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Jiang M, Yao X, Peng J, Feng L, Ma Y, Shi X, Fang Y, Fang H. Cost-Effectiveness of Recombinant Zoster Vaccine for Adults Aged ≥50 Years in China. Am J Prev Med 2023; 65:818-826. [PMID: 37182556 DOI: 10.1016/j.amepre.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/06/2023] [Accepted: 05/07/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Adjuvanted recombinant zoster vaccine (RZV) was the first vaccine made available for herpes zoster in China. Authors aimed to evaluate its economic and health impacts on Chinese adults aged ≥50 years. METHODS A lifetime Markov model was developed to compare the cost-effectiveness of RZV with that of no vaccination from a societal perspective. Model inputs were derived from published literature and analyzed in 2022. Outcomes included total costs, quality-adjusted life-years, incremental cost-effectiveness ratio, and number of herpes zoster and herpes zoster-related cases. Sensitivity analyses were performed to examine the robustness of the model results. RESULTS RZV was more costly than no vaccination by $2.78 billion with an additional 65,008 quality-adjusted life-years gained and could avoid 1,893,530 herpes zoster cases, 295,761 postherpetic neuralgia cases, 51,734 other complications, and 229 herpes zoster-related deaths. Incremental cost-effectiveness ratios of RZV varied in a range of $34,465.5-$51,002.7 per quality-adjusted life-year. RZV for the entire cohort would be cost-effective when discount rate was <2.4%, a waning rate of 2-dose RZV efficacy decreased to <0.8%, the utility of postherpetic neuralgia was <0.496, duration of postherpetic neuralgia was >12.86 months, or the cost of RZV per dose decreased to <$229.6. In a probabilistic sensitivity analysis, the probability of RZV being cost-effective was 43.95%, 59.32%, 45.27%, and 39.50% for people aged 50-59, 60-69, 70-79, and ≥80 years, respectively, with threefold gross domestic product per capita (37,654.5 per quality-adjusted life-year) as the willingness-to-pay threshold. CONCLUSIONS RZV was most likely to be cost-effective in people aged 60-69 years. A slight decrease in vaccine cost would result in RZV being cost-effective in all people aged ≥50 years.
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Affiliation(s)
- Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Sciences and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Sciences and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Liuxin Feng
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yue Ma
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Sciences and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Xinke Shi
- Health Sciences Center, Xi'an Jiaotong University, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Sciences and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing, China; Peking University Health Science Center, Chinese Center for Disease Control and Prevention Joint Research Center for Vaccine Economics, Beijing, China.
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Zhang Y, Chen X, Sun Y, Feng S, Wang F, Gu H, Jia H, Zhang Q, Ding W, Lu H, Zhang J. Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis. Front Public Health 2023; 11:1257133. [PMID: 37954046 PMCID: PMC10634533 DOI: 10.3389/fpubh.2023.1257133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/29/2023] [Indexed: 11/14/2023] Open
Abstract
Background Transitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes. Methods This cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels. Results After applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = -0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p < 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis. Conclusion Our findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.
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Affiliation(s)
- Yi Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Xiangfan Chen
- Department of Biobank, Nantong First People's Hospital, Nantong, China
| | - Yimei Sun
- Finance Department, Nantong First People's Hospital, Nantong, China
| | - Sujuan Feng
- Blood Dialysis Room of Nantong First People’s Hospital, Nantong, China
| | - Fang Wang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Haiyan Gu
- Nursing Department of Nantong First People’s Hospital, Nantong, China
| | - Hanyu Jia
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Quanxing Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Wenbin Ding
- The President's Office, Nantong First People's Hospital, Nantong, China
| | - Hongjian Lu
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
| | - Jidong Zhang
- Department of Science and Education, Nantong First People's Hospital, Nantong, China
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Hu F, Jing Y, Qin W, Han W, Xu L, Li Y. The mechanisms underlying the negative effect of socioeconomic status on depressive symptoms among older adults: The roles of social support and living arrangement. Int J Geriatr Psychiatry 2023; 38:e5991. [PMID: 37655502 DOI: 10.1002/gps.5991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 08/12/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES Previous studies have found an association between socioeconomic status (SES) and depressive symptoms among older adults, however the mechanisms underlying this association remained unclear. This study aimed to examine the mediating role of social support and the moderating role of living arrangement in the association between SES and depressive symptoms. METHODS Data was collected from the 2020 Household Health Interview Survey in Taian city, Shandong Province, China. A total of 3896 older adults aged 60 and above were included in this study. Depressive symptoms was measured by the Patient health Questionnaire-9 (PHQ-9), Social support by the Multidimensional Scale of Perceived Social Support (MSPSS), and other variables by related demographic scales. The moderated mediation model was examined using HAYES PROCESS 3.5. RESULTS SES negatively predicted depressive symptoms among older adults, and social support could mediate this association. Living arrangement played a moderating role in the relationship between social support and depressive symptoms (the second half of the mediating effect), and the effect was stronger among older adults who lived alone. CONCLUSIONS Social support partially mediated the relationship between SES and depressive symptoms among older adults, and living alone strengthened the effect of social support on depressive symptoms. Interventions that address older adults' social support and living arrangement may ameliorate depressive symptoms among older adults.
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Affiliation(s)
- Fangfang Hu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Yurong Jing
- School of Public Health, Fudan University, Shanghai, China
| | - Wenzhe Qin
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Wantong Han
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Lingzhong Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong, China
| | - Yinlong Li
- School of Public Health, Jining Medical University, Jining, Shandong, China
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Li W, Yin H, Song Y, Tu W, Wang L, Liang Y, Bai Y, Xu G. Evaluating the Risk of Social Isolation in Older People: AHP-Fuzzy Comprehensive Evaluation. Risk Manag Healthc Policy 2023; 16:79-92. [PMID: 36743450 PMCID: PMC9897070 DOI: 10.2147/rmhp.s383031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/10/2023] [Indexed: 02/01/2023] Open
Abstract
Background Social isolation is a serious and pervasive health issue among older people, and it is difficult to identify and assess effectively. Based on a thorough and scientific evaluation index system, AHP-Fuzzy comprehensive evaluation could be a valuable technique. Objective It is crucial to establish interventions that focus on risk factors for the prevention of social isolation in order to give a strong scientific foundation for enhancing older people's health habits. This can be achieved by using a fuzzy comprehensive evaluation method to assess the risk of social isolation in older people. Methods A hundred community members over 60 from Nanjing were selected as the evaluation subjects in China. After the element layer was split into three categories of "social risk, economic risk, and cultural risk" using the analytic hierarchy process approach, a total of 22 assessment indicators were picked to develop a risk evaluation index system. Results The risk level of social isolation belonging to the "low risk, relatively low risk, medium risk, relatively high risk, high risk" of membership degree are respectively "0.3392, 0.2632, 0.2257, 0.1069, 0.0650". Fuzzy comprehensive evaluation analysis showed that social relations (0.4934), monthly income (0.4654), health status (0.5960) were significant factors of social isolation risk in older people. The results showed that factors related to social risk had the most significant impact on social isolation. Conclusion It is scientific and feasible to construct the risk evaluation index model of social isolation risk for the elderly by using AHP-Fuzzy comprehensive evaluation method. In preventing social isolation of older people in the future, we should pay attention to the impact of social and cultural factors on them, and provide practical intervention programs and references from the government, community, family.
