The care types choice in filial culture: A cross-sectional study of disabled elderly in China

The impact of information technology applications on the quality of life of disabled older adults in nursing homes in China: a qualitative study

Objective

China's smart aging policy system has been evolving to become more comprehensive, continuously promoting the application of information technology in nursing homes. This study explores the adaptation process and experiences of disabled older adults with the use of information technology in nursing homes from four perspectives: physiological, psychological, social, and environmental, and examines its impact on their quality of life.

Methods

An interpretative phenomenological approach was adopted, with purposive sampling used to recruit participants. Semi-structured interviews were conducted with 14 disabled older adults, and the data were analyzed using Van Manen's phenomenology of practice method.

Results

Four main themes and 16 sub-themes were identified: Physical Health and Functional Capacity: subjective health perception, physical functioning, chronic disease management, sleep quality, and nutritional status; Psychological Wellbeing and Emotional Support: attitudes toward aging, negative emotions, emotional companionship, and sense of meaning in life; Social Relationships and Social Engagement: interactions with family and friends, participation in social activities, social roles, and social support; and Environmental Adaptation and Digital Challenges: safety and comfort of the living environment, ease of independent mobility, the 'digital divide', and protection of personal privacy and data.

Conclusion

The application of information technology in nursing homes in China has partially resolved longstanding issues in traditional older adults care, such as inaccurate health management, lack of personalized and diverse services, and inefficient resource allocation. These advancements have contributed to improving the quality of life for older adults in nursing homes. However, new challenges have emerged, including the 'digital divide,' data misuse, and privacy breaches. To fully leverage the benefits of information technology, it is crucial to enhance the digital literacy of disabled older adults, provide robust technical support during implementation, and prioritize data security and privacy protection. These measures will help maximize the positive effects of information technology on the quality of life of disabled older adults.

Analysis of promotion and obstacles in long-term care grading services for home-based older adults with disabilities in China

Long-term care (LTC) grading services refers to professional assessors using specific tools to systematically evaluate people with long-term care needs,develop and implement graded service standards that align with the care needs of individuals based on their varying levels of disability.It has been nearly a decade since China initiated home-based long-term care for the disabled elderly; however, challenges remain, such as the lack of detailed graded service standards and inadequate allocation of medical and nursing resources. This study aimed to gain insights into factors about influencing the current system by understanding the perspectives of those directly involved in providing care and to promote LTC services for older adults with disabilities in China.Using purposive sampling, nurses and certified nursing assistants were selected as participants for this qualitative study. Data were analysed using deductive method, guided by the Association Standard for Long-Term Care Grading Services for the Elderly, the Consolidated Framework for Implementation Research, and the Capability, Opportunity, and Motivation-Behavior (COM-B) model.This study identifies five themes-innovation, external and internal environmental factors, personal characteristics, and implementation process-along with five promoting and six obstacle factors. It explores nurses and certified nursing assistants perspectives on home-based long-term care grading for individuals with disabilities, offering a theoretical basis for a Chinese-specific long-term care model.

Can Informal Care Be a Substitute for Formal Care? Evidence from Older People with Disabilities in Beijing, China

BACKGROUND

The demand for long-term care is increasing as the elderly population continues to grow, prompting a critical examination of care modalities.

METHODS

This study employs data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to assess the relationship between informal and formal care for older people with disabilities in Beijing. The analysis employs the Probit model and incorporates the application of instrumental variable techniques and propensity score matching to ensure robustness in the results.

RESULTS

The findings highlight the important role of informal care.

CONCLUSIONS

Policymakers should incorporate support policies for informal care into the overall design of the system, provide support to informal caregivers, and reduce their burden. Our research conclusions provide empirical reference for cities with similar characteristics to Beijing.

Relationship Between Primary Caregiving Type and a Peaceful End-Of-Life Experience Among Older Adults in China

Few studies have compared pain management provided by informal and formal caregivers of older adults in China at the end of life. This study aims to address this gap by investigating the association between formal and informal care and painfulness at the end of life among older adults in China. Specifically, the study focuses on the influence of various types of informal care. Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 2002 to 2018, which is the largest nationally representative study of older adults in China, with a sample size of 21,849 deceased participants. Results from multiple logistic regressions suggest that informal care is associated with a more painful end-of-life experience compared to formal care, with care provided by adult children being a more favorable option within informal care. These findings underscore the urgent need to prioritize education on death and dying, improve the formal care system, and enhance professionalism within informal care.

