Correlations of external social capital in social organizations providing integrated eldercare services with medical care in China

Analysis of the current situation and factors influencing the utilization of somatic and somatic-mental disorder comorbidity and health services among middle-aged and older adult people in China

Background

The aging process has led to a significant increase in the prevalence of somatic chronic diseases (e.g., cardiovascular diseases, diabetes) among the middle-aged and older adult population. Additionally, this demographic is also susceptible to mental disorders (e.g., depression, anxiety). However, most studies in China focus on somatic chronic disease comorbidities, with less attention on comorbidities between somatic and mental disorders, as well as health service utilization.

Purpose

To investigate the factors influencing the comorbidities of somatic and somatic-mental disorder and the status of health service utilization among middle-aged and older adult individuals in China.

Methods

Data from the 2020 China Health and Retirement Longitudinal Study (CHARLS) were analyzed, including 16,565 middle-aged and older adult individuals. Among them, 9,498 had somatic chronic disease comorbidities, and 4,577 had somatic-mental disorder comorbidities. Logistic regression was used to analyze factors influencing comorbidity and health service utilization. Spatial distribution maps were created using ArcGIS 10.8 software, and association rules were mined using IBM SPSS Modeler 18.0 and R 4.4.1.

Results

The prevalence of somatic chronic disease comorbidity (57.34%) was higher than that of somatic-mental disorder comorbidity (27.63%). The patterns of comorbidity exhibited a complex network structure, with arthritis or rheumatism, hypertension, and stomach or other digestive disorders serving as core nodes. Dispositional factors (e.g., gender, age) and demand factors (e.g., number of comorbidities, self-rated health) had a significantly greater influence on the risk of comorbidities and health service utilization behaviors than enabling factors (e.g., household income, basic health insurance). Patients with somatic-mental disorder comorbidities had 1.09 times higher outpatient utilization compared to those with somatic chronic disease comorbidities (95% CI, 1.01 to 1.18). The average number of outpatient visits was also higher for the somatic-mental disorder comorbidities (2.55 ± 2.81 visits) than the somatic chronic disease comorbidities (2.34 ± 2.69 visits).

Conclusion

Pay attention to the variations in the distribution of various combinations of comorbidity patterns within the population and develop targeted treatment strategies and preventive measures. Emphasize enhancing patients' self-management skills and health literacy, also considering economic factors. Elevate the significance of mental health services and management, strengthen patients' social support networks, and reduce social stigma and discrimination.

Living environment, service quality satisfaction and depression among Chinese older adults in elderly caring social organizations

BACKGROUND

Older adults living in elderly caring social organizations (SOs) are prone to suffer from depression. Many studies have found correlations between environmental and quality-of-life factors and depression; however, evidence from elderly caring SOs is rare, particularly in China.

METHODS

A cross-sectional study was conducted among service recipients in elderly caring SOs in Anhui and Chongqing, China. Data on demographic and health-related characteristics, living environment factors, and service quality satisfaction factors in 2171 older adults were used for analysis. The binary logistic regression model was conducted to estimate the association between living environment and service quality satisfaction factors and depression.

RESULTS

Our results indicated that living environment factors in terms of exposure to suitable temperature and humidity (OR = 0.655; 95 % CI: 0.446, 0.963), green coverage >30 % (OR = 0.432; 95 % CI: 0.337, 0.553) were associated with lower odds of developing depression. Also, an opposite relationship was found in the noise factor (OR = 1.985; 95 % CI: 1.395, 2.823). Higher satisfaction with admission and discharge services, dietary services, entertainment services, and psychological support services were also found to be associated with a lower risk of depression.

LIMITATIONS

A cross-sectional design precluded determining whether living environment, service quality satisfaction, and depression are causally related. Measurement of living environment factors and service quality satisfaction factors needs to be further clarified comprehensively.

CONCLUSIONS

Enhancing the living environment and the quality of the services provided to seniors in the elderly caring SOs is conducive to the reduction of the likelihood of depression.

Revealing the enhancement effect of social capital on the individual performance of core members in elderly caring organizations: A study from Anhui, China

Aging is a challenge to global development. This challenge is particularly significant for China because it has the largest elderly population worldwide. The proportion of aging population continues to increase, and solely relying on government efforts to meet the needs of the elderly is inadequate. Hence, involvement of social organizations in elderly care services is needed. Their core members exhibit higher sense of responsibility and identification with the organization than regular members, thus profoundly affecting organizational development. Based on the Social Capital Theory, this study employed a multistage stratified random sampling method to examine the social capital stock of elderly social organizations and their core members across six cities in Anhui Province, China. Chi-square tests analyzed the relationship between the core members' demographic factors and individual performance. Independent-sample t-tests assessed the relationship between social capital and individual performance. Finally, binary logistic regression models determined the factors influencing the individual performance of core members. Social networks within core members' social capital and the internal social capital of elderly caring social organizations (ESOs) affect the individual performance of core members. Therefore, organizations should provide more training opportunities for core members to expand their networks. Cultivating a shared language and vision as components of social capital can enhance organizational cohesion and operational stability.