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Affiliation(s)
- Weitong Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Haiyan Yin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Yulei Song
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Wenjing Tu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Lulu Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Yongqi Liang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Guihua Xu
- Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China,Correspondence: Guihua Xu, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China, Email
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Zhao B, Kim JE, Moon J, Nam EW. Social engagement and subjective health among older adults in South Korea: Evidence from the Korean Longitudinal Study of Aging (2006-2018). SSM Popul Health 2023; 21:101341. [PMID: 36845671 PMCID: PMC9950723 DOI: 10.1016/j.ssmph.2023.101341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/09/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Background Social engagement serves as the foundation for social connections by providing a sense of belonging, social identity, and fulfillment. Previous studies have mainly focused on the one-way relationship between social engagement and subjective health among older individuals, and little attention has been paid to their mutual relationship. Therefore, this study aimed to examine the mutual association relationship between social engagement and their subjective health in older Koreans. Methods Seven waves of data samples (aged ≥60 years) from 2006 to 2018 from the Korean Longitudinal Study of Aging (KLoSA) was used in this study. Descriptive analysis, chi-squared tests, 2-year lagged Generalized estimating equation (GEE) model, and cross-lagged panel model were performed to investigate the mutual association between social engagement and subjective health among six survey periods. Results Results of the GEE model revealed when controlling for other variables, older Koreans who reported good subjective health only had a higher OR (1.678 vs. 1.650, p < 0.001) of participating in social engagement than those who had bad subjective health in 2006-2008 period; the occurrence rate of more social engagement was significantly higher among older adults with good subjective health than among those with bad subjective health (five out six survey periods). Cross-lagged analysis showed similar results that coefficients of social engagement on subjective were relatively larger in three survey periods; coefficients of subjective health on social engagement were relatively larger in the other three survey periods. The impact of social engagement on subjective health might be greater than that of subjective health on social engagement. Conclusion All-around participation and engagement of older people in society have become a consensus among the international community. In view of the single social engagement activities and less relevant participation channels in Korea, government departments should consider not only regional but also local characteristics to create more social participation opportunities for older individuals.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea
| | - Ji Eon Kim
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea
| | - Jiyoung Moon
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Gangwon-do, South Korea
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Yonsei Global Health Center, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea,Corresponding author. Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do, South Korea.
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Mu Y, Zheng Z. Multimorbidity patterns, social networks, and depression among chinese older women. Curr Psychol 2022. [DOI: 10.1007/s12144-022-04122-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Chen X, Giles J, Yao Y, Yip W, Meng Q, Berkman L, Chen H, Chen X, Feng J, Feng Z, Glinskaya E, Gong J, Hu P, Kan H, Lei X, Liu X, Steptoe A, Wang G, Wang H, Wang H, Wang X, Wang Y, Yang L, Zhang L, Zhang Q, Wu J, Wu Z, Strauss J, Smith J, Zhao Y. The path to healthy ageing in China: a Peking University-Lancet Commission. Lancet 2022; 400:1967-2006. [PMID: 36423650 PMCID: PMC9801271 DOI: 10.1016/s0140-6736(22)01546-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/22/2022]
Abstract
Around the world, populations are ageing at a faster pace than in the past and this demographic transition will have impacts on all aspects of societies. In May 2020, the UN General Assembly declared 2021–2030 the Decade of Healthy Ageing, highlighting the importance for policymakers across the world to focus policy on improving the lives of older people, both today and in the future. While rapid population ageing poses challenges, China’s rapid economic growth over the last forty years has created space for policy to assist older persons and families in their efforts to improve health and well-being at older ages. As China is home to 1/5 of the world’s older people, China is often held up as an example for other middle-income countries. This Commission Report aims to help readers to understand the process of healthy ageing in China as a means of drawing lessons from the China experience. In addition, with the purpose of informing the ongoing policy dialogue within China, the Commission Report highlights the policy challenges on the horizon and draws lessons from international experience.
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Affiliation(s)
- Xinxin Chen
- Institute of Social Science Survey, Peking University, Beijing, China
| | | | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Winnie Yip
- Department of Global Health and Population, Harvard University, Boston, MA, USA
| | - Qinqin Meng
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, Harvard University, Boston, MA, USA; Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - He Chen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Xi Chen
- Department of Health Policy and Management, Department of Economics, Yale School of Public Health, New Haven, CT, USA
| | - Jin Feng
- School of Economics, Fudan University, Shanghai, China
| | | | | | - Jinquan Gong
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Perry Hu
- Division of Geriatric Medicine, UCLA, Los Angeles, CA, USA
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiaoyan Lei
- National School of Development, Peking University, Beijing, China
| | - Xiao Liu
- School of Labor Economics, Capital University of Economics and Business, Beijing, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Gewei Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Harold Wang
- Program in Bioinformatics, UCLA, Los Angeles, CA, USA
| | - Huali Wang
- Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing, China
| | - Yafeng Wang
- Institute of Social Science Survey, Peking University, Beijing, China
| | - Li Yang
- Department of Health Policy and Management, Peking University, Beijing, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital and National Institute of Health Data Science, Peking University, Beijing, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Zunyou Wu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - John Strauss
- Department of Economics, University of Southern California, Los Angeles, CA, USA
| | | | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China.
