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Berryman K, Wirth M, Bombardier CH, Motl RW, Bartle B, Jacob RL, Aguina K, LaVela SL. Variables Associated With Moderate to High Loneliness Among Individuals Living With Spinal Cord Injuries and Disorders. Arch Phys Med Rehabil 2024; 105:1076-1082. [PMID: 38281576 DOI: 10.1016/j.apmr.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To identify variables independently associated with moderate to high loneliness in individuals living with Spinal Cord Injuries or Disorders (SCI/D). DESIGN A cross-sectional, national survey of a random sample of community-dwelling Veterans with SCI/D in the United States. Survey methodology was used to collect data on demographic and injury characteristics, general health, chronic and SCI-secondary conditions, and loneliness. SETTING The VHA SCI/D System of Care including 25 regional SCI/D Centers (or Hubs). PARTICIPANTS Among 2466 Veterans with SCI/D, 592 completed surveys (24%). Most participants were men (91%), white (81%), not currently married (42%), had tetraplegia (33%), and on average injured for 18 years at the time of data collection (N=562). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The dependent variable, loneliness, was collected using the UCLA-3 instrument. Loneliness was dichotomized into never/low loneliness and moderate/high loneliness (UCLA score ≥ 4). RESULTS Bivariate analyses assessed unadjusted associations in demographics, injury characteristics, chronic disease, and SCI-secondary conditions. Multivariable logistic regression was used to identify factors independently associated with moderate/high loneliness. Participants had a mean loneliness score of 5.04, SD=1.99. The point prevalence of moderate to high loneliness was 66%. Lower duration of injury, paraplegia, being unmarried, being in fair/poor general health, having dysfunctional sleep, and having a diagnosis of bowel dysfunction were each independently associated with greater odds of moderate/high loneliness. CONCLUSIONS Findings suggest that interventions to reduce/manage loneliness in the Veteran SCI/D population should focus on those who are more newly injured, have paraplegia, currently unmarried, have bowel problems, and experience dysfunctional sleep.
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Affiliation(s)
- Kelsey Berryman
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL.
| | - Marissa Wirth
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | | | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL
| | - Brian Bartle
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - R Lorie Jacob
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - Keith Aguina
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Pollak C, Verghese J, Blumen H. Loneliness and Functional Decline in Aging: A Systematic Review. Res Gerontol Nurs 2023; 16:202-212. [PMID: 37159388 PMCID: PMC10926714 DOI: 10.3928/19404921-20230503-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Loneliness is prevalent in adults aged ≥65 years in the United States and is associated with functional decline. The purpose of the current review was to synthesize evidence on the relationship between loneliness and functional decline using Roy's Adaptation Model as a theoretical framework. A comprehensive review of PubMed, Medline, and Embase databases was performed. Inclusion criteria were samples including adults primarily aged >60 years, peer-reviewed, published in the English language, and included a measure for loneliness and function. A total of 47 studies were analyzed. Most studies examined correlates, risk factors, and predictors of loneliness, rather than the relationship between loneliness and function. Evidence suggests there is bidirectionality in the relationship between loneliness and functional decline. Loneliness is associated with functional decline in aging via multiple possible pathways. Further studies are needed to determine causality and biological mechanisms underlying the relationship. [Research in Gerontological Nursing, 16(4), 202-212.].
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Krohne K, Flor AD, Nicolaisen M. Friendship in Befriending? Older Service Users' Notions of Friendship in a Befriending Scheme. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:459-473. [PMID: 36052456 DOI: 10.1080/01634372.2022.2118406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Social isolation and feelings of loneliness are main reasons that befriending services are approached by older adults. The promise of an individually matched volunteer, a befriender, paying them regular visits, offers hope of increased social interaction, meaningfulness, and connectedness in everyday life. The current consensus in qualitative research literature is that loneliness and isolation may be alleviated by such home visits. Still, the actual mechanisms of successful befriending have not been identified. In this small-scale qualitative study, we highlight older befriendees' notions of friendship in befriending. Drawing on in-depth interviews with seven Norwegian befriendees over the age of 80 years, we suggest that having a befriender visit regularly spurs a new bond and supports befriendees' notions of a relationship consistent with a traditional understanding of friendship. Our findings illustrate how the older befriendees identify and portray notions of friendship in terms of bonding, compatibility and meaningful activities, commitment, appreciation, and insecurities. Understanding how a formalized volunteer service is recognized and valued as a friendship may contribute to a better starting point for improving befriending services. Furthermore, it can improve our understanding of the significance of friendship in old age.
