 1.31 times. The average score of mental health level measured by CES-D is 15.24 points. Participate in social activities can reduce the depression level of the older adult (β = -0.352, 95%CI: -0.547~-0.158); the more social activities the older adult participate in, the lower the depression level of the older adult (β = -0.214, 95%CI: -0.313~-0.115); the higher the frequency of participating in social activities, the lower the depression level of the older adult (β = -0.133, 95%CI: -0.182~-0.083). In summary, social activities can improve the mental health level of the older adults in China. As for different types of social activities, visiting and socializing with friends, participating in club organization activities, playing mahjong, chess, cards, or going to community activity rooms and attending school or training courses can improve the mental health of the older adult.

Discussion

The social activities in three dimensions among older adults in China need to be further improved, and participating in social activities can help improve their mental health. The conclusion provides important policy implications for encouraging and supporting older adults to participate in various social activities, increasing the number and frequency of older adult social activities, then help improving the mental health level of older adults.

Association of increased participation in social activity in later life with risk of all-cause mortality and heart diseases in older people: results from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

Background

Previous studies have shown social activity is associated with reduced risk of health outcomes. However, among older people (≥65 years) who were socially inactive at baseline, limited study explored whether increased participation in social activity in later life was associated with reduced risk of health outcomes; therefore, using the data from the Chinese Longitudinal Healthy Longevity Survey, the study was performed.

Methods

The study outcomes were 10-year all-cause mortality (sample number = 9,984) and 10-year heart diseases (sample number = 7,496). The exposure was the change of social activity frequency. Cox regression analysis was used for data analysis.

Results

During the follow-up, there were 6,407 all-cause mortalities and 1,035 heart diseases, respectively. Kaplan-Meier analysis demonstrated that cumulative incidences of all-cause mortality were significantly lower in participants with changes into more frequent social activity (log-rank p < 0.001), while no significant difference was observed for heart diseases (log-rank p = 0.330). Compared with the subgroup who never participated in social activity at baseline, adjusted HRs of all-cause mortality were 0.79 (95% CI: 0.70-0.90, p < 0.001), 0.78 (95% CI: 0.63-0.96, p = 0.019), 0.74 (0.59-0.92, p = 0.006), and 0.70 (95% CI: 0.56-0.88, p = 0.002) for the subgroup of switching to sometimes, the subgroup of switching to once a month, the subgroup of switching to once a week, and the subgroup of switching to everyday, respectively. The corresponding HRs of heart diseases were 0.83 (95% CI: 0.65-1.08, p = 0.170), 0.82 (95% CI: 0.51-1.31, p = 0.412), 0.91 (0.58-1.42, p = 0.675) and 0.75 (95% CI: 0.47-1.20, p = 0.227), respectively. Stratified and sensitivity analyses revealed similar results.

Conclusion

Among older people who never participated in social activity, increased participation in social activity in later life was associated with reduced risk of all-cause mortality, but was not associated with reduced risk of heart diseases.

The relationship between stigma and quality of life in hospitalized middle-aged and elderly patients with chronic diseases: the mediating role of depression and the moderating role of psychological resilience

Objective

Patients with chronic diseases may have some psychological problems due to their own or surrounding environmental factors, which can adversely affect the patient's illness and life. Given that the number of chronically ill patients in China is currently increasing every year, more research is needed to determine the best ways to manage changes in psychological status and psychological stress responses in chronically ill patients. The researchers constructed a mediated moderation model to explore the impact of stigma on the quality of life of chronically ill patients, as well as the mediating role of depression and the moderating role of psychological resilience.

Methods

A stratified sampling method was used to select 363 middle-aged and old-aged patients with chronic diseases aged 45 years and older from the Affiliated Hospital of Zhejiang University for the study. Data were collected from patients with chronic diseases such as cardiac, respiratory, renal, and other chronic diseases using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G), the Stigma Scale for Patients with Chronic Diseases (SSCI), the Patient Health Questionaire-9 (PHQ-9), the Quality of Life Inventory (SF-12), and the Conner-Davidson Resilience Scale (CD-RISC) were collected from patients with cardiac, respiratory, renal, and other chronic diseases. A descriptive analysis was used to describe the sample. Linear regression was used to evaluate the relationship between the variables. Mediation and moderation analyses were used to explore the mediating role of depression and the moderating role of psychological resilience.

Results

There was a moderate negative correlation between stigma and quality of life (r = -0.378, P < 0.01). There was a moderate negative correlation between depression and quality of life (r = -0.497, P < 0.01). There was a moderately positive correlation between psychological resilience and quality of life (r = 0.382, P < 0.01). There was a moderate negative correlation between psychological resilience and depression (r = -0.348, P < 0.01). There was a weak negative correlation between psychological resilience and stigma (r = -0.166, P < 0.01). There was a strong positive correlation between stigma and depression (r = 0.607, P < 0.01) The mediation study showed that stigma was a significant predictor of quality of life and that stigma and quality of life were mediated to some extent by depression, with the mediating effect accounting for 67.55% of the total effect. The direct path from stigma to depression is moderated by psychological resilience (β = -0.0018, P < 0.01).

Conclusions

Depression mediates the relationship between stigma and quality of life, while psychological elasticity plays a moderating role between stigma and depression, and when the level of psychological elasticity increases, the more significant the role of stigma on depression. As a physiologically and psychologically vulnerable group, patients with chronic diseases' overall quality of life and mental health should be taken more seriously, and clinical workers should pay timely attention to the psychological and mental conditions of patients with chronic diseases and provide timely and appropriate interventions and therapeutic measures. The relevant results of this study also provide a new perspective for clinical work on psychological intervention for patients with chronic diseases.

Exploring the association between social isolation and utilization of primary health services by older adults: evidence from China

Objective

This study aims to investigate the impact of social isolation on the utilization of primary health services among older adults in China.