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Nie J, Fan R, Wu Y, Li D. By Internal Network or by External Network?-Study on the Social Network Mechanism of Reducing the Perception of Old-Age Support Risks of Rural Elders in China. Int J Environ Res Public Health 2022; 19:15289. [PMID: 36430008 PMCID: PMC9690998 DOI: 10.3390/ijerph192215289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Nowadays, it is a general trend for China to enter a deep aging society, and the aging situation of the rural population is particularly severe. As informal endogenous resources in rural areas, social networks play an essential role in ensuring elders' later life. Data were drawn from a questionnaire survey of 1126 rural elders in 11 provinces of China. Descriptive statistics and an ordinary least square regression model were conducted to explore the impact of social networks on the perception of old-age support risks of rural elders. There was a significant positive association between the social network size and the reduction in perception of old-age support risks of rural elders. The reduction effect was mainly reflected in the internal network size, whereas it was not evident in the external network size. There was a significant positive association between the heterogeneity of the network and the perceived level of old-age support risks of rural elders. There was a significant positive association between the communication frequency of external network relationships and the perceived level of old-age support risks of rural elders. We found a significant negative association between the ratio of communication frequency between the internal and external network relationships and the perception of old-age support risks of rural elders. Compared with the external network, the internal network had a more evident reduction effect on the social network mechanism of perception of old-age support risks of rural elders.
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Affiliation(s)
| | | | | | - Dan Li
- Correspondence: ; Tel.: +86-150-0291-7385
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Li W, Wang Q, Yin H, Song Y, Tu W, Wang L, Liang Y, Bai Y, Xu G. Construction of path analysis model on related factors of social isolation in older people. Psychogeriatrics 2022; 22:743-756. [PMID: 35859517 DOI: 10.1111/psyg.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/12/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND With the gradual acceleration of population ageing, social isolation in older people has increasingly become a hot topic of social concern. The reduction of valid social participation will cause older people to weaken their sense of belonging to the community and social acquisition, negatively impacting on older people's quality of life. This study is aimed to explore the main related factors affecting the social isolation of older people, so as to provide a solid scientific basis for improving the health behaviour of older people in China. METHOD A cross-sectional study was conducted among 2267 community residents over 60 years old from four cites in Jiangsu Province, China. Perceived social support scale, Geriatric Depression Scale, Connor-Davidson Resilience Scale, Comprehensive Ability of Older People Assessment Scale and other influencing factors scales were used to investigate the current situation. Social isolation was measured with the Lubben Social Network Scale. Demographic data were evaluated using descriptive statistical analyses and relationships among study variables were determined to use a path analysis. All data were analyzed using SPSS version 22 and AMOS version 26 using T-test, analysis of variance, logistic regression analyses, and path analysis method. The test level was set at alpha = 0.05, and the difference was statistically significant at P-value <0.05. RESULTS The results of the model test analysis indicated that the hypothesised paths were supported by data from our samples and demonstrated significance on the path coefficients (P < 0.05). Related factors in the three dimensions of social risk, economic risk and cultural risk have an impact on the social isolation of older people in the community through direct and indirect pathways, and also indirectly through the partially mediated role of depression. Overall, our hypothesised model was retained, indicating empirical support and adequate model fit indices for the theoretical model. CONCLUSION The findings demonstrated the predictive role of related factors of social isolation in older people. In the future, we should focus on developing interventions by uniting many forces such as society, family and older people themselves to reduce social isolation among this vulnerable population and improve the quality of life of older people and promote healthy ageing.
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Affiliation(s)
- Weitong Li
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Qing Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Haiyan Yin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Yulei Song
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Wenjing Tu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Lulu Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Yongqi Liang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Guihua Xu
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
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Moon J, Woo S, Shim J, Lee WS. Antecedents of Subjective Health among Korean Senior Citizens Using Archival Data. Behav Sci (Basel) 2022; 12:315. [PMID: 36135119 PMCID: PMC9496000 DOI: 10.3390/bs12090315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the determinants of subjective health among South Korean senior citizens. Secondary data for the year 2018 was used from the Senior Citizen Research Panel data collected by the Korea Employment Information Service. A total of 3822 valid observations were analyzed. The dependent variable was subjective health, and the independent variables were religion participation, social gathering participation, economic activity, food expenditure, leisure expenditure, travel frequency, and art watching frequency. Descriptive analysis, correlation matrix, and independent t-test were carried out for data analysis. Multiple linear regression analysis was employed using assets, age, and gender as control variables to test the research hypotheses. The results indicate that all the proposed attributes have a significant positive impact on the subjective health of Korean senior citizens, with implications for policy making.
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Zhang J, Xiao S, Shi L, Xue Y, Zheng X, Dong F, Xue B, Zhang C. Differences in Health-Related Quality of Life and Its Associated Factors Among Older Adults in Urban and Rural Areas. Risk Manag Healthc Policy 2022; 15:1447-1457. [PMID: 35923554 PMCID: PMC9342693 DOI: 10.2147/rmhp.s373077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Urban-rural health disparity is one of the most prominent challenges in China today. The goal of this study is to find differences in health-related quality of life (HRQoL) and its associated factors among older people in urban and rural areas. Methods A multi-stage stratified sampling method was conducted in Shanxi Province, with a total of 3250 older adults participated in this cross-sectional survey. HRQoL was assessed using the Chinese version of the EQ-5D-5L. Tobit regression models were employed to identify associated factors for HRQoL. Results The mean EQ-5D utility score of the total sample was 0.87± 0.23, with a statistically significant difference observed between urban (0.89 ± 0.22) and rural areas (0.86 ± 0.23). Obesity (Coe=−0.10, p=0.021) and nutrition awareness (Coe=−0.14, p=0.009) were two unique associated factors to rural older adults’ HRQoL. While, age (Urban: Coe=0.13, p=0.001; Rural: Coe=−0.019, p<0.001), socioeconomic status (Urban: Coe=0.13, p<0.001; Rural: Coe=0.14, p<0.001), number of chronic non-communicable diseases (Urban: Coe=−0.20, p<0.001; Rural: Coe=−0.15, p<0.001), sleep quality (Urban: Coe=−0.22, p<0.001; Rural: Coe=0.15, p<0.001) and daytime sleepiness (Urban: Coe=−0.13, p<0.001; Rural: Coe=−0.13, p<0.001) were found to be associated with HRQoL regardless of the residential area. Conclusion This study suggested that rural older adults are facing HRQoL disadvantages compared to those in urban area. Accordingly, more attention should be devoted to rural older adults’ HRQoL, particularly to the unique factors like body weight and nutrition awareness. Targeted policies and interventions should be implemented to improve HRQoL and bridge the urban-rural HRQoL gap.
