Relationship between family functionality and the quality of life of the elderly

The Relationships Among Family Functioning, Sleep Quality and Quality of Life in Chinese Community-Dwelling Older Adults with Insomnia: A Structural Equation Model

OBJECTIVES

The proportion of individuals with insomnia is increasing, and many older adults have insomnia. This study aimed to explore the relationships between family functioning and quality of life (QOL) among community-dwelling older adults with insomnia, as well as to explore the mediating role of sleep quality in this relationship.

METHODS

The participants were 225 older adults with insomnia from community health service centers in Chongqing, China. The Family Care Index (APGAR) was used to assess family functioning, the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and the 36-item Short-Form Health Survey (SF-36) was used to assess QOL.

RESULTS

The results showed that family functioning would be positively associated with QOL (p = .005) and that this relationship would be partially mediated by higher sleep quality (p < .001).

CONCLUSIONS

Family functioning has a direct effect on QOL and an indirect effect on QOL through the regulation of sleep quality. Maintaining good family functioning is important for improving sleep quality and QOL in older adults with insomnia.

CLINICAL IMPLICATIONS

Developing family functioning-based assessments and targeted intervention strategies could be beneficial for older adults with insomnia.

Network structure of family function and self-management in patients with early chronic kidney disease amid the COVID-19 pandemic

Background

Family function plays a pivotal role in self-management among patients with early chronic kidney disease (CKD), which has been especially important during the COVID-19 pandemic. Previous studies have investigated the relationships between family function and self-management using total scores through self-report questionnaires while ignoring the different components in both family function and self-management. The specific objective of this study was to explore the network structure of family function and self-management at the component level.

Methods

A total of 360 patients with early CKD from three tertiary hospitals were enrolled in our cross-sectional survey from September to December 2021 in China. Components of family function were measured by the Family Adaptation Partnership Growth and Resolve Index, and components of self-management were measured by the Chronic Kidney Disease Self-management Instrument. Network analysis was used to establish the network structure.

Results

Edges across the community of family function and self-management were mainly positive. Edges between F3 "Growth" and M1 "Self-integration", F2 "Partnership" and M3 "Seeking social support," F5 "Resolve" and M3 "Seeking social support" were the strongest. F3 "Growth" had the greatest positive bridge expected influence of family function community (0.12), and M3 "Seeking social support" had the greatest positive bridge expected influence of self-management community (0.16).

Conclusion

We explored the potential pathways between different components of family function and self-management among patients with early CKD during the COVID-19 pandemic and found fine-grained relationships between them. The two nodes F3 "Growth" and M3 "Seeking social support" may provide a new idea from the perspective of family function for interventions to improve self-management.

Family functions, social support and quality of life among elderly during pandemic COVID-19

This study aims to determine the relationship between family function, social support, and the quality of life of the elderly in Kebumen District. Commonly elderly face weakness, limitation, and disability issues so that their quality of life decreases. Families have an important role to improve the quality of life of the elderly. This study used a cross-sectional design involving 468 elderly determined by a simple random sampling technique. Data analysis used univariate, bivariate, and multivariate analysis. The bivariate analysis used simple logistic regression analysis and if the value of the bivariate analysis was < 0.25, then it would be continued with the multivariate analysis. The multivariate analysis used multiple logistic regression with Adjusted OR and 95% CI with a significant level of 0.05. : there is a significant relationship between family function and social support and the quality of life of the elderly with a p-value of 0.001 with 95% CI (2.35-4.19) and a p-value of 0.001 with 95% CI (3.33 – 6.02) respectively. Family function and social support are factors reducing the morbidity and mortality rates which finally can improve the quality of life of the elderly.

Development and validation of a model for predicting the risk of suicide in patients with cancer

OBJECTIVE

The objective of this study was to establish a nomogram model to predict SI in patients with cancer and further evaluate its performance.

METHOD

This study was performed among 390 patients in oncology departments of Affiliated Hospital of Nantong University from April 2020 to January 2021. Of these, eligible patients who were diagnosed with cancer were split into training and validation cohorts according the ratio of 2:1 randomly. In the training cohort, multivariate regression was performed to determine the independent variables related to SI. A nomogram was built incorporating these variables. The model performance was evaluated by an independent validation cohort.

RESULTS

The prevalence of SI in patients with cancer was 22.31% and 19.23% in training and validation cohorts, respectively. The nomogram model suggested independent variables for SI, including depression, emotional function, time after diagnosis, family function and educational status. The area under the curve (AUC) was 0.93 (95%CI, 0.90-0.97) and 0.82 (95%CI, 0.74-0.90) in training and validation cohorts respectively, which indicated good discrimination of the nomogram in predicting SI in cancer patients. The p-value of the goodness of fit (GOF) test was 0.197 and 0.974 in training and validation cohorts respectively, suggesting our nomogram model has acceptable calibration power, and the calibration curves further indicated good calibration power.