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Affiliation(s)
- Kariann Krohne
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Annelise D Flor
- National Humanitarian Programs and Preparedness, Norwegian Red Cross, Oslo, Norway
| | - Magnhild Nicolaisen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, and Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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4
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Goldman AW, Compernolle EL. Personal network size and social accompaniment: Protective or risk factor for momentary loneliness, and for whom? SOCIETY AND MENTAL HEALTH 2023; 13:23-44. [PMID: 38665906 PMCID: PMC11045043 DOI: 10.1177/21568693221142336] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Personal networks yield important health benefits for individuals, in part by providing more opportunities to be in the company of others throughout daily life. Social accompaniment is generally believed to protect against momentary feelings of loneliness, although this hypothesis remains understudied. We examine how personal network size shapes older adults' experiences of momentary loneliness and whether this association varies by momentary social accompaniment. We use three waves of ecological momentary assessments (EMA; N = 12,359) and personal network data from 343 older adults in the Chicago Health and Activity in Real-Time study. Older adults with large personal networks experienced more intense momentary loneliness compared to those with smaller social networks when they were momentarily alone. This association was more pronounced among men. We discuss how research approaches that bridge global and momentary measures of social connectedness can reveal important nuances of our understanding of how interpersonal factors influence later-life well-being over time.
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Abramowska-Kmon A, Łątkowski W, Rynko M. Informal Care and Subjective Well-Being among Older Adults in Selected European Countries. AGEING INTERNATIONAL 2023. [DOI: 10.1007/s12126-023-09521-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
AbstractA person’s health status is one of the strongest determinants of well-being. The negative impact of poor health on subjective well-being may be moderated by providing care to individuals in need. In this paper, we investigate the relationships between receiving informal care and the amount of care received and subjective well-being among people aged 65 or older in selected European countries. Our analysis of data from the 6th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) showed that receiving regular informal care was associated with higher subjective well-being among older people in Northern European countries, and with lower subjective well-being among older males in Southern European countries. Moreover, we found that the perception of the amount of help received affected the subjective well-being of older people, as those who reported that the support they received was either insufficient or met their needs had lower subjective well-being than those who were not in need of care. Our results also showed that receiving formal care was negatively related with subjective well-being among older adults in Northern Europe and Central and Eastern Europe. In the context of population ageing and the growing need for care, social policies that support both sides of the caregiving relationship could enhance subjective quality of life.
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Khodabakhshi-Koolaee A, Amoogholi Z. The psychosocial experiences of girls with visual impairment about the ideal spouse and marriage. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221124427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mate choice is one of the biggest psychological, social, and emotional changes in the life of every human being. This issue is associated with challenges and problems for people especially blind and visual impairment (VI) people. Although marriage leads to many changes and transformations in the life of blind and VI people, it is essential for meeting psychological, social, emotional, and sexual needs. Accordingly, this study aimed to analyze the psychosocial experiences of VI girls about the ideal husband and marriage. This qualitative study was conducted with a descriptive phenomenological approach. The data were collected through targeted interviews with 20 single girls with VI who were members of the White Cane Society of Tehran in 2021. The collected data were analyzed using Colaizzi’s seven-step method. Four main themes were extracted from the participants’ experiences, including “experience of love and freedom,” “criteria for selecting an ideal spouse,” “fear and worry about the marriage,” and “stigma and strict public judgments.” Following the findings of the study, it can be argued that paying attention to the experience of girls with VI can shed light on their criteria for mate choice and marriage and clarify their needs and demands. This perspective helps mental health professionals and rehabilitation counseling experts to meet their needs through social welfare planning and family awareness programs.