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Affiliation(s)
- Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Shujuan Xiao
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
- Institute of Health Management, Southern Medical University, Guangzhou, People’s Republic of China
- Correspondence: Chichen Zhang, School of Health Management, Southern Medical University, No. 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, People’s Republic of China, Tel +86-20-61648756, Email
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Yu J, Ma G, Wang S. Do Age-Friendly Rural Communities Affect Quality of Life? A Comparison of Perceptions from Middle-Aged and Older Adults in China. Int J Environ Res Public Health 2021; 18:ijerph18147283. [PMID: 34299736 PMCID: PMC8306948 DOI: 10.3390/ijerph18147283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 06/24/2021] [Accepted: 06/30/2021] [Indexed: 01/09/2023]
Abstract
The aging population in rural areas of China faces serious challenges due to urban–rural disparities. In order to improve the active aging of rural older adults, the establishment of age-friendly communities is encouraged. However, globally, the focus is on age-friendly communities in urban areas, not reflecting rural communities. Hence, we addressed the importance of age-friendly rural communities (AFRCs) and aimed to investigate their impact on the quality of life (QoL) of older adults. We examined different perceptions of AFRCs among older adults (aged over 60) and middle-aged people (45–60) in rural communities with questionnaire surveys (n = 470 and 393, respectively). Several statistical methods, such as Chi-squared test, t-test, reliability test, and multiple regression, were adopted to investigate and compare the perceptions of these two. The results indicated that (1) middle-aged people were more satisfied with AFRC components and had a higher QoL than older adults; (2) the QoL of middle-aged people was predicted by housing, accessibility, and outdoor spaces; (3) the QoL of older adults was affected by housing, outdoor spaces, social participation, and public transportation. These findings aid in our understanding of rural communities and the QoL of rural residents. They are helpful for urban planners and policymakers to improve the planning of AFRCs and supplement research on age-friendly communities in rural areas. Practical implementations are proposed for the planning of AFRCs, such as the passive design of residential housing, grouping of community facilities together, and improvement in the hygiene of outdoor spaces in rural areas.
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Affiliation(s)
- Jingyu Yu
- School of Civil Engineering, Hefei University of Technology, Hefei 230009, China;
| | - Guixia Ma
- School of Civil Engineering, Hefei University of Technology, Hefei 230009, China;
- Correspondence:
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Siette J, Jorgensen ML, Georgiou A, Dodds L, McClean T, Westbrook JI. Quality of life measurement in community-based aged care - understanding variation between clients and between care service providers. BMC Geriatr 2021; 21:390. [PMID: 34182935 PMCID: PMC8240205 DOI: 10.1186/s12877-021-02254-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets. METHODS A retrospective sample of 1141 Australians aged ≥60 years receiving community-based care services from a large service provider within 19 service outlets. Clients' QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e. sociodemographic, social participation and service use) were extracted from clients' electronic records and examined using multivariable regression. Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets. RESULTS Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0-1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected. CONCLUSION Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support. TRIAL REGISTRATION Australian and New Zealand clinical trial registry number: ACTRN12617001212347 . Registered 18/08/2017.
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Affiliation(s)
- Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, 2109, Australia.
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Macquarie Park, New South Wales, 2109, Australia.
| | - Mikaela L Jorgensen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, 2109, Australia
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, 2109, Australia
| | - Laura Dodds
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, 2109, Australia
| | - Tom McClean
- Uniting, Sydney, New South Wales, 2000, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, 2109, Australia
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Burnette D, Ye X, Cheng Z, Ruan H. Living alone, social cohesion, and quality of life among older adults in rural and urban China: a conditional process analysis. Int Psychogeriatr 2021; 33:469-79. [PMID: 32611467 DOI: 10.1017/S1041610220001210] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To test the independent and combined impact of social cohesion and geographic locale (urban/rural) on quality of life (QoL) for older adults in China. Using conditional process analysis, we tested three hypotheses: (1) QoL will be lower for persons living alone than those who live with family; (2) social cohesion will mediate the association of living arrangement and QoL; and (3) geographic locale will moderate direct and indirect pathways in the mediation model. DESIGN Cross-sectional data from WHO Study on Global Aging and Adult Health (SAGE) (China, Wave 1, 2007-2010). SETTING National probability sample of 74 primary sampling units in China, 32 in urban, and 32 in rural areas. PARTICIPANTS A total of 9,663 adults aged 50 years and older. MEASUREMENTS We measured QOL with the 8-item version of the WHOQOL-Bref; living arrangement as alone versus with family; and social cohesion with an 9-item index of frequency of a range of social activities in the previous 12 months. We controlled for sociodemographic characteristics and health and mental health variables in multivariate analyses. RESULTS Data supported the first two hypotheses; however, the mediating effects of social cohesion held only in urban areas. CONCLUSION This study advances the large body of work on living arrangements and well-being of older adults in China. Social cohesion contributed to better QoL regardless of living arrangement, and cohesion mediated the association of living arrangement and QOL in urban but not rural areas. Programs and policies that strengthen social cohesion through older adults' community involvement, especially in urban areas, will help to enhance QoL.
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Abstract
Background EQ-5D-3L is one of the most commonly used instruments for assessing health-related quality of life and cost-utility analyses, but it is not yet available in China. This study aims to develop population norms for the EQ-5D-3L in China in order to encourage appropriate use and interpretation of the EQ-5D-3L instrument. Methods Data were extracted from the 2013 National Health Services Survey on a nationally representative sample of 188 720 participants. The utility index based on the 2018 Chinese preference-based value sets were calculated for the participants with different demographic and socio-economic characteristics. Differences in reported problems and visual analogue scale (VAS) and utility index scores were tested using a logistic, linear and tobit regression model, respectively. Results The Chinese respondents were less likely to report problems on the EQ-5D dimensions compared with most populations in other countries. Pain/discomfort was the most commonly reported problem (12.6%). This resulted in a high ceiling effect (84.19%) on the utility index and high mean scores for the utility index (0.985 ± 0.056) and VAS (80.91 ± 13.74) in the Chinese population. Those who were younger, better educated, employed, married, had no illness condition, lived in a more developed region and had a higher income obtained higher scores in both VAS and utility index. The VAS and utility index scores were also associated with gender, residency and lifestyles, but not always in a consistent way. Male and rural residents had a higher VAS score but not in the utility index compared with their female and urban counterparts. Conclusions This study provides national population norms for the EQ-5D-3L based on the 2018 Chinese preference-based value sets. The norms can be used as a reference for health evaluation studies. Cautions need to be taken for presenting and interpreting the utility index results given the high ceiling effect of the EQ-5D-3L instrument.