Methods

Data from the China Longitudinal Aging Social Survey (CLASS) conducted in 2018 were utilized. A binary logistic regression model was established, and propensity score matching (PSM) was employed for analysis.

Results

The results of the binary logistic regression showed that family isolation within social isolation had a significant negative impact on the utilization of primary health services for older adults. In contrast, there was no significant association between friend isolation, community isolation, and the utilization of primary health services. Furthermore, the PSM results, using three matching methods (nearest neighbor matching, radius matching, and kernel matching), confirmed that family isolation significantly reduced older adults' utilization of primary health services, consistent with the baseline regression findings.

Conclusion

Reducing the occurrence of family isolation among older adults may be a cost-effective intervention measure. Efforts should be directed toward improving family support for older adults, promoting the utilization of primary health services, and strengthening disease prevention.

Effect of Physical Performance Levels of Elderly Living in Urban and Rural Areas on Social Participation, Social Functioning, and Quality of Life: A Cross-sectional Study from the Mediterranean Region of Turkey

BACKGROUND

Social interaction is a very important subject for the elderly, especially in the context of active aging.

AIM

This study aims to investigate the effect of physical performance levels of the elderly living in rural and urban areas on social participation, social functioning, and quality of life.

METHODS

A total of 418 volunteer elderly aged 65 and over, living in rural (42.3%) and urban (57.7%) areas, participated in this study. The Mini-Mental State Examination, Short Physical Performance Battery, the World Health Organization Quality of Life Scale for Older Adults, Social Functioning Scale, and the Community Integration Questionnaire were applied to participants.

RESULTS

The scores of social functioning (P = 0.027) and the social network subscale of social participation (P = 0.001) were significantly higher among participants living in urban areas compared to those living in rural areas. Physical performance was positively correlated with social participation (r = 0.404) and social functioning (r = 0.324) at a moderate level (P = 0.000), and with quality of life at a low level (r = 0.158) (P = 0.001). Social participation was positively correlated with social functioning at a high level (r = 0.572) and with quality of life at a moderate level (r = 0.300) (P = 0.000). Social functioning was positively correlated with quality of life at a low level (r = 0.234) (P < 0.01).

CONCLUSION

To increase social participation, social functioning, and quality of life among the elderly, it is necessary to keep physical performance levels higher. In addition, in the planning of social participation, it is crucial to take into account where the elderly live in.

Examining behaviour change techniques (BCTs) in technology-based interventions for enhancing social participation in people with mild cognitive impairment (MCI) or dementia: a scoping review protocol

INTRODUCTION

Technology-based interventions have improved the social participation of older adults with mild cognitive impairment (MCI) or dementia. Nevertheless, how these interventions modify social participation remains to be seen, and what efficient behaviour change techniques (BCTs) have been used. As such, this study aims to conduct a scoping review, identifying the features and BCTs behind technology-based interventions that improve social participation for individuals with MCI or dementia.

METHODS AND ANALYSIS

The scoping review method will be used to search journal articles from electronic databases, such as PsycINFO, PubMed, MEDLINE, Web of Science, Scopus and reference lists. Following the population, concept and context structure, this study focuses on adults over 60 diagnosed with MCI or dementia. It delves into technology-based interventions, specifically focusing on BCTs, features and overall effectiveness for improving social participation. The research considers contextual factors, exploring the diverse settings where these interventions are used, including homes, healthcare facilities and community centres. This approach aims to provide nuanced insights into the impact of technology-based interventions on social participation in the targeted demographic. Two authors will independently screen titles, abstracts and full texts using Covidence software. Disagreements will be resolved through consensus or a third reviewer, and reasons for exclusion will be documented. We will conduct a detailed analysis of BCTs to pinpoint effective strategies applicable to future technology-based intervention designs. Through this scoping review, we aim to provide valuable insights that guide the direction of future research. Specifically, we seek to inform the development of effective technology-based interventions tailored to support social participation for people with MCI or dementia.

ETHICS AND DISSEMINATION

Ethical approval is not necessary, as this review will use available articles from electronic databases. The outcome of the study will be published in a peer-reviewed journal. PROTOCOL REGISTRATION NUMBER: https://osf.io/tkzuf/.

Impact of Hearing Loss on Social Participation in Children: A Scoping Review

Social participation can be defined as involvement in activities that provide a platform to interact with society and others. Untreated hearing loss effects communication skills, academic achievements, and peer-group interaction. Since a typical body structure and body functioning are essential to demonstrate day to day activities. Altogether these factors can influence the social participation in children with HL. The aim of this study is to systematically review the impact of hearing loss on social participation in children.A literature search was carried out to obtain studies exploring social participation among children with HL. Two authors independently searched four electronic databases, PubMed, Scopus, Embase, and Web of Science. The search strategy was designed by using six main terms 'social participation', 'social engagement', 'social interaction', 'hearing loss', 'hearing impairment', 'hearing disorder', and Boolean operators 'AND', 'OR' were used to make the search strings. The current review included four studies after meeting the eligibility criteria. Findings showed that social participation is affected in children with HL. Reduced hearing ability is one of the factors of reduced social participation in children. Children using hearing aids or cochlear implants, participate more frequently in social activities. The findings of this review suggest that HL is associated with reduced social participation. However, using hearing aids and cochlear implants followed by auditory verbal therapy has significant improvement in social participation. Future studies need to investigate whether early rehabilitation can increase social participation in children.

Does digital technology make people healthier: the impact of digital use on the lifestyle of Chinese older adults

BACKGROUND

With the arrival of the era of large-scale production, sharing and application of data, digital use has gradually changed people's daily entertainment, consumption, social interaction, learning and other behaviors in its efficient form. This paper mainly discusses whether this fast and convenient behavior leads Chinese older adults to adopt healthier lifestyles.

METHODS

Using the most recent information from the Chinese Family Panel Studies (CFPS) in 2020, this paper conducted a descriptive statistical analysis on the basic situation of digital use and lifestyles among Chinese older adults and used a structural equation model to analyse the influence of frequency and types of digital use in a variety of different aspects of the real life of Chinese older adults.