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Zamani Varkaneh M, Khodabakhshi-Koolaee A, Sheikhi MR. Identifying psychosocial challenges and introducing coping strategies for people with albinism. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221099155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Albinism refers to a group of genetic disorders that, following genetic mutations, lead to impaired melanin production, resulting in skin allergies and visual impairment in affected people. Visual impairment brings not only physical limitations and challenges but also many social problems, including psychosocial challenges, leading to different experiences in the lives of these people. To this end, using a qualitative content analysis approach, the present study aimed to identify psychosocial challenges and introduce coping strategies for people with albinism living in Tehran in 2021. The participants were people with albinism aged 20 to 40 years in Tehran. The participants were selected from among members of the Iranian Albinism Association (AMAL) using purposive sampling. The data were saturated through semi-structured interviews with 20 participants in the research sample. The collected data were analyzed using conventional content analysis. Analysis of the participants’ experiences revealed three main themes: (1) The challenges and difficulties of living with albinism, (2) welfare, specialized facilities, and support seeking, and (3) strategies for coping with psychosocial challenges. According to the findings, albinism, due to its limitations, brings many bitter and painful experiences in education, job finding, and marriage for affected patients. The condition is also associated with some limitations such as visual impairment affecting various aspects of the patient’s life and different developmental periods. Each person may have different interpretations of their challenges and thus seek unique strategies for coping with the challenges. The findings of this study can have some implications for mental health professionals and managers of relevant institutions and to become aware of the nature and complications of albinism, the challenges faced by people with albinism, and the special needs of these people. Findings from this study can be used to identify the relationship between albinism, the challenges of living with albinism, and the special needs of these individuals, by mental health professionals, related institutions, and psychosocial environments.
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Affiliation(s)
| | | | - Mohammad Reza Sheikhi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Shankar A, Kidd T. Loneliness in Older Indian Dyads. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095302. [PMID: 35564697 PMCID: PMC9101006 DOI: 10.3390/ijerph19095302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 02/05/2023]
Abstract
Background: Loneliness has been recognised as a major public health concern in older adults in developed nations, with little focus on low- and middle-income countries such as India. While the protective nature of social relationships on loneliness has been explored in the context of marriage, typically these benefits are examined in individual spouses rather than within the marital dyad. Methods: A sample of 398 opposite-sex married Indian couples (mean age 54.8 years) was obtained from the pilot wave of the Longitudinal Aging Study in India (LASI) conducted in 2010. These cross-sectional data were analysed using the Actor-Partner Interdependence Model, with one’s own and one’s partner’s cognitive function, functional limitations, depressive symptoms, employment status and contact with friends included as predictors of loneliness. Results: There were no gender differences in the pattern of associations. Depression was positively associated with loneliness with actor and partner effects being significant. One’s partner being employed was associated with less loneliness. Conclusions: The sample showed low levels of depression, loneliness, and reduced functionality; however, depression still predicted one’s own and one’s partner’s loneliness. Future work using longitudinal data could examine the role of employment in loneliness, particularly within the context of gender roles.
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Affiliation(s)
- Aparna Shankar
- Department of Psychological Sciences, FLAME University, 401 Phoenix Complex, Bund Garden Rd., Opp. Residency Club, Pune 411001, India
- Correspondence: ; Tel.: +91-206-790-6308
| | - Tara Kidd
- Department of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK;
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Dahlberg L, McKee KJ, Lennartsson C, Rehnberg J. A social exclusion perspective on loneliness in older adults in the Nordic countries. Eur J Ageing 2022; 19:175-188. [PMID: 35663913 PMCID: PMC9156591 DOI: 10.1007/s10433-022-00692-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 01/05/2023] Open
Abstract
Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.
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Affiliation(s)
- Lena Dahlberg
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, 171 65 Solna, Sweden
| | - Kevin J. McKee
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, 171 65 Solna, Sweden
- Swedish Institute for Social Research, Stockholm University, 106 91 Stockholm, Sweden
| | - Johan Rehnberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Tomtebodavägen 18A, 171 65 Solna, Sweden
- Department of Public Health Sciences, Stockholm University, 106 91 Stockholm, Sweden
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10
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Dahlberg L, McKee KJ, Frank A, Naseer M. A systematic review of longitudinal risk factors for loneliness in older adults. Aging Ment Health 2022; 26:225-249. [PMID: 33563024 DOI: 10.1080/13607863.2021.1876638] [Citation(s) in RCA: 121] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To effectively reduce loneliness in older adults, interventions should be based on firm evidence regarding risk factors for loneliness in that population. This systematic review aimed to identify, appraise and synthesise longitudinal studies of risk factors for loneliness in older adults. METHODS Searches were performed in June 2018 in PsycINFO, Scopus, Sociology Collection and Web of Science. Inclusion criteria were: population of older adults (M = 60+ years at outcome); longitudinal design; study conducted in an OECD country; article published in English in a peer-review journal. Article relevance and quality assessments were made by at least two independent reviewers. RESULTS The search found 967 unique articles, of which 34 met relevance and quality criteria. The Netherlands and the United States together contributed 19 articles; 17 analysed national samples while 7 studies provided the data for 19 articles. One of two validated scales was used to measure loneliness in 24 articles, although 10 used a single item. A total of 120 unique risk factors for loneliness were examined. Risk factors with relatively consistent associations with loneliness were: not being married/partnered and partner loss; a limited social network; a low level of social activity; poor self-perceived health; and depression/depressed mood and an increase in depression. CONCLUSION Despite the range of factors examined in the reviewed articles, strong evidence for a longitudinal association with loneliness was found for relatively few, while there were surprising omissions from the factors investigated. Future research should explore longitudinal risk factors for emotional and social loneliness.