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Affiliation(s)
- Qiang Yao
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Yaoguang Zhang
- Centre for Health Statistics Information, National Health Commission, Beijing, China
| | - Ling Xu
- China Health Human Resources, National Health Commission, Beijing, China
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Liu N, Andrew NE, Cadilhac DA, Yu X, Li Z, Wang J, Liang Y. Health-related quality of life among elderly individuals living alone in an urban area of Shaanxi Province, China: a cross-sectional study. J Int Med Res 2021; 48:300060520913146. [PMID: 32253961 PMCID: PMC7140192 DOI: 10.1177/0300060520913146] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objectives To describe health-related quality of life (HRQoL), sex differences in HRQoL,
and factors affecting the HRQoL of elderly people living alone in urban
areas of Shaanxi Province, China. Methods A cohort was obtained using multistage stratified cluster random sampling. We
collected cross-sectional data using surveys. HRQoL was measured using the
36-item Short Form Health Survey. Multivariable multilevel linear regression
analysis was used to examine factors associated with mental and physical
health component summary scores. Results Overall, 442 elderly Chinese individuals who lived alone completed the survey
(mean age 73 years, women: 59%). Women were more likely to report better
mental health than men. Factors significantly associated with reduced mental
health scores were older age, having never been married or being divorced,
and having a history of cancer, urinary tract disease, fractures or
gastrointestinal disorders. Factors associated with physical health were
having never been married or being divorced and having hypertension. Conclusions To our knowledge, this is the first study to describe HRQoL in a
representative sample of elderly people living alone in urban areas of
Shaanxi, China. Poor physical and mental HRQoL in this elderly Chinese
population was mainly associated with chronic diseases and demographic
factors.
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Affiliation(s)
- Ning Liu
- School of Nursing, Zhu Hai Campus of Zunyi Medical University, Zhu Hai, GuangDong Province, P. R. China
| | - Nadine E Andrew
- Department of Medicine, Peninsula Clinical School, Monash University, Clayton, VIC, Australia.,Translational Public Health Unit, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Dominique A Cadilhac
- Translational Public Health Unit, Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia
| | - Xuewen Yu
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. China
| | - Zhe Li
- Network Operations Management Center, Zhu Hai Campus of Zunyi Medical University, Zhu Hai, GuangDong Province, P. R. China
| | - Jue Wang
- School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yu Liang
- School of Public Administration, Nanjing University of Finance & Economics, Nanjing, P. R. China
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König HH, Brettschneider C, Lühmann D, Kaduszkiewicz H, Oey A, Wiese B, Werle J, Weyerer S, Fuchs A, Pentzek M, Conrad I, Röhr S, Weeg D, Bickel H, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, Hajek A. EQ-5D-3L health status and health state utilities of the oldest-old (85 +) in Germany: results from the AgeCoDe-AgeQualiDe study. Qual Life Res 2020; 29:3223-3232. [PMID: 32851600 DOI: 10.1007/s11136-020-02597-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To describe health status and health state utilities measured by the EQ-5D-3L in a population-based sample of individuals aged 85 + in Germany, and to analyze associations with basic socio-demographic variables. METHODS Cross-sectional data from follow-up wave 7 (n = 761) of the German AgeCoDe Study were used. The EQ-5D-3L questionnaire was used to record problems in five health dimensions, its visual analogue scale (EQ VAS) was used to record self-rated health status, and the German EQ-5D-3L index was used to derive health state utilities. RESULTS Mean age of respondents was 88.9 years (SD 2.9; range 85 to 100), 67.4% were female. 81.9% reported problems in at least one of the EQ-5D dimensions, with 15.3% reporting extreme problems. Most frequent were problems with pain/discomfort (64.8%), followed by mobility (62.5%), usual activities (42.6%), self-care (28.2%), and anxiety/depression (20.5%). Mean EQ VAS score was 62.4 (SD 18.8), and mean EQ-5D index was 0.77 (SD 0.24). Multiple regression analysis showed associations of problem frequency in various EQ-5D dimensions with age, gender, living situation, marital status, and education. The EQ VAS score was negatively associated with age (β = - 0.56; p < 0.05) and female gender (β = - 3.49; p < 0.05). The EQ-5D index was negatively associated with not living in the community (β = - 0.10; p < 0.001) and being single (β = - 0.09; p < 0.05). CONCLUSIONS The results show a substantially impaired health status of the oldest-old population. The data can be used for comparing health status of population groups as well as for health economic models.
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Affiliation(s)
- Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Wu H, Han S, Zhang G, Wu W, Tang N. Health-related quality of life and determinants in North-China urban community residents. Health Qual Life Outcomes 2020; 18:280. [PMID: 32795293 PMCID: PMC7427717 DOI: 10.1186/s12955-020-01522-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objectives of this study were to investigate the HRQoL of residents living in central urban areas (CUA) and developing neighborhoods (DN) areas of North-China and to examine the relationship between health conditions and the physical and mental components of quality of life. METHODS A stratified random sample was taken and health survey scoring system questionnaire SF-36 was used to conduct the HRQoL survey among community residents in the two selected districts in 10 cities. A general questionnaire was also administered with questions that collected general information, population demographic characteristics and health behaviours, social relationships and perception of life satisfaction. RESULTS Five thousand eight hundred eighty-one questionnaires were returned from 6059 invitations with a effective response rate of 97%. The residents in DN had a higher score of physical function, role limitation due to physical problems and vitality than those living in CUA. The prevalence of several chronic diseases was lower in DN's residents than CUA's residents. Age, presence/absence of chronic diseases, leisure time exercise, regular daily routine, sleep quality, appetite, family and social relationships and life satisfaction were significant determinants of HRQoL. CONCLUSIONS Residents living in newly developed neighborhoods in China while keeping some habits and lifestyles of their original rural communities are healthier in terms of chronic diseases and HRQoL. Together with other risk factors chronic diseases are an important determinant on HRQoL. Several healthy habits and behaviors such as having a regular daily routine and exercising during leisure time improved HRQoL in Chinese urban communities. Targeted policies of public health based on these findings can better the health-related quality of life.