RESULTS

Research revealed that the quality of life of Chinese older adults improved significantly as a result of their use of digital technology. The frequency of digital use (FDU) significantly improved Chinese older adults' diet, sleep, exercise, smoking and drinking, and relieved their depression. The types of digital use (TDU) had a significant positive correlation with the lifestyle of Chinese older adults, especially in the influence of digital entertainment (DE), digital consumption (DC) and digital social interaction (DI) on the lifestyle of Chinese older adults.

CONCLUSIONS

Digital use can improve the health of Chinese older adults by promoting a healthy lifestyle through various means. The findings of this study have a substantial positive impact on bridging the digital divide that Chinese older adults face, as well as fostering the integration of digital use into their healthy lifestyles.

Social Participation of Older Adults in Rural and Urban Areas: A Cross-Sectional Survey in Turkey

Social participation is important in terms of active aging and quality of life during old age. This cross-sectional study aimed to determine the social participation of older adults in rural and urban areas in Turkey. Related factors were similarly identified. The sample comprised 1,224 people over the age of 60, with a mean of 69.78 ± 7.48 years. Among the participants, 61.4% live in urban areas. The data were collected in family health centers through face-to-face interview and the Interview Form, Social Participation Assessment Form, and Social Participation Dimension of the Turkish Version of the Aging Module of the World Health Organization Quality of Life (WHOQOL) Scale. The scores obtained from the social participation dimension of the scale among the elderly in urban areas were higher than those obtained among the elderly in rural areas (p = .002). In addition, older adults in the urban areas who talked on the phone several times a month (p = .025), went to concerts, theater/cinema, museum/exhibition, various visual/musical shows (p = .046), and engaged in gardening (p = .032) obtained higher scores in the social participation dimension than the other participants. Health care professionals should take an advocacy role in building relationships with policy makers and create suitable socialization opportunities for older adults in urban and rural areas.

Healthy Aging and its Determinants Among Community-dwelling Older Persons in East Coast, Malaysia: A Multidimensional Assessment

Objectives

Exploring the possibility of healthy aging among older persons is crucial for achieving optimal health in the growing older population. This study aimed to determine the prevalence, pattern, and determinants of healthy aging among older persons in Terengganu, Malaysia.

Methods

We conducted a community-based cross-sectional study involving older persons aged % 60 years. An interviewer-guided questionnaire, anthropometric measurements, and physical assessments were administered to operationalize healthy aging based on a multidimensional concept.

Results

Among the 765 older persons surveyed, only 14.1% (95% CI: 11.64?"16.59) were classified as healthy agers. Multiple logistic regression analysis revealed that superior intrinsic religiosity (odds ratio (OR) = 3.42; 95% CI: 1.34?"8.73), higher social interaction (OR = 2.82; 95% CI: 1.32?"6.04), larger calf circumference (OR = 2.05; 95% CI: 1.24?"3.38), taking water intake % 5 cups per day (OR = 2.01; 95% CI: 1.23?"3.30), better gait speed (OR = 1.71; 95% CI: 1.04?"2.80), having savings (OR = 1.71; 95% CI: 1.10?"2.66), and normal waist circumference (OR = 1.63; 95% CI: 1.04?"2.55) were found positively associated with healthy aging.

Conclusions

Only one in 10 older persons in the state met all the criteria for healthy aging. Specific aspects of religious status, social interaction, socioeconomic, behavioral, physical, and nutritional factors were found to predict healthy ageing in this population. These important determinants should be considered in developing a well-defined and comprehensive public health policy to promote healthy aging in the nation.

The willingness to continue using wearable devices among the elderly: SEM and FsQCA analysis

BACKGROUND

With population aging and the scarcity of resources for elderly individuals, wearable devices pose opportunities and challenges for elderly care institutions. However, few studies have examined the effects of technical characteristics, personal characteristics, and health promotion on the willingness of elderly individuals to continue using wearable devices.

OBJECTIVE

This study explored the effects of technical characteristics and personal characteristics on the willingness of elderly individuals to continue using wearable devices through health promotion, drawing on the technology acceptance model and the value attitude behaviour model.

METHODS

We obtained 265 valid samples through questionnaire surveys and used structural equation modelling (SEM) and fuzzy set qualitative comparative analysis (FsQCA) to clarify the complex causal patterns of elderly people's willingness to continue using wearable devices.

RESULTS

The SEM results showed that perceived usefulness, perceived reliability, self-perceived ageing, and health promotion affected willingness to continue using wearable devices. However, perceived ease of use had no effect. FsQCA showed that elderly individuals are highly willing to continue using wearable devices, yielding five solutions. Perceived ageing was essential in four of these solutions. The impact of perceived ease of use on continued use intention was dynamic and complex.

CONCLUSIONS

This study used two methods to provide insight into the willingness of elderly individuals to continue using wearable devices. In addition, this study discussed associated implications, limitations, and future research directions.

Correlation between air pollution and cognitive impairment among older individuals: empirical evidence from China

BACKGROUND

Little information is available regarding the impact of air pollution on cognitive impairment in older individuals in developing countries. This study empirically tested the impacts of the air quality index (AQI), air pollution intensity (quantified by the number of days of extreme air pollution in a year), and different pollutants on the cognitive abilities of older Chinese individuals.

METHODS

A panel of 28,395 participants spanning 122 cities in 2015 and 2018 was used, based on 3-year follow-up survey data from the China Health and Retirement Longitudinal Study (CHARLS) database. Data from the two phases of the CHARLS microsurvey were combined with relevant statistical data on air pollution in each region in the current year. These two surveys were used to investigate changes in basic health and macro-environmental indicators in older individuals in China, and a mean difference test was conducted. We then reduced the sample selection error by controlling for environmental migration and used two-way fixed and instrumental variable methods for endogenous treatment to avoid the estimation error caused by missing variables.

