Loneliness, Stress, and Depressive Symptoms Among the Chinese Rural Empty Nest Elderly: A Moderated Mediation Analysis

How is intergenerational emotional cohesion linked to depression among older internal migrants in China: the mediating roles of loneliness and perceived stress

BACKGROUND

Late-life internal migration is frequently associated with a higher risk of depression in older parents. This research delves into the impact of intergenerational emotional cohesion (IEC) on depression in older internal migrants and the underlying mechanisms within the contemporary Chinese context.

METHODS

Obtained from a cross-sectional survey in Nanjing, China, the research involved 654 older internal migrants (66.97% female; mean age = 66.05 years; SD = 4.67). Variables were assessed using the Intergenerational Solidarity Inventory, 3-item R-UCLA Loneliness Scale, Perceived Stress Scale, and 9-item Patient Health Questionnaire (PHQ-9). For mediation exploration, a serial mediation model was utilized, and the Bootstrap method was employed to test the signifcance of these mediation effects.

RESULTS

IEC demonstrates a negative correlation with depression. Through IEC, three significant mediation pathways were identified that directly affect depression: (1) loneliness (β=-0.06; Ratio=17.14%), (2) perceived stress (β=-0.09; Ratio=25.71%), and (3) loneliness and perceived stress (β=-0.03; Ratio=8.57%).

CONCLUSIONS

IEC can impact the depression of older internal migrants by mitigating negative psychological emotions during the migration process. This finding provides valuable theoretical insights for the prevention of mental health problems among this demographic.

Mindfulness and loneliness in retired older adults in China: mediation effects of positive and negative affect

Objectives: Drawing from the mindfulness framework and the broaden-and-build theory, this study investigates the extent to which mindfulness influences loneliness and whether the relation is mediated by positive and negative affect.Method: Data were collected from 748 retired older adults aged 60 and above in Chengdu, China in 2022. Loneliness and mindfulness were measured by the UCLA loneliness scale and by the short-form version of the Five Facet Mindfulness Questionnaire, while the positive and negative affect was assessed by the International Positive and Negative Affect Schedule.Results: The results of this study show that mindfulness was positively associated with positive affect (β = 0.37, p<.001), negatively related to negative affect (β=-0.21, p<.001) and loneliness (β=-0.13, p<.001), and had an indirect effect on loneliness via positive and negative affect (β=-0.20, p<.001).Conclusion: The findings suggest that mindfulness could be a positive resource for improving mental health and reducing loneliness among retired older adults in China.

Community engagement and loneliness in older adults in China: mediation effects of social support in the wake of COVID-19

Introduction

Loneliness is a key indicator of well-being in older adults. Drawing from the ecological model of aging, the active aging perspective, and the convoy model of social relations, this study investigates the extent community engagement influences loneliness and whether the relationship is mediated by social support during the COVID-19 pandemic.

Methods

Data was collected from 1,067 retired older adults in a cross-sectional design in Chengdu, China in 2022. Structural equation modeling was conducted to examine the direct and indirect effects of community engagement on loneliness through the hypothesized mediator of social support.

Results

The results show community engagement was positively associated with social support (β = 0.26, p < 0.001) and social support was negatively related to loneliness (β = -0.41, p < 0.001). Social support fully mediated the relationship between community engagement and loneliness. Additionally, community engagement had an indirect effect on loneliness via social support (β = -0.11, p < 0.001).

Discussion

The findings from the moderation analysis suggests community engagement and social support are likely to have large effects on loneliness for older adults over the age of 70 and who have low educational attainment. The findings suggest community engagement could be an important factor for improving social support and reducing loneliness amongst retired, older adults in China, especially in the wake of the COVID-19 pandemic where millions of individuals were isolated for extended periods of time.

Loneliness, depression and sleep quality among the type 2 diabetic patients during COVID-19 local epidemic: A mediation analysis

AIMS

To investigate loneliness, depression and sleep quality in patients with Type 2 Diabetes (T2DM) and to examine the mediating role of depression between loneliness and sleep quality among this group of patients with T2DM.

DESIGN

A cross-sectional study.

METHODS

A group of T2DM patients was recruited from a tertiary hospital affiliated with a university in Wuhu City, Anhui Province from May to October 2021 by convenient sampling. Pearson correlation analysis and structural equation modelling were used for data analysis in this study.