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Affiliation(s)
- Hui Wu
- School of Public Health, Xinxiang Medical University, 22 Qixiangtai Rd, Tianjian, 300070, China
- School of Public Health, Tianjin Medical University, 601 Jinsui Rd, Xinxiang, 453000, Henan, China
| | - Shengbo Han
- Zhengzhou Traditional Chinese Medicine Hospital, 65 wenhuagong Rd, Zhongyuan District, Zhengzhou, 450002, Henan, China
| | - Guicheng Zhang
- School of Public Health, Xinxiang Medical University, 22 Qixiangtai Rd, Tianjian, 300070, China
- School of Public Health, Curtin University, Roberts Rd, Subiaco WA, Perth, 6008, Australia
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, 22 Qixiangtai Rd, Tianjian, 300070, China.
| | - Naijun Tang
- School of Public Health, Tianjin Medical University, 601 Jinsui Rd, Xinxiang, 453000, Henan, China.
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Lu S, Wu Y, Mao Z, Liang X. Association of Formal and Informal Social Support With Health-Related Quality of Life Among Chinese Rural Elders. Int J Environ Res Public Health 2020; 17:E1351. [PMID: 32093116 DOI: 10.3390/ijerph17041351] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 02/14/2020] [Accepted: 02/16/2020] [Indexed: 12/03/2022]
Abstract
Objectives: To explore the association of formal and informal social support with health-related quality of life (HRQOL) among Chinese rural elders and further investigate the influence of quantity and quality of social support on their HRQOL. Methods: The sample of 4189 Chinese rural elders over 60 years old was acquired from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The HRQOL was evaluated by EQ-5D-3L questionnaire. The social support assessment was mainly based on the social support rating scale (SSRS), and Tobit regression analysis was used to explore the impact of social support on HRQOL. Results: The average EQ-5D index score (0 to 1) of the Chinese rural elders was 0.78 ± 0.16. Participants who were male or with better education were found to have higher scores. Those elders living alone, suffering from chronic diseases or disabled acquired lower scores. As for formal social support, higher medical or pension insurance and more social activities statistically significantly possessed higher scores. As for informal social support, higher number of offspring had a significant association with lower scores, while more contact with children and financial support from family were shown to be statistically significantly associated with higher scores after controlling for sociodemographic characteristics. The quality of social support is more important than its quantity. An interesting finding was that the EQ-5D index scores did not support the Chinese traditional belief that ‘the more children, the more blessings’. Conclusions: The EQ-5D index scores of the rural elders in China is above the median level based on the scores of EQ-5D. Social support is significantly associated with elderly peoples’ quality of life. The results would be significant for accurately improving the life quality of Chinese rural elders from the perspective of social support.
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Lin WQ, Huang TY, Liu L, Yang YO, Li YH, Sun MY, Qin FJ, Yang QY, Shen JC. Prevalence and related factors of depression and falls among the elderly living in rural communities of Guangzhou. PSYCHOL HEALTH MED 2020; 25:980-988. [PMID: 31967487 DOI: 10.1080/13548506.2020.1714064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Few studies have concentrated on the prevalence and related factors of depression and falls among the elderly living in rural communities of Guangzhou. A total of 335 participants aged ≥60 years were recruited by simple random sampling method. A structural equation model was applied to determine interrelationships between depression, falls and other variables. As high as 27.5% and 23.3% participants had reported depressive symptoms and falls, respectively. The path analysis showed the total effect (β = -0.58) of depression on quality of life (QOL) consisted of a direct effect (β = -0.51) and an indirect effect (β = -0.07), which was mediated by family function and number of falls, and the R 2 was 0.36. The model fit indices were χ 2 /df = 1.096, P > 0.05, Root Mean Square Error of Approximation (RMSEA) = 0.017, Tucker-Lewis Index (TLI) = 0.998 and Comparative Fit Index (CFI) = 0.999. Depression and falls were prevalent among the elderly living in rural communities of Guangzhou city. Pay attention to strengthen family function and prevent falls may prevent depression and improve the QOL among the elderly.
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Affiliation(s)
- Wei-Quan Lin
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Ting-Yuan Huang
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Lan Liu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Yun-Ou Yang
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Yao-Hui Li
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Min-Ying Sun
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Fa-Ju Qin
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Qiong-Ying Yang
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
| | - Ji-Chuan Shen
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou , Guangzhou, China
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Luo M, Ding D, Bauman A, Negin J, Phongsavan P. Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data. BMC Public Health 2020; 20:99. [PMID: 31973695 PMCID: PMC6979381 DOI: 10.1186/s12889-019-7841-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/24/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social engagement forms the basis of social relationships by providing a sense of belonging, social identity, and fulfillment. Previous research demonstrates that social engagement was associated with positive health behaviors among older adults. However, the results have been different across health-related behaviors, and mostly based on data from high-income countries. For example, studies from the US and UK showed that social engagement was protective against smoking, while others found social engagement encouraged more smoking in many Asian cultures. In this study, we aim to examine the association between social engagement and a range of health-related behaviors and subjective well-being among older adults in six low- to middle-income countries. METHODS Data from the WHO Study on Global Ageing and Adult Health (SAGE Wave 1) were used. A total of 33,338 individuals aged 50 and older in China, Russia, India, Ghana, South Africa, and Mexico were included. Social engagement, tobacco use, alcohol consumption, fruit and vegetable intake, physical activity, sedentary behavior, sleep duration, depression symptoms, self-rated health status, and quality of life were assessed using established self-reported measures. Multiple logistic regression models were used to examine the relationship between social engagement and nine outcome variables, adjusting for socio-demographic characteristics. RESULTS Lower levels of social engagement were positively related to physical inactivity, prolonged sitting time, unhealthy sleep duration, perceived depression, poor self-rated health, and low quality of life. However, the associations between social engagement and tobacco use, excessive drinking, and insufficient fruit and vegetable intake were mixed across countries. CONCLUSION This international study found high social engagement as a potential health-promoting factor in some low- to middle-income countries. Although the impacts of social engagement on tobacco and alcohol use and diet were complicated and culture-specific, interventions at both individual and community levels should encourage healthy lifestyles through positive social engagement.
