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Kim H, Bae EJ, Choi Y, Son H. Biopsychosocial factors of quality of life among middle-aged adults living alone in South Korea: a secondary data analysis using the 2017 Korea Community Health Survey. Arch Public Health 2024; 82:108. [PMID: 39026231 PMCID: PMC11256506 DOI: 10.1186/s13690-024-01342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 07/11/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND This study aimed to investigate quality of life (QoL) in middle-aged adults living alone and identify comprehensive biological, psychological, interpersonal, and contextual factors related to QoL using the dynamic biopsychosocial model. As a secondary analysis, this study used data from the 2017 Korea Community Health Survey conducted by the Korea Disease Control and Prevention Agency. METHODS Among the total 228,381 respondents, 10,639 middle-aged individuals aged 40-64 years from single-person households (5,036 men and 5,603 women) were included in the analysis. QoL was measured using the EuroQoL-5 Dimension (EQ-5D). The EQ-5D descriptive statistics were provided according to biological, psychological, interpersonal, and contextual factors. Considering the data structure of the multistage stratified cluster sampling method, a complex samples general linear model statistic was used to identify the predictors of QoL. RESULTS QoL was lower in those who had undesirable psychological status (e.g., more depressive symptoms, poor subjective health, and higher perceived stress), less engagement in social networking (less frequent contact with friends and less frequent participation in social activities such as religious activities, friendship gathering, and leisure), and lower physical, behavioral, and socioeconomic factors. CONCLUSIONS This study's findings indicate that psychological and interpersonal factors should be addressed and prioritized to improve the QoL of middle-aged adults living alone. By providing many opportunities for easily accessible social activities that meet the needs and interests of this demographic, their QoL can be improved through strengthening social support.
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Affiliation(s)
- Hyerang Kim
- Department of Nursing Science, Howon University, 64 Howondae 3gil, Impi, Gunsan city, Jeollabuk-do, 54508, Republic of Korea
| | - Eun Jung Bae
- Department of Nursing, Ansan University, 155Ansan Daehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do, 15328, Republic of Korea
| | - Yunkyung Choi
- College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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Pasanen TP, White MP, Elliott LR, van den Bosch M, Bratman GN, Ojala A, Korpela K, Fleming LE. Urban green space and mental health among people living alone: The mediating roles of relational and collective restoration in an 18-country sample. ENVIRONMENTAL RESEARCH 2023:116324. [PMID: 37311473 DOI: 10.1016/j.envres.2023.116324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
Rates of living alone, especially in more urbanised areas, are increasing across many industrialised countries, with associated increases in feelings of loneliness and poorer mental health. Recent studies have suggested that access to nature (e.g. parks and green spaces) can reduce the stressors associated with loneliness, partly through providing opportunities to nurture personal relationships (relational restoration) and engage in normative community activities (collective restoration). Such associations might vary across different household compositions and socio-demographic or geographical characteristics, but these have not been thoroughly tested. Using data collected across 18 countries/territories in 2017-2018, we grouped urban respondents into those living alone (n = 2062) and those living with a partner (n = 6218). Using multigroup path modelling, we tested whether the associations between neighbourhood greenspace coverage (1-km-buffer from home) and mental health are sequentially mediated by: (a) visits to greenspace; and subsequently (b) relationship and/or community satisfaction, as operationalisations of relational and collective restoration, respectively. We also tested whether any indirect associations varied among subgroups of respondents living alone. Analyses showed that visiting green space was associated with greater mental well-being and marginally lower odds of using anxiety/depression medication use indirectly, mediated via both relationship and community satisfaction. These indirect associations were equally strong among respondents living alone and those living with a partner. Neighbourhood green space was, additionally, associated with more visits among respondents living with a partner, whereas among those living alone, this was sensitive to the green space metric. Within subgroups of people living alone, few overall differences were found. Some indirect pathways were, nevertheless, stronger in males, under 60-year-olds, those with no financial strain, and residents in warmer climates. In conclusion, supporting those living alone, as well as those living with a partner, to more frequently access their local greenspaces could help improve mental health via promoting relational and collective restoration.
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Affiliation(s)
- Tytti P Pasanen
- Faculty of Social Sciences / Psychology, Tampere University, Kalevantie 4, 33014, Tampere University, Finland; Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland.
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK; Cognitive Science HUB, University of Vienna, Vienna, Austria
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; School of Population and Public Health, University of British Columbia, Canada; Department of Forest and Conservation Sciences, University of British Columbia, Canada
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, USA; Department of Psychology, University of Washington, USA
| | - Ann Ojala
- Natural Resources Institute Finland (Luke), Finland
| | - Kalevi Korpela
- Faculty of Social Sciences / Psychology, Tampere University, Kalevantie 4, 33014, Tampere University, Finland
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
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Fernandez-Portero C, Amian JG, Alarcón D, Arenilla Villalba MJ, Sánchez-Medina JA. The Effect of Social Relationships on the Well-Being and Happiness of Older Adults Living Alone or with Relatives. Healthcare (Basel) 2023; 11:222. [PMID: 36673590 PMCID: PMC9858722 DOI: 10.3390/healthcare11020222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/04/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023] Open
Abstract
The aim of this study is to analyze the effect of the type of habitation of older adults-with relatives or alone-on their health and well-being. The participants were 352 people over 65 years of age who collaborated with the research on a voluntary basis. The data indicated that those who live with family members have better social integration, well-being and happiness than those who live alone. A multiple regression analysis showed the positive effect of living with relatives on well-being and happiness. However, participation in social activities mitigates the effect of the type of cohabitation explaining better well-being and happiness in the older population. These findings support the idea of designing and implementing intervention policies focused on activities that promote social participation and social interactions to improve well-being and happiness in the older adults.