RESULTS

The direct effect of loneliness on sleep quality was not statistically significant, but the indirect effect of depression on sleep quality was statistically significant. Depression mediated the relationship between loneliness and sleep quality. Depression can affect emotional health and reduce sleep quality. We should reduce the loneliness of patients, prevent the occurrence of depression and improve the quality of sleep.

Cognitive flexibility and emotional self-regulation of the elderly with Empty nest syndrome: Benefits of acceptance and commitment therapy

Background and Aims

Empty nest syndrome (ENS) is a mental condition that affects both parents. When children leave their parents' home, the parents experience such feelings as unhappiness, loss, fear, inability, difficulty in adjusting roles, and changing their relationships. The present study aimed to evaluate the cognitive flexibility and emotional self-regulation of the elderly with ENS: benefits of Acceptance and Commitment Therapy (ACT).

Methods

The research method was quasi-experimental where a pretest-posttest design was used with a control group. The statistical population included all the elderly with the ENS in Tehran in the academic year of 2019-2020. Thirty of them were selected by convenience sampling method and then stochastically placed in two experimental and control groups. Dennis and VanderWal's Cognitive Flexibility Inventory, and Hofmann and Kashdan's Emotional Self-Regulatory Questionnaire for data collection in the pretest and posttest phases. Group-based ACT was implemented on experimental group members in 8 sessions of 90 min, while controls received no intervention. The collected data were analyzed by SPSS version 25 and analysis of covariance.

Results

The results showed a significant difference between the posttest scores of the experimental and control groups so the group-based ACT increased the cognitive flexibility and emotional self-regulation of the experimental group members (p < 0.05).

Conclusions

According to our results, therapists and health professionals can use ACT for interventions related to the health of the elderly with ENS, especially to improve cognitive flexibility and emotional self-regulation.

Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS

Background

Depressive symptoms are a serious public health problem that affects the mental health of older adults. However, current knowledge of the association between ADL disability and physical dysfunction and depressive symptoms in Chinese adults is insufficient. We intend to analyze the association between physical function, ADL, and depressive symptoms in older Chinese adults.

Methods

The data obtained from the China Health and Retirement Longitudinal Survey (2015 and 2018) (CHARLS). This includes 3,431 in 2015 and 3,258 in 2018 over the age of 60. Comparing 2015 and 2018 data, multivariate logistic regression models were used to explore the relationship between physical function, ADL, and depressive symptoms in urban and rural older adults, adjusting for sociodemographic factors associated with depression in older adults.

Results

The prevalence of depressive symptoms among older adults in China was 33.8 percent in 2015 and 50.6 percent in 2018. In baseline data from 2015 and 2018, residence, gender, marital status, drinking, physical function, ADL, and self-rated health were all found to be significantly associated with depressive symptoms in older adults. The differences in physical function, ADL and depressive symptoms among older adults in 2015 and 2018 were further analyzed based on urban and rural stratification. Both physical dysfunction and ADL disability were significantly associated with depressive symptoms in rural older adults in 2015 and 2018. And in urban areas, ADL was found to be significantly associated with depressive symptoms in urban older adults. Multivariate logistic regression analysis demonstrated that ADL disability was significantly associated with depressive symptoms among older adults in both urban and rural areas. Physical dysfunction was only significant in rural areas with depressive symptoms. The alpha level was instead set to 0.05 for all statistical tests.

Conclusion

Rural, female, 60-70 years of age, primary school or below, married, non-smoking, non-drinking, physical dysfunction, ADL disability and self-rated poor health make-up a higher proportion of depressed older adults. ADL disability and physical dysfunction were more likely to be associated with depressive symptoms in rural Chinese older adults. Therefore, the physical and mental health of rural elderly should be of concern. The rural older adults should receive additional support from the government and society.

