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Pan Q, Hu J, Yangzong, Zhang X, Zhaxidawa. Factors Associated with Elderly Health-Related Quality of Life in Tibet: A Cross-Sectional Study from a Health Ecological Perspective. J Multidiscip Healthc 2024; 17:177-190. [PMID: 38292921 PMCID: PMC10825583 DOI: 10.2147/jmdh.s436486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/16/2023] [Indexed: 02/01/2024] Open
Abstract
Background Aging and its consequences are receiving considerable global attention in developed and developing countries. The health-related quality of life (HRQoL) of elderly individuals is crucial for public health and social welfare. Despite advances in understanding the health status of the elderly population in Tibet, a region located on China's southwest border, a significant research gap remains regarding their HRQoL. Methods We conducted a cross-sectional study in Tibet, China, in 2018, which thoroughly examined HRQoL and its determinants in individuals aged 60 and above. The EQ-5D-VAS instrument, consisting of two standardized scales (EQ-5D-3L and EQ-VAS), was utilized to measure HRQoL. We based the selection of potential determinants on a novel health ecological model encompassing various environmental and personal factors. We employed the Least Absolute Shrinkage and Selection Operator regression to systematically pinpoint key predictive factors for dimensionality reduction. The Tobit regression analysis further elucidated the relationship between these factors and the EQ-VAS and EQ-5D-index scores. Results Our study encompassed 1604 elderly participants. They presented varying severity levels across all five dimensions of the EQ-5D-3L. The most commonly observed issue was pain/discomfort, with a prevalence of 40.27%. The average EQ-VAS score was 56.15 (SD=21.15), and the mean EQ-5D-index score was 0.78 (SD=0.25). Our multivariate analysis revealed that determinants such as age, sex, number of chronic illnesses, vision problems, hearing problems, physical activity, employment status, social participation, place of residence, and insurance type were significantly associated with HRQoL. Conclusion The HRQoL of Tibet's elderly population presents significant concerns, especially given the region's challenging natural conditions. This underscores the urgent need for focused policy interventions at the socio-economic strata to extend vital support and aid.
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Affiliation(s)
- Qiuyu Pan
- Medical College of Tibet University, Lhasa, Tibet, 850000, People’s Republic of China
- School of Public Health, North Sichuan Medical College, Nanchong, Sichuan, 610037, People’s Republic of China
| | - Jun Hu
- Medical College of Tibet University, Lhasa, Tibet, 850000, People’s Republic of China
- School of Management, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250355, People’s Republic of China
| | - Yangzong
- Medical College of Tibet University, Lhasa, Tibet, 850000, People’s Republic of China
| | - Xiuling Zhang
- The Hospital of Shandong Normal University, Jinan, Shandong, 250014, People’s Republic of China
| | - Zhaxidawa
- Medical College of Tibet University, Lhasa, Tibet, 850000, People’s Republic of China
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Wu S, Du S, Feng R, Liu W, Ye W. Behavioral deviations: healthcare-seeking behavior of chronic disease patients with intention to visit primary health care institutions. BMC Health Serv Res 2023; 23:490. [PMID: 37189156 DOI: 10.1186/s12913-023-09528-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/10/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Although primary health care (PHC) has been proven to be effective in preventing and treating chronic diseases, the visits rate of PHC institutions is still not ideal. Some patients initially express a willingness to visit PHC institutions but end up seeking health services at non-PHC institutions, and the reasons for this behavior remain unclear. Therefore, the objective of this study is to analyze the factors that contribute to behavioral deviations among chronic disease patients who originally intended to visit PHC institutions. METHODS Data were collected from a cross-sectional survey among chronic disease patients with original intention to visit PHC institutions in Fuqing City, China. The analysis framework was guided by Andersen's behavioral model. Logistic regression models were employed to analyze the factors affecting the behavioral deviations among chronic disease patients with a willingness to visit PHC institutions. RESULTS A total of 1,048 individuals were finally included and about 40% of the participants with the original willingness to seek care from PHC institutions finally chose non-PHC institutions in their subsequent visits. The results of logistic regression analyses indicated that at the predisposition factor level, older participants (aOR60-69 = 0.602, P < 0.01; aOR70-75 = 0.475, P < 0.01) were less likely to have behavioral deviations. At the enabling factor level, compared to those covered by Urban Employee Basic Medical Insurance (UEBMI) and not reimbursed, those covered by Urban-Rural Resident Basic Medical