Pathways from education and childhood parental death to successful aging: the role of social conditions and perceived income level.

OBJECTIVES: Although the association between adverse childhood conditions and health in later life has been relatively well established, little is known about how and through which mechanism this association develops. Building on the developmental adaptation model (Martin & Martin, 2002), the present study investigates the effects of distal and proximal influences on successful aging (SA). METHODS: A cross-sectional survey was conducted of 475 adults aged 50 and above (Mean age = 72.13, SD = 10.46). SA was measured based on Rowe and Kahn's successful aging criteria model (1997) and an SA operationalization based on a number of multidimensional biopsychosocial indicators, including no disease and disability, active engagement with life, high physical and cognitive functioning, psychological well-being, life satisfaction and a one-item subjective SA question. RESULTS: Parental death had no direct effect on SA (ß = .03, p = .629), whereas education had (ß = .39, p < .001). Furthermore, perceived income level and social conditions were identified as two sequential mediators between both education and SA; and parental death and SA. CONCLUSIONS: The findings suggest that both early life and current factors contribute to explaining SA in a variety of ways.

Testing a model of biopsychosocial successful aging based on socioemotional selectivity theory in the second half of life.

OBJECTIVES: We first tested a successful aging model, which included biomedical and psychosocial indicators. Next, we tested the assumptions on the social network characteristics of the socioemotional selectivity theory in a model where the outcome variable is successful aging. DESIGN: Cross-sectional study. SETTING: The study was carried out in municipal centers and nursing homes. PARTICIPANTS: A total of 478 adults (Mean age = 72.11, SD = 10.43) were enrolled. MEASUREMENTS: Psychological Well-being Scale, Life Satisfaction Scale, Future Time Perspective, Katz Index of Independence in Activities of Daily Living Scale, Lawton Instrumental Activities of Daily Living Scale, and Mini-Mental State Examination Test were completed. RESULTS: The structural equation modeling analyses indicated that higher social satisfaction mediated the association of the future time perspective with successful aging. Furthermore, there was another significant indirect sequential path from the future time perspective to successful aging. The path was first via the number of close social partners and second, social satisfaction. CONCLUSIONS: The findings highlight the importance of social satisfaction in the process of successful aging and provide novel evidence that the socioemotional selectivity theory can be considered as a biopsychosocial model of successful aging in future studies.

Reliability and Validity of the Turkish Version of SF-12 Health Survey. / SF-12 Yasam Kalitesi Ölçegi'nin Türkçe Formunun Güvenirlik ve Geçerlik Çalismasi.

OBJECTIVE: The aim of this study is to determine the psychometric properties of the Turkish version of the SF-12 Health - a widely used scale that assesses health - related quality of life - and to assess whether its psychometric properties are as good as with the 36 items long version (SF-36). METHOD: The study included a total of 190 participants including 138 young adults aged from 18 to 29 years (22.04±2.35) and 52 older adults aged from 60 to 80 years (67.27±5.22). The relationships between EQ-5D-3L, CES-D and SF-12 scales were investigated for content, convergent and divergent, criterion-related and the known-groups construct validity. In order to assess reliability, internal consistency and item-total correlation coefficients were calculated and test re-test analyses were conducted. RESULTS: The internal consistency coefficients of the scale were found to be satisfactory (for the components α=0.73 and 0.72). Consistent with the original study, physical and mental components of the SF-12-TR were found to be strongly correlated with the components of the SF- 36 and explained, respectively, 86.6% and 92.4% of the variance. The components of the SF-12-TR were found to be moderately or strongly correlated to the sub-dimensions of the EQ-5D-3L and CES-D, which measure the same structures, while they were unrelated or weakly correlated with the sub-dimensions measuring different structures. CONCLUSION: The findings indicated that the psychometric properties of the Turkish form of SF-12-TR are similar to the original version, and the SF-12-TR can be used as an alternative to the SF-36-TR in clinical and research settings in our country.

Psychometric Properties of the Future Time Perspective Scale for the Turkish Population: Age Differences in Predictors of Time Perspective.

