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An S, Roh SY, Kwon J. Health and Socio-Demographic Factors Affecting Happiness Among Korean Adults with Moderate and Severe Disabilities: A National Survey-Based Study. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:704. [PMID: 40282995 PMCID: PMC12029011 DOI: 10.3390/medicina61040704] [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: 03/05/2025] [Revised: 04/07/2025] [Accepted: 04/09/2025] [Indexed: 04/29/2025]
Abstract
Background and Objectives: This study identified health-related factors that affect the happiness of Korean adults with disabilities based on the disability level. Materials and Methods: Data of 7581 adults with disabilities aged 20 or older were collected from the 2023 Survey on the Status of Persons with Disabilities. The collected data were analyzed using frequency and multivariate logistic regression analyses. Results: Among individuals with moderate disability, males were less happy than females. Those with elementary school or lower education levels were less happy than those with college or higher education levels. Those who experienced stress, sadness and despair, suicidal thoughts, or discrimination were less happy than those who did not. In contrast, married individuals were happier than unmarried individuals. Those who exercised, went out alone, engaged in paid work, or participated in social activities were happier than those who did not. Among individuals with severe disabilities, males were less happy than females. Those with lower levels of education were less happy than those with higher levels of education. Those who experienced stress, sadness and despair, suicidal thoughts, suicide attempts, difficulty in communication, or discrimination were less happy than those who did not. Those who perceived their body as very thin were less happy than those who perceived it as very obese. Those who suffered from chronic disease were less happy than those who did not. In contrast, those aged 20-29 were happier than those aged 80 years or older. Married individuals were happier than unmarried ones. Those who exercised, went out alone, engaged in paid work, or participated in social activities were happier than those who did not. Conclusions: Factors affecting the happiness of Korean individuals with disabilities differ depending on the disability degree. Therefore, health policies, plans, and support measures must be established based on the disability degree to support daily physical activities, along with health services facilitating physical activity.
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Affiliation(s)
- Seungok An
- Department of Special Physical Education, Yongin University, Yongin 17092, Republic of Korea;
| | - Su-Yeon Roh
- Department of Exercise Rehabilitation, Gachon University, Incheon 21936, Republic of Korea
| | - Jeonga Kwon
- Department of Elementary Education, College of First, Korea National University of Education, Cheongju 28173, Republic of Korea
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de Graaff MLA, van der Heide I, Rademakers JJDJM, van Valkengoed IGM, Francke AL, Woonink A, Bijnsdorp FM. Is caregiver burden associated with sex and gender-related characteristics? A large-scale survey study among family caregivers of people with dementia. BMC Geriatr 2025; 25:171. [PMID: 40087581 PMCID: PMC11908074 DOI: 10.1186/s12877-025-05795-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Accepted: 02/17/2025] [Indexed: 03/17/2025] Open
Abstract
BACKGROUND The association between the sex of family caregivers and their perceived care burden has been examined thoroughly. The role of sex- and gender-related characteristics of these caregivers in this association remains unknown. We therefore explored the extent to which various gender-related characteristics of caregivers and the sex of people with dementia explain or affect the association between sex of caregivers and their perceived care burden. METHODS Data were derived from a large-scale survey among Dutch family caregivers of people with dementia in 2022 (N = 3067). Both linear and logistic regression analyses were performed to assess mediation of gender-related caregiver characteristics in the association between the sex of the caregiver and the perceived care burden. These characteristics included: hours per week spent on caregiving, being the primary caregiver, relationship with the person with dementia and perceived difficulty in combining daily activities with caregiving. Linear regression analyses were used to assess moderation of the sex of the person with dementia in the association between the sex of the caregiver and the perceived care burden. RESULTS Female caregivers perceived a greater care burden than male caregivers. This association was partly explained by female caregivers more often perceiving difficulty of combining daily activities with caregiving than male caregivers. Male caregivers perceived a slightly greater care burden when caring for a female than when caring for a male. The perceived care burden of female caregivers was not related to the sex of the person with dementia. DISCUSSION This study highlights how gender-related aspects of family caregiving can contribute to sex differences in perceived care burden. The findings imply that it is important to take gender-related aspects of caregiving into account when developing or offering caregiver support, as support needs differ between male and female caregivers.
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Affiliation(s)
- M L A de Graaff
- Nivel. Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
| | - I van der Heide
- Nivel. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Faculty of Humanities, Utrecht University, Utrecht, The Netherlands
| | - J J D J M Rademakers
- Nivel. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - I G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam UMC, Universiteit Van Amsterdam, Amsterdam, the Netherlands
| | - A L Francke
- Nivel. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Center of Expertise in Palliative Care, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - A Woonink
- , Alzheimer Netherlands, Amersfoort, the Netherlands
- Fyris Research & Data, Den Haag, the Netherlands
| | - F M Bijnsdorp
- Nivel. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Inholland University of Applied Sciences, Amsterdam, the Netherlands
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Fu L, Wang R, He C. Gender differences in later life: Labor supply responses to spousal disability. Soc Sci Med 2025; 366:117638. [PMID: 39718278 DOI: 10.1016/j.socscimed.2024.117638] [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: 08/14/2024] [Revised: 12/11/2024] [Accepted: 12/16/2024] [Indexed: 12/25/2024]
Abstract
This study uses panel data from the 2011, 2013, 2015, 2018, and 2020 China Health and Retirement Longitudinal Study to examine the labor supply effects of spousal disability in later life. Employing a staggered difference-in-differences strategy, we provide causal evidence of gender-specific impacts, with a significant and enduring negative effect on female employment lasting over eight years, in contrast to minimal changes for males. The negative effect on female employment is particularly pronounced among low-educated individuals, those with agricultural hukou, and those influenced by stronger Confucian cultural norms. Mechanism analysis attributes the gender disparity to the caregiving effect and the health effect, with females experiencing increased caregiving responsibilities and health deterioration. We do not find enough evidence to support the added worker effect and the joint leisure effect. Furthermore, following the death of a disabled spouse, both genders exhibit an increased withdrawal from the labor market, with females increasingly assuming grandchild care responsibilities. These findings reveal the persistent gender differences in later life and suggest that policy interventions should prioritize the equitable allocation of social welfare resources to mitigate caregiving burdens faced by older women.