Insurance (URRBMI) (aOR = 0.297, P < 0.01), and those answering that reimbursement from medical institutions was convenient (aOR = 0.501, P < 0.01) or very convenient (aOR = 0.358, P < 0.001) were less likely to have behavioral deviations. At the need factor level, participants who visited PHC institutions due to illness last year (aOR = 0.348, P < 0.001) and with polypharmacy (aOR = 0.546, P < 0.01) were less likely to have behavioral deviations compared to those without the visit of PHC institutions and not taking polypharmacy, respectively. CONCLUSIONS The deviations between the original willingness of PHC institution visits and subsequent behavior among chronic disease patients were associated with a number of predisposing, enabling, and need factors. Developing the health insurance system, strengthening the technical capacity of PHC institutions, and steadily developing a new concept of orderly healthcare-seeking behavior among chronic disease patients, will help promote their access to PHC institutions as well as improve the effectiveness of the tiered medical system for chronic disease care.
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Affiliation(s)
- Shiyin Wu
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou, Fujian, China
| | - Shanshan Du
- School of Public Health, Fujian Medical University, 1 Xuefubei Road, Minhou District, Fuzhou, 350122, China
| | - Ruimei Feng
- School of Public Health, Fujian Medical University, 1 Xuefubei Road, Minhou District, Fuzhou, 350122, China
| | - Wenbin Liu
- Department of Health Management, School of Health Management, Fujian Medical University, Fuzhou, Fujian, China.
| | - Weimin Ye
- School of Public Health, Fujian Medical University, 1 Xuefubei Road, Minhou District, Fuzhou, 350122, China.
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Ohta R, Sano C. The Effectiveness of Family Medicine-Driven Interprofessional Collaboration on the Readmission Rate of Older Patients. Healthcare (Basel) 2023; 11:healthcare11020269. [PMID: 36673637 PMCID: PMC9859164 DOI: 10.3390/healthcare11020269] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Interprofessional collaboration (IPC) for older patient care among family physicians, dentists, therapists, nutritionists, nurses, and pharmacists in the rural hospital care of older patients could improve the hospital readmission rate. However, there is a lack of interventional studies on IPC for improving the readmission rate among Japanese older patients in rural hospitals. This quasi-experimental study was performed on patients >65 years who were discharged from a rural community hospital. The intervention was IPC implementation with effective information sharing and comprehensive management of older patients’ conditions for effective discharge and readmission prevention; implementation started on 1 April 2021. The study lasted 2 years, from 1 April 2021 to 31 March 2022 for the intervention group and from 1 April 2020 to 31 March 2021 for the comparison group. The average participant age was 79.86 (standard deviation = 15.38) years and the proportion of men was 45.0%. The Cox hazard model revealed that IPC intervention could reduce the readmission rate after adjustment for sex, serum albumin, polypharmacy, dependent condition, and Charlson Comorbidity Index score (hazard ratio = 0.66, 95% confidence interval: 0.54−0.81). Rural IPC intervention can improve inpatient care for older patients and decrease readmission rates. Thus, for effective rural IPC interventions, family physicians in hospitals should proactively collaborate with various medical professionals to improve inpatient health outcomes.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 699-1221 96-1 Iida, Daito-cho, Unnan 699-1221, Japan
- Correspondence: ; Tel.: +81-90-5060-5330
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo 693-8501, Japan
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Ohta R, Katsube T, Sano C. Challenges in Help-Seeking Behaviors among Rural Older People Mitigated through Family Physician-Driven Outreach: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17004. [PMID: 36554886 PMCID: PMC9779724 DOI: 10.3390/ijerph192417004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Help-seeking behaviors (HSBs) refer to approaches taken by individuals towards their health and symptoms, and they are supported by healthcare professionals. Outreach interventions aimed at older people in rural communities can mitigate difficulties in implementing HSBs and help them remain healthy. This systematic review investigated evidence regarding family medicine-involved outreach aimed at HSBs among older individuals in rural areas. We searched three databases (PubMed, EMBASE, and Web of Science) for international and original interventional articles regarding family physicians involved in outreach to older people in rural or underserved areas between April 2000 and October 2022. The articles were analyzed and summarized based on the setting, country, health issues, and outreach outcomes. Of the 376 studies identified, four were included in this review. Our findings showed that family physician-involved outreach to rural and underserved areas improved health outcomes, including anxiety, subjective physical function, and diabetic care. The challenges of outreach interventions include the duration and continuity of outreach, the active participation of family physicians and patients in the outreach programs, and the focus of outreach participants. Although the number of studies included was small, family physician-involved outreach to rural and underserved areas was shown to improve various health outcomes.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| | - Takuji Katsube