Latent profile analysis of benefit finding among family caregivers of Chinese older adults with disabilities and its influencing factors

OBJECTIVES

The increase in the number of older adults with disability creates new challenges for caregivers. Benefit finding is the positive experience that caregivers get from caregiving, helping to reduce the negative impact on the caregiver's quality of life. However, there is less research on the positive experiences of family caregivers of older adults with disabilities. This study aimed to identify different benefit finding profiles among family caregivers of older adults with disabilities in China and to explore the sociodemographic characteristics and psychosocial factors with different benefit finding profiles.

METHODS

A cross-sectional study of 218 family caregivers of Chinese older adults with disabilities using the sociodemographic questionnaire, the Family-APGAR, the Sense of Coherence-13, the Emotion Regulation Scale and Benefit Finding Scale from October 2022 to June 2023 in communities and hospitals of China, Shenyang, Liaoning Province. Latent profile analysis was used to analyze the latent profiles of benefit finding among family caregivers of Chinese older adults with disability. Multiple logistic regression was used to explore the predictors of different profiles.

RESULTS

The benefit finding among family caregivers of Chinese older adults with disability can be classified into three potential profiles: Profile 1 - high-level benefit finding group (12.84%), Profile 2 - medium-level benefit finding group (43.58%), Profile 3 - low-level benefit finding group (43.58%). Working status, family function, and cognitive reappraisal of caregiver were predictors of different profiles.

CONCLUSIONS

Nurses and community health care staffs should pay attention to the characteristics, family function, and emotion regulation strategies of family caregivers of older adults with different disability. Help family caregivers enhance family cohesion and cognitive reappraisal to improve positive experiences for caregivers in different profiles.

Choice of formal and informal care among community-dwelling older people with or without dementia under a long-term care insurance pilot program in China

OBJECTIVE

This study examines the use of publicly funded formal and informal care among community-dwelling long-term care insurance (LTCI) beneficiaries in China and how dementia differentiates the choice of care.

METHODS

Using administrative data from a LTCI pilot scheme in Guangzhou (n = 2043), we conducted a multinomial logistic regression to examine the association between dementia and the choice of family members (informal unpaid care), domestic helpers (informal paid care) and care workers (formal care), controlling for demographics, living environment and intensity of paid care hours.

RESULTS

Most LTCI beneficiaries chose a family member (65%), followed by a domestic helper (21%) and a care worker (14%). After controlling for covariates, LTCI beneficiaries with dementia were more likely than their counterparts without dementia to choose care provided by a care worker (RRR: 1.73) or a living-in helper (RRR: 1.43) than a family member.

CONCLUSIONS

A preference for informal care was observed among LTCI beneficiaries in China. Those with dementia were more likely than those without dementia to use care provided by non-family caregivers. The pilot scheme findings provide further insight into care recipients' preferences for service utilisation and how dementia impacts these preferences, which should be considered in future policy and service provision.

The impact of basic pension for urban and rural residents on the subjective well-being of the older adult in Chinese rural areas

Introduction

As an important component of the social security system, basic pension insurance for urban and rural residents is expected to improve the quality of life of rural older adult people and make their lives better and happier. This article mainly studies the relationship between the basic pension for urban and rural residents and the subjective well-being of older adult people in rural China.

Methods

This paper uses data from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2018 and 2020. It selected samples of rural older adult people aged 60 and above, ultimately obtaining 9,310 samples. The impact of the basic pension for urban and rural residents on the subjective well-being of rural older adult people was estimated by constructing Ordinary Least Squares (OLS) estimation methods and ordered logistic regression models. The robustness of the results was verified by changing the regression methods, and the samples were divided into different groups for heterogeneity analysis according to three different standards.

Results

The results show that the basic pension for urban and rural residents significantly improves the life satisfaction of rural older adult, reduces their degrees of depression, and thereby enhances their subjective well-being. The impact of the basic pension for urban and rural residents is more significant for older adult individuals in areas with a higher gender ratio, those suffering from chronic diseases, and those in the eastern regions of the country. Further verification indicates that the basic pension for urban and rural residents enhances the subjective well-being of the rural older adult by improving their health status and reducing their labor supply.

Discussion

Most of the existing research on basic pension insurance for urban and rural residents and subjective well-being has been conducted from the perspective of whether individuals are enrolled in the pension scheme or whether they received a pension. However, there are few studies analyzing from the perspective of the amount of pension benefits received by residents. The results of this study help to enrich the research perspective on the basic pension insurance system for urban and rural residents in China and expand the understanding of the impact and value of the basic pension for urban and rural residents.