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Affiliation(s)
- Liping Fu
- College of Management and Economics, Tianjin University, Tianjin, 300072, China; Center for Social Science Survey and Data, Tianjin University, Tianjin, 300072, China; College of Politics and Public Administration, Qinghai Minzu University, Qinghai, 810007, China
| | - Ruizhen Wang
- College of Management and Economics, Tianjin University, Tianjin, 300072, China; Center for Social Science Survey and Data, Tianjin University, Tianjin, 300072, China
| | - Chaoying He
- College of Management and Economics, Tianjin University, Tianjin, 300072, China; Center for Social Science Survey and Data, Tianjin University, Tianjin, 300072, China.
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Tien YH, Huang J. Evaluation of Health-related Factors Influencing Fears of Aging among Elderly Chinese Citizens. Indian J Public Health 2024; 68:552-554. [PMID: 39670939 DOI: 10.4103/ijph.ijph_1450_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/02/2024] [Indexed: 12/14/2024] Open
Abstract
SUMMARY Many countries face an increasingly aging population, but China is now home to the largest population of older people in the world. This study aims to analyze health-related factors influencing fears of aging among elderly Chinese citizens. Multiple regression models were constructed using fears of aging as the dependent variable and demographics and other key components as independent variables, respectively. Results showed that individuals with a chronic disease had more fears of aging than those without a chronic disease. Individuals with a higher personal annual income had less fears of aging. Individuals who were less worried about the lack of timely treatment and unaffordable medical expenses had less fears of aging.
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Affiliation(s)
- Yun-Hsiang Tien
- Associate Professor, Department of Public Administration, School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Jingchi Huang
- Lecturer, Department of Public Administration, School of Political Science and Public Administration, Wuhan University, Wuhan, China
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Kim H, Jung YH, Park S, Shin J, Jang SI. Effects of disability-related limitations in daily living on unmet needs: a longitudinal-study 1. BMC Public Health 2024; 24:351. [PMID: 38308206 PMCID: PMC10835996 DOI: 10.1186/s12889-024-17674-z] [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: 08/02/2023] [Accepted: 01/04/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Unmet health needs are particularly important to people with disabilities; however, these unmet needs owing to limitations in daily life have been under-researched thus far. This study examined the effects of disability-related limitations in daily life on unmet needs. METHODS This study included 5,074 adults with disabilities from the 2018-2020 Korea Disability and Life Dynamics Panel. We analyzed the effects of disability-related limitations in daily life on unmet needs using logistic regression with a generalized estimating equation model. RESULTS Overall, 4.8% men and 4.6% women with disabilities had unmet needs. For men, unmet needs were 1.46 times (95% confidence interval [CI] 1.09-1.96) higher for those with moderate limitations in daily life. For women, unmet needs were 1.79 times (95% CI 1.22-2.39) higher when there were moderate limitations in daily life. The prominent factors causing this effect were physical or brain lesion disability for men and internal or facial disability and burden of medical expenses for women. CONCLUSIONS Limitations in daily life due to disability increase the risk of having unmet needs, an effect that is significantly more pronounced in men. These unmet needs differ depending on an individual's sex, disability type, limited body parts, and other specific causes. Efforts are required to reduce the unmet needs of people with disabilities by considering the type of disability, impaired body parts, and causes of unmet needs in daily life.
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Affiliation(s)
- Hanseul Kim
- Southern Seoul Regional Headquarters, National Pension Service, Seoul, Republic of Korea
| | - Yun Hwa Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sohee Park
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.
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Kim HJ, Lim JY, Jang SN. Korean primary health care program for people with disabilities: do they really want home-based primary care? BMC Health Serv Res 2023; 23:1086. [PMID: 37821901 PMCID: PMC10568830 DOI: 10.1186/s12913-023-10102-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Despite many studies on home-based primary care (HBPC)-related benefits and challenges, little is known about the perspectives of potential target groups of the care and their intention or preference for using it. This study aimed to explore the demand for HBPC from the perspective of people with disabilities (PWDs) and caregivers and identify relevant determinants for that demand. METHODS Data from the population-based survey conducted in the Gyeonggi Regional Health & Medical Center for People with Disabilities in South Korea were analyzed. Logistic regression analysis was performed to identify relevant determinants for the demand on HBPC. RESULTS Overall, 22% of respondents required HBPC, and 34.7% of persons aged ≥ 65 years demanded it. Older adults with disability, homebound status, and a need for assistance with daily living activities were associated with a demand for HBPC. Though having severe disability, only 19.49% of self-reported respondents demanded for HBPC, while 39.57% of proxy-reported respondents demanded for HBPC. Among self-reported group, only marital status was a predictor associated with a demand for HBPC. In contrast, among proxy-reported groups, PWDs with external physical disabilities, or with unmet medical needs due to availability barriers reported a higher demand for HBPC. CONCLUSIONS The demand for HBPC does not derive from the medical demands of the users themselves, but rather the care deficit by difficulty in getting out of the house or in outpatient care. Beyond an alternative to office-based care, HBPC needs to be considered to solve the care deficit and as well as to deal with PWDs' medical problems.