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Affiliation(s)
- Lena Dahlberg
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Aging Research Center, Karolinska Institutet & Stockholm University, Solna, Sweden
| | - Kevin J McKee
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Amanda Frank
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Mahwish Naseer
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Aging Research Center, Karolinska Institutet & Stockholm University, Solna, Sweden
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11
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Waite LJ, Duvoisin R, Kotwal AA. Social Health in the National Social Life, Health, and Aging Project. J Gerontol B Psychol Sci Soc Sci 2021; 76:S251-S265. [PMID: 34918156 PMCID: PMC8678439 DOI: 10.1093/geronb/gbab138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In this article, we present the theoretical framework that guided the development of the National Social Life, Health, and Aging Project (NSHAP) including the measures of social health. We discuss the literature that links social measures to other outcomes, and we discuss in detail how researchers might construct common measures of social health, including those that reflect social relationships, sexuality, social networks, social resources, and social participation. METHODS The NSHAP includes multiple detailed measures of social health, collected in the rounds of data collection carried out in 2005, 2010, and 2015, allowing for study of changes over time and as people age among a nationally representative sample of the community-dwelling population of older adults in the United States. RESULTS We define indicators of social health, describe measures of each in the 2015 round of NSHAP, and show the distribution of the measures by gender and age. We present scales of dimensions of social health that have been developed elsewhere and describe their properties. DISCUSSION We briefly discuss the distribution of these measures by age and gender in the 2015 round of NSHAP. Simple analyses of these categorized measures reveal differences by age and gender that deserve closer attention in future investigations using the NSHAP data.
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Affiliation(s)
- Linda J Waite
- Department of Sociology, University of Chicago, Illinois, USA
- NORC at the University of Chicago, Illinois, USA
| | | | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California San Francisco, USA
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12
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Risk factors for loneliness among older people in a Nordic regional context – a longitudinal study. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The aim of this study was to examine the prevalence of loneliness among older people and to identify risk factors for loneliness in a Nordic regional context over a six-year period. Longitudinal data from the Gerontological Regional Database (GERDA) study of 4,269 older adults living in northern Sweden and western Finland, aged 65, 70, 75 and 80 at baseline in 2010, were analysed. Logistic regressions were used to analyse socio-demographic, social and health-related risk factors at baseline and changes in these for experiences of loneliness at follow-up. The results showed that most older adults (85%) did not experience loneliness at baseline or at follow-up in our study region. However, 3 per cent of the sample reported loneliness in both study years, indicating enduring and chronic loneliness. Analyses revealed that being widowed and becoming a widow/er as well as poor self-rated health at baseline and the onset of depression were risk factors for loneliness. Finally, the risk of loneliness was higher in older people living in Sweden. Further work is needed to explore changes and stability in loneliness as well as to increase our understanding of between-country differences in loneliness.