- Community Care, Unnan City Hospital, Unnan 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo 690-0823, Japan
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Qin S, Liang J, Tang D, Chen Y, Duan R, Lu X, Bukai A, Zheng X, Lv D, He Z, Wu W, Han H, Jing H, Wang X. Serological investigation of plague and brucellosis infection in Marmota himalayana plague foci in the Altun Mountains on the Qinghai-Tibet Plateau. Front Public Health 2022; 10:990218. [PMID: 36466443 PMCID: PMC9716105 DOI: 10.3389/fpubh.2022.990218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
The Altun Mountains are among the most active regions of Marmota himalayana plague foci of the Qinghai-Tibet Plateau where animal plague is prevalent, whereas only three human cases have been found since 1960. Animal husbandry is the main income for the local economy; brucellosis appears sometimes in animals and less often in humans. In this study, a retrospective investigation of plague and brucellosis seroprevalence among humans and animals was conducted to improve prevention and control measures for the two diseases. Animal and human sera were collected for routine surveillance from 2018 to 2021 and screened for plague and brucellosis. Yersinia pestis F1 antibody was preliminarily screened by the colloidal gold method at the monitoring site to identify previous infections with positive serology. Previous plague infection was found in 3.2% (14/432) of the studied human population having close contact with livestock, which indicates evidence of exposure to the Yersinia antigen (dead or live pathogenic materials) in the Altun Mountains. Seroprevalence of brucellosis was higher in camels (6.2%) and sheepdogs (1.8%) than in other livestock such as cattle and sheep, suggesting a possible transmission route from secondary host animals to humans.
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Affiliation(s)
- Shuai Qin
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Junrong Liang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Deming Tang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuhuang Chen
- Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Ran Duan
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinmin Lu
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Asaiti Bukai
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Xiaojin Zheng
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Dongyue Lv
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaokai He
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weiwei Wu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haonan Han
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huaiqi Jing
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China,*Correspondence: Xin Wang
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Song J, Jin C, Cheng X. The association between cigarette smoking and health care service utilization among middle-aged and elderly adults in China. Front Public Health 2022; 10:952357. [PMID: 36408002 PMCID: PMC9667111 DOI: 10.3389/fpubh.2022.952357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
Objective To assess the associations between tobacco use and health care service utilization in Chinese individuals aged more or equal to 40 years old. Method This research was a cross-sectional study using data from eight provinces in China, and the final sample consisted of 4,733 observations (4,749 participants) aged more or equal to 40 years old. The dependent variable was health care utilization measured by outpatient and inpatient service utilization. Descriptive statistics were used to summarize the socio-demographic characteristics of the sample according to smoking status. The association between tobacco use and health care service utilization was examined by an instrumental variable (IV) probit model. Results Of the respondents interviewed in 2020, 3,116 (65.84%) were never smokers, 654 (13.82%) were smokers with the smoking index (SI) <400, and 963(20.34%) were smokers with SI≥400. Smokers with SI <400 reported a 6.80% higher probability of using outpatient services. Smokers with SI <400 and SI≥400 reported a 3.10 and 4.20% higher average probability of using ≥3 outpatient visits than never smokers, respectively. Additionally, smokers with SI <400 and SI≥400 reported a 6.30 and 6.20% higher average probability of using inpatient services than those who had not smoked. Moreover, smokers with SI≥400 were more likely to have had ≥2 hospital visits than nonsmokers. Conclusions Smokers make greater use of health care services. Control of smoking may ease the burden of related health care utilization.