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Affiliation(s)
- Hye-Jin Kim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, South Korea
| | - Jae-Young Lim
- Department of Gyeonggi Regional Health & Medical Center for Persons with Disabilities, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea
| | - Soong-Nang Jang
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, South Korea.
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Zhylkybekova A, Turlayev A, Grjibovski AM, Koshmaganbetova GK. Measures to support informal care for the older adults in Kazakhstan: a review of the current status. Front Public Health 2023; 11:1247684. [PMID: 37670833 PMCID: PMC10475596 DOI: 10.3389/fpubh.2023.1247684] [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: 06/26/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023] Open
Abstract
The demand for informal caregivers to support the older adults has grown worldwide in recent decades. However, informal caregivers themselves require support. This article aims to examine existing support measures for caregivers of the older adults in the Republic of Kazakhstan. Relevant articles and grey literature were identified through manual searches on Google and Google Scholar, as well as electronic searches using indexed databases like PubMed, Web of Science, and Scopus. Moreover, the reference lists of identified sources and government ministry websites were meticulously scrutinized. This review highlights the scarcity of research on caregiver support measures in Kazakhstan, supported by the lack of peer-reviewed articles on this subject. A comprehensive analysis of the literature shows that in Kazakhstan's legislative framework, "caregivers" exclusively refers to individuals providing care for a first-degree disability. The responsibility of caring for older adults parents lies with able-bodied children. However, there is a lack of registration and assessment procedures to evaluate the burden and quality of life of caregivers. As a result, the medical and social support provided to caregivers is standardized, failing to adequately address their unique needs and requirements. The analysis of current support measures for informal caregivers highlights the need to develop support mechanisms and recognize individuals providing informal care as key figures in the long-term care system.
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Affiliation(s)
- Aliya Zhylkybekova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Andrey Turlayev
- Department of Law, Buketov Karaganda University, Karaganda, Kazakhstan
| | - Andrej M. Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
- Department of Health Policy and Management, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Gulbakit K. Koshmaganbetova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Kehoe MacLeod K, Flores KN, Chandra K. Identifying facilitators and barriers to integrated and equitable care for community-dwelling older adults with high emergency department use from historically marginalized groups. Int J Equity Health 2023; 22:97. [PMID: 37208757 PMCID: PMC10198019 DOI: 10.1186/s12939-023-01900-y] [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: 11/04/2022] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND High rates of emergency department (ED) use by older adults persist despite attempts to improve accessibility of appropriate and comprehensive care. Understanding the drivers of ED visits from the perspective of older adults from historically marginalized groups could help reduce ED use by patients with needs that are preventable or could have been treated in a more appropriate setting. This interpretivist, feminist study aims to explore the unmet care needs of older adults (age 65 +) with high ED use and belonging to historically marginalized groups to better understand how social and structural inequities reinforced by neoliberalism; federal and provincial governance structures and policy frameworks; and regional processes and local institutional practices, shape the experiences of these older adults, particularly those at risk of poor health outcomes based on the social determinants of health (SDH). METHODS/DESIGN This mixed methods study will employ an integrated knowledge translation (iKT) approach, starting with a quantitative phase followed by a qualitative phase. Older adults self-identifying as belonging to a historically marginalized group, having visited an ED three or more times in the past 12 months, and living in a private dwelling, will be recruited using flyers posted at two emergency care sites and by an on-site research assistant. Data obtained through surveys, short answer questions, and chart review will be used to compile case profiles of patients from historically marginalized groups with potentially avoidable ED visits. Descriptive and inferential statistical analyses and inductive thematic analysis will be conducted. Findings will be interpreted using the Intersectionality-Based Policy Analysis Framework to identify the interconnections between unmet care needs, potentially avoidable ED admissions, structural inequalities, and the SDH. Semi-structured interviews will be conducted with a subset of older adults at risk of poor health outcomes based on SDH, family care partners, and health care professionals to validate preliminary findings and collect additional data on perceived facilitators and barriers to integrated and accessible care. DISCUSSION Exploring the linkages between potentially avoidable ED visits by older adults from marginalized groups and how their care experiences have been shaped by inequities in the systems, policies, and institutions that structure health and social care provision will enable researchers to offer recommendations for equity-focused policy and clinical practice reforms to improve patient outcomes and system integration.
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Affiliation(s)
- Krystal Kehoe MacLeod
- Bruyère Research Institute, Ottawa, Ontario, Canada.
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Horizon Health Network, Saint John, New Brunswick, Canada.
| | - Karyle Nama Flores
- Horizon Health Network, Saint John, New Brunswick, Canada
- Faculty of Health Sciences and Nursing, University of New Brunswick, Saint John, New Brunswick, Canada
| | - Kavish Chandra
- Horizon Health Network, Saint John, New Brunswick, Canada
- Faculty of Medicine, Dalhousie University, Saint John, New Brunswick, Canada
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Park BY, Cho HA, Shin H. Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study. BMC Oral Health 2023; 23:213. [PMID: 37060034 PMCID: PMC10102694 DOI: 10.1186/s12903-023-02948-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/06/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities. METHODS Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002-2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated. RESULTS The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among older individuals (p < 0.001). The proportion and frequency of annual dental visits was lower among women than among men with disabilities. RSDC had differential effects on the severity of disability. Compared to people without disabilities, RSDC increased the number of annual dental visits (p = 0.067) and the dental expenses per visit (p < 0.05) among those with severe disabilities, but the effect on the number of annual dental visits was not significant among those with mild disabilities (p = 0.698). CONCLUSIONS Our results suggest a need for a special dental care system for people with disabilities, to ensure an RSDC, particularly for women and for older people with disabilities.