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Leggett AN, Carmichael A, Leonard N, Jackson J, Kirch M, Solway E, Kullgren JT, Singer D, Malani PN, Gonzalez R. Care Challenges Due to COVID-19 and Mental Health Among Caregivers of U.S. Adults With a Chronic or Disabling Condition. Innov Aging 2021; 5:igab031. [PMID: 34632106 PMCID: PMC8493889 DOI: 10.1093/geroni/igab031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 01/21/2023] Open
Abstract
Background and Objectives The coronavirus disease 2019 (COVID-19) pandemic poses new challenges for caregivers of adults with chronic or disabling conditions. This study uses nationally representative data to examine the prevalence of pandemic care challenges and supports and their associations with caregiver mental health and interpersonal well-being. Research Design and Methods Participants include 311 caregivers aged 50–80 in the United States who were providing care for an adult with a chronic or disabling condition from the June 2020 National Poll on Healthy Aging. Five care challenges (e.g., confusion on public health guidelines) and 2 supports (e.g., physician offered information on care during COVID-19) are treated as predictors of caregiver mental health (care-related stress, self-reported mental health, and depressive symptoms) and interpersonal well-being (interpersonal conflicts, lack of companionship, and isolation). Results Each care challenge/support was endorsed by 13%–23% of caregivers. In adjusted models, difficulty getting needed medical care was associated with greater caregiver stress, depressive symptoms, and lower interpersonal well-being. All care challenges universally predicted greater caregiver stress. Caregiving supports were not independently associated with caregiver’ mental health and interpersonal well-being. Discussion and Implications Care challenges were associated with caregivers’ mental health and interpersonal well-being during the early months of the pandemic. Some of these challenges may be attributed to changing public health guidelines and practices as the pandemic unfolded, whereas others are relevant to all care contexts (e.g., less support from family). Tools and supports for caregivers must consider both changing policies and care needs.
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Affiliation(s)
- Amanda N Leggett
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Alicia Carmichael
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Natalie Leonard
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeannette Jackson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthias Kirch
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Erica Solway
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeffrey T Kullgren
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Dianne Singer
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Preeti N Malani
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Richard Gonzalez
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Tough H, Gross-Hemmi M, Stringhini S, Eriks-Hoogland I, Fekete C. Who is at Risk of Loneliness? A Cross-sectional Recursive Partitioning Approach in a Population-based Cohort of Persons With Spinal Cord Injury. Arch Phys Med Rehabil 2021; 103:305-312. [PMID: 34560050 DOI: 10.1016/j.apmr.2021.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop a more thorough understanding of the risk factors for loneliness in persons with a physical impairment, using a population-based sample of persons with spinal cord injury (SCI), based on regression modeling and a recursive partitioning approach. DESIGN Cross-sectional, observational cohort. SETTING Community, Switzerland. PARTICIPANTS Community-dwelling persons with spinal cord injury (N=1283) 16 years or older. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Loneliness was assessed using a modified version of the UCLA Three-Item Loneliness Scale. RESULTS Those with the most disadvantaged socioeconomic characteristics in terms of education, income, subjective social position, employment status, and financial hardship demonstrated the highest risk for loneliness. Of the sociodemographic characteristics, only age had an association with loneliness, whereby persons aged 31-45 had the highest propensity for experiencing loneliness. We also saw that those with higher lesion levels and less functional independence were associated with higher levels of loneliness. In conditional inference tree analysis subjective social position, financial hardship, and functional independence had the highest discriminative power, with nationality and living arrangement having a less important role. CONCLUSIONS Our findings highlight the vulnerability of persons with SCI with unfavorable socioeconomic status to loneliness. Furthermore, our findings show that persons who are more constrained because of functional limitations may face restrictions to social participation and therefore be at a higher risk of loneliness. This population-based evidence contributes to the better targeting of services aimed at alleviating loneliness for persons with a lower socioeconomic position and those with more functional limitations in everyday life.
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Affiliation(s)
- Hannah Tough
- Swiss Paraplegic Research, Nottwil; Department of Health Sciences and Medicine, University of Lucerne, Lucerne.
| | | | - Silvia Stringhini
- Department of Population Health, Epidemiology, and Public Health, HUG - Hôpitaux Universitaires de Genève, Geneva
| | | | - Christine Fekete
- Swiss Paraplegic Research, Nottwil; Department of Health Sciences and Medicine, University of Lucerne, Lucerne
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15
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Own health, spousal health and transitions in loneliness among middle-aged and older adults in China. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
This study examines the effects of own and spousal health on transitions in loneliness over time among married middle-aged and older adults in China, and explores the possible gender differences in these effects using data from the three waves of the China Health and Retirement Longitudinal Study (2011–2015). The sample includes 6,422 men and 6,391 women who were married and aged 45 and older at the baseline survey. Middle-aged and older adults with poorer physical and emotional health statuses are more likely to transition into and less likely to transition out of loneliness in a two-year period. Spouse's emotional health also affects both types of transition in loneliness and spouse's functional limitation affects transition into loneliness through spouse's emotional health. In addition, for married men, their own functional limitation is significantly associated with their transitions into and out of loneliness. For married women, their spouse's functional limitation is significantly associated with their transition into loneliness and this is mainly through its association with spouse's emotional health. Also, for married women, their spouse's emotional health is significantly associated with their transition out of loneliness. Social interventions to reduce feelings of loneliness need to take a couple approach and consider both spouses’ health problems and how they may affect their daily activities and their interactions with each other and with others.