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Affiliation(s)
- Jiarui Song
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chenggang Jin
- Research Center for Health and Social Policy, Beijing Normal University, Zhuhai, China
| | - Xi Cheng
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China,*Correspondence: Xi Cheng
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7
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Ohta R, Sano C. Associations between Perception of Help-Seeking Behaviors and Quality of Life among Older People in Rural Communities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13331. [PMID: 36293909 PMCID: PMC9602601 DOI: 10.3390/ijerph192013331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Older people's help-seeking behaviors (HSBs) may be limited because of various factors and are essential in improving healthcare in aging societies. This cross-sectional study investigated the association between perception of HSBs, concrete HSBs, quality of life (QOL), and other variables among people over 65 in rural Japan using standardized questionnaires. Participants were divided into high or low health status index score groups based on a median split. Logistic regression was used to assess the association between perception of HSBs and high QOL while controlling for age, sex, living conditions, annual health checks, having chronic diseases, regular clinic visits, smoking, habitual alcohol consumption, education, living conditions, social support, social capital, socioeconomic status (SES), and health literacy. Participants in the high QOL group were younger (p < 0.001), and had fewer chronic diseases and regular clinic visits than those in the low QOL group (p < 0.001). The multivariate logistic regression model revealed that age, chronic diseases, tobacco usage, family consultation, and consulting primary care physicians negatively predicted QOL. High SES, social capital and support, and HSB intention positively predicted QOL. Self-efficacy and intention regarding HSBs should be investigated to improve health among older rural people.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-Cho, Unnan 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya Cho, Izumo 693-8501, Japan
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Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, Boyd CM, Pati S, Mtenga S, Smith SM. Multimorbidity. Nat Rev Dis Primers 2022; 8:48. [PMID: 35835758 PMCID: PMC7613517 DOI: 10.1038/s41572-022-00376-4] [Citation(s) in RCA: 181] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 02/06/2023]
Abstract
Multimorbidity (two or more coexisting conditions in an individual) is a growing global challenge with substantial effects on individuals, carers and society. Multimorbidity occurs a decade earlier in socioeconomically deprived communities and is associated with premature death, poorer function and quality of life and increased health-care utilization. Mechanisms underlying the development of multimorbidity are complex, interrelated and multilevel, but are related to ageing and underlying biological mechanisms and broader determinants of health such as socioeconomic deprivation. Little is known about prevention of multimorbidity, but focusing on psychosocial and behavioural factors, particularly population level interventions and structural changes, is likely to be beneficial. Most clinical practice guidelines and health-care training and delivery focus on single diseases, leading to care that is sometimes inadequate and potentially harmful. Multimorbidity requires person-centred care, prioritizing what matters most to the individual and the individual's carers, ensuring care that is effectively coordinated and minimally disruptive, and aligns with the patient's values. Interventions are likely to be complex and multifaceted. Although an increasing number of studies have examined multimorbidity interventions, there is still limited evidence to support any approach. Greater investment in multimorbidity research and training along with reconfiguration of health care supporting the management of multimorbidity is urgently needed.