Validation of the De Jong Gierveld Loneliness Scale in Peruvian old adults: a study based on SEM and IRT multidimensional models

Loneliness is a public health problem. Its assessment is important to identify older adults who experience greater loneliness and appropriate interventions can be carried out. The De Jong Gierveld Solitude Scale (DJGLS) is one of the most widely used, at least in the European context, to measure loneliness. Although the Spanish version of the DJGLS has shown reliability and validity in Spanish samples of older adults, there is no evidence of adequacy in the Latin American context. Therefore, this study aims to evaluate the psychometric properties of the DJGLS in Peruvian older adults. Specifically, factorial validity, internal consistency and criterion-related validity were studied, based on a double analytical perspective: Classical Test Theory (SEM models) and Item Response Theory. The participants were 235 Peruvian older adults with ages ranging from 61 to 91 years old (Mean = 72.69, SD = 6.68) that assisted to Centers for the Elderly in the city of Trujillo, Peru. Together with the DJGLS, information from the three-item UCLA loneliness scale, Satisfaction with Life Scale, Brief Resilient Coping Scale and the Patient Health Questionnarie-2 was also gathered. The results support a one-dimensional structure of the DJGLS but with the presence of method effects associated to the negatively worded items. Additionally, the IRT multidimensional model applied also indicated the presence of a second dimension related to these negative items. Finally, other evidences of reliability and validity were adequate. In summary, the DJGLS may be considered a reliable and valid instrument to be used in the Peruvian (older adults) context.

Does loneliness before the age of twelve indirectly affect impaired control over drinking, alcohol use, and problems through perceived stress?

Loneliness is the pain of feeling socially isolated from others (Russell et al., 1980). The Stress-Dampening Hypothesis (Marlatt, 1987; Sayette, 1993; Sher, 1987) posits that individuals drink to alleviate negative affect. To date, it has not been determined whether loneliness experienced as a child can indirectly influence at-risk patterns of alcohol use through the mediating mechanism of stress and impaired control. Impaired control over alcohol use (IC) is the difficulty adhering to one's own self-proscribed limits on drinking behaviors (Heather et al., 1993). Impaired control is an at-risk pattern of use that is particularly relevant to emerging adults. Methods: We examined the direct and indirect relationships between childhood loneliness, stress, IC, and alcohol-related problems with a structural equation model. In a college student sample, we utilized a (k = 20,000) bootstrap technique and a model indirect command in Mplus to examine potential mediational pathways. Cisgender sex was included as a covariate. Results: Loneliness was directly linked to stress as well as to alcohol-related problems. Higher levels of loneliness were indirectly linked to both more alcohol use and alcohol-related problems through more stress and in turn, more impaired control over drinking. Conclusions: The current study is consistent with the Stress Dampening Hypothesis (Marlatt, 1987; Sayette, 1993; Sher, 1987). Our findings suggest that therapeutic interventions combating loneliness in childhood may disrupt the stress-dampening pathway to dysregulated alcohol use in emerging adulthood.

Effects of self-stereotype on older adults' self-integrity through the intervening effects of sense of coherence and empathy

Self-integrity plays a vital role in the psychological wellbeing of older adults. The present study investigated whether or not the confrontation with negative, self-stereotyped information leads to a deterioration of older adults' self-integrity. Additionally, the current study attempted to examine the mediating effects of sense of coherence and empathy on the relationship between self-stereotype and self-integrity. A total of 825 Chinese older adults aged 55 or above from Xi'an and Beijing were recruited as research participants. A self-stereotype scale, sense of coherence scale, interpersonal reactivity index and self-integrity scale were used. Results showed that self-stereotypes are negatively associated with sense of coherence, empathy and self-integrity. Furthermore, sense of coherence and empathy are positively associated with self-integrity and played important roles in mediating the relationship between self-stereotype and self-integrity. Findings of this study can contribute to an improved understanding of the mechanism of associations between self-stereotype and self-integrity in older adults. Lastly, results obtained can provide guidance for effectively improving older adults' self-integrity to limit the negative effects of self-stereotypes.

Chinese elderly migrants' loneliness, anxiety and depressive symptoms: The mediation effect of perceived stress and resilience