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Summaka M, Zein H, Naim I, Fneish S. Assessing the psychological impact of COVID-19 outbreak and its related factors on Lebanese individuals with physical disabilities. Disabil Health J 2021; 14:101073. [PMID: 33653673 PMCID: PMC7891081 DOI: 10.1016/j.dhjo.2021.101073] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/17/2021] [Accepted: 02/11/2021] [Indexed: 12/23/2022]
Abstract
Background In February 2020, the Lebanese authorities announced the first Coronavirus 2019 (COVID-19) case. Since then, the cases increased significantly, but information on the public’s psychological status and specifically individuals with physical disabilities is still limited. Purpose The study aims to assess the psychological impact of the COVID-19 outbreak on Lebanese individuals with physical disabilities and study the associated factors. Materials and methods This is a cross-sectional study involving 118 individuals with physical disabilities. Each filled out an online survey with three sections: a personal questionnaire, the Arabic versions of the Hopkins Symptom Checklist-25 and the Fear of COVID-19 scale. Data regarding participants’ baseline characteristics, fear, anxiety, and depression were collected and analyzed using the Chi-square test and regressions models. Results Individuals with physical disabilities exhibited mild fear of COVID-19, with fear being correlated with age, educational level, and employment status. Furthermore, 22.9% of the population was found to be anxious, and 31.5% were depressed. Anxiety was associated with both marital status and employment status. Finally, depression was proved to be influenced by marital status, employment, and educational level. Conclusion Results extracted showed that individuals with physical disabilities require substantial attention in order to manage their psychological state during pandemics.
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Affiliation(s)
- Marwa Summaka
- Department of Neurological Rehabilitation, Health, Rehabilitation, Integration and Research Center (HRIR), Beirut, Lebanon.
| | - Hiba Zein
- Department of Neurological Rehabilitation, Health, Rehabilitation, Integration and Research Center (HRIR), Beirut, Lebanon.
| | - Ibrahim Naim
- Department of Neurological Rehabilitation, Health, Rehabilitation, Integration and Research Center (HRIR), Beirut, Lebanon.
| | - Sleiman Fneish
- Department of Neurological Rehabilitation, Health, Rehabilitation, Integration and Research Center (HRIR), Beirut, Lebanon.
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Liu Y, Upenieks L. Marital Quality and Well-Being Among Older Adults: A Typology of Supportive, Aversive, Indifferent, and Ambivalent Marriages. Res Aging 2020; 43:428-439. [PMID: 33107384 DOI: 10.1177/0164027520969149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A large body of work has linked marital quality to the health and well-being of older adults, but there is a lack of agreement on how to best measure dimensions of marital quality. Drawing on a stress-process life course perspective, we construct a typology of marriage type that captures the synergistic relationship between positive and negative marital qualities and health. Using data from Wave 1 (2005/2006) and Wave 2 (2010/2011) of the NSHAP survey from the United States, we examine the association between supportive, aversive, ambivalent, and indifferent marriages for older adults that remained married over the study period on multiple indicators of well-being (depression, happiness, and self-rated health; N = 769 males and 461 females). Results suggest that older adults in aversive marriages reported lower happiness (men and women) and physical health (men). There was less evidence that those in ambivalent and indifferent marriages reported worse well-being.