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Affiliation(s)
- Mengyun Luo
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025 People’s Republic of China
| | - Ding Ding
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
| | - Adrian Bauman
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
| | - Joel Negin
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
| | - Philayrath Phongsavan
- The University of Sydney, Sydney School of Public Health, Faculty of Medicine and Health and Charles Perkins Centre, Sydney, NSW 2006 Australia
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22
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Lu J, Zhang C, Xue Y, Mao D, Zheng X, Wu S, Wang X. Moderating effect of social support on depression and health promoting lifestyle for Chinese empty nesters: A cross-sectional study. J Affect Disord 2019; 256:495-508. [PMID: 31271867 DOI: 10.1016/j.jad.2019.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/26/2019] [Accepted: 04/06/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Health promoting lifestyle (HPL) may be a facilitator for empty nesters' active aging against depression. Social support (SS) may improve their HPL. This study aimed to examine moderating effect of SS and its three sources of SS on relationship between depression and HPL among empty nesters. The compensating role of socioeconomic status (SES) for lack of SS was examined, too. METHODS A cross-sectional survey of empty nesters (n = 1593) was conducted in six districts of Taiyuan, China, using a stratified random cluster sampling method. Hierarchical multiple linear regression analyses were performed to assess moderation models by SS and its three sources. RESULTS The findings indicated that low depression (p < 0.001) and sufficient perceived SS (p < 0.001) could directly predict better HPL among empty nesters. The effect of SS on HPL declined with the raise of educational level (p < 0.001). Family support (β = 0.083, p < 0.001), friends support (β = 0.085, p < 0.001) and others support (β = 0.098, p < 0.001) expressed significant negative buffer effects on depression and HPL individually. LIMITATIONS There was a cross-sectional study that limited the moderating effect of SS on depression and HPL just for empty nesters in Taiyuan, China. The results cannot explain the causal relationships among the study variables. CONCLUSIONS SS might be a protective factor of empty nesters' health in China. Three sources of SS all showed moderating effect on the relationship between depression and HPL among empty nesters, and should be integrated to achieve maximum utility. Friends support/ others support could play complement role for lack of family support. SES expressed partial compensatory for lack of SS.
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Affiliation(s)
- Jiao Lu
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Chichen Zhang
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China; School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Yaqing Xue
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Danhui Mao
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiao Zheng
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Shengnan Wu
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaoli Wang
- School of Business, Jiangnan University, Wuxi, China
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Yao Q, Liu C, Zhang Y, Xu L. Changes in health-related quality of life of Chinese populations measured by the EQ-5D-3 L: a comparison of the 2008 and 2013 National Health Services Surveys. Health Qual Life Outcomes 2019; 17:43. [PMID: 30866953 PMCID: PMC6417242 DOI: 10.1186/s12955-019-1109-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS The EuroQol Group Five-Dimensional (EQ-5D) instruments have been validated in China for measuring health-related quality of life (HRQoL) and are increasingly being used in health economic studies. However, there is paucity in the literature documenting long-term changes in the EQ-5D results in the Chinese populations. This study aims to identify such changes and their determinants using the EQ-5D-3 L instrument. METHODS Data were obtained from the National Health Services Surveys in China, which included the EQ-5D-3 L since 2008. We compared the differences between the 2008 and 2013 surveys in the percentage of reported problems, visual analogue scale (VAS) scores, and the EQ-5D-3 L utility index derived from the national value sets. Factors associated with population changes in these EQ-5D results were identified using logistic, linear and Tobit regression models, respectively. RESULTS Compared with 2008, reported problems in self-care (3.3% vs 3.1%), usual activities (4.8% vs 4.6%) and anxiety/depression (6.4% vs 5.3%) decreased, whereas reported problems in mobility (5.1% vs 5.9%) and pain/discomfort (9.3% vs 12.6%) increased significantly (p < 0.05) in 2013. The regression models revealed a rise (β = 1.61, p < 0.001) in VAS scores, but a slight drop (β = - 0.01, p < 0.001) in utility index in 2013 compared with 2008 after controlling for variations in demographic, behavioral, socioeconomic and residential variables. But the effect sizes of the changes over time (estimated by "average change divided by baseline standard deviation") did not reach the threshold of clinical importance after adjustment for variations in other factors. Higher socioeconomic status (in terms of education, income and residential location) was associated with better EQ-5D-3 L results. CONCLUSION The changing trend (decrease) of the utility index is contradictory to that (increase) of the VAS scores, although neither is deemed clinically important. It is evident that socioeconomic and regional disparities in HRQoL exist in China.
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Affiliation(s)
- Qiang Yao
- School of Political Science and Public Administration, Institute of Health Research, Wuhan University, Wuhan, Hubei, China.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Yaoguang Zhang
- Center for Health Statistics and Information, National Health Commission, Beijing, China.
| | - Ling Xu
- Health Human Resources Development Center, National Health Commission, Beijing, China.
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Zhao X, Zhang D, Wu M, Yang Y, Xie H, Li Y, Jia J, Su Y. Loneliness and depression symptoms among the elderly in nursing homes: A moderated mediation model of resilience and social support. Psychiatry Res 2018; 268:143-151. [PMID: 30025285 DOI: 10.1016/j.psychres.2018.07.011] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 07/03/2018] [Accepted: 07/06/2018] [Indexed: 12/16/2022]
Abstract
Loneliness has been identified as a risk factor for depressive symptoms. Resilience and social support have been regarded as underlying protective factors. Little is known about the complex relations among these factors in the nursing home elderly. This study aimed to assess the prevalence of depressive symptoms, explore whether resilience mediated the association between loneliness and depressive symptoms, and investigate whether social support moderated the indirect or direct effect of mediation model. A total of 323 nursing home elderly were recruited in Jinan City, China. Loneliness, resilience, social support and depressive symptoms were measured. Results shown the association between loneliness and depressive symptoms was partially mediated by resilience. Besides, the indirect effect of the mediation model was moderated by social support. When the level of social support was higher, the indirect effect of loneliness on depressive symptoms through resilience was weaker. The incidence of depressive symptoms among the nursing home elderly could not be neglected. The findings suggest that interventions, such as improving resilience and social support, may help break the link between loneliness and depressive symptoms among the elderly in nursing homes.
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Affiliation(s)
- Xia Zhao
- School of Nursing, Shandong University, Jinan 250012, China
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan 250012, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan 250012, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan 250012, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan 250012, China
| | - Yuqin Li
- School of Philosophy and Social Development, Shandong University, Jinan 250100, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan 250012, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan 250012, China; School of Foreign Languages and Literature, Shandong University, Jinan 250012, China.