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Affiliation(s)
- Bo-Young Park
- Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea
| | - Han-A Cho
- Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea
| | - Hosung Shin
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan Dearo, Iksan, 54538, North Jula, Korea.
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Park VMT, Ly Q, von Oppenfeld J, Lee Y, Joo Y, Shin HW, Rhee Y, Park LG. A scoping review of dementia caregiving for Korean Americans and recommendations for future research. Clin Gerontol 2023; 46:223-239. [PMID: 36268979 PMCID: PMC9928901 DOI: 10.1080/07317115.2022.2133907] [Citation(s) in RCA: 1] [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] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This scoping review aims to examine the caregiving experiences of Korean American caregivers of persons with dementia. METHODS A comprehensive electronic search was conducted within 5 databases (PubMed, CINAHL, Web of Science, Embase, PsycINFO-ProQuest) for papers published from 01/01/00 -01/24/22. Seventeen articles met the inclusion criteria. Thematic analysis was used to summarize key findings from these papers. RESULTS Most Korean American dementia caregivers were immigrants and wives/daughters/daughters-in-law. Two themes emerged: 1) how Korean American caregivers perceived their caregiving experiences, and 2) how Korean American caregivers perceived their caregiving support services. Korean American caregivers often experience poor mental health and burden. Social support and familism were found to be two of the most important factors that determine their attitudes toward caregiving. Most reported barriers to utilizing public services. Challenges in finding culturally relevant resources were common. CONCLUSIONS Dementia caregiving is a significant public health problem facing Korean Americans. Recommendations for future research are provided.
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Affiliation(s)
- Van M. Ta Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
- Asian American Research Center on Health (ARCH), University of California San Francisco, San Francisco, California, USA
- Multi-Ethnic Health Equity Research Center (MERC), University of California San Francisco, San Francisco, California, USA
| | - Quyen Ly
- J6-Acuity Adaptable Unit, Stanford Health Care, Stanford, California, USA
| | - Julia von Oppenfeld
- San Francisco Veteran Administration Health Care System, San Francisco, California, USA
| | - Yelim Lee
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Yoonmee Joo
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Hye-Won Shin
- Somang Society, Cypress, California, USA
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, California, USA
| | - YongJoo Rhee
- Department of Health Science, Dongduk Women’s University, Seoul, South Korea
| | - Linda G. Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California, USA
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Singh K, Alomari A, Lenjawi B. Prevalence of Multimorbidity in the Middle East: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16502. [PMID: 36554382 PMCID: PMC9778740 DOI: 10.3390/ijerph192416502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There has not been a review that evaluated the prevalence of multimorbidity in the Middle East. This review aims to measure the prevalence, demographic factors, and consequences of multimorbidity in the Middle East region. STUDY DESIGN A quantitative systematic review includes cross-sectional and longitudinal cohort studies. METHODS The prevalence systematic review approach from the Joanna Briggs Institute was applied. We searched PsychINFO, MEDLINE, EMCARE, CINAHL, Scopus, Science Direct, and the Cochrane Central Register of Controlled Trials. Data were extracted methodically in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Studies written in English and released between 2012 and March 2022 were included. For the meta-analysis, a random-effects model was applied. PROSPERO registration number: CRD42022335534. RESULTS The final sample consisted of eight cohort and observational studies. The number of participants varied from 354 to 796,427. Multimorbidity was present in all populations with a prevalence of 21.8% (95% confidence interval (CI): 21.7-21.8%). CONCLUSION Multimorbidity affects a significant section of the world's population. A uniform operationalization of multimorbidity is required in the Middle East in order to enable reliable estimates of illness burden, effective disease management, and resource distribution.
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Quashie NT, Andrade FCD, Meltzer G, García C. Living Arrangements and Intergenerational Support in Puerto Rico: Are Fathers Disadvantaged? J Gerontol B Psychol Sci Soc Sci 2022; 77:2078-2090. [PMID: 35240683 PMCID: PMC9683498 DOI: 10.1093/geronb/gbac044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To examine how intergenerational support varies by parents' living arrangements and whether there are gender differences in received support in Puerto Rico. METHODS Data come from the 2006-2007 Puerto Rican Elderly and Health Conditions Project, a representative longitudinal study of adults aged 60 and older in Puerto Rico (n = 2,288). We examined the association between parents' living arrangements (alone, with spouse/partner only, with children) and their receipt of functional (help with errands/housework/transport) and health (help when sick) support from children, and whether parents' gender moderates the association. RESULTS Intergenerational coresidence was associated with higher odds of receiving functional and health support than living alone. Women were more likely than men to receive both forms of support. Parents' gender significantly moderated the association between living arrangements and receiving health support-men living with their partners were less likely to receive health support from children than women in similar living arrangements. These associations persisted when analyses were restricted to those with disability. DISCUSSION Our findings suggest that parents' receipt of support from children is conditioned upon their living arrangement and gender, even when their functional health is jeopardized. We discuss these results in relation to the heterogeneous influence of living arrangements for older adults' support needs and provide suggestions for policy and directions for future research in rapidly aging Puerto Rico.