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Affiliation(s)
| | | | - David Alarcón
- Department of Social Anthropology, Psychology and Public Health, Universidad Pablo de Olavide de Sevilla, 41013 Sevilla, Spain
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Frail Older People Ageing in Place in Italy: Use of Health Services and Relationship with General Practitioner. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159063. [PMID: 35897424 PMCID: PMC9332283 DOI: 10.3390/ijerph19159063] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023]
Abstract
Functional limitations, chronic diseases and frailty often occur in later life. These aspects become very challenging when older people age alone in place, thus needing support in the activities of daily living, and in this context, it is important they can access and use health services. The present study aimed to explore these issues in Italy. In 2019, 120 qualitative interviews were carried out within the “Inclusive Ageing in Place” (IN-AGE) project, involving frail older people living at home in three Italian regions (Lombardy, Marche, and Calabria). A content analysis and some quantifications of main statements are presented. Results showed that the majority of seniors report poor self-rated health (SRH), suffer from many chronic diseases, and mainly use the General Practitioner (GP) and Medical Specialists (MSs), even though long waiting list in the public sector and high costs in the private one act as barriers to access health services. Complaints regarding GPs mainly refer to the almost exclusive provision of prescriptions and the lack of home visits. Some regional peculiarities highlighted a better overall context in the north than in the south, especially with regards to the public health sector. These results can provide useful insights for policy makers, in order to deliver health services assuring frail, older people the continuity of assistance needed at home.
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Association between Healthy Eating Index and Mental Health in Middle-Aged Adults Based on Household Size in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084692. [PMID: 35457558 PMCID: PMC9032092 DOI: 10.3390/ijerph19084692] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023]
Abstract
This study examined the association between dietary lifestyle and mental health outcomes among middle-aged individuals (40−60-year-olds) living alone, using the Korean Healthy Eating Index (KHEI). The participants were selected (1334 men and 2185 women) from the Korea National Health and Nutrition Examination Survey 2016−2018 and categorized into single/multi-person households. The KHEI scores were calculated based on the 24 h recall data of dietary intake. Among both sexes, single-person households had significantly lower subjective health status scores (p = 0.015 for men; p < 0.001 for women), lower EuroQol-5D index scores (p = 0.011 for men; p = 0.003 for women), and higher Patient Health Questionnaire-9 index scores (p = 0.004 for men; p < 0.001 for women), compared to multi-person households. Men had a higher risk of depression in single-person households compared to multi-person households (OR, 3.5; 95% CI, 1.2−10.1). For women, the ORs for stress perception with the first tertile group of KHEI scores in single-person and multi-person households compared to the third tertile group were 3.5 (95% CI, 1.3−9.0) and 1.4 (95% CI, 1.0−1.8), respectively. The results of this study are expected to be used as baseline data to establish nutrition, healthy eating behavior, and health policies for the middle-aged living alone.
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Wang Z, Chen L, Xiao J, Jiang F, Min W, Liu S, Wang Y, Qi M. Subjective health status: an easily available, independent, robust and significant predictive factor at the prometaphase of vaccination programs for the vaccination behavior of Chinese adults. BMC Psychiatry 2022; 22:180. [PMID: 35287644 PMCID: PMC8920520 DOI: 10.1186/s12888-022-03830-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) proposed COVID-19 vaccination as an emergent and important method to end the COVID-19 pandemic. Since China started vaccination programs in December 2020, vaccination has spread to provinces and municipalities nationwide. Previous research has focused on people's vaccination willingness and its influencing factors but has not examined vaccination behavior. We examine the effectiveness of psychosocial factors in predicting vaccination behavior. METHODS A cross-sectional online survey was performed among Chinese adults on 8 May and 4 June 2021. The statistical analysis of the data included univariate analysis, receiver operator characteristics (ROC) analysis and ordinal multiclassification logistic regression model analysis. RESULTS Of the 1300 respondents, 761 (58.5%) were vaccinated. Univariate analysis showed that a high education level and good subjective health status were protective factors for vaccination behavior, while suffering from chronic diseases was a risk factor. ROC analysis showed that subjective health status (AUC = 0.625, 95% CI: 0.594-0.656, P < 0.001) was the best predictor of vaccination behavior. Logistic regression analysis with subjective health status as a dependent variable indicated that older age, female sex, depression, neurasthenia, obsession, hypochondriasis and chronic disease were significant risk factors, while positive coping tendencies were a significant protective factor. CONCLUSION Our study found a simple and effective marker, subjective health status, that can predict vaccination behavior. This finding can guide future epidemic prevention work.
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Affiliation(s)
- Zuxing Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China.
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China.
| | - Lili Chen
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
| | - Jun Xiao
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
| | - Fugui Jiang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
| | - Wenjiao Min
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
| | - Shuyun Liu
- The People's Hospital of Wenjiang Chengdu, 86 Kangtai Road, Wenjiang District, Chengdu, 611135, China
| | - Yunqiong Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
| | - Mengsha Qi
- The People's Hospital of Wenjiang Chengdu, 86 Kangtai Road, Wenjiang District, Chengdu, 611135, China.
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