RESULTS

Air pollution had a significantly negative effect on the cognitive abilities of older individuals (odds ratio [OR]: 1.4633; 95% confidence interval [95% CI]: 1.20899-1.77116). Different pollution intensities(only AQI value is greater than 200 or more) had apparent effects on cognitive impairment, with an OR of approximately 1.0. Sulfur dioxide had significantly negative effects on cognitive ability, with OR of 1.3802 (95% CI: 1.25779-1.51451). Furthermore, air pollution impact analysis showed heterogeneous results in terms of age, sex, education, and regional economic development level. In addition, social adaptability (calculated using social participation, learning, adaptability, and social support) not only had a significant positive effect on the cognitive abilities of older individuals, but also regulated the cognitive decline caused by air pollution.

CONCLUSIONS

Air pollution affects cognitive impairment in older individuals, especially in those with lower education levels, and living in economically underdeveloped areas. This effect is synchronous and has a peak at an AQI of > 200.

Longitudinal health behaviour patterns among adults aged ≥50 years in China and their associations with trajectories of depressive symptoms

OBJECTIVES

Against the background of the growing recognition of the need for a holistic perspective on health behaviour, we aim to identify longitudinal patterns of multiple health behaviours, and to assess associations of such patterns with depressive symptoms among older people in China.

METHODS

Using three waves of China Health and Retirement Longitudinal Study data (n = 8439), we performed latent class growth analyses (LCGAs) to identify longitudinal patterns of multiple health behaviours. Random-effects models were estimated to assess associations between health behaviour patterns and depressive symptoms.

RESULTS

The best fitting LCGA model had seven classes: (1) connected active non-smokers (average posterior probability: 21.8%), (2) isolated active non-smokers (24.7%), (3) isolated inactive non-smokers (17.0%), (4) isolated active smokers (14.5%), (5) connected active smokers (12.2%), (6) increasingly connected and active non-smokers (5.4%), and (7) moderately connected inactive smokers (4.4%). Depressive symptoms were highest in the four classes with lower probabilities of social participation across waves. No evidence was found of change over time in depressive symptomatology gaps between people with different health behaviour trajectories.

CONCLUSION

Health behaviour patterns characterized by consistently low social participation were associated with raised depressive symptomatology, suggesting that focusing on social participation may benefit later-life mental health promotion strategies.

Examining Patient Outcomes at a Faculty-Led Clinic for Uninsured and Underserved Clients

IMPORTANCE

Routine measurements used in clinical settings can foster evidence-based interventions and show the treatment effectiveness.

OBJECTIVE

To examine the efficacy of occupational therapy services for health outcomes, as determined by modified self-care and mobility items of the Continuity Assessment Record and Evaluation Tool, also known as Section GG.

DESIGN

Retrospective and longitudinal. Data were obtained from medical records at four time points over 1 yr.

SETTING

The study took place at a pro bono, faculty-led clinic.

PARTICIPANTS

Ninety-one client charts were reviewed; 64 (70%) clients met the inclusion criteria and were enrolled.

INTERVENTIONS

Interventions were provided by registered occupational therapists and entry-level occupational therapy students under supervision.

OUTCOMES AND MEASURES

Self-care and mobility function were measured using modified GG0130 and GG0170 items from the Centers for Medicare & Medicaid Services Quality Reporting Program; three additional functional items were added. The 36-Item Short Form Health Survey, Version 2® (SF-36v2) was used to evaluate clients' quality of life at intake.

RESULTS

Self-care and mobility composites significantly improved throughout the 1-yr intervention period. The additional functional composite significantly improved during the first 6 mo. Clients' scores on the physical function subdomain of the SF-36v2 were significantly related to their self-care, mobility, and additional functional items.

CONCLUSIONS AND RELEVANCE

Faculty-led clinics can improve the occupational performance of clients in need of occupational therapy services, particularly in the areas of self-care and mobility, which have previously been identified as top priorities for clients. What This Article Adds: This study addressed health disparities in unique and effective ways. By using objective measures of functional mobility and self-care, the study provides robust evidence of the faculty-led clinic's impact in providing underserved and uninsured communities with effective client-centered occupational therapy services.

Factors facilitating and inhibiting the social participation of the elderly in health-oriented activities in Shiraz, Southern Iran

BACKGROUND

The social participation (SP) of the elderly is one of the factors that contribute to the improvement of their well-being. SP, one of the most important factors of active ageing, is mainly influenced by a number of facilitating or inhibiting factors.

AIMS

This study aimed to identify the factors that prevent and facilitate the SP of the elderly population in Iran.

METHODS

A cross-sectional study carried out in Shiraz, southern Iran in 2021. Participants were selected using a convenience sampling method. Shiraz is divided into 11 districts and the largest park in each district is selected for data gathering. The questionnaires were completed by 612 people aged over 60. Data were collected using the Canadian Elderly Survey Project scale and a health-related lifestyle questionnaire and were analyzed using t-test, ANOVA, Pearson's correlation, and ANCOVA.

RESULTS

The mean SP score of the elderly in Shiraz was 24.2 out of 60, which is below the midpoint. The results of the covariance analysis revealed that the SP had a significant relationship with the experience of physician consultation, cost barriers, age, marital status, income level, and education level (P < 0.001). Moreover, the results of Pearson correlation revealed a significant correlation between SP and different dimensions of health-oriented activities (< 0.001).

CONCLUSIONS

This study revealed that the main barriers to older people's participation in health-related activities are cost and access barriers, such as transportation issues. Moreover, higher income level and higher educational attainment have been recognized as the main facilitators of SP in the elderly. In this regard, it can be suggested to apply a combination of health promotion strategies, financial support programs, and development of optimal transportation infrastructure to increase the SP of the elderly.

Association between social activity frequency and overall survival in older people: results from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

BACKGROUND

This study aimed to explore the impact of social activity frequency on mid- and long-term overall survival in older Chinese people.

