Impact of compensation and willingness to keep same career path on burnout among long-term care workers in Japan.

BACKGROUND: This study examined the relationships between compensation, willingness to keep same career path, and burnout among long-term care workers in Japan. METHODS: Data were collected from 319 care workers at long-term care facilities in Japan. The study variables included data on demographics, compensation, willingness to keep same career path, and burnout. RESULTS: The study found that compensation and willingness to keep same career were significantly negatively associated with burnout levels among long-term care workers in Japan. Long-term care workers with high compensation levels were found to be more likely to have low burnout levels. In addition, care workers who expressed an intention to keep same career path were likely to have low burnout levels. In addition, compensation is associated with burnout as the mediating role of willingness to keep same career. CONCLUSIONS: These results highlight the importance of implementing policies and measures that reduce the risk of burnout among care workers to improve the quality of care. Strategies for improving working conditions include increasing wages, increasing compensation for experienced care workers, and reorganizing benefits.

Suicidal ideation associated with depression and social support: a survey-based analysis of older adults in South Korea.

BACKGROUND: This study examined the effect of depression on suicidal ideation among older adults in South Korea. Furthermore, this study investigated how social support, as a factor that reduces depression among older adults, mediates the relationship between depression and suicidal ideation. METHODS: Based on a survey of 260 older adults in Seoul and Gyeonggi Province, suicidal ideation, depression, and social support were evaluated using the Beck Scale for Suicidal Ideation, the Center of Epidemiological Studies Depression Scale, and the Measurement of Social Support in the Elderly, respectively. RESULTS: A multiple regression analysis confirmed that depression and social support were significantly associated with suicidal ideation. Based on path analysis, we found that social support mediated the relationship between depression and suicidal ideation. CONCLUSIONS: Therefore, this study provides concrete insights for policymakers and social workers about how suicidal ideation among older adults may be diminished. Particularly, the role of depression and social support in suicidal ideation is a matter of concern for older adults in South Korea.

Determinants of Discretionary and Non-Discretionary Service Utilization among Caregivers of People with Dementia: Focusing on the Race/Ethnic Differences.

Using Andersen's behavioral model of service utilization, this study aimed to understand how predisposing, enabling, and need factors were associated with two types of service utilization among caregivers of people with dementia. Caregiver participants (N = 637) were from the Resources for Enhancing Alzheimer's Caregivers Health (REACH II) study. Binary logistic and linear regression analyses were conducted to predict whether participants used services and the frequency of such service utilization. Results showed that some enabling and need factors were significantly associated with both discretionary and non-discretionary service utilization. Results also indicated some need factors were significant factors of the frequency of use for both discretionary and non-discretionary services. In addition, being Hispanic or African American moderated the association between some enabling or needs factors and service utilization. Practice attention needs to be paid on several enabling and needs factors among Hispanic and African American caregivers of people with dementia.

Leisure activity, gender and depressive symptoms among dementia caregivers: findings from the REACH II.

Objectives: Providing care to individuals with dementia places burden on family caregivers, which may relate to depressive symptoms. Although leisure activities may serve as a coping resource to relieve caregiving stress, only a few studies exist on how leisure and depressive symptoms associate in dementia caregivers. Moreover, less is known about the role of gender in this relationship. Thus, this study examined the relationship among leisure activity, gender and depressive symptoms.Method: A cutoff score (≥10) on the short form of the Center for Epidemiological Studies Depression Scale was used to measure presence of depressive symptoms. Independent variables were frequency of engagement in and satisfaction with leisure activities.Results: Logistic regression analyses from 632 dementia caregivers in the Resources for Enhancing Alzheimer's Caregiver Health II Study showed that more frequent and higher satisfaction in leisure engagement were negatively related to having depressive symptoms. Moreover, the negative association between frequent leisure engagement and depressive symptoms was more pronounced among male caregivers.Conclusion: Providing respite care for dementia caregivers to engage in leisure can be a promising coping strategy for this population. Also, gender difference in leisure-depressive symptoms relationship suggests different support needed for male and female caregivers in addition to leisure.

