期刊论文详细信息
BMC Geriatrics
The importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: a cross sectional study
Espen Bjertness1  Odd Steffen Dalgard2  Hege Bøen2 
[1] Faculty of Medicine, UiO, Department of Community Medicine, Institute of Health and Society, Oslo, Norway;Division of Mental Health, Department of Surveillance and Prevention, Norwegian Institute of Public Health, Oslo, Norway
关键词: Social inequality;    Somatic health;    Psychological distress;    Social support;    Older adults;   
Others  :  858114
DOI  :  10.1186/1471-2318-12-27
 received in 2011-08-23, accepted in 2012-06-08,  发布年份 2012
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【 摘 要 】

Background

Little is known of the importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home. The objectives of the present study were to investigate the associations of social support, somatic health problems and socio-economic factors with psychological distress. We also examined changes in the association of somatic health problems and socio-economic factors with psychological distress after adjusting for social support.

Methods

A random sample of 4,000 persons aged 65 years or more living at home in Oslo was drawn. Questionnaires were sent by post, and the total response was 2,387 (64%). Psychological distress was assessed using Hopkins Symptom Checklist (HSCL-10) and social support with the Oslo-3 Social Support Scale (OSS-3). A principal component analysis (PCA) included all items of social support and psychological distress. Partial correlations were used, while associations were studied by logistic regression.

Results

After adjusting for socio-demographics and somatic health problems, we reported a statistically significant association between psychological distress and social support: “Number of close friends”, OR 0.61; 95% CI 0.47-0.80; “Concern and interest”, OR 0.68; 95% CI 0.55-0.84. A strong association between lack of social support and psychological distress, irrespective of variables adjusted for, indicated a direct effect. The associations between psychological distress and physical impairments were somewhat reduced when adjusted for social support, particularly for hearing, whereas the associations between somatic diagnoses and psychological distress were more or less eliminated. Income was found to be an independent determinant for psychological distress.

Conclusions

Lack of social support and somatic health problems were associated with psychological distress in elders. Social support acted as a mediator, implying that the negative effect of somatic health problems, especially hearing, on psychological distress was mediated by low social support. We hypothesize that physical impairments reduced social support, thereby increasing psychological distress to a greater extent than the selected diagnoses. The combination of poor social support, poor somatic health and economic problems may represent a vulnerable situation with respect to the mental health of older persons. Free interventions that highlight social support should be considered in mental health promotion.