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Affiliation(s)
- Nekehia T Quashie
- Department of Health Studies, University of Rhode Island, Kingston, Rhode Island, USA
| | - Flavia C D Andrade
- School of Social Work, University of Illinois, Urbana-Champaign, Champaign, Illinois, USA
| | - Gabriella Meltzer
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York City, New York, USA
| | - Catherine García
- Department of Human Development and Family Science, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, Syracuse University, Syracuse, New York, USA
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Swinkels JC, van Tilburg TG, Broese van Groenou M. Why do spouses provide personal care? A study among care-receiving Dutch community-dwelling older adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e953-e961. [PMID: 34245192 PMCID: PMC9291597 DOI: 10.1111/hsc.13497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 06/13/2023]
Abstract
This study investigates under what conditions older spouses receive personal care from their spouse. Whether spousal care is provided is determined by individual and societal factors related to informal and formal care provision. Individual factors concern the need for care (the care recipient's health status), the spouse's ability to provide care (the spouse's health status) and the quality of the marital bond. Societal factors reflect changing policies on long-term care (indicated by the year in which care started) and gender role socialisation (gender). From the Longitudinal Aging Study Amsterdam, which completed eight observations between 1996 and 2016, we selected 221 independently living married respondents, aged 59-93, who received personal care for the first time and had at least one previous measurement without care use. The results show that if an older adult received personal care, the likelihood of receiving that care from the spouse decreased over the years: from 80% in 1996 to 50% in 2016. A husband or wife was less likely to receive spousal care when the spouse was unable to provide care or the quality of the relationship was low. No gender differences were found in either the prevalence of spousal care use or in the factors associated with that use. Thus, individual factors and the societal context seem to determine whether one receives personal care from their spouse. The decline in the likelihood of personal care provision from a spouse over the years may indicate a crumbling of family solidarity, an unmeasured and growing inability of the older spouse to provide care or an increasing complexity of care needs that requires the use of formal care. As care-giving can be a chronic stressor and most spouses provide care without assistance from others, attention from policy makers is needed to sustain the well-being of older couples.
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Affiliation(s)
- Joukje C. Swinkels
- Department of SociologyFaculty of Social SciencesVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Theo G. van Tilburg
- Department of SociologyFaculty of Social SciencesVrije Universiteit AmsterdamAmsterdamthe Netherlands
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Zhao B, Kong F, Shin DE, Nam EW. Gender Disparity and the Association Between Socioeconomic Status, Mental Health, and the Need for Long-Term Services and Support Among the Older Koreans. Front Public Health 2022; 10:888011. [PMID: 35719606 PMCID: PMC9203953 DOI: 10.3389/fpubh.2022.888011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Population aging-the inevitable increase in the percentage of older adults-is occurring all around the world as the fertility rate declines and life expectancy rises. This study examined the relationship between socioeconomic status (SES), mental health, and the need for long-term services and support (LTSS) among Korean older adults. It also aimed to provide evidence-based information for South Korea's long-term support services and programs. METHODS This study used the data on older adults aged over 60 years from the 2018 Korean Longitudinal Study of Aging (KLoSA). Ultimately, 5,527 older adults were included in the database (42.6% men, 57.4% women). To clarify the association between SES, mental health, and the need for LTSS among older Korean men and women, chi-squared test, t-test, and structural equation modeling (SEM) were performed. RESULTS The SEM analysis showed that a significant, negative association was observed between SES and the need for LTSS among these older adults-the higher SES groups would generally have less need for LTSS. Mental health had a strong, negative impact on the need for LTSS-better mental health status of the older individuals would indicate a lower need for LTSS, and the effect was stronger among older men. Meanwhile, the positive relationship between SES and mental health was verified-the higher the SES of these older adults the better their mental health. CONCLUSIONS Gender- and social class-sensitive impacts of mental health on the need for LTSS were observed in this study. These findings could provide an evidence-based reference for interventions targeting different genders and social classes in Korea's long-term care system, such as the enhancement of social welfare and mental health status of the older adults.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, Wonju, South Korea
- Yonsei Global Health Center, Yonsei University, Wonju, South Korea
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Dong Eun Shin
- Yonsei Global Health Center, Yonsei University, Wonju, South Korea
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, Wonju, South Korea
- Yonsei Global Health Center, Yonsei University, Wonju, South Korea
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Park GR, Kim J. Gendered trajectories of depressive symptoms and social interactions among cancer patients. Eur J Oncol Nurs 2022; 56:102092. [PMID: 34999426 DOI: 10.1016/j.ejon.2021.102092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/08/2021] [Accepted: 12/29/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examines whether and how depressive symptoms and social interactions change before and after cancer diagnosis, and whether this pattern varies by gender. METHODS This study used data about 722 middle- and older-aged adults from seven waves (3,963 person-observations) of the Korean Longitudinal Study of Ageing spanning 12 years between 2006 and 2018. Gender-stratified fixed effects regression models were used to investigate the effect of cancer diagnosis on changes in depressive symptoms and the frequency of social interactions (with friends, relatives, acquaintances, and neighbors) before and after cancer diagnosis. RESULTS For both men and women, an increase in depressive symptoms was found in the first and second year after cancer diagnosis, though the increase in the second year was significantly greater for men than women. Only men continued to suffer higher depressive symptoms after the third year and subsequent years. This study also found a decrease in the frequency of social interactions only among men in the second year and subsequent years after cancer diagnosis. CONCLUSION Trajectories of psychosocial adjustment to cancer are gendered. The psychosocial consequences of cancer are greater and last longer for men than women.
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Affiliation(s)
- Gum-Ryeong Park
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada; Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA.