Depression among older Japanese Americans: The impact of functional (ADL & IADL) and cognitive status.

PURPOSE: The objective of this article is to investigate the relationship between activities of daily living, instrumental activities of daily living, cognitive impairment, and depression among Japanese American elders. METHODS: A cross-sectional study of 207 older Japanese Americans (68 years and older) was conducted in Los Angeles, California and Honolulu, Hawaii. Independent variables included activities of daily living, instrumental activities of daily living, and cognitive functioning. Age, gender, marital status, and income were also identified. Depression was the dependent variable. RESULTS: Descriptive analyses were done to show group differences in terms of gender, age and marital status. Gender (male) and marital status (married) were the determinants of lower rates of depression. Lower rates of IADL and cognitive functioning were significant determinants of higher rates of depression among older Japanese Americans. CONCLUSIONS: This study provides empirical evidence that physical and cognitive functioning are directly associated with depression in older Japanese Americans. Social workers need to provide the services of ethnic-based via formal agencies in order to prevent depression of older Japanese Americans. Also, it is important to have sensitivity and competency to assess depressive symptoms and refer elders to an appropriate mental health agency.

Traumatic brain injury as a result of violence in Native American and Black communities spanning from childhood to older adulthood.

PRIMARY OBJECTIVE: The purpose of this study was to compare the aetiology of TBI between different race, gender and age groups to understand demographic characteristics of people who experience TBI. RESEARCH DESIGN: A secondary data analysis of the Arizona Trauma Database consisting of 18 868 cases of TBI between 2008-2010 was conducted. METHODS AND PROCEDURES: The sample consisted of patients who ranged in age from 0-79 and were White, Black, Native American, Asian or other race. Cross-tabulations, chi-squares and a logistic regression were conducted. MAIN OUTCOMES AND RESULTS: Standardized residuals indicated that Native Americans and Blacks were more likely to experience violent TBI, regardless of gender or age group (p < 0.01). The logistic regression indicated that Native Americans (OR = 3.13), Blacks (OR = 1.95) and other race (OR = 1.56) patients had statistically significantly (p < 0.001) higher odds of experiencing violent TBI compared to Whites. In addition, females (OR = 0.40), children (OR = 0.75) and older adults (OR = 0.17) had statistically significantly (p < 0.001) lower odds of violent TBI. CONCLUSIONS: Providers of Native American and Black patients who have experienced violence should encourage them to receive assessments and treatment for TBI.

Factors that influence suicidal ideation among elderly Korean immigrants: focus on diatheses and stressors.

OBJECTIVES: The study examined major diatheses and stressors directly related to suicidal ideation among elderly Korean immigrants. The study also explored the significant interactions among these factors. METHOD: Data were collected from a cross-sectional survey of 220 elderly Korean immigrants (age ≥ 65) in Los Angeles County. RESULTS: Using a robust hierarchical regression, the study found that neuroticism and hopelessness were significantly associated with suicidal ideation. In addition, two interaction terms - neuroticism by hopelessness and neuroticism by acculturation - were both significant predictor variables with strong explanatory power. CONCLUSION: The theoretical implications as well as the practical implications for developing and implementing late-life suicide prevention strategies are discussed.

Problem-Focused Coping: Skipped-Generation Caregivers Affected by HIV/AIDS in Vietnam.

In this article, we examine skipped-generation caregivers who foster their grandchildren orphaned by HIV/AIDS in Vietnam. We investigated the challenges facing this population and the ways in which grandparents handled their trials on behalf of their families. Specifically, how did caregivers make sense of their roles, and how did these meanings inform their coping strategies? We conducted in-depth qualitative interviews with 21 older caregivers and 7 key informants and selected 5 caregivers from the sample to complete participant observations. The participants understood coping as problem-focused coping; for example, by considering a set of caregiving-related activities that included providing childcare, making money, borrowing money, cooking, and doing other daily chores. The voices of older caregivers must be a vital component to influence and inform service organizations and HIV sectors working in Vietnam. Based on a deeper understanding of the caregiving process, we outline implications for service development within the area of HIV caregiving.