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Wong JS, Hsieh N. Functional Status, Cognition, and Social Relationships in Dyadic Perspective. J Gerontol B Psychol Sci Soc Sci 2019; 74:703-714. [PMID: 28369622 PMCID: PMC6460338 DOI: 10.1093/geronb/gbx024] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/15/2017] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES Health limitations can change older adults' social relationships and social engagement. Yet, researchers rarely examine how the disability of one's spouse might affect one's social relationships, even though such life strains are often experienced as a couple. This study investigates the association between functional and cognitive limitations and social experience in a dyadic context. METHOD We use actor-partner interdependence models to analyze the partner data from 953 heterosexual couples in Wave II (2010-2011) of the National Social Life, Health, and Aging Project. RESULTS One spouse's functional and cognitive health is associated with the other's relationship quality, but the pattern varies by gender. Husbands' functional limitations are associated with lower marital support and higher marital strain in wives, but wives' functional limitations are related to lower family and friendship strain in husbands. Husbands' cognitive impairment also predicts higher family and friend support in wives. DISCUSSION Findings support a gendered dyadic relationship between health and social life and highlight women's caregiver role and better connection with family and friends. There are also differences between experiencing cognitive and physical limitations in couples. Finally, mild health impairment sometimes shows stronger effects on social relationships than severe impairment, suggesting adaptation to health transition.
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Affiliation(s)
- Jaclyn S Wong
- NORC, Department of Sociology, University of Chicago, Illinois
| | - Ning Hsieh
- Department of Sociology, Michigan State University, East Lansing
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Hsieh N, Waite L. Disability, Psychological Well-Being, and Social Interaction in Later Life in China. Res Aging 2019; 41:362-389. [PMID: 30636536 DOI: 10.1177/0164027518824049] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many studies show that disability predicts lower social participation and poorer psychological well-being. However, few have examined how disability, social interaction, and psychological well-being interrelate with one another. We use diary data from World Health Organization's Study on Global AGEing and Adult Health, 2007-2010 ( N = 8,771) and mediation analysis to examine the links between disability, daily social interaction, and the momentary and global well-being of older adults in China. We find suggestive support for the hypothesis that psychological well-being predicts social interaction in the context of disablement, but little evidence for the converse. Specifically, in a cross-sectional analysis, disability predicts lower levels of momentary affect, happiness, and life satisfaction, which are linked to spending more time alone and participating in fewer activities with grandchildren, friends, and coworkers. These findings are consistent with the hypothesis that a less active social life is explained by poor functional performance and compromised psychological vibrancy.
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Affiliation(s)
- Ning Hsieh
- 1 Department of Sociology, Michigan State University, East Lansing, MI, USA
| | - Linda Waite
- 2 Department of Sociology, The University of Chicago, Chicago, IL, USA
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Ejlskov L, Wulff J, Bøggild H, Kuh D, Stafford M. Assessing the relative importance of correlates of loneliness in later life. Gaining insight using recursive partitioning. Aging Ment Health 2018; 22:1486-1493. [PMID: 28885038 PMCID: PMC6364306 DOI: 10.1080/13607863.2017.1370690] [Citation(s) in RCA: 3] [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: 04/25/2017] [Accepted: 08/17/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Improving the design and targeting of interventions is important for alleviating loneliness among older adults. This requires identifying which correlates are the most important predictors of loneliness. This study demonstrates the use of recursive partitioning in exploring the characteristics and assessing the relative importance of correlates of loneliness in older adults. METHOD Using exploratory regression trees and random forests, we examined combinations and the relative importance of 42 correlates in relation to loneliness at age 68 among 2453 participants from the birth cohort study the MRC National Survey of Health and Development. RESULTS Positive mental well-being, personal mastery, identifying the spouse as the closest confidant, being extrovert and informal social contact were the most important correlates of lower loneliness levels. Participation in organised groups and demographic correlates were poor identifiers of loneliness. The regression tree suggested that loneliness was not raised among those with poor mental wellbeing if they identified their partner as closest confidante and had frequent social contact. CONCLUSION Recursive partitioning can identify which combinations of experiences and circumstances characterise high-risk groups. Poor mental wellbeing and sparse social contact emerged as especially important and classical demographic factors as insufficient in identifying high loneliness levels among older adults.