METHODS

The association between social activity frequency and overall survival was analysed in 28 563 subjects from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) cohorts.

RESULTS

A total of 21 161 (74.1%) subjects died during the follow-up of 132 558.6 person-years. Overall, more frequent social activity was associated with longer overall survival. From baseline to 5 years of follow-up, adjusted time ratios (TRs) for overall survival were 1.42 (95% CI 1.21 to 1.66, p<0.001) in the not monthly but sometimes group, 1.48 (95% CI 1.18 to 1.84, p=0.001) in the not weekly but at least once/month group, 2.10 (95% CI 1.63 to 2.69, p<0.001) in the not daily but at least once/week group, and 1.87 (95% CI 1.44 to 2.42, p<0.001) in the almost everyday group versus never group. From 5 years to the end of follow-up, adjusted TRs for overall survival were 1.05 (95% CI 0.74 to 1.50, p=0.766) in the not monthly but sometimes group, 1.64 (95% CI 1.01 to 2.65, p=0.046) in the not weekly but at least once/month group, 1.23 (95% CI 0.73 to 2.07, p=0.434) in the not daily but at least once/week group, and 3.04 (95% CI 1.69 to 5.47, p<0.001) in the almost everyday group versus the never group. Stratified and sensitivity analysis revealed similar results.

CONCLUSION

Frequent participation in social activity was significantly associated with prolonged overall survival in older people. However, only participating in social activity almost every day could significantly prolong long-term survival.

Social Participation Considered as Meaningful in old age - the Perceptions of Senior Housing Residents in Finland

As populations across the world age, there is a recognised need for promoting social participation in older adults. Previous studies related to social participation have addressed that interactions perceived as meaningful may improve quality of life in old age. However, what is less clear is the nature of such participation from the perspective of older adults, as the vast majority of studies have been quantitative. The present study aimed to explore what characterises social participation that contributes to a meaningful everyday life, from the viewpoint of independently living Finnish older adults. Thematic analysis was used as an interpretative method drawing on semi-structured in-depth interviews with six residents aged 82 to 97 years from one senior housing facility. The analysis showed that social participation perceived as meaningful involved caring reciprocal interactions with people they connected with; having the freedom to make autonomous decisions and influence matters that affected their own or others' everyday life; and, on a more abstract level, feeling significant as a person. It furthermore fostered independence and companionship as well as reduced loneliness. To describe social participation that is perceived as meaningful from a theoretical perspective, we used Levasseur and colleagues' (2010) taxonomy and found that such involvement creates a sense of connectedness, a sense of belonging and relates to the concepts of social integration, social networking and social engagement. This type of involvement is associated with enhanced quality of life and a more meaningful life, highlighting the importance of creating environments where older adults can socially connect.

The effect of telenursing education of self-care on health-promoting behaviors in patients with multiple sclerosis during the COVID-19 pandemic: A clinical trial study

INTRODUCTION

Multiple sclerosis is associated with decrease in health-promoting behaviors (HPBs) and require appropriate nursing interventions. Telenursing can play an important role in education of patients during the COVID-19 pandemic in which face-to-face education is limited. This study aimed to investigate the effect of self-care education with telenursing approach on HPBs in patients with MS.

MATERIALS AND METHODS

In this clinical trial, 68 patients with MS were selected using simple random sampling from Jahrom MS Society and randomly assigned to the intervention (n = 34) and control (n = 34) groups. In the intervention group, educational sessions were held three days a week for six weeks. Data were collected using demographic information and Walker's Health-Promoting Lifestyle questionnaires before and immediately after the intervention. Data were analyzed by Mann-Whitney and Wilcoxon tests using SPSS software (Ver. 21).

RESULTS

Based on the findings, immediately after the intervention, the mean score of HPBs was significantly higher (p = 0.005) in the intervention group (145.38 ± 26.66) than the control group (129.18 ± 22.35). The means of nutrition, exercise, health responsibility, and stress management were significantly different between the intervention and control groups immediately after the intervention (p < 0.05).

CONCLUSION

results this study indicated that self-care education with telenursing approach was effective on HPBs in patients with MS. It can be beneficial to employ as an educative-supportive approach in MS patients.

Older People's Perception and Experience Regarding Health Promotion in Turkey: A Qualitative Study

The aim of this study is to examine the perceptions and experiences of older people regarding health promotion. Using a phenomenological design, semi-structured in-depth interviews were conducted with 22 older people. Data analysis was carried out according to the Colaizzi's method. The analysis revealed five themes (health-promoting activities, outcome expectations, triggers for activities, supporting factors, perceived obstacles). Older people emphasized healthy eating, walking, avoiding stress, and having health checkups as health-promoting behaviors. It was determined that the older people made efforts to display health-promoting behaviors, but they performed the activities insufficiently. The study findings show that interventions to be developed to improve the health of older people should aim at both cognitive and behavioral changes. Nurses should plan multidisciplinary and community-based interventions to reduce the socioeconomic and environmental factors that prevent older people from participating in health-promoting activities.

Moderation of marital status and living arrangements in the relationship between social participation and life satisfaction among older Indian adults

Social participation is considered one of the central components of successful and healthy aging. This study aimed to examine the moderating role of marital status and living arrangement with social participation and its association with life satisfaction of older Indian adults. Samples of 31,464 individuals aged ≥ 60 years were extracted from the Longitudinal Ageing Study in India, wave-1. Descriptive statistics, bivariate analysis, and multivariable linear regression were performed for the analysis. The moderation effect of marital status and living arrangements on the relationship between social participation and level of life satisfaction among Indian older adults were also analyzed. Overall, life satisfaction among older men was relatively higher than older women in this study. Older adults' involvement in social participation [β = 0.39, p < 0.05], being in marital union [β = 0.68, p < 0.001] and co-residing either with spouse [β = 1.73, p < 0.001] or with other family members [β = 2.18, p < 0.001] were positively related to their greater life satisfaction. Interaction of social participation with marital status showed that participating in social activities can boost life satisfaction only among married older people. Further, moderation effect of social participation with living arrangements showed that older adults who were not involved in social participation but living with a spouse or any other household members had higher life satisfaction, and again participation in social activities increased their life satisfaction to a greater level. The establishment of social clubs and advocating social policies oriented toward meaningful social connections are highly needed, especially for older Indians living alone or currently not in a marital union, which will help to enhance their overall life satisfaction.