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Affiliation(s)
- Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark.
| | - Frances S Mair
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Quebec, Canada
| | - Bruce Guthrie
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Bruno P Nunes
- Postgraduate Program in Nursing, Faculty of Nursing, Universidade Federal de Pelotas, Pelotas, Brazil
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Cynthia M Boyd
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Epidemiology and Health Policy & Management, Johns Hopkins University, Baltimore, MD, USA
| | - Sanghamitra Pati
- ICMR Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sally Mtenga
- Department of Health System Impact Evaluation and Policy, Ifakara Health Institute (IHI), Dar Es Salaam, Tanzania
| | - Susan M Smith
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, Russell Building, Tallaght Cross, Dublin, Ireland
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Factors Associated with Health-Related Quality of Life among Older Adults in Rural South Korea Based on Ecological Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127021. [PMID: 35742266 PMCID: PMC9222736 DOI: 10.3390/ijerph19127021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/26/2022] [Accepted: 06/07/2022] [Indexed: 12/10/2022]
Abstract
As the portion of older adults in the population in rural areas of South Korea exceeds 20%, the importance of health-related quality of life is increasing. The aim of the study was to examine the health-related quality of life through the ecological model and its basic determining factors for older adults. The study was conducted on 184 respondents aged 65 and over living in rural areas of South Korea. The measurements were health-related quality of life, health care service needs, sleep quality, social support, and personal characteristics. The collected data were tested using descriptive, t-test, ANOVA, and hierarchical multiple regression. The results showed that older adults in rural areas experienced a low quality of life. Religion, having a helper, and social support were significantly related to health-related quality of life in older adults. This directly shows that the government should make efforts to build a social support system to improve the gap between urban and rural areas. To improve the health-related quality of life of older adults in rural areas, it would be helpful to increase physical activity and to form a community, leading to a social network.
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Improvement in Quality of Life through Self-Management of Mild Symptoms during the COVID-19 Pandemic: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116652. [PMID: 35682238 PMCID: PMC9180648 DOI: 10.3390/ijerph19116652] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/11/2022]
Abstract
The COVID-19 pandemic has inhibited people's help-seeking behaviors (HSBs). In particular, older people in rural communities experienced limited access to medical care, which negatively affected their quality of life (QOL). Within HSB, self-management of mild symptoms may mitigate the difficulties experienced by older people in rural communities. However, few studies have examined the relationship between self-management and QOL. Therefore, we conducted a prospective cohort study to clarify this relationship. Our participants were over 65 years of age and lived in rural communities. QOL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Demographic data and QOL were collected from participants via questionnaires in 2021 and 2022. The exposure group showed a significantly greater change in EQ-5D-5L health status index scores than the control group (p = 0.002). In addition, the exposure group scored significantly lower than the control group on the EQ-5D-5L dimension "usual activities" in 2021 and on all dimensions in 2022. Thus, self-management of mild symptoms may improve QOL among older people in rural communities during the COVID-19 pandemic. Educational interventions for this population regarding self-management could improve QOL for entire communities.
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Liu J, Wang J. Trends and Disparities in Quality of Life Among Older Adults From 1998 to 2018 in China: A National Observational Study. Front Med (Lausanne) 2022; 8:796208. [PMID: 35155473 PMCID: PMC8832120 DOI: 10.3389/fmed.2021.796208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate 20-year trends and disparities in quality of life among older adults in China from 1998 to 2018.MethodsOur study was based on eight representative nationwide health surveys among older adults conducted in China from 1998 to 2018. Quality of life data were obtained from 91,993 individuals aged 65 years or above. All surveys included identical indicators of self-reported quality of life, demographic factors, socioeconomic status, lifestyle habits, and health status. The trends in the standardized prevalence of poor quality of life from 1998 to 2018 were examined by locally weighted scatterplot smoothing regression (LOWESS) analysis. We assessed the prevalence of poor quality of life and its related factors by logistic regression models after adjusting for potential confounders.ResultsThe prevalence of poor quality of life was 38.2% (95% CI: 37.9–38.5%). The trends of poor quality of life showed an inverted “U” shape, that the prevalence increased from 27.8% in 1998 to 43.6% in 2008, and then decreased from 39.2% in 2011 to 32.1% in 2018. Disparities in the prevalence of poor quality of life were exacerbating among participants with low or moderate household income per capita and participants with high household income per capita from 1998 to 2018. After controlling potential confounders, living in rural areas, aged below 80 years, unmarried, living alone, low household income, current smoker, poor dietary diversity, never participating in organized social activities, with chronic diseases, functional disability, poor self-reported health, and unhealthy psychological status were risk factors related with poor quality of life in the multivariate model (all p < 0.05).ConclusionDuring the past two decades, poor quality of life in Chinese older adults showed an inverted “U” trend from 1998 to 2018 that the prevalence of poor quality of life peaked in 2008 and declined since China's deepening health system reform in 2009. However, disparities in the poor quality of life were exacerbating among participants with different socioeconomic statuses. Strengthening the health system is of great importance in improving the quality of life. More efforts are needed to reduce the disparities in the quality of life among the population at the different socioeconomic levels.