Elderly migrants who face the dual challenges of aging and migration are more likely to suffer psychological disorders. Existing research has demonstrated a link between loneliness and psychological disorders in the general elderly population. However, we know little about the relationships among elderly migrants, and the psychological mechanisms linking them. This study aims to examine the effects of loneliness on anxiety and depressive symptoms among Chinese elderly migrants, and explore the mediating roles of perceived stress and resilience. All 654 participants were recruited in Nanjing, Jiangsu Province, China. Results showed that loneliness was significantly correlated with anxiety and depressive symptoms (p < 0.001). Perceived stress and resilience mediated the relationship between loneliness and anxiety symptoms. The mediating effect of perceived stress was 0.128 (Bootstrap 95% CI: 0.092-0.168, Ratio = 37.4%). Resilience was 0.026 (Bootstrap 95% CI: 0.005-0.049, Ratio = 7.6%). Furthermore, perceived stress and resilience also mediated the relationship between loneliness and depressive symptoms. The mediating effects were 0.111 and 0.043, respectively (Bootstrap 95% CI: 0.073-0.151, Ratio = 27.9%; Bootstrap 95% CI: 0.020-0.069, Ratio = 10.8%). All the mediating effects were significant because the bootstrap 95% CIs did not contain zero. Overall, our findings suggested that loneliness not only can directly influence elderly migrants' anxiety and depressive symptoms but also by increasing perceived stress or decreasing resilience.

Efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) on loneliness and perceived stress of rural older adults living alone in China: a randomized controlled trial

OBJECTIVES

This study aimed to explore the efficacy of group reminiscence therapy based on Chinese traditional festival activities (CTFA-GRT) to mediate the loneliness and perceived stress of older adults living alone in rural China. The results can provide a scientific foundation for improving psychological health.

METHOD

A randomized controlled trial of 64 (aged 65.70 ± 3.69 years) Chinese rural older adults living alone was conducted. They were randomly divided into either an eight-month intervention group or a control group. The perceived stress scale (PSS) and the UCLA loneliness scale (UCLA-LS) evaluated the perceived stress and loneliness of the two groups at three different times. A repeated-measures analysis of variance model was used to compare each outcome measure of the two groups.

RESULTS

The CTFA-GRT yielded a benefit for the perceived stress and loneliness of rural older adults living alone in the intervention group. Combined with a simple effects test, the PSS and UCLA-LS of those in the intervention groups significantly decreased at eight months after the baseline (F _PSS = 23.540, F _UCLA-LS = 40.159; all P < 0.01). In addition, the sustainable effect of this program lasted three months after the intervention (F _PSS = 65.756, F _UCLA-LS = 60.983; all P < 0.01).

CONCLUSION

The CTFA-GRT significantly decreased the perceived stress and loneliness of rural older adults living alone in China.

Association of objective and subjective far vision impairment with perceived stress among older adults in six low- and middle-income countries

OBJECTIVES

To assess the association between far vision impairment (objective and subjective) and perceived stress among older adults from six low- and middle-income countries (LMICs, i.e., China, Ghana, India, Mexico, Russia, and South Africa).

METHODS

Data from the WHO Study on global AGEing and adult health were analyzed. Objective visual acuity was measured using the tumbling E LogMAR chart and was used as a four-category variable (no, mild, moderate, and severe visual impairment). Subjective visual impairment referred to difficulty in seeing and recognizing an object or a person across the road. Using two questions from the Perceived Stress Scale, a perceived stress variable was computed, and ranged from 0 (lowest stress) to 100 (highest stress). Multivariable linear regression with perceived stress as the outcome was conducted.

RESULTS

Data on 14,585 adults aged ≥65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Only severe objective visual impairment (versus no visual impairment) was significantly associated with higher levels of stress (b = 6.91; 95% CI = 0.94-12.89). In terms of subjective visual impairment, compared with no visual impairment, mild (b = 2.67; 95% CI = 0.56-4.78), moderate (b = 8.18; 95% CI = 5.84-10.52), and severe (b = 11.86; 95% CI = 9.11-14.61) visual impairment were associated with significantly higher levels of perceived stress.

CONCLUSIONS

This large study showed that far vision impairment was associated with increased perceived stress levels among older adults in LMICs. Increased availability of eye care services may reduce stress among those with visual impairment in LMICs, while more research is needed to better characterize the directionality of the far vision impairment-perceived stress relationship.

