Relationship between social support and life satisfaction among the rural elderly: Mediating effect and moderating effect / 中国心理卫生杂志

Objective:To investigate the relationship between social support and life satisfaction among the rural elderly,and to explore the moderating and mediating variable between them.Methods:Totally 768 rural elders [aged 60-96 years,average age (70 ±7) years] from Beijing,Hubei and Anhui Province were measured with selfmade General Questionnaire (including self-reported health,rated by five grades from very poor,poor,common,good to very good),self-made Social Support Scale for the Elderly,University of California Los Angeles Loneliness Scale-6 (ULS-6) and Satisfaction with Life Scale (SWLS).Results:Loneliness partly mediated the relationship between social support and life satisfaction and the value of mediating effect was 56.3％.The effect of social support on the rural elders'life satisfaction was moderated by self-evaluated health.Post-hoc analysis indicted that only when the scores of self-evaluated health were lower,social support could predict life satisfaction at a significant level (β =0.25,P ＜0.001).When the scores of self-evaluated health were higher,the predicting effect was not significant (β=0.04,P ＞ 0.05).Conclusion:The relationship between social support and life satisfaction of the rural elderly is mediated by loneliness and moderated by self-evaluated health.

Investigation on the Quality of Life about Rural Elderly Population and Its Influencing Factors / 中国医学伦理学

Objective:To understand the quality of life about rural elderly population and its influencing factors.Methods:Using WHOQOL-BREF scale and self-designed questionnaire,a survey about quality of life was conducted among 1074 rural elderly in Shandong Province selected by stratified,random method.T test,variaace analysis and multiple linear regression were used to analyze the influencing factors.Results:The score of environment field was the highest (13.83 ± 1.05),while social relations field was the lowest (8.63± 0.45).Single factor analysis showed that age,education level,economic situation,pension source,chronic disease,pension mode,physical exanination had significant effect on quality of life scores in each dimension (P ＜ 0.05).Marital status only had significant effect on psychological and social relations scores (P ＜ 0.05).Gender and the number of children were not statistically significant on the quality of life score in each dimension (P ＞ 0.05).Multiple regression analysis showed that the influencing factors of quality of life score in each dimension were chronic disease and economic situation.Physical examination only had significant effect on the physiology and psychological score.Pension mode had significant effect on psychological and social relations score.Age influenced physiology health score.Marital status influenced psychology health score.Conclusion:The government should pay attention to the health status of elderly and the psychological status of elderly without spouse;increase the support efforts to the poor rural elderly;strengthen the prevention and treatment of chronic diseases;improve the social support network and social security system.

Analysis of Social Support Conditionand Influencing Factors of Rural Elderly in Shandong Province / 中国医学伦理学

Obiecrive:To investigate the social support condition and its influencing factors of the rural elderly in Shandong province.Methods:With multi-stage stratified random sampling method,a questionnaire survey was conducted among 2200 elderly people aged over 60 years using self-developed questionnaire and Social Support Rating Scale (SSRS).Results:Total score of social support in 1115 rural elderly people was (38.01 ±8.39),higher than the national norm.Multiple factor analysis showed that marital status (P ＜ 0.01) and self-care ability (P ＜0.01) had significant effect on the social support of the rural elderly in Shandong Province.Conclusion:The social support condition of the rural elderly in Shandong province is good.We should pay more attention to the spir-itual demands of the rural elderly and further improve the social support of the rural elderly,and thusto promote the development of the rural elderly physical and mental health.