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Higashi RT, Craddock Lee SJ, Pezzia C, Quirk L, Leonard T, Pruitt SL. Family and Social Context Contributes to the Interplay of Economic Insecurity, Food Insecurity, and Health. Ann Anthropol Pract 2017; 41:67-77. [PMID: 30233917 DOI: 10.1111/napa.12114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In this study, we show how household health, economic instability, and food insecurity are inextricably linked; disruptions in individual health or income create cumulative and interdependent challenges faced by multiple household members. Drawing upon semi-structured focus groups with English- and Spanish-speaking clients of an urban food pantry, we demonstrate: (1) the impact of economic scarcity on health, (2) the impact of one household member's health on the health and food security of all household members, and (3) food sharing behaviors among family and social networks, including multi-generational families and non-kin individuals. We identify the gap between household-level assessments of food insecurity and individual-level health reports, which may obscure poor health among other household members. Understanding the social and family context of health and food insecurity may inform future interventions that address the interrelated challenges of diverse and disadvantaged households and communities.
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Affiliation(s)
- Robin T Higashi
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066
| | - Simon J Craddock Lee
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75235
| | - Carla Pezzia
- University of Dallas, 1845 East Northgate Drive, Irving, TX 75062
| | - Lisa Quirk
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066
| | - Tammy Leonard
- University of Dallas, 1845 East Northgate Drive, Irving, TX 75062
| | - Sandi L Pruitt
- UT Southwestern Medical Center, Department of Clinical Sciences, 5323 Harry Hines Blvd, Dallas, TX 75390-9066.,Harold C. Simmons Comprehensive Cancer Center, 2201 Inwood Road, Dallas, TX 75235
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Jin C, Zheng Z, Xian W, Bai M, Jin L, Li Y, Yang X, Sheng Y, Ai W, Liu H. Gender differences in positive life orientation among the nursing home elders in China: A cross-sectional study. Arch Gerontol Geriatr 2017; 72:86-90. [DOI: 10.1016/j.archger.2017.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
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Si L, Shi L, Chen M, Palmer AJ. Establishing benchmark EQ-5D-3L population health state utilities and identifying their correlates in Gansu Province, China. Qual Life Res 2017; 26:3049-3058. [PMID: 28593532 DOI: 10.1007/s11136-017-1614-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/26/2022]
Abstract
PURPOSES Despite a flurry of cost utility analyses conducted in the Chinese population in recent years, a standard set of health state utilities (HSUs) for the Chinese population is lacking. The aims of this study were to (1) determine benchmark age- and sex-specific HSUs for a Chinese population, and (2) assess key correlates of HSUs in this population. METHODS Quality-of-life was evaluated using the validated EQ-5D-3L questionnaire. HSUs were calculated using data collected from Gansu Province (n = 9833). Overall differences in HSUs were analysed using linear regression and a two-tailed p value <0.05 was determined to be statistically significant. The minimal difference in weighted index was set at 0.074. RESULTS HSUs decreased with age in both males and females. Living in the non-capital areas, being separated/divorced/widowed or never married, being never educated, diagnosed with chronic disease, and no regular physical activity were associated with lower HSUs. HSUs for women were lower than for men in univariate regression analysis; however, no differences were found after adjusting for other covariates. In addition, the difference in HSU reached the level of minimal difference in weighted index for participants with chronic disease. HSUs for those who were diagnosed with chronic disease were 0.098 (0.092-0.104) lower than those without chronic disease. CONCLUSIONS This study reports HSUs for a Chinese population in Gansu and investigates the key correlates of HSUs in this population. In addition, the use of EQ-5D-3L in assessing population health is limited given the high ceiling effect and skewed HSUs.
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Affiliation(s)
- Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
- School of Health Administration, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Lei Shi
- Bayer HealthCare, Shanghai, 200000, China
| | - Mingsheng Chen
- School of Health Policy & Management, Nanjing Medical University, Hanzhong Road 140, Nanjing, 210029, China.
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
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Sun Y, Zhang D, Yang Y, Wu M, Xie H, Zhang J, Jia J, Su Y. Social Support Moderates the Effects of Self-esteem and Depression on Quality of Life Among Chinese Rural Elderly in Nursing Homes. Arch Psychiatr Nurs 2017; 31:197-204. [PMID: 28359433 DOI: 10.1016/j.apnu.2016.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Yaoyao Sun
- School of Nursing, Shandong University, Jinan 250012, Shandong, China
| | - Dan Zhang
- School of Nursing, Shandong University, Jinan 250012, Shandong, China
| | - Yang Yang
- School of Nursing, Shandong University, Jinan 250012, Shandong, China
| | - Menglian Wu
- School of Nursing, Shandong University, Jinan 250012, Shandong, China
| | - Hui Xie
- School of Nursing, Shandong University, Jinan 250012, Shandong, China
| | - Jie Zhang
- School of Public Health, Shandong University, Jinan 250012, Shandong, China; Department of Sociology, State University of New York Buffalo State, Buffalo, NY 14222, USA
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan 250012, Shandong, China
| | - Yonggang Su
- School of Foreign Languages and Literature, Shandong University, Jinan 250012, Shandong, China; School of Nursing, Shandong University, Jinan 250012, Shandong, China.
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Abstract
OBJECTIVES To examine whether the association between resting heart rate (RHR) and all-cause mortality and cardiovascular events differs according to age. DESIGN Prospective cohort. SETTING Community in Beijing, China. PARTICIPANTS Individuals aged 40 and older without cardiovascular disease at baseline (N = 6,209). MEASUREMENTS Trained investigators interviewed participants using a standard questionnaire to obtain information on demographic characteristics, medical history and lifestyle risk factors in 1991. RHR was evaluated according to quartiles (<72, 72-76, 76-84, ≥84 beats/min). Cox regression models were used to assess the associations between RHR and all-cause mortality and cardiovascular events. RESULTS During a mean follow-up of 8.3 years, 840 subjects died, and 676 experienced a cardiovascular event. Higher RHR was significantly associated with all-cause mortality (P trend < .001) and cardiovascular events (P trend = .002) in older (≥60) but not younger (<60) participants (both P trend > .05). There were significant modifying effects of age on the association between RHR and all-cause mortality (P interaction < .001) and cardiovascular events (P interaction =.002). Similar results were observed after exclusion of individuals who died (n = 100) or had a cardiovascular event (n = 45) during the first 2 years of follow-up. CONCLUSION High RHR appears to be an independent determinant of all-cause mortality and cardiovascular events in older but not younger individuals.
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Affiliation(s)
- Kuibao Li
- Heart Center of Beijing, Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chonghua Yao
- Beijing Centers for Disease Control and Prevention, Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xinchun Yang
- Heart Center of Beijing, Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lei Dong
- Beijing Centers for Disease Control and Prevention, Anzhen Hospital, Capital Medical University, Beijing, China
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