【 授权许可】

   
2012 Bøen et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Golden J, Conroy RM, Bruce I, Denihan A, Greene E, Kirby M, et al.: Loneliness, social support networks, mood and well-being in community-dwelling elderly. Int J Geriatr Psychiatry 2009, 24:694-700.
  • [2]Heikkinen RL, Kauppinen M: Depressive symptoms in late life: A 10-year follow-up. Arch Gerontol Geriatr 2004, 38:239-250.
  • [3]Moak ZB, Agrawal A: The association between perceived interpersonal social support and physical and mental health: Results from the national epidemiological survey on alcohol and related conditions. J Public Health 2009, 32(2):191-201.
  • [4]Blazer DG: Depression in late life: Review and commentary. Focus 2009, 7:118.
  • [5]Dalgard OS: Social inequalities in mental health in Norway: Possible explanatory factors. International Journal for Equity in Health 2008, 7:27. BioMed Central Full Text
  • [6]Bruce ML: Psychosocial risk factors for depressive disorders in late life. Biol Psychiatry 2002, 52:175-84.
  • [7]Cohen S, Wills TA: Stress, social support, and the buffering hypothesis. Psychol Bull 1985, 98:310.
  • [8]European Union Public Health Information System, Dalgard OS: Social support: Occurrence. , ; 2009. http://.euphix.org EUPHIX is a European community health monitoring model and no journal webcite
  • [9]Dalgard OS, Bjørk S, Tambs K: Social Support, Negative Life Events and Mental Health. Br J Psychiatry 1995, 166:29-34.
  • [10]Dalgard OS: A randomized controlled trial of a psychoeducational group program for unipolar depression in adults in Norway (NCT00319540). Clin Pract Epidemol Ment Health 2006, 2:15. BioMed Central Full Text
  • [11]Kawachi I, Berkman LF: Social ties and mental health. J Urban Health 2001, 78:458-67.
  • [12]Moussavi S, Chatterji S, Verdes E, Tandom A, Patel V, Ustun B: Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 2007, 370:851-8.
  • [13]Ormel J, Rijsdijk FV, Sullivan M, van Sonderen E, Kempen GIJM: Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2002, 57:338.
  • [14]Hanson BS, ISACSSON SO, Janzon L, LINDELL SE: Social network and social support influence mortality in elderly men: Prospective population study of men born in 1914, Malmø. Sweden. Am J Epidemiol 1989, 130:100.
  • [15]Tomaka J, Thompson S, Palacios R: The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging Health 2006, 18:359.
  • [16]Hawthorne G: Perceived social isolation in a community sample: Its prevalence and correlates with aspects of peoples lives. Soc Psychiatry Psychiatr Epidemiol 2008, 43:140-50.
  • [17]Koster A, Bosma H, Kempen GIJM, Penninx BWJH, Beekman ATF, Deeg DJH, et al.: Socioeconomic differences in incident depression in older adults: The role of psychosocial factors, physical health status, and behavioral factors. J Psychosom Res 2006, 61:619-27.
  • [18]Mojtabai R, Olfson M: Major depression in community-dwelling middle-aged and older adults: Prevalence and 2-and 4-year follow-up symptoms. Psychol Med 2004, 34:623-34.
  • [19]Derogatis LR, Lipman RS, Rickels Keal: The Hopkins Symtom Checklist (HSCL): A self-report symptom inventory. Behav Sci 1974, 19:1-15.
  • [20]Strand BH, Dalgard OS, Tambs K, Rognerud M: Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36). Nord J Psychiatry 2003, 57:113-8.
  • [21]Müller JM, Postert C, Beyer T, Furniss T, Achtergarde S: Comparison of Eleven Short Versions of the Symptom Checklist 90-Revised (SCL-90-R) for Use in the Assessment of General Psychopathology. Journal of Psychopathology and Behavioral Assessment 2009.
  • [22]Dalgard OS, Dowrick C, Lehtinen V, Vazquez-Barquero JL, Casey P, Wilkinson G, et al.: Negative life events, social support and gender difference in depression: A multinational community survey with data from the ODIN study. Soc Psychiatry Psychiatr Epidemiol 2006, 41:444-51.
  • [23]WHO Regional Office for Europe: EUROHIS: Developing Common Instruments for Health Surveys. WHO Regional Office for Europe by IOS press, Copenhagen; 2003.
  • [24]Korkeila J, Lehtinen V, Bijl R, Dalgard OS, Kovess V, Morgan A, et al.: Establishing a set of mental health indicators for Europe. Scand J Public Health 2003, 31:451-9.
  • [25]Phillipson C: Social relationships in later life: A review of the research literature. Int J Geriatr Psychiatry 1997, 12:505-12.
  • [26]Oxman TE, Berkman LF, Kasl S, Freeman DH, Barrett J: Social support and depressive symptoms in the elderly. Am J Epidemiol 1992, 135:356.
  • [27]Felmlee D, Muraco A: Gender and Friendship Norms Among Older Adults. Res Aging 2009, 31:318.
  • [28]Mulrow CD, Aguilar C, Endicott JE, Velez R, Tuley MR, Charlip WS, et al.: Association Between Hearing Impairment and the Quality of Life of Elderly Individuals. Journal of American Geriatrics Society 1990, 38:45-50.
  • [29]Yueh B, Shapiro N, Shekelle PG, MacLean CH: Screening and management of adult hearing loss in primary care: Scientific review. JAMA 1976, 2003:289.
  • [30]Beekman ATF, Penninx B, Deeg DJH, Ormel J, Braam AW, Van Tilburg W: Depression and physical health in later life: Results from the Longitudinal Aging Study Amsterdam (LASA). J Affect Disord 1997, 46:219-31.
  • [31]Prince MJ, Harwood RH, Thomas A, Mann AH: A prospective population-based cohort study of the effects of disablement and social milieu on the onset and maintenance of late-life depression. The Gospel Oak Project VII. Psychol Med 1998, 28:337-350.
  • [32]Schoevers RA, Beekman ATF, Deeg DJH, Geerlings MI, Jonker C, Van Tilburg W: Risk factors for depression in later life: Results of a prospective community based study (AMSTEL). J Affect Disord 2000, 59:127-37.
  • [33]Blazer DG: Social support and mortality in an elderly community population. Am J Epidemiol 1982, 115:684.
  • [34]Seeman TE, Lusignolo TM, Albert M, Berkman L: Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging. Health Psychol 2001, 20:243-55.
  • [35]Fratiglioni L, Wang H, Ericsson K, Maytan M, Winblad B: Influence of social network on occurence of demtia: A community-based longitudinal study. Lancet 2000, 355:1315-9.
  • [36]Fratiglioni L, Winblad B, von Strauss E: Prevention of Alzheimer's disease and dementia. Major findings from the Kungsholmen Project. Physiology & behavior 2007, 92:98-104.
  • [37]Lupsakko T, MSntyjSrvi M, Kautiainen H, Sulkava R: Combined hearing and visual impairment and depression in a population aged 75 years and older. Int J Geriatr Psychiatry 2002, 17:808-13.
  • [38]Heine C, Browning CJ: Communication and psychosocial consequences of sensory loss in older adults: Overview and rehabilitation directions. Disability & Rehabilitation 2002, 24:763-73.
  • [39]Bisschop MI, Kriegsman DMW, Beekman ATF, Deeg DJH: Chronic diseases and depression: The modifying role of psychosocial resources. Social Science & Medicine 2004, 59:721-33.
  • [40]Rostad B, Deeg DJH, Schei B: Socioeconomic inequalities in health in older women. European Journal of Ageing 2009, 6:39-47.
  • [41]Keith VM: Gender, financial strain, and psychological distress among older adults. Res Aging 1993, 15:123.
  • [42]Ferraro KF, Su YP: Financial strain, social relations, and psychological distress among older people: A cross-cultural analysis. Journals of Gerontology Series B 1999, 54:3-15.
  • [43]Lien L, Oppedal B, Haavet OR, Hauff E, Thoresen M, Bjertness E: Clinical Practice and Epidemiology in Mental Health. Clinical Practice and Epidemiology in Mental Health 2006, 2:30. BioMed Central Full Text
  • [44]Barnett PA, Gotlib IH: Psychosocial Functioning and Depression - Distinguishing Among Antecedents, Concomitants, and Consequences. Psychol Bull 1988, 104:97-126.
  • [45]Sommerfeldt E, Bevefelt E: Eldresentre i utvikling. Norsk Gerontologisk Institutt, Oslo; 1993.
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