The purpose of this study was to determine the psychometric properties of the Turkish version of the Future Time Perspective Scale (FTPS-T) and examine age-group differences in the predictors of respondents' future time perspective. Data were collected from a sample of 202 young adults (aged 18-28 years) and 127 community-dwelling older adults (aged 60-86 years). The internal consistency and test-retest methods were employed to assess the reliability of the FTPS-T, and the FTPS-T's validity was assessed using construct- and criterion-related validity. The reliability and validity analyses demonstrated that the FTPS-T had satisfactory psychometric properties. Multiple regression analyses revealed that the strongest predictor of future time perspective in young adults was subjective psychological health, whereas chronological and subjective (i.e., physical) ages were stronger predictors among older adults. These findings indicate that subjective variables shape the perceptions of a lifetime, and the results are discussed in the context of socioemotional selectivity theory.

Assessment of psychosocial factors and distress in women having adjuvant endocrine therapy for breast cancer: the relationship among emotional distress and patient and treatment-related factors.

PURPOSE: The aims of this study were to comprehensively describe the psychosocial and medical characteristics of women who initiated tamoxifen or aromatase inhibitors for breast cancer and to compare levels of emotional distress according to their medical (tumor demographics, treatment type, treatment duration) and psychosocial (self-esteem, perceived social support, sociodemographic) characteristics. METHODS: A total of 104 women currently receiving tamoxifen or aromatase inhibitors was recruited from outpatient clinics and they were asked to complete self-report questionnaires including the Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support and the Hospital Anxiety and Depression Scale during their routine follow-up. Psychosocial and medical characteristics of the patients were first described and subsequently the score of emotional distress was compared with these. RESULTS: The patients' mean age was 52.49 ± 10.30 and they were being treated for an average of 24.3 months. Out of the patients' characteristics, educational and marital status, level of perceived social support and self-esteem were all significantly related with emotional distress. As for medical variables, the score of distress was relatively higher among patients in the first 2 years of their treatment than the patients who were in the second to fifth years of treatment, but this was not statistically significant. CONCLUSIONS: Given the results of this study, it appeared that patient variables, rather than the medical or treatment characteristics, were related with emotional distress in women undergoing endocrine treatment. For that reason it is critical that medical staff are aware of patient factors that relate to distress during a long period of adjuvant endocrine therapy.

Patients' understanding of treatment goals and disease course and their relationship with optimism, hope, and quality of life: a preliminary study among advanced breast cancer outpatients before receiving palliative treatment.

PURPOSE: The aims of this study were to explore advanced breast cancer patients' knowledge of treatment intent and expectation of illness course and to evaluate their relationship with optimism, hope, and quality of life (QoL). METHODS: Patients with advanced breast cancer (n = 55) who were treated in the ambulatory clinic of the University of Hacettepe were included in the study. They completed Life Orientation Scale, The Hope Scale, and the European Organization for Research and Treatment of Cancer Quality of Life questionnaires. The data regarding the knowledge of illness progression and the perceptions of therapy intent were assessed using self-administered open-ended questionnaires that were answered by the patients. RESULTS: The data revealed that 58.2 % of the patients had an inaccurate perception of treatment intent, believing the aim of treatment was cure, whereas only 38.2 % of the patients had a realistic expectation that their disease may remain stable or may progress over a year. In addition, the awareness of disease progression and perception of goals of treatment was significantly related to hope and optimism scores but not to QoL. CONCLUSIONS: A large proportion of patients diagnosed with advanced breast cancer believed that their treatment was "curative", and they would improve within a year. Findings of our study suggest that patients with inaccurate perception of treatment intent and unrealistic expectation of prognosis have higher hope and optimism scores than those who do not, but there were no significant differences in terms of global health status.

Psychological distress and loneliness in caregiver of advanced oncological inpatients.

The objective of this study is to compare and examine the relationships between levels of loneliness, anxiety, depression, and other variables on primary caregivers and cancer inpatients. The study involved 100 Turkish primary caregivers of inpatients with advanced or terminal stages of cancer. Loneliness and anxiety scores were significantly higher for the primary caregivers of inpatients with terminal stage of cancer than primary caregivers of inpatients with advanced stage of cancer. Excluding the cancer stage, loneliness and anxiety were primarily associated with the socio-demographic factors of primary caregivers rather than the characteristics of patients.