Health behaviours and well-being among older adults with a Surinamese migration background in the Netherlands

Background

This study aims to identify the relationships between health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being among older adults with a Surinamese background.

Methods

Community-dwelling older adults (≥ 70 years) with a Surinamese background living in Rotterdam, the Netherlands, were identified by the municipal register. A survey study was conducted to assess background information, health behaviours (healthy diet, physical activity, not smoking and social activity) and well-being. Multiple regression analyses were performed to assess the relationships of health behaviours with well-being while controlling for background characteristics.

Results

Average age of participants was 76.2 (4.9) years, slightly more than half of them were female (54.2%). Almost half of the participants had a low-income level (49.6%). More than half of the participants met the Dutch guidelines of fruit intake (63.0%) and vegetable intake (62.8%). Less than half of the participants met the guidelines of fish intake (40.9%) and physical activity (39.8%). The majority of the participants were non-smokers (87.9%). Most of the participants had daily contact with family/friends (90.9%) and slightly more than half of the participants visited family/friends often (53.6%). Looking at the health behaviours, a positive relationship was found between eating enough fruit (β = .109; p ≤ 0.05) and vegetables (β = .135; p ≤ 0.01), physical activity (β = .164; p ≤ 0.001) and often visiting family/friends (β = .158; p ≤ 0.001) with well-being.

Conclusion

This study suggests that next to traditional health behaviours also social activity is an essential health behaviour for the well-being of older Surinamese adults. Research about health promotion should expand its focus by including social activity as health behaviour.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14414-z.

Social participation of community-dwelling older adults in western China: A latent profile analysis

Objective

Social participation has become a policy framework to address population aging. However, little is known about the social participation of older adults in western China, and extensive, multicenter, regional research is lacking. This research investigated the profiles of social participation of older adults in western China and explored the characteristics and factors influencing social participation.

Method

This cross-sectional study was conducted in 3 provinces (Chongqing, Sichuan, and Inner Mongolia) in western China from March 2021 to December 2021 and included 3,456 participants aged 60 years or older. Social participation was assessed using the Chinese version of the Impact on Participation and Autonomy Questionnaire (IPA). Latent profile analysis (LPA) was performed to extract latent classes of social participation among older adults in western China. The chi-square test and multinomial regression analyses were used to identify differences between these classes.

Results

Three social participation classes were identified by LPA: high social participation (25.2%), moderate social participation (55.1%), and low social participation (19.7%). Being older, having a primary school education level, having mobility or speaking impairment, using assistive devices, and having a chronic disease were highly associated with the low social participation class (P < 0.05). Furthermore, older adults with no dependence (OR = 0.018, 95% CI = 0.005-0.062) or mild dependence (OR = 0.039, 95% CI = 0.011-0.139) in activities of daily living (ADLs) were less likely to be in the low social participation class. Older adults who were cared for by non-spouse primary caregivers were more likely to be assigned to the moderate social participation group (OR = 2.097, 95% CI = 1.501-2.930) than to the high social participation group.

Conclusions

Most older adults in western China have a moderate level of social participation. Advanced age, reduced ADL ability, reduced speech ability, reduced mobility, and non-spouse care are related to the level of social participation. Healthcare professionals should pay attention to the predictors for different classes, identifying high-risk groups as early as possible.

Effects of Social Participation by Middle-Aged and Elderly Residents on the Utilization of Medical Services: Evidence From China

Objectives

Aim to evaluate the effect of social participation on utilization of medical services among middle-aged and elderly residents in China.

Methods

We used data from the 2018 wave of the China Health and Retirement Longitudinal Study. Social participation is classified into three types. Furthermore, to control for confounding factors, our study computed propensity score matching (PSM) to evaluate the effect of social participation on the utilization of medical services.

Result

The result of PSM indicates that social participation significantly positively affects the utilization of outpatient services, the average treatment effect on the treated (ATT = 0.038***) and the utilization of inpatient services (ATT = 0.015**) by middle-aged and elderly residents. Furthermore, the utilization of outpatient health care services was significantly positively associated with leisure activities (ATT = 0.035***), social activities to help others (ATT = 0.031***), and learning activities to gain new knowledge (ATT = 0.034***) among middle-aged and elderly residents. The utilization of inpatient health care was significantly positively associated with leisure activities (ATT = 0.015***) but had no significant association with social deeds that help others and increased new knowledge among middle-aged and elderly residents.

Conclusion

Thus, social participation significantly positively affects healthcare utilization by middle-aged and elderly residents. Hence, the government and society should provide more conveniences and promote social participation among middle-aged and elderly residents.

Social activity as mediator between social support and psychological quality of life among people with rare diseases: A national repetitive cross-sectional study

BACKGROUND

Considerable proportion of people with rare diseases (RDs) have suffered from severe mental health problems. However, specific attention on the psychological quality of life (QoL) of people with RDs is sparse. Evidence documented the benefits of social support and social activity on recipients' mental health and overall QoL, but no corresponding study answered how both social support and social activity work on the psychological QoL among people with RDs. This study aims to report the psychological QoL and evaluate the mediating role of social activity between social support and psychological QoL among people with RDs.

METHODS

Data were from two national repetitive cross-sectional surveys, conducted in China in February 2016 and February 2018. In this study, eligible people were those aged 18 or above and had clinical-diagnosed RDs. Psychological QoL was measured by the subdomain of World Health Organization Quality of Life: Brief Version. Social support was measured by the Medical Outcomes Study Social Support Survey. Social activity was measured with seven items selected from the measurement on leisure activities used by the Chinese General Social Survey. Using the mediation model, we assessed the direct and indirect (via social activity) association between social support and psychological QoL, both on overall and subtypes of RDs. We controlled for a variety of potential socioeconomic and demographic confounding factors.