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Affiliation(s)
- Linda Ejlskov
- Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jesper Wulff
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Henrik Bøggild
- Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, UCL, London, United Kingdom
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing, UCL, London, United Kingdom
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Hsieh N, Hawkley L. Loneliness in the older adult marriage: Associations with dyadic aversion, indifference, and ambivalence. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2018; 35:1319-1339. [PMID: 32099270 PMCID: PMC7041908 DOI: 10.1177/0265407517712480] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Marriage protects against loneliness, but not all marriages are equally protective. While marriage is a highly interdependent relationship, loneliness in marital dyads has received very little research attention. Unlike most studies proposing that positive and negative marital qualities independently affect loneliness at the individual level, we used a contextual approach to characterize each partner's ratings of the marriage as supportive (high support, low strain), ambivalent (high support, high strain), indifferent (low support, low strain), or aversive (low support, high strain), and examined how these qualities associate with own and partner's loneliness. Using couple data from the Wave II National Social Life, Health and Aging Project (N=953 couples), we found that more than half of the older adults live in an ambivalent, indifferent, or aversive marriage. Actor-partner interdependence models showed that positive and negative marital qualities synergistically predict couple loneliness. Spouses in aversive marriages are lonelier than their supportively married counterparts (actor effect), and that marital aversion increases the loneliness of their partners (partner effect). In addition, wives (but not husbands) in indifferent marriages are lonelier than their supportively married counterparts. These effects of poor marital quality on loneliness were not ameliorated by good relationships with friends and relatives. Results highlight the prominent role of the marriage relationship for imbuing a sense of connectedness among older adults, and underscore the need for additional research to identify strategies to help older adults optimize their marital relationship.
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Warner DF, Adams SA, Anderson RK. The Good, the Bad, and the Indifferent: Physical Disability, Social Role Configurations, and Changes in Loneliness Among Married and Unmarried Older Adults. J Aging Health 2018; 31:1423-1453. [PMID: 29907072 DOI: 10.1177/0898264318781129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To examine how social role configurations (SRCs)-combinations of the quality of spousal, family, and friend relationships-moderate the association between functional limitations (FLs) and loneliness among married and unmarried older adults and whether this differs by gender. Method: Longitudinal data from the National Social Life, Health, and Aging Project on married (n = 945) and unmarried (n = 443) older adults (aged 57-85 years). Latent class analysis was used to identify SRCs. Tobit regression models examined the associations between FLs, SRCs, and loneliness. Results: Nine SRCs were identified. The effectiveness of SRCs for coping with FLs did not differ by marital status despite higher loneliness among the unmarried. Only for women with FLs did SRCs characterized by negativity/strain exacerbate loneliness. For men with FLs, SRCs characterized by excess positivity/support were problematic. Discussion: These findings underscore the importance of considering how SRCs provide resources for coping with FLs that have gendered implications.
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Affiliation(s)
- David F Warner
- 1 University of Nebraska-Lincoln, NE, USA.,2 Bowling Green State University, OH, USA
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“Strength of Weak Ties,” Neighborhood Ethnic Heterogeneity, and Depressive Symptoms among Adults: A Multilevel Analysis of Korean General Social Survey (KGSS) 2012. SOCIAL SCIENCES-BASEL 2017. [DOI: 10.3390/socsci6020065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Liu H, Waite L, Shen S. Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality. J Gerontol B Psychol Sci Soc Sci 2016; 71:1070-1080. [PMID: 27216861 PMCID: PMC5067945 DOI: 10.1093/geronb/gbw061] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/04/2016] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES We assess the association between marital quality and both the risk of developing diabetes and the management of diabetes after its onset in later life. METHOD We use data from the first two waves of the National Social Life, Health, and Aging Project to estimate regression models with lagged dependent variables. The sample includes 1,228 married respondents, among whom 389 were diabetic. Those with either a reported diagnosis or with HbA1c ≥ 6.5% are identified diabetic. We categorize diabetic respondents into three groups: controlled, undiagnosed, and uncontrolled diabetes. We conduct factor analysis to construct positive and negative marital quality scales. RESULTS For women, an increase in positive marital quality between Waves 1 and 2 is related to a lower risk of being diabetic at Wave 2, net of diabetes status at Wave 1; surprisingly, for men, an increase in negative marital quality between Waves 1 and 2 is related to both a lower risk of being diabetic at Wave 2 and a higher chance of controlling diabetes at Wave 2 after its onset. DISCUSSION Our results challenge the traditional assumption that negative marital quality is always detrimental to health and encourage family scholars to distinguish different sources and types of negative marital quality.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, East Lansing.
| | - Linda Waite
- Department of Sociology and NORC, University of Chicago, Illinois
| | - Shannon Shen
- Department of Sociology, Michigan State University, East Lansing
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