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Hyun MK. How fatigue level is related to sleep disturbances: A large cross-sectional community study. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.102097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zhao X, Wang H. Disparities in unmet health service needs among people with disabilities in China. Int J Qual Health Care 2021; 33:6382275. [PMID: 34613344 DOI: 10.1093/intqhc/mzab136] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/30/2021] [Accepted: 10/06/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Extensive research has explored disparities in access to health care between people with and without disabilities, but much less is understood about disparities and associated factors within the disabled population. OBJECTIVE The aim of this study was to examine differences in the prevalence of unmet health-care needs by residential status (hukou status) and disability type among people with disabilities. METHODS Our data were from the National Survey on Basic Public Service Delivery of Persons with Disabilities. The analysis sample included a nationally representative sample of 9 642 112 adults (aged 16+ years) with disabilities. Associated factors were obtained at both individual level and community level. Cross-sectional multivariable logistic regression analyses were conducted to compare unmet medical, care, rehabilitation and accessibility needs among people with different residential statuses and different types of disabilities. RESULTS The estimated prevalence of unmet medical, care, rehabilitation and accessibility needs is 15.4%, 10.2%, 45.6% and 13.7%, respectively. Rural hukou was associated with an important 13-40% increase in unmet health-care needs for people with disabilities in China. These rural-urban disparities in unmet health service needs can be partly explained by community-level factors, including access to facilities, social participation and health professionals. Disparities across the type of disability were smaller, but on average, people with multiple disabilities appeared to have the highest rates of unmet care, medical and accessibility needs, whereas those with physical disability had the highest unmet rehabilitation need. CONCLUSIONS Differences by residential status and impairment type were evident in all types of unmet health service needs. Targeted policy designs that meet the needs for justice and equality of people with disabilities are advisable. Public health and policy efforts are required to improve access to health service and meet the needs of people with disabilities, especially in rural practices and for particular disability groups.
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Affiliation(s)
- Xintong Zhao
- School of Labor and Human Resources, Renmin University of China, No. 59, Zhongguancun Street, Haidian, Beijing 100872, China
| | - Hongchuan Wang
- School of Public Policy & Management, Tsinghua University, No. 30 Shuangqing Road, Haidian, Beijing 100084, China
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Kim J, Yoon H. Longitudinal Associations Between Expectations of Receiving Care in the Future and Life Satisfaction Among Older Adults in Korea. J Gerontol B Psychol Sci Soc Sci 2021; 77:604-614. [PMID: 34192320 DOI: 10.1093/geronb/gbab121] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Uncertainty about receiving care and assistance in the future has been increasing among older adults in Korea. This study examines whether expectations about receiving care from various sources (i.e., formal and/or filial caregivers) are related to life satisfaction among older adults in Korea. METHODS Using data from the Korean Longitudinal Study of Ageing (N = 3,607, aged 65 or older), this study estimated fixed effects regression models to investigate longitudinal within-person associations between future care expectations and life satisfaction. RESULTS The results of this study revealed that developing expectations of care from family caregivers is positively associated with life satisfaction. Beginning to expect care from non-family caregivers, however, is not associated with life satisfaction. When disaggregating different sources of care by family member type, expecting care from a spouse or daughter(s), but not son(s), is associated with higher life satisfaction. Gender-specific analyses showed that expecting care from daughter(s) is positively associated with life satisfaction among both men and women, whereas expectations of spousal care are associated with only men's life satisfaction. This study also found suggestive but not conclusive evidence that an association between care expectations from family caregivers and life satisfaction is stronger among older adults with lower education. DISCUSSION Reducing uncertainty about future care may improve older adults' subjective well-being. Policymakers may consider policies and programs that support family care of the aged, and more fundamentally, encourage family involvement in the lives of older people.
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Affiliation(s)
- Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea.,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.,Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Heesoo Yoon
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
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Influence of socio-economic profile of neighbourhoods on the selection of home care strategies for older dependants. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Care strategies for older dependants are determined by not only individuals or network characteristics, but also contextual factors. The objective of this study is to determine whether urban contexts (neighbourhoods) are linked to the use of family care (informal), public services or private care at home (formal). We applied logistic regression analysis to data from the Survey of People in a Situation of Dependence 2018. The sample was composed of 530 older people (55 years old and over) living in two types of socio-economic groups of neighbourhoods in Barcelona, Spain. The type of neighbourhood is relevant in explaining the home care that older dependants receive. In neighbourhoods with a high socio-economic level, dependants are more likely to use private services and less likely to use informal care services and public services, even after controlling for household income, degree of dependency, sex, age and the number of people in the household. Understanding the factors that determine the use of public care services, private care services or family care-giving is important due to the increment in the number of older people in the population. Our results suggest that differences in urban socio-economic contexts determine some inequalities in the use of services even after controlling for socio-economic individual differences. The characteristics of neighbourhoods should be considered to adjust care policies for older dependants.
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Mansour A, Sirichotiratana N, Viwatwongkasem C, Khan M, Srithamrongsawat S. District division administrative disaggregation data framework for monitoring leaving no one behind in the National Health Insurance Fund of Sudan: achieving sustainable development goals in 2030. Int J Equity Health 2021; 20:5. [PMID: 33407542 PMCID: PMC7789368 DOI: 10.1186/s12939-020-01338-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 11/30/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The aim of this study is to monitor the concept of 'leaving no one behind' in the Sustainable Development Goals (SDGs) to track the implications of the mobilization of health care resources by the National Health Insurance Fund (NHIF) of Sudan. METHODS A cross-sectional study was used to monitor 'leaving no one behind' in NHIF by analyzing the secondary data of the information system for the year 2016. The study categorized the catchment areas of health care centers (HCCS) according to district administrative divisions, which are neighborhood, subdistrict, district, and zero. The District Division Administrative Disaggregation Data (DDADD) framework was developed and investigated with the use of descriptive statistics, maps of Sudan, the Mann-Whitney test, the Kruskal-Wallis test and health equity catchment indicators. SPSS ver. 18 and EndNote X8 were also used. RESULTS The findings show that the NHIF has mobilized HCCs according to coverage of the insured population. This mobilization protected the insured poor in high-coverage insured population districts and left those living in very low-coverage districts behind. The Mann-Whitney test presented a significant median difference in the utilization rate between catchment areas (P value < 0.001). The results showed that the utilization rate of the insured poor who accessed health care centers by neighborhood was higher than that of the insured poor who accessed by more than neighborhood in each state. The Kruskal-Wallis test of the cost of health care services per capita in each catchment area showed a difference (P value < 0.001) in the median between neighborhoods. The cost of health care services in low-coverage insured population districts was higher than that in high-coverage insured population districts. CONCLUSION The DDADD framework identified the inequitable distribution of health care services in low-density population districts leaves insured poor behind. Policymakers should restructure the equation of health insurance schemes based on equity and probability of illness, to distribute health care services according to needs and equity, and to remobilize resources towards districts left behind.