RESULTS

Of the 2403 adults studied, their average score of psychological QoL was 42.49 out of 100. The psychological QoL was directly associated with received emotional/information support (coefficient = 0.159, 95% CI = [0.093, 0.231], p < 0.0001) and positive social interaction (coefficient = 0.159, 95% CI = [0.097, 0.221], p < 0.0001). The psychological QoL was indirectly (via social activity) associated with received tangible support (coefficient = -0.035, 95% CI = [-0.046, -0.025], p < 0.0001) and positive social interaction (coefficient = 0.056, 95% CI = [0.040, 0.074], p < 0.0001). Above results by subtypes of RDs were also reported.

LIMITATIONS

The causal inference was not able to be investigated due to the cross-sectional study design.

CONCLUSION

People with RDs suffered from a low psychological QoL. Social activity mediated the association between social support and psychological QoL, but its mediating role depended on the subscales of social support as well as the subtypes of RDs. Customized measures based on the type of RDs and support that will be provided could perhaps improve the psychological QoL of people with RDs directly and indirectly.

Capability, opportunity, motivation, and social participation after stroke

BACKGROUND

Stroke survivors report limited social participation, despite it being an important rehabilitation outcome. Interdisciplinary interventions for increasing social participation amongst stroke survivors lack theoretical guidance and evidence-based approaches. The Behavior Change Wheel (BCW) theorizes that capability, opportunity, and motivation contribute to behavior change.

OBJECTIVES

This study applied the BCW to understand the relationship between social participation and stroke survivors' capability, opportunity, and motivation.

METHODS

In this cross-sectional study, we recruited 30 community-dwelling adult stroke survivors. Assessments explored the frequency and satisfaction of social participation; physical and psychological capability; environmental accessibility and social opportunity; and motivation. A linear regression analysis was done.

RESULTS

Motivation (R² change = 29.3%, ß = 0.55) and environmental opportunity (R² change = 11%, ß = 0.39) were statistically significant predictors of social participation frequency. Motivation (R² change = 36.9%, ß = 0.61) was the only statistically significant predictor of satisfaction with social performance.

CONCLUSIONS

Motivation and environmental accessibility are statistically significant independent predictors of frequency of social participation after stroke. Motivation is the strongest predictor of satisfaction with social participation. Clinicians may support stroke survivors to promote social participation using approaches that increase motivation and environmental accessibility. Development of such theoretically sound interventions may be guided by the BCW.

Interventions to improve social connections: a systematic review and meta-analysis

PURPOSE

The importance of both frequent and high-quality social connections is widely recognised. Previous reviews of interventions for promoting social connections found mixed results due to the inclusion of uncontrolled studies and merging of objective and subjective dimensions of social connections. This study aimed to compare the effectiveness of interventions designed to promote 'objective social contact' and the 'quality of social connections'; and compare the effectiveness of interventions from different theoretical orientations on these social dimensions through a systematic review and meta-analysis of controlled trials.

METHODS

A systematic search of electronic databases Medline, Embase, PsycINFO and PubMed was conducted to identify randomised controlled trials of interventions for social isolation, loneliness, social participation and/or social connectedness in adults. Data were analysed using Stata V.16.0.

RESULTS

Fifty-eight studies met inclusion criteria (mean age = 62 years). Overall, interventions led to significant improvements in objective social contact (Hedges' g = 0.43) and perceived quality of social connections (Hedges' g = - 0.33). Increasing access to other people was the most effective strategy for promoting objective social contact (Hedges' g = 0.67). Providing adults with skills to manage maladaptive attributional biases, fear-related avoidance of social situations, and barriers to social contact, was the most effective strategy for addressing deficits in perceived quality of social connections (Hedges' g = - 0.53).

CONCLUSION

In summary, different interventions had differential effects on the frequency and quality of social relationships and associated emotional distress. Psychological interventions hold the most promise for increasing meaningful social connections and reducing distress.

Optimism and survival: health behaviors as a mediator-a ten-year follow-up study of Chinese elderly people

Background

Optimism—the generalized expectation that good things will happen—is a promising health asset. Mounting evidence indicates that there are specific associations between optimism and survival rates. However, for public health purposes, it is critical to consider whether the relationship between optimism and survival holds for older adults as a whole and to explore the role of health behaviors as potential mediators.

Methods

Prospective data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Optimism was measured in 2008, and survival was measured by survival time of the interviewees during the whole observation period from 2008 to 2018. Cox proportional hazard models were employed to evaluate the association between optimism and survival among the elderly. The mediating effect analysis method was used to explore the potential mediating role of health behaviors on the association between optimism and survival.

Results

Compared to less optimistic older adults, optimistic individuals were associated with lower odds of mortality (HR = 0.94, 95% CI = 0.89 − 0.99). Health behaviors are key elements that play a positive role in survival (HR = 0.95, 95% CI = 0.94 − 0.96). Health behaviors played an intermediary role in the relationship between optimism and mortality, and the mediating effect was -0.005.

Conclusions

Optimism and health behaviors were broadly and robustly associated with a lower risk of mortality. Health behaviors mediate the relationship between optimism and mortality. Appropriate intervention should be carried out on optimism and health behaviors among elderly people to improve the likelihood of health in aging.