CONCLUSION

In conclusion, the nomogram model for predicting individualized probability of SI could help clinical caregivers estimate the risk of SI in patients with cancer and provide appropriate management.

Burden, family functioning, and psychological health of older caregivers of older adults: a path analysis

Objectives: To evaluate an explanatory model of direct and indirect associations regarding the psychological health of older caregivers of functionally dependent older adults. Methods: This is a cross-sectional study performed with older caregivers recruited in contexts of outpatient and home care. We collected information on sociodemographic characteristics, duration of caregiving, physical and cognitive function indicators of the older care recipients, perceived burden, family functioning, and psychological health measures (psychological need satisfaction and depressive symptoms). Results: We evaluated 133 caregivers (76% female, 69.5 ± 6.98 years). Variables that were significantly correlated with psychological health were selected to form an association model to be tested by structural equation modeling via path analysis. Depressive symptom variability was best explained by this model. Caregiver burden remained in the model as a mediator of indirect associations between physical function for instrumental activities of daily living and indicators of family functioning and psychological health. Three associative paths between caregiver burden and depressive symptoms were found — one of them was direct and the other two were mediated whether by family functioning or by the level of psychological need satisfaction. Conclusion: Depressive symptoms were the psychological health indicator best explained by the model involving instrumental functional demands that generate burden. Clinical consequences suggested by the model indicate interventions aimed at family functioning and opportunities of psychological need satisfaction as strategies for promoting caregivers’ psychological health.

Self-care deficit among older men in the COVID-19 pandemic: implications for nursing

ABSTRACT Objectives: to analyze self-care deficit among older men in the COVID-19 pandemic in Brazil and to discuss the implications for nursing practice. Methods: web survey, multicentric, qualitative. A total of 120 older men participated, applying a form from April to June 2020 and April to August 2021. Reflective Thematic Analysis, interpreted by Orem’s Self-Care Deficit Theory, was used. Results: temporally, the self-care of older men was manifested in the self-care requirements - affective bonds, self-care for development - meditation and self-care with health deviations - remote consultations. Fully, partially compensatory, educational/support systems mobilized self-care. Final Considerations: as care managers, nurses can strengthen the support network for older men by activating professionals from the multidisciplinary team, family members, caregivers and the community to promote self-care and correct health deviations in times of crisis.

Social support and family functioning: a cross-sectional study of older people in the context of COVID-19

Abstract Objective To determine the association between perceived social support and family functioning in older people during the COVID-19 pandemic. Method A cross-sectional study was carried out of 72 participants aged ≥60 years enrolled at an Open University of the Third Age (U3A) in the interior of Sao Paulo state, Brazil. The variables analyzed were socioeconomic and demographic conditions, social support (Medical Outcomes Study Scale), and family functioning (Family APGAR). The Chi-Square, Mann-Whitney, and Multivariate Poisson Regression tests were used for data analysis, with a significance level of 5%. Results The type of support with the highest mean scores was affectionate (95.1 points) while the lowest was emotional (87.4 points). Family dysfunction rate was 22.2%. For every additional point of affectionate support score, there was a decrease in the probability of presenting family dysfunction (OR=0.96; p=0.001). Conclusion Affectionate support was associated with family functioning. These findings highlight the importance of identifying family structure, dynamics, and relationships in planning comprehensive health care for the older population.

Apoio social e funcionalidade familiar: um estudo transversal com pessoas idosas no contexto da covid-19

Resumo Objetivo Verificar a associação entre apoio social percebido e funcionalidade familiar em pessoas idosas durante a pandemia de covid-19. Método Trata-se de um estudo transversal, realizado com 72 participantes idosos que estavam matriculados em uma Universidade Aberta para Pessoas Idosas, no interior do estado de São Paulo, Brasil. As variáveis analisadas foram: condições socioeconômicas, demográficas, apoio social (Escala do Medical Outcomes Study) e funcionalidade familiar (Apgar de família). Utilizaram-se os testes: Qui-Quadrado, Mann Whitney e Regressão de Poisson Múltipla para as análises dos dados, com nível de significância de 5%. Resultados O tipo de apoio com maiores escores médios foi o afetivo (95,1 pontos) e o menor, o emocional (87,4 pontos). A disfunção familiar foi de 22,2%. A cada ponto do escore de apoio afetivo havia o decréscimo na probabilidade de apresentar disfunção familiar. (RP=0,96; p=0,001). Conclusão O apoio afetivo associou-se à funcionalidade familiar. Tais achados demonstram a importância de identificar a estrutura, dinâmica e relações familiares para planejar o cuidado integral à saúde da população idosa.