Listening to the voices of native Hawaiian elders and 'ohana caregivers: discussions on aging, health, and care preferences.

Native Hawaiians, the indigenous people of Hawai'i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai'i. Six listening meetings were conducted, involving 41 community-dwelling kupuna (Native Hawaiian elders) and 'ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories­life course perspective, minority stress theory, and historical trauma­that guided the design of this study and provided the study's context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers.

The impact of social capital on depression among older Chinese and Korean immigrants: similarities and differences.

OBJECTIVES: The objective of this study is to examine similarities and differences in terms of the influence of social capital on depression among older Chinese and Korean immigrants. METHODS: The study used data collected from both 172 Chinese and 210 Korean immigrants living in Los Angeles County. The variables included depression Geriatric Depression Scale-Short Form, (GDS-SF), social capital (five indices of norms, trust, partnership in community, information sharing, and political participation), and demographics. RESULTS: The study found that partnership in community was significantly associated with a lower level of depression for both the groups. On the other hand, political participation was only associated with a lower level of depression for older Chinese immigrants. Also, norms and information sharing were only associated with a lower level of depression for older Korean immigrants. CONCLUSION: There was an evidence for the correlation between social capital and depression in older Chinese and Korean immigrant population. It suggests the needs to develop social programs and service in order to build more social capital for older immigrants.

Effects of acculturation and social network support on depression among elderly Korean immigrants.

OBJECTIVE: Acculturation and social network support have been identified as predictors of mental health for immigrant and elderly populations. The present study examined both independent and interactive effects of acculturation and social network support on depressive symptomatology among elderly Korean immigrants. METHOD: Self-reported measures included sociodemographic characteristics, acculturation, social network support, and depressive symptoms. This study used cross-sectional analysis of a community-based cohort. RESULTS: After controlling for the effects of demographic variables, a robust hierarchical regression model indicated that social network support was negatively associated with depressive symptoms. Also, the interaction between acculturation and social network was significantly associated with lower levels of depressive symptoms (ß = -0.29, p < 0.05). In other words, elderly Korean immigrants who had high social network support and were highly acculturated exhibited lower levels of depression compared to those who had low support and were highly acculturated. CONCLUSION: Our findings call attention to the role of social network support in the mental health of elderly Korean immigrants. Service providers can develop strategies for decreasing depression by increasing social network support, especially with family members, among their elderly parents.

Effects of Trauma and Postmigration Stress on Refugee Women's Health: A Life Course Perspective.

Trauma exposure and postmigration stress are associated with adverse health outcomes among refugees, yet the relative effect of these factors for subgroups of refugees and those resettled long-term remains unclear. Drawing on life course theory, this study evaluated the associations between war trauma, postmigration stress, and health among Southeast Asian refugee women in the United States, and whether these patterns differ across the life span. A community sample of Vietnamese and Cambodian refugee women aged 30-72 years (N = 293) reported mental and physical health outcomes, conflict-based trauma exposure, and postmigration measures of discrimination and community violence. Both trauma exposure and discrimination were associated with mental and physical health problems, with the relative effect of each stressor varying across specific health outcomes; community violence was associated with poorer mental health. Age moderated the effect of trauma exposure across health outcomes, with stronger associations between trauma and health for older women in particular. Findings provide support for the influence of trauma exposure and the importance of postmigration stressors on health across the life span for refugees. Attending to age group differences in the effects of these stressors, and to subgroups such as women, has implications for interventions addressing the long-term health of refugee populations.

Preventive Care and Outcomes of Interprofessional Medicare Annual Wellness Visits for Older Adults.

As we anticipate a growing population of older adults, we will see an increase in chronic conditions such as dementia and falls. To meet these public health needs, we must systematically provide screening, education, preventive care, and supportive care for older patients and their caregivers in a primary care setting. This will require a workforce trained in providing for the complex medical and psychosocial needs of an older adult population in an interprofessional and collaborative fashion. By integrating geriatric screening tools into an interdisciplinary Annual Wellness Visit teaching clinic, we were able to successfully improve rates of geriatric screening for dementia, depression, falls, medication reconciliation and advance care planning. We also saw improvements in patient care and satisfaction and provided the opportunity for interprofessional collaboration and education for students in medicine, nursing, pharmacy and social work.