Effects of High-speed Elastic Band Training on Physical Fitness and Muscle Function in Rural Community-dwelling Elderly: a Single-blinded Randomized Controlled Trial

BACKGROUND: Aging related decrease in muscle strength and flexibility leads to functional loss of physical ability. Power training is known to improve these capacities and helps in performing daily routine better. Therefore, we modified previously proven and certified sarcopenia intervention exercise for elderly in rural community and applied them to examine the effects on physical fitness and muscle functions to show its applicability. METHODS: Subjects were divided into control and exercise group using single-blind method. Exercise group underwent high-speed elastic band training(concentric contraction in 1 second) 2 days per week for 12 weeks. Before and after the intervention, we performed body composition analysis, anthropometric measurement, blood test, blood pressure check, senior fitness test (SFT), upper body and lower body strength examination. Korean version of Physical Activity Scale for the Elderly (K-PASE), and Center for Epidemiological Studies- Depression Scale (CES-D) were also assessed. RESULTS: Body weight in control group was significantly increased (Paired t-test: P=0.008), although it was consistent in exercise group (GroupxTime: P=0.013). 30-second chair stand (P<0.001) and 30-second arm curl (P<0.001) of the senior fitness test were also significantly improved in exercise group compared to control. In addition, muscle strength of knee flexion (P=0.034) and K-PASE score (P<0.001) were improved in training group with statistical significance. CONCLUSIONS: The modified high-speed elastic band training for rural elderly improved muscle strength and daily physical performance. This result suggests a simple and easy to perform band training could be an excellent solution to prevent sarcopenia in rural elderly. It also supports the evidence that this program would be widely distributed.

Sleep and quality of life among rural elderly in Anhui province / 中华流行病学杂志

Objective The primary purposes of this article were to examine the distributions and correlation between conditions of sleep and the quality of life,so as to explore the risk factors of abnormal sleep among elderly in the rural areas of Anhui province.Methods Elderly who aged 60 years or more (n= 1680) were randomly selected from rural areas in Anhui province.Conditions of sleep and quality of life of the subjects were assessed independently,using the pittsburgh sleep quality index (PSQ1) scale and SF-36 scale.A generalized logistic model analysis was performed,using sleep-related factors as explanatory variables.Results The average PSQI score was 7.43 + 4.13.Persons whose sleep conditions were graded as well,common or poor were accounted for 29.4%,24.3%,46.3%,respectively.Sex and sleep quality were different in terms of quality of life among all the factors (P＜0.05).Men had better quality than women,and poor sleepers had poorer quality of life as compared to the one with better conditions.Factors as being married/living alone/economically independent,having better social function,often eating meat or wheat were significant predictors for having good sleep conditions.However,factors as better education received,living alone,with poor vitality/general health,having chronic diseases (back pain,coronary heart or stomach disease),less meat intake,rice as major foods etc.were predictors for poorer sleeping condition.Conclusion Our data showed that it was unsatisfactory on the quality of sleep among the rural elderly in Anhui province.Conditions on general,health and nutrition should be improved in order to prevent the poor sleep condition.

Effect of Nutrition Support Program for the Elderly in a Rural Community / 農村醫學 地域保健

OBJECTIVES: This study was performed to assess the effects of nutrition support for the elderly in rural communities. METHODS: The data for this study were obtained from 148 aged over 65 years in G district(70 intervention group and 78 control group). General characteristics, physical health status, food intake, dietary habits, knowledge of nutrition and nutrition risk factors of the subjects were examined by individual interview. The participants were divided into two groups through the first questionnaire of nutrition: nutritional intervention group(nutritional intervention and education of nutrition) and control group(education of nutrition alone). RESULTS: Nutritional intervention group showed significant increase of energy intake to 87.4% from 71.0% and of most nutrients except vitamin A and niacin after intervention. After nutritional intervention program, depression index was significantly decreased and changes of food habits, self-efficacy and conviction indices were significantly increased. CONCLUSIONS: This study showed that the nutritional intervention serving foods for short-term intervention period was very effective in improving the nutritional status. In addition, it suggested that it was not enough for nutritional improvement of the elderly to provide public health education or counseling alone, therefore, for achieving its goals, it should be needed proper nutritional supply to them.