COVID-19 Adaptive Interventions: Implications for Wellbeing and Quality-of-Life

Social bonds may assist in cultivating a more positive attitude to life through commonly shared meanings about the COVID-19 pandemic. The key challenge, however, is how to foster social bonds meeting the changing demands in a post pandemic world. Yet, it is in the middle of a crisis that the conversation needs to start about how to strategically plan for the recovery. This is important not only in the current pandemic, but also in a post pandemic world. Reinforcing or fostering new social bonds is likely to bring positive experiences. The latter is central to human health and wellbeing, and has potential to contribute greatly in enhancing people's quality of life. In an attempt to foster place social bonding in the COVID-19 pandemic and beyond to subsequently contribute to wellbeing, this paper develops and proposes a new conceptual framework suggesting the need for adaptive social bonding interventions in the SARS-CoV-2 pandemic. This is an essential measure to manage the significant impacts on our global health services due to a decline in people's mental health in addition to COVID-19 physical impacts. The paper discusses how promoting adaptive social bonding interventions (psycho-socio, digital and nature social bonding) can make people more resilient. It further discusses how they can be empowered psychologically, socially, and emotionally in the current challenging times. The conceptual framework posits that social bonding interventions can assist in maintaining better mental, physical, emotional, and spiritual wellbeing and discusses how these wellbeing outcomes may also be experienced post the pandemic. This has important benefits and is of relevance to governments, policy makers and healthcare professionals in delivering better health care and equipping people with coping mechanisms both throughout the pandemic and in the long run.

Factors associated with participation in life situations in people with COPD

Objective

To examine potential determinants of participation frequency and limitations in people with Chronic Obstructive Pulmonary Disease (COPD).

Methods

For this secondary analysis, we grouped the following factors using the International Classification of Functioning, Disability and Health (ICF) components: age, psychological distress (Hospital Anxiety and Depression Scale (HADS)), gait aid use, supplemental oxygen use, grip strength, modified Medical Research Council Dyspnea scale, Short Physical Performance Battery, and Six-Minute Walk Test (6MWT). Participation was measured using the frequency and limitation domains of the Late Life Disability Instrument (LLDI). Relationships between factors and participation were examined using linear regression.

Results

Ninety-six participants (age 68.7 ± 8.1 yrs; FEV₁ %pred 34 IQR 25–54) were included in the analysis. Factors were linked to four ICF components: activity, body functions, personal, and environmental factors. The final model for LLDI-frequency contained HADS, use of gait aid, and 6MWT (F (3, 81) = 27.69 (p < .001), R² = 0.51), and for LLDI-limitations, the final model included age, HADS, and 6MWT (F (3, 82) = 19.74 (p < .001), R² = 0.42).

Discussion

Participation in life situations in people with COPD is associated with multiple ICF components. Psychological distress (i.e., anxiety and depression symptoms) and mobility were important determinants of participation frequency and limitations. Prospective studies are needed to confirm these relationships.

Impact of the Changes in the Frequency of Social Participation on All-Cause Mortality in Japanese Older Adults: A Nationwide Longitudinal Study

Previous studies have shown that more frequent social participation was associated with a reduced risk of mortality. However, limited studies have explored the changes in the frequency of social participation in older adults. We investigated the impact of the changes in the frequency of social participation on all-cause mortality in Japanese older adults aged 60 years and older. The current study, conducted as a secondary analysis, was a retrospective cohort study using open available data. The participants were 2240 older adults (45.4% male and 54.6% female) sampled nationwide from Japan who responded to the interview survey. Changes in the frequency of social participation were categorized into four groups (none, initiated, decreased, and continued pattern) based on the responses in the baseline and last surveys. The Cox proportional-hazards model showed a decreased risk of all-cause mortality in decreased and continued patterns of social participation. Stratified analysis by sex showed a decreased risk of mortality in the continued pattern only among males. The results of the current study suggest that the initiation of social participation at an earlier phase of life transition, such as retirement, may be beneficial for individuals.

Associations of Social Cohesion and Socioeconomic Status with Health Behaviours among Middle-Aged and Older Chinese People

Background: An understanding of factors associated with health behaviours is critical for the design of appropriate health promotion programmes. Important influences of social cohesion, education, and income on people's health behaviours have been recognised in Western countries. However, little is known about these influences in the older Chinese population. Objective: To investigate associations of social cohesion and socioeconomic status (SES) with health behaviours among middle-aged and older adults in China. Methods: We used data from the World Health Organization's Study on Global AGEing and Adult Health. Logistic regression and multivariate linear regression were performed. Results: Participants who reported greater social cohesion were more likely to have adequate vegetable and fruit (VF) consumption, be socially active, and less likely to smoke daily, but were not physically more active; participants with lower education levels were less likely to have adequate VF consumption and be socially active, and more likely to smoke daily; higher incomes were associated with decreased odds of daily smoking, increased odds of adequate VF consumption, increased likelihood to be socially active, but also less likelihood to have sufficient physical activity (PA). Associations of social cohesion and SES with health behaviours (smoking, PA, and VF consumption) differed between men and women. Discussion: Our findings are an essential step toward a fuller understanding of the roles of social cohesion and SES in protecting healthy behaviours among older adults.

Health-Related Quality of Life in Older Adults: Its Association with Health Literacy, Self-Efficacy, Social Support, and Health-Promoting Behavior

This cross-sectional study aimed to explore the relationships among sociodemographics, health literacy, self-efficacy, social support, health-promoting behavior, and health-related quality of life (HRQOL) in older adults. A total of 240 older adults aged >65 years were recruited from three community senior welfare centers in South Korea. Standardized self-administered questionnaires measuring sociodemographic characteristics, health literacy, social support, self-efficacy, health-promoting behavior, and health-related quality of life were distributed to older adults. Multiple regression analyses with stepwise selection was used to determine the factors affecting health-related quality of life. Factors affecting a higher physical component score of HRQOL were a higher comprehension level of and numeracy in health literacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. Factors affecting a higher mental component score of HRQOL were a higher comprehension level of and numeracy in health literacy, self-efficacy, physical health-promoting behavior, perceived emotional-informational support, and a lesser number of comorbidities. To improve HRQOL among older adults, nursing interventions are required to measure health literacy, empower physical health-promoting behavior and self-efficacy, and enhance emotional-informational support from family or other resources.