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Affiliation(s)
- Ashraf Mansour
- Department of Public Health Administration, Faculty of Public Health, Mahidol University, Bangkok, 10400 Thailand
| | - Nithat Sirichotiratana
- Department of Public Health Administration, Faculty of Public Health, Mahidol University, Bangkok, 10400 Thailand
| | - Chukiat Viwatwongkasem
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Mahmud Khan
- Arnold School of Public Health, University of South Carolina, Columbia, USA
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21
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Sadowska A, Wyczalkowska-Tomasik A, Zegarow P, Czarkowska-Paczek B. Depression But Not Inflammatory Markers Are Increased in Family Versus Nonfamily Caregivers of Persons With Dementia. J Geriatr Psychiatry Neurol 2021; 34:29-36. [PMID: 31996080 DOI: 10.1177/0891988720901782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We investigated quality of life (WHOQoL-BREF), perceived stress (PSS-10), anxiety and depression (HADS-M), life satisfaction (SWLS), and serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), and cortisol in family caregivers (n = 94) and professional caregivers (n = 48) of demented patients, as well as among noncaregivers (n = 30). Compared with professional caregivers, family caregivers had higher scores in HADS-M depression (P = .003) and anxiety (P = .033), lower life satisfaction (P = .04), and lower quality of life in psychological (P = .02) and social relationship (P = .03) domains. There were no differences in serum levels of IL-6, CRP, or cortisol between caregivers and control participants. In multivariable analysis, when family relationship was considered together with the time period of caregiving and results of the Mini-Mental State Examination test in care recipients (n = 118, 12.49 ± 7.99), only family relationship influenced scores in HADS-M depression (P = .004), SWLS scores (P = .011), and WHOQoL-BREF scores in psychological (P = .011) and social relationship (P = .008) domains. In conclusion, family caregivers are more stressed and have deeper depressive and anxiety disorders, lower life satisfaction, and lower quality of life than professional caregivers.
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Affiliation(s)
- Anna Sadowska
- Department of Clinical Nursing, 37803Medical University of Warsaw, Warsaw, Poland
| | | | - Pawel Zegarow
- Department of Gerontology, Public Health and Didactics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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Jakubowska K, Wysokiński M, Chruściel P. Place of Residence and Marital Status as Variables Differentiating a Sense of Self-Efficacy in the Elderly-A Descriptive Cross-Sectional Survey. Healthcare (Basel) 2020; 8:healthcare8030300. [PMID: 32858817 PMCID: PMC7551759 DOI: 10.3390/healthcare8030300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Studies on the self-efficacy of the elderly are still being conducted to a very limited extent. Nevertheless, they can provide relevant information for specialists to use in many disciplines of science, as well as for practitioners, especially gerontologists, geriatricians, psychologists and other people associated with prophylaxis and health promotion. The aim of the study is to assess the impact of the place of residence and marital status on the self-efficacy in the elderly. Methods: A diagnostic survey method was used for the study and within the method, the authors' sociodemographic data questionnaire and the generalized self-efficacy scale (GSES) were applied. The study was carried out in a group of 171 females and 130 males under nursing care in the home environment or in nursing-home care in Poland. Results: The average level of generalized sense of self-efficacy in the research cohort was M = 26.69, SD = 8.49. A relatively high percentage of the group (48.9%) showed a sense of self-efficacy at a high level. The level of a sense of self-efficacy was low in 38.2% of the cohort, while its average intensity in the remaining ones constituted 12.9% of the total. A statistically significant impact of a place of residence (Z = -2.940; p = 0.003) and marital status (H = 12.000; p = 0.007) on the sense of efficacy in the research cohort was proven in favor of those from the rural environment and the respondents having spouses. Conclusions: On the scale of the studied group, the results of a sense of self-efficacy are optimistic, as older people with high levels predominated. However, the results of the cohort whose self-efficacy is insufficient to cope with their old age should be considered carefully, especially in the case of lonely people living in the urban environment and NHC (nursing-home care) residents.