Social exclusion and health outcomes among empty nest and non-empty nest older people in China

Many existing studies lack a comprehensive picture of the social exclusion statuses and health outcomes of empty nesters and those empty nesters living alone or with a spouse only. Cross-sectional analysis was conducted on representative national data from the 2014 China Longitudinal Aging Social Survey, focusing on respondents aged 60 and above (N = 7,923). Four dimensions of social exclusion (social relationships, subjective feeling of being excluded, social activities and financial products) and three health outcomes (self-reported health (SRH), activities of daily living (ADLs) and depression), were considered. Results show that ‘empty nest’ older people were more likely to be excluded from social relationships and to experience subjective feelings of being excluded, and were less likely to participate in social activities than non-empty nesters. Empty nesters were significantly less likely to report fair SRH and ADL difficulties than non-empty nesters, but they were more likely to report having depression than non-empty nesters. Among ‘empty nest’ older people, empty nesters who were living alone were associated with higher levels of being excluded from social relationships and to experience subjective feelings of being excluded than those who were living with a spouse only. Future research could focus on the development of age-friendly communities which act as health interventions to address relevant situations of social exclusion and depression among empty nesters.

Patterns and Predictors of Preparation for Future Care Among Older Rural Chinese Adults: A Latent Profile Analysis

This study aimed to identify profiles of preparation for future care (PFC) among older rural Chinese adults. A total of 481 older adults were recruited. PFC was evaluated using Preparation for Future Care Needs and respondents' social services knowledge. Information on individual characteristics, physical health indicators, mental health, and support system was collected. Four profiles of PFC were identified: scarce-preparation (22.42%), high-avoidance/low-action (26.91%), moderate-preparation (44.17%), and high-avoidance/high-action (6.50%). The scarce-preparation and high-avoidance/low-action profiles had the lowest levels of social services knowledge. Multinomial logistic regression showed that older adults in moderate-preparation and high-avoidance/high-action profiles had fewer illnesses, exercised more frequently, and had higher loneliness levels compared with those in the scarce-preparation profile. Compared with high-avoidance/low-action persons, high-avoidance/high-action persons had fewer illnesses, exercised more frequently, and had lower self-esteem and higher loneliness levels. People who performed poorly in physical health indicators and well in mental health need to increase PFC.

The Impact of Leisure Activities on the Mental Health of Older Adults: The Mediating Effect of Social Support and Perceived Stress

As the aging continues, China has become the country with the largest older population. In order to ensure the well-being of older adults in their later years, the whole society is increasingly concerned about the mental health of older adults. In 2019, we conduct a questionnaire survey in Shaanxi Province. Stratified random sampling is used to select three representative cities, and 677 samples are selected from the survey results for research. By using the structural equation model, we aim to reveal the mechanism of leisure activities' influence on mental health of the older adults and verify whether social support and perceived stress play a mediating role. The study finds that the older adults' leisure activities have no significant direct impact on mental health. Social support has a significant mediating effect between leisure activities and mental health of the older adults. Leisure activities indirectly affect the mental health of the older adults through social support, and participation in leisure activities can improve the social support of the older adults, thus improving the mental health level of the older adults. Perceived stress plays a significant mediating role between leisure activities and mental health of the older adults. By participating in leisure activities, the perceived stress of the older adults will be reduced, thus improving their mental health. Social support and perceived stress play a sufficient mediating role in the influence of leisure activities on mental health.

Self-Care Experiences of Empty-Nest Elderly Living With Type 2 Diabetes Mellitus: A Qualitative Study From China

Background

The number of type 2 diabetes mellitus (T2DM) cases among empty-nest elderly increases with increasing aging in China. Self-care plays an important role in preventing and reducing adverse outcomes of diabetes; however, few studies focus on self-care experiences of empty-nest elderly with T2DM.

Objective

To explore self-care experiences for a chronic disease among empty-nest elderly patients with T2DM in mainland China.

Methods

A descriptive phenomenological design was used in this study. Semi-structured interviews were conducted for 15 empty-nesters with T2DM. Interviews were implemented in department of endocrinology at a tertiary teaching hospital located in Shandong province, east of China.

Results

The participants were poorly adept with monitoring their blood glucose and lacked the ability to deal with abnormal blood glucose levels. Most participants had a good relationship with medication and physical activity. Living without children was perceived as a benefit that improved dietary management and is a disadvantage in terms of economic and emotional support and access to medical resources. Elderly empty-nesters also lacked knowledge about diabetes and paid little attention to potential complications.

Conclusion

Empty-nest elderly patients with T2DM value medication compliance and lifestyle modification more than blood glucose monitoring, complication prevention, and coping with negative emotions. Friends and spouses play indispensable roles in patients' self-care motivation and maintenance. Diabetes education on self-care, access to medical resources, and social support is needed for better diabetes management.