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Affiliation(s)
- Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- *Correspondence: Jue Liu
| | - Jun Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, China
- Jun Wang
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12
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Guo X, Zhao B, Chen T, Hao B, Yang T, Xu H. Multimorbidity in the elderly in China based on the China Health and Retirement Longitudinal Study. PLoS One 2021; 16:e0255908. [PMID: 34352011 PMCID: PMC8341534 DOI: 10.1371/journal.pone.0255908] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/26/2021] [Indexed: 11/19/2022] Open
Abstract
This study aimed to investigate the spatial distribution and patterns of multimorbidity among the elderly in China. Data on the occurrence of 14 chronic diseases were collected for 9710 elderly participants in the 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Web graph, Apriori algorithm, age-adjusted Charlson comorbidity index (AAC), and Spatial autocorrelation were used to perform the multimorbidity analysis. The multimorbidity prevalence rate was estimated as 49.64% in the elderly in China. Three major multimorbidity patterns were identified: [Asthma/Chronic lungs diseases]: (Support (S) = 6.17%, Confidence (C) = 63.77%, Lift (L) = 5.15); [Asthma, Arthritis, or rheumatism/ Chronic lungs diseases]: (S = 3.12%, C = 64.03%, L = 5.17); [Dyslipidemia, Hypertension, Arthritis or rheumatism/Heart attack]: (S = 3.96%, C = 51.56, L = 2.69). Results of the AAC analysis showed that the more chronic diseases an elderly has, the lower is the 10-year survival rate (P < 0.001). Global spatial autocorrelation showed a positive spatial correlation distribution for the prevalence of the third multimorbidity pattern in China (P = 0.032). The status of chronic diseases and multimorbidity among the elderly with a spatial correlation is a significant health issue in China.
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Affiliation(s)
- Xiaorong Guo
- Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- * E-mail:
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Bin Hao
- Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Tao Yang
- Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Huimin Xu
- Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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Ohta R, Nishida M, Okuda N, Sano C. The Smiles of Older People through Recreational Activities: Relationship between Smiles and Joy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1600. [PMID: 33572046 PMCID: PMC7914444 DOI: 10.3390/ijerph18041600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
Recreational activities are found to increase people's smiles, arising joy in older people, but there is limited research on this topic within the Japanese context. This cross-sectional study aimed to measure the quality and frequency of smiles in older people living in rural settings using a smile analysis application. The participants comprised 13 females aged over 65 years who lived in Unnan City, Japan, and regularly attended recreational meetings. In this study, the recreational activity that the participants joined was a game called Mattoss. A video camera captured the participants' faces, while a smile assessment application assessed their facial expressions for smiles and joy. A total of 2767 smiles were recorded. For validity, we calculated the Spearman's rho score between smile and joy, which was 0.9697 (p < 0.001), while for reliability, we determined the Spearman's rho score for each participant, which exceeded 0.7 (p < 0.001). Surges of smiles were induced by one's own mistakes, successes, and big mistakes in the game and by severe or mild judgments by the referee. High validity and reliability of smile evaluation were demonstrated. The study found that smiling increased during recreational activities. Therefore, recreational activities can be encouraged for older people living in rural communities.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan, Shimane 699-1221, Japan
| | - Megumi Nishida
- Takenaka Corporation, Hommachi, Chuo-ku, Osaka 541-0053, Japan; (M.N.); (N.O.)
| | - Nobuyasu Okuda
- Takenaka Corporation, Hommachi, Chuo-ku, Osaka 541-0053, Japan; (M.N.); (N.O.)
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, Izumo, Shimane 693-8501, Japan;
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