A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout Among Long-Term Care Staff in Hawaii.

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

Self-Rated Health and Subjective Economic Status in Life Satisfaction among Older Chinese Immigrants: A Cross-Sectional Study.

This study examines the influence of self-rated health and subjective economic status on the life satisfaction of older Chinese immigrants in the United States. Data were obtained from a cross-sectional survey of 205 older Chinese immigrants aged 66 to 90 years living in Los Angeles and Honolulu. Ordinary Least Squares (OLS) regression analysis was employed to explore the independent effects of self-rated health and subjective economic status. The results demonstrated that self-rated health and subjective economic status were positively associated with life satisfaction. This cross-sectional study provides empirical evidence that self-rated health and subjective economic status are directly associated with subjective life satisfaction among older Chinese immigrants.

A pilot study of Trabajadora de salud, a lay health worker intervention for Latinas/os with traumatic brain injuries and their caregivers.

BACKGROUND: Latinas/os with traumatic brain injuries (TBIs) and their caregivers experience worse outcomes than others. OBJECTIVE: The study aimed to assess the acceptability and promise of Trabajadora de Salud on the functional abilities, hospital readmission, rehabilitation, employment, depression, somatic symptoms, and caregiver burden among Latinas/os with TBIs and their caregivers. METHODS: A pre-posttest experimental pilot study was conducted. A total of eight Latina/o adult patients (50% female) with mild or moderate TBI and six of their caregivers (66.7% female) were randomized to receive Trabajadora de Salud or a telephone only control group. Trabajadora de Salud, a three-month, in-home intervention administered by bilingual lay health workers, focused on: 1) providing empathy and validation of TBI symptoms, 2) addressing basic needs, 3) goal setting, and 4) improving communication with healthcare providers. RESULTS: Trabajadora de Salud was widely accepted by patients, caregivers, and health professionals. The functional, depression, and somatic symptoms of the patients as well as the somatic symptoms and caregiver burden of the caregivers improved more for participants in the intervention group than the control group. CONCLUSIONS: Trabajadora de Salud demonstrated promise in improving outcomes of Latinas/os with TBIs and their caregivers and should be further studied.

Effects of cognitive impairment and functional limitation on depressive symptoms among community-dwelling older Korean immigrants in the U.S.

The present study examined the effects of cognitive impairment and functional limitation on depressive symptoms among older Korean American immigrants. The sample was drawn from a cross-sectional survey of 210 older Korean immigrants (aged 65 years or older) in Los Angeles County. Based on robust hierarchical regression, the study found that cognitive ability and functional status were significant explanatory factors related to depressive symptoms among older Korean immigrants. In addition, the interaction of instrumental activities of daily living (IADL) and cognitive function (MMSE) had a significant effect on depressive symptoms. This finding suggests that older Korean immigrants in the U.S. who experience deficits in cognitive function and/or IADL performance are vulnerable to psychological distress as indicated by depressive symptoms. Recommendations include implementing culturally-responsive health interventions aimed at enabling accessibility to dementia care services and supporting improvement of IADL performance among older Korean American immigrants.

The Impacts of Social Support and Cognitive Function on Depression among Community-Dwelling Older Japanese Americans.

Research has demonstrated a relationship between social support, cognitive function, and depression among older adults, yet fewer studies have explored this association with Japanese American elders. This study aims to examine depression and describe its relationship with social support, cognitive function, and socioeconomic condition among Japanese American elders. A cross-sectional study of 205 Japanese American elders was conducted in Honolulu and Los Angeles County. A hierarchical regression model was used with depression as a dependent variable and with independent variables such as social support, cognitive function, and socioeconomic status. The study found that social support and cognitive function were significantly associated with depression for Japanese