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Zhang W, Sun H. Formal and informal care received by middle-aged and older adults with chronic conditions in Canada: CLSA data. PLoS One 2020; 15:e0235774. [PMID: 32634161 PMCID: PMC7340302 DOI: 10.1371/journal.pone.0235774] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/23/2020] [Indexed: 11/19/2022] Open
Abstract
Background Middle-aged and older adults are more likely to suffer from chronic conditions, which can increase their need for both formal and informal care. This study seeks to assess and compare the extent to which the use of formal and informal care is attributed to different chronic conditions among middle-aged and older women and men in Canada. Methods We used baseline data from the Canadian Longitudinal Study on Aging (CLSA). Outcomes of interest were the number of hours of formal care and informal care received during the past 12 months. All chronic conditions were first classified according to existing classification frameworks. If total formal and informal care hours for a particular condition differed greatly from other conditions, we considered it as a stand-alone classification. We used a two-part model consisting of a logistic regression for the probability of receiving formal/informal care and a generalized linear model for the hours of formal/informal care for those who received care. Results Our final analytic sample was 23,206 women and 22,903 men who did not have missing data. Among the 16 chronic conditions considered, multiple sclerosis, memory problems, Parkinsonism, and stroke had the greatest average marginal effects on overall hours of formal care among women (53.07, 13.95, 9.13 and 8.14 incremental hours annually, respectively) and men (152.17, 8.13, 13.95 and 6.00 incremental hours). Similarly, the average marginal effects of these four conditions on informal care were the greatest (77.78, 29.52, 26.18 and 34.95 incremental hours for women and 133.94, 34.99, 104.86 and 17.85 incremental hours for men). Conclusions Chronic conditions, especially multiple sclerosis, Parkinsonism, memory problems, and stroke, are associated with substantial time of formal and informal care in middle-aged and older women and men. Findings will help decision-makers assess the potential impact of chronic disease prevention and management programs in an aging population.
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Affiliation(s)
- Wei Zhang
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
- * E-mail:
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
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Awuviry-Newton K, Wales K, Tavener M, Byles J. Do factors across the World Health Organisation's International Classification of Functioning, Disability and Health framework relate to caregiver availability for community-dwelling older adults in Ghana? PLoS One 2020; 15:e0233541. [PMID: 32469915 PMCID: PMC7259767 DOI: 10.1371/journal.pone.0233541] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/25/2020] [Indexed: 01/15/2023] Open
Abstract
Introduction In Ghana, the care needs of older adults in the later years has become a critical issue given population ageing and increased proportions of older adults with difficulties with functional abilities. However, factors related to caregiver availability is unknown. The purpose of this study was to examine how the World Health Organisation’s International Classification of Functioning, Disability and Health (WHO-ICF) framework relates to caregiver availability for community-dwelling older adults in Ghana. This evidence will strengthen our understanding of the perceived unmet care needs of older adults in Ghana in Africa. Materials and methods A hospital-based survey was conducted among 400 consecutively recruited older adult in-patients using a questionnaire at Komfo Anokye Teaching Hospital in southern Ghana. Multivariate logistic regression tested associations between caregiver availability and other factors as related to the WHO-ICF conceptual framework. Results Eighty-six per cent of the participants reported having an available caregiver. In the final parsimonious model, the environmental factors were highly related to caregiver availability, seconded by personal factors, and then health conditions. Body function and structure, activity, and participation variables were not statistically significant. Overall, the variables that were associated with caregiver availability were age, being a widow, having a single chronic condition, being hardly understood by friends and family, receiving no neighbourhood support, and having 2–4 children. Interaction existed between being a widow and living as a couple in relation to caregiver availability. Conclusions Caregiver availability is associated with variables under the personal, health and environmental components of the WHO-ICF. Increased effort to strengthen the current and future welfare programs, including the health of older adults and their caregivers is relevant.
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Affiliation(s)
- Kofi Awuviry-Newton
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- * E-mail:
| | - Kylie Wales
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- School of Health Sciences, The University of Newcastle, Newcastle, Australia
| | - Meredith Tavener
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Julie Byles
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
- Global Innovation Chair in Responsive Transitions in Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Live Discharge From Hospice Due to Acute Hospitalization: The Role of Neighborhood Socioeconomic Characteristics and Race/Ethnicity. Med Care 2020; 58:320-328. [PMID: 31876664 DOI: 10.1097/mlr.0000000000001278] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Acute hospitalization is a frequent reason for live discharge from hospice. Although risk factors for live discharge among hospice patients have been well documented, prior research has not examined the role of neighborhood socioeconomic characteristics, or how these characteristics relate to racial/ethnic disparities in hospice outcomes. OBJECTIVE To examine associations between neighborhood socioeconomic characteristics and risk for live discharge from hospice because of acute hospitalization. The authors also explore the moderating role of race/ethnicity in any observed relationship. RESEARCH DESIGN Retrospective cohort study using electronic medical records of hospice patients (N=17,290) linked with neighborhood-level socioeconomic data (N=55 neighborhoods). Multilevel models were used to identify the independent significance of patient and neighborhood-level characteristics for risk of live discharge because of acute hospitalization. RESULTS Compared with the patients in the most well-educated and affluent sections of New York City [quartile (Q)4], the odds of live discharge from hospice because of acute hospitalization were greater among patients who resided in neighborhoods where lower proportions of residents held college degrees [Q1 adjusted odds ratio (AOR), 1.36; 95% confidence interval (CI), 1.06-1.75; Q2 AOR, 1.41; 95% CI, 1.07-1.84] and median household incomes were lower (Q1 AOR, 1.42; 95% CI, 1.10-1.85; Q2 AOR, 1.43; 95% CI, 1.10-1.85; Q3 AOR, 1.39; 95% CI, 1.07-1.80). However, these observed relationships were not equally distributed by patient race/ethnicity; the association of neighborhood socioeconomic disadvantage and risk for live discharge was significantly lower among Hispanic compared with white patients. CONCLUSIONS Findings demonstrate neighborhood socioeconomic disadvantage poses a significant risk for live discharge from hospice. Additional research is needed to clarify the social mechanisms underlying this association, including greater attention to the experiences of hospice patients from under-represented racial/ethnic groups.
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