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Goodarzi F, Khoshravesh S, Ayubi E, Bashirian S, Barati M. Psychosocial determinants of functional independence among older adults: A systematic review and meta-analysis. Health Promot Perspect 2024; 14:32-43. [PMID: 38623346 PMCID: PMC11016145 DOI: 10.34172/hpp.42354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/11/2023] [Indexed: 04/17/2024] Open
Abstract
Background In current years, the increase in older population has led to creating one of the main public health challenges, worldwide. Because of the special characteristics of older adults, this age group is exposed to possible problems, such as mental and physical disorders, that usually affect their functional independence. The study aimed to determine the psychosocial determinants (e.g., depression, social support, and self-efficacy) affecting functional independence among older population. Methods Our search was conducted on three international databases (Web of Sciences, PubMed/Medline, and Scopus) for all the observational studies (cross-sectional, cohort or longitudinal designs) on the social and psychological determinants of functional independence among older adults. Papers published in English without limitation of time were reviewed from inception to 26 August 2023. The quality assessment tool was the Newcastle-Ottawa Scale (NOS). The I2 index was used to quantify the degree of heterogeneity among the studies. In the case of heterogeneity higher than 50%, the random effects model has been used for overall estimation of the effects; otherwise, the fixed effects model was used. The pooled associations were expressed as odds ratio (OR) and 95% confidence intervals (CIs). Stata version 14 software (StataCorp LP) was used for data analysis. The significance level was considered at 0.05. Results In the initial search, 6978 articles were retrieved, and finally, considering the inclusion criteria, 46 articles were examined. Finally, 18 articles were eligible for meta-analysis. The findings indicated that among all the determinants affecting functional independence among older adults, depression could lead to a 76% increase in functional dependence. Conclusion The findings provide a statistically significant relationship between psychosocial factors and functional independence. Depression was the strongest determinant of functional dependence among older adults.
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Affiliation(s)
- Fataneh Goodarzi
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Nursing, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Maeda M, Harigane M, Horikoshi N, Takebayashi Y, Sato H, Takahashi A, Momoi M, Goto S, Oikawa Y, Mizuki R, Miura I, Itagaki S, Yabe H, Ohira T, Yasumura S, Ohto H, Kamiya K. Long-Term, Community-based Approach for Affected People Having Problems With Mental Health and Lifestyle Issues After the 2011 Fukushima Disaster: the Fukushima Health Management Survey. J Epidemiol 2022; 32:S47-S56. [PMID: 36464300 PMCID: PMC9703932 DOI: 10.2188/jea.je20210178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/14/2021] [Indexed: 12/07/2022] Open
Abstract
A Mental Health and Lifestyle Survey (MHLS) has been conducted yearly as part of the Fukushima Health Management Survey since 2012, in order to monitor different health issues related to long-term evacuation of affected people after the 2011 Fukushima disaster. This survey is a mail-based one of nearly 210,000 affected people living in the evacuation zone at the time of the disaster. Another purpose of the MHLS is to provide efficient interventions by telephone based on the results of the survey. Significant findings contributing to understanding of non-radiological health effects caused by long-term evacuation were obtained from the MHLS, directly connecting to telephone-based interventions for over 3,000 respondents per year. In this article, the mental health outcomes of the MHLS, including depressive symptoms and posttraumatic responses, are reviewed, and the usefulness of telephone-based interventions is discussed. The evidence showed that, despite improvement of core mental health outcomes, the prevalence of respondents at high risk of some psychiatric problems remained high compared to that among the general population in Japan. In particular, several mental health consequences of respondents staying outside of Fukushima Prefecture were higher than those staying inside Fukushima. Along with further efforts to increase the response rate, we need to continue and modify the MHLS to meet the requirements of the affected people and communities.
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Affiliation(s)
- Masaharu Maeda
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Mayumi Harigane
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naoko Horikoshi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yui Takebayashi
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hideki Sato
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Maho Momoi
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Saori Goto
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Yuichi Oikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Rie Mizuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Itaru Miura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shuntaro Itagaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 2: emotional and behavioral consequences. CNS Spectr 2021; 26:30-42. [PMID: 32189603 DOI: 10.1017/s1092852920000115] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To compile the findings of studies assessing emotional and behavioral changes in the survivors of the 2011 Fukushima nuclear disaster, we performed a systematic review in August 2019 using four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI). Peer-reviewed manuscripts, either in English or Japanese, were included in the searches. Sixty-one studies were retrieved for the review. Of these, 41 studies (67.2%) assessed emotional consequences, 28 studies (45.9%) evaluated behavioral consequences, and 8 studies (13.1%) evaluated both emotional and behavioral outcomes. The main research topic in emotional change was radiation exposure-associated risk perception, as reported in 15 studies. This risk perception included immediate health effects (eg, acute radiation syndrome) as well as future health effects (eg, future cancer and genetic effects). Lowered subjective well-being was reported in eight studies. Six studies reported perceived discrimination/stigmatization in the disaster survivors. The most critical behavioral change was an increase in suicides compared with residents in the whole of Japan or affected by the earthquake and tsunami, but not by the nuclear disaster. Increased rate of alcohol and tobacco use was reported, although the effect on one's health was inconsistent. As a conclusion, the Fukushima nuclear disaster survivors suffered issues in risk perception, well-being, stigmatization, and alcohol/tobacco use in the first 8 years after the disaster. The present study is important in order to better understand the emotional and behavioral responses to future nuclear/radiological disasters as well as other "invisible" disasters, such as chemical and biological public health crises.
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Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 1: psychological consequences. CNS Spectr 2021; 26:14-29. [PMID: 32192553 DOI: 10.1017/s1092852920000164] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey-large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.
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