WITHDRAWN: Health risk assessment of rural older population

Ahead of Print article withdrawn by publisher.

Health-related quality of life among elderly individuals living alone in an urban area of Shaanxi Province, China: a cross-sectional study

Objectives

To describe health-related quality of life (HRQoL), sex differences in HRQoL, and factors affecting the HRQoL of elderly people living alone in urban areas of Shaanxi Province, China.

Methods

A cohort was obtained using multistage stratified cluster random sampling. We collected cross-sectional data using surveys. HRQoL was measured using the 36-item Short Form Health Survey. Multivariable multilevel linear regression analysis was used to examine factors associated with mental and physical health component summary scores.

Results

Overall, 442 elderly Chinese individuals who lived alone completed the survey (mean age 73 years, women: 59%). Women were more likely to report better mental health than men. Factors significantly associated with reduced mental health scores were older age, having never been married or being divorced, and having a history of cancer, urinary tract disease, fractures or gastrointestinal disorders. Factors associated with physical health were having never been married or being divorced and having hypertension.

Conclusions

To our knowledge, this is the first study to describe HRQoL in a representative sample of elderly people living alone in urban areas of Shaanxi, China. Poor physical and mental HRQoL in this elderly Chinese population was mainly associated with chronic diseases and demographic factors.

Gratitude and loneliness in adults over 40 years: examining the role of psychological flexibility and engaged living

OBJECTIVES

The aim of the present study was to investigate the association between trait gratitude and loneliness in a Dutch population sample of adults over 40 years. In addition, the mediating role of psychological flexibility and engaged living between trait gratitude and loneliness was assessed.

METHOD

A total sample of 163 adults of which 65 men (40%) and 98 women (60%) between 41 and 92 years (M_age = 66, SD_age = 12) participated in this study. Data from the Loneliness Questionnaire, Flexibility Index Test, Engaged Living Scale and the Short Gratitude, Resentment, and Appreciation Test were used. Mediation analysis was performed.

RESULTS

Analysis showed a negative association between trait gratitude and loneliness. In addition, after adjusting for the demographic variables age, gender and educational level, the association between trait gratitude and loneliness was fully mediated by psychological flexibility, and partially mediated by engaged living.

CONCLUSION

This study endorses the importance of trait gratitude and psychological flexibility in relation to experiencing loneliness. Further research is needed to replicate these findings in a more diverse sample and to investigate the causal relationships between these constructs. It would also be interesting to further investigate the role of different age groups and goal (dis)engagement strategies in this relation.

Preparation for future care moderates the relationship between loneliness and depression among Chinese rural older adults: A cross-sectional study

Loneliness has been identified as a risk factor for depression, while preparation for future care (PFC) can be a protective factor. Little is known about their complex relationships in older adults in China. This study aimed to explore whether PFC moderated the association between loneliness and depression. A total of 481 older adults aged 60 years and above were recruited in rural Shandong, China. After excluding those whose data missing rates were over 15%, data were analyzed for a total of 436 participants. Loneliness, PFC, and depression were measured. Statistical analyses included descriptive analysis, and moderating effects analyses. Our findings showed that PFC and its related dimensions can moderate the relationship between loneliness and depression. When the level of PFC and its dimensions were higher, the effect of loneliness on depression was weaker. PFC should be taken into consideration when interventions are being developed to reduce depression in older adults.

The Effect of Social Communication on Life Satisfaction among the Rural Elderly: A Moderated Mediation Model

Life satisfaction of the rural elderly has increasingly become an important issue for society. Based on the social support theory and Cha Xu Ge Ju (pattern of difference sequence), this study investigates the underlying mechanisms and boundary conditions that explain the relationship between social communication and life satisfaction among the rural elderly. Specifically, it explores the mediating role of psychological well-being in the relationship between social communication and life satisfaction. In addition, it examines whether emotional support moderates the effect of social communication on psychological well-being. Data from 658 rural elderly in China were analyzed using structural equation modeling. Results show that psychological well-being mediates the relationship between social communication and life satisfaction. Additionally, the relationship between social communication on psychological well-being was negatively moderated by emotional support. Finally, implications for management theory and practice are discussed.