Factors related to the internal social capital of elderly-caring social organizations: a cross-sectional study in Chongqing, China

BACKGROUND

Aging has given birth to the demand for high-quality elderly care service and social organizations (ESOs) are gradually taking on a supportive role in the field of elderly care services.. In view of this, our study is designed to examine influencing factors of social capital within the elderly-caring social organizations.

METHOD

The study was conducted in four districts of Chongqing Province and a multi-stage random sampling method was used to sample 80 ESOs as subjects for the research. Through a meticulously crafted questionnaire, we gathered valuable data on internal social capital, basic information about the organization, and other variables. Univariate and Binary Logistic Regression analysis were performed on the data to explore the factors associated with social capital within the elderly-caring social organizations using IBM SPSS version 26.0.

RESULT

The results showed that 67(83.8%) OF ESOs surveyed were A-type institutions and 13(16.3%) B-type institutions. Among them, 49(61.3%) institutions covered an area of more than 50m2.The institutions of ≤ 2 years were 33(41.3%), 21(26.3%) were established for ≤ 3 ≤ 8 years, and residual 26(32.5%) were institutions ˃ 8 years old. ESOs that possessed 4-6 management employees were 52.422 times more likely to score high for social support (p<0.05, OR = 52.422). Accommodating special care objects and hiring 16-30 employees were significantly linked to the shared language and shared vision dimension (p<0.001, OR = 0.8) and (p<0.05, OR = 8.672), respectively. and the overall social capital dimension (p<0.01, OR = 0.221) (p<0.05, OR = 5.730).

CONCLUSION

ESOs with different basic conditions have different amounts of social capital. Factors such as the presence of special care and volunteer staff, a certain number of full-time staff as well as types of services rendered are accompanied with the higher internal social capital of ESOs.

Factors Associated with Medication Adherence among Community-Dwelling Older People with Frailty and Pre-Frailty in China

BACKGROUND

Frail and pre-frail older people often need to take medications. However, factors related to medication adherence among this population remain unclear, warranting further research. This study aims to identify correlates of medication adherence among frail and pre-frail older adults.

METHODS

From November 2020 to December 2020; a total of 4218 community-dwelling residents aged ≥ 60 years were interviewed by a cross-sectional survey in China. Data on subjects' general information; medication adherence; and frailty status was obtained via the face-to-face structured questionnaire. Logistic regression models were fitted; separately; to examine these factors linked to medication adherence.

RESULTS

We found that 36.2% (n = 1527) and 18.8% (n = 792) of respondents were classified as pre-frail and frail. According to the Morisky scale scores, 66.74% (n = 2815) were found to have adequate medication adherence, and 33.26% (n = 1403) were found to have inadequate medication adherence. Among the pre-frail respondents, age (adjusted odds ratio (AOR) = 1.64; 95% confidence interval (CI): 1.18-2.29, P = 0.003), marital status (AOR = 1.52; 95% CI: 1.04-2.21, P = 0.030), smoking status (AOR = 0.61; 95% CI: 0.37-0.99, P = 0.044), and functional ability (AOR = 0.72; 95% CI: 0.58-0.91, P = 0.006) were significantly related to medication adherence. Among them, advanced age and single were risk factors, which were positively related to the medication adherence of subjects in pre-frailty, while quitting smoking and limited functional ability contributed to improving their medication adherence. In contrast, only age (AOR = 1.77; 95% CI: 1.16-2.69, P = 0.008) was significantly associated with medication adherence among frail subjects.

CONCLUSION

Influencing factors to medication adherence of old people in pre-frailty and frailty have been enriched, which provides a certain reference for promoting medication adherence in this population. Future adherence intervention methods should be designed based on these factors.

The Relationship between Social Support and Anxiety among Rural Older People in Elderly Caring Social Organizations: A Cross-Sectional Study

BACKGROUND

Social support and anxiety have a major impact on later life quality in rural, older people in elderly caring social organizations (SOs). This study aimed to explore the relationship between social support and anxiety and their relevant influential factors among rural older people in elderly caring SOs in Anhui Province, China.

METHODS

This cross-sectional study was conducted through a multi-stage stratified cluster random sampling method. Independent t-tests, one-way ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, and a generalized linear model were employed.

RESULTS

A significantly negative association between friends' support and anxiety were found among rural older people in elderly caring SOs. Statistically significant relationships were found between social support and gender, marital status, education level, whether visited by relatives, and institutional satisfaction. Similarly, anxiety was associated with gender, institutional satisfaction, comorbid chronic diseases, and friends' support.

CONCLUSIONS

Social support from friends plays an important role in preventing and regulating anxiety among rural older people, especially those from elderly caring SOs. To reduce the occurrence and level of anxiety among rural elderly in elderly caring SOs, an effort should be given to strengthening social support, improving institutional satisfaction, and emphasizing comorbid chronic diseases.