The Effects of a Health Promotion Program in Rural Elderly on Health Promotion Lifestyle and Health Status / 간호학회지

PURPOSE: The purpose of this study was to identity the effects of a health promotion program for rural elderly on health promotion lifestyle and health status. METHOD: The study was a nonequivalent control group pre-post experimental design. Data collection was performed from April 12th, 2003 to August 2nd, 2003. The subjects were selected at Mari Myun Geochang Gun in Korea. 44 elders were in the experimental group and 45 elders were in the control group. The 16-week health promotion program was given to the experimental group. Data was analyzed by descriptive statistics, chi2-test, t-test, and ANCOVA test with SPSS/Win 10.0 program. RESULT: The experimental group showed higher scores of a health promotion lifestyle and perceived health status than the control group. In addition, systolic BP, heart rate, body fat and glucose of the experimental group were lower than the control group. Waist flexibility, left hand grip power, back strength and leg strength of the experimental group were higher than the control group. However, there were no significant differences in diastolic BP, total cholesterol and right hand grip power between the two groups. CONCLUSION: This health promotion program for rural elderly can be recommended as an effective nursing intervention in rural communities.

A Comparative Study on Barrier Factors in Health Behaviors of Urban vs Rural Elderly / 성인간호학회지

The purpose of this study was to identify the barrier factors of health behaviors of urban and rural elderly and to compare the health behaviors and level of barriers between two groups, and finally to get the basic informations about the adequate nursing strategies to promote the health state of urban and rural elderly. The subjects of this study were 177 over the age of 65, 81 elderly lived in Seoul and 96 elderly lived in rural areas. The instruments for this study were the health behavior scale(14 items) and the barrier scale (118 items) developed by Gu et al(2003). For the data analysis, SPSS PC program was utilized for descriptive statistics, chi2- test, t-test, Pearson correlation. The results of this study were ; 1. The mean score of health behaviors (range 1-4) was 2.69 in urban elderly and 2.33 in rural elderly ; there was significant difference(t=5.03, P=.00). 2. There were significant differences in levels of barriers(range 1-3) between the two groups, such as calcium intake(t=-3.16, P=.00), regular exercise(t=-3.80, P=.00), exercise time(t=-5.54, P=.00), use of stress reduction method(t=-3.45, P=.00), regular check up(t=-3.89, P=.00), vaccination(t= -3.83, P=.00). Higher levels of barriers were found in rural elderly than in urban elderly.3. Lack of habituation, lack of will power and lack of knowledge in calcium intake; lack of time, lack of habituatuion, lack of family support, lack of will power and lack of environment in exercise; lack of perceived benefit, lack of time, lack of will power and lack of knowledge in use of stress reduction method; lack of time, lack of interest, lack of habituation and lack of will power in disease prevention were significantly higher in rural elderly than in urban elderly.In the conclusion, nursing interventions should be planned based on the social environment of elderly. To promote the health state of elderly, interventions to decrease the barrier levels and to reduce the barrier factors to health behaviors should be implemented.

Nutritional Status and Related Factors of Residents Aged Over 50 in Longevity Areas : I. Anthropometric and Biochemical Nutritional Status

Studies on the health problems of the elderly have been increased with increasing life expectancy of Koreans. To assess the health status of people over 50 years old including the elderly (678 free-living people: men (168), women (510)), anthropometric measurements and biochemical nutritional status were analyzed. General characteristics and the prevalences of specific diseases were also examined. The mean anthropometric values for males and females were heights of 162 cm and 149 cm, respectively; and weights of 59 kg and 52 kg, respectively, which were much lower than the Korean standards established in the Korean Recommended Dietary Allowances. The mean BMI, WHR (waist hip ratio), and body fat rate (%), which are obesity indices, were significantly higher in females than in males. As the age went up, height, weight, lean body mass, and mid-arm circumference decreased. Whereas, blood pressure (SBP) for women increased. Mean blood HDL-cholesterol levels of men and women were 46.0 mg/dl and 46.3 mg/dl, respectively; their triglyceride levels were 129.1 mg/dl and 135.6 mg/dl, respectively, which were not significantly different. Total cholesterol and LDL-cholesterol levels were significantly higher in females than in males. For man, there were significantly different in gamma-GTP, Na levels by age. As the age went up for women, RBC, hemoglobin, hematocrit, HDLcholesterol, gamma-GTP and Ca2+ levels significantly decreased. Levels of total protein and albumin were above the lower normal limit for the majority of the participants. Prevalence of anemia, assessed by hemoglobin using World Health Organization (WHO) definition, was 43.9% for men and 42.1% for women. Also, many of the subjects were out of the normal range in total cholesterol (women), HDL-cholesterol, TAS (total antioxidant status), APase, RBC, hemoglobin, hematocrit levels. Therefore, measures to improve the biochemical nutritional status for the people in rural area are required.

A Structural Relational Analysis of the Determinants of Functional Status in Korean Rural Elderly People / 간호학회지

This study was conducted to develop a theoretical model for the determinants of activities of daily living in Korean rural elderly people. The theoretical model was derived from Lawton's Ecological Model to explain human behavior. The model includes determinant variables for functional status such as age, sex, physical status, cognitive status, physical environment, social environment, and depression. Data for this study was collected from 189 elderly people in a rural district near Chonju City. The data was analyzed with SPSS PC+ 4.1 and LISREL 8. The analysis of the data showed that the first proposed theoretical model did not fit the collected data well. In order to increase the fit of the model to the data, the model was modified by deleting the exogenous variables of sex, physical environment, and social environment. The fit of the modified model to the data was increased and was move suitable. The results of this study show that the determinants of the activities of Korean rural elderly people were age, perceived physical condition, cognitive status, and depressional status. Age has a significant direct and indirect effect on the activities of daily living of rural elderly people. Perceived physical condition has a significant indirect effect through depression on activities of daily living. Cognitive status also has a significant indirect effect through depression of functional status. Depression has a significant direct effect on the functional status. Physical environment and social environment showed reversal relationships to functional status. In conclusion, the results of this study show that personal characteristic factors are more important than environmental characteristic factors for functional status of elderly people. However, the importance of depression to functional status in korean rural elderly people and the reverse relationship between social environment and functional status, reflect Korean specificity. Korean nursing needs to focus more on this Korean specificity in order to develop nursing knowledge and practice appropriate to Korea people.

The Relationship between the Cognitive Impairment and Mortality in the Rural Elderly / 예방의학회지

The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respondents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

A study on the depression and cognitive impairment in the rural elderly / 예방의학회지

For the purpose of promotion of mental health in the rural elderly, the author surveyed 558 elderlies aged 60 years or more, and assessed the prevalence rates of depression and cognitive impairment by using self-rating depression scale of Zung(SDS) and the Korean version of mini-mental state examination(MMSEK). Also the association between depression or cognitive function and socio-environmental factors were investigated. The major findings were as follows; 1. The prevalence rates of severe depression and cognitive impairment were 20.9% and 14.9% in all the elderly of both sexes, respectively. 2. The rates of depression and cognitive impairment increased with increasing age in both sex groups. The mean scores of SDS increased and the mean scores of MMSEK decreased significantly among them(P<0.01). 3. Those being female, widows or widowers, and those having low levels of physical activity, showed significantly high the mean scores of depression and had significantly low the mean scores of cognitive impairment(P<0.01). 4. The depression scores relating to decreased libido, confusion, psychomotor retardation, hopelessness and indecisiveness were relatively high in both sexes. 5. All the items of mini-mental state examination were significantly correlated with depression. 6. In stepwise multiple regression analysis on depression, MMSEK, level of physical activity, chronic disease, marital status and family income were selected as highly correlated variables, and the R2-value for these variables was 33.7%. 7. In stepwise multiple regression analysis on cognitive function, level of physical activity, age, depression, sex and marital status were selected as highly correlated variables, and the R2-value for these variables was 62.6%. The depression and cognitive impairment of the elderly were positively correlated with nearly all sociodemographic variables.