The influence of different sources of anticipated instrumental support on depressive symptoms in older adults

Objective

This study investigated how anticipated instrumental support sources and intergenerational support influence depressive symptoms in older Chinese adults.

Methods

We employed binary logistic regression on data from 7,117 adults aged ≥60 in the 2018 China Health and Retirement Longitudinal Study, controlling for gender, marital status, and self-rated health.

Results

38.89% of respondents exhibited depressive symptoms. Anticipated support from spouse and children, spouse only, children only, or other sources showed 52, 25, 46, and 40% lower odds of depression, respectively, compared with no anticipated support. Those providing financial support had 36% higher odds of depression than those without exchanges. However, those receiving financial support, receiving instrumental support, and receiving and providing financial and emotional support had 19, 14, 23, and 24% lower odds of depression.

Conclusion

Different anticipated instrumental support sources and intergenerational support influenced depression odds in older adults, suggesting potential benefits in promoting such support systems.

Study on the time and scale of mutual aid for aging care under the background of active aging

Background

China has entered an aging society and will likely become the fastest-aging country in the world. The demand for aging care services has greatly increased. In recent years, the model of mutual aid for aging care has met the needs of older adults, especially those in rural areas. In this case, how much time should be spent on mutual aid for the older adult in terms of time and how much influence the size of the group has in terms of space are two very important questions when studying mutual aid for aging care.

Methods

An overlapping generations model is built in this article, which includes representative agents, representative enterprises, the endowment insurance system constructed by the government, and the behavior of representative agents in mutual aid for aging care under the background of active aging.

Results

In the base case, the optimal proportion of time to participate in the mutual aid group is 9.31%, and the optimal proportion of time is influenced by the benchmark time of care and the size of the care group. With the increase in the benchmark time of care, the optimal proportion of time increases correspondingly, but the increase is decreasing. With the increase in the size of the care group, the optimal proportion of time decreases, but after the size reaches 4 or 5, the impact becomes very small. When parents' psychological preference coefficient changes from 0.1 to 0.9, that is, when parents change from introverted to extroverted personalities, the optimal proportion of time and parents' utility will also change.

Conclusion

For children who usually take care of their parents for a long benchmark time, the optimal time to participate in the mutual aid group based on personal utility maximization is also long. Second, as the size of the group increases, the time for representative agents to participate in the mutual aid group gradually decreases. In addition, the model of mutual aid for aging care is highly correlated with parents' personalities, and extrovert parents benefit more from this model.

Challenges and coping experiences faced by nursing staff in long-term care facilities in China: a qualitative meta-analysis

Objective

The aim of this study is to discern the challenges and coping experiences encountered by nursing staff in long-term care facilities in China. This will be achieved through the identification, evaluation, and qualitative synthesis of comprehensive data.

Design

This is a qualitative meta-analysis.

Methods

The research systematically examined relevant literature sourced from six databases, concluding the search in August 2023. The inclusion criteria encompassed qualitative and mixed-methods studies in both Chinese and English, focusing on challenges faced by nursing staff in long-term care facilities and their corresponding coping strategies. The application of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework facilitated the qualitative meta-integration process. Three independent researchers meticulously screened and assessed the quality of the chosen studies. The synthesis process sought to amalgamate and structure analogous findings into novel categories through multiple readings of the original literature. These categories were subsequently distilled into comprehensive themes.

Results

Analyzed 15 articles revealed 14 sub-themes and 4 overarching analytical themes. These encompassed Sources of Challenges such as multitasking, clinical emergencies, workplace conflict, demand exceeding resources, and occupational discrimination. Psychological impacts included suppressed emotion, compassion fatigue, and self-doubt. Practical consequences involved damaged health, imbalanced life, and occupational disappointment. Coping strategies identified were self-adjusting, feeling validation and belonging, and finding support.

Conclusion

Our research identified the challenges faced by nursing staff in Chinese long-term care facilities and their coping experiences. We found that most challenges could be mitigated through appropriate adjustments in managerial strategies, such as reasonable human resources planning, and providing resource support, including material, emotional, and informational support. Similarly, institutions should have offered necessary emotional and psychological support to nursing staff to overcome the negative impacts of challenges and encourage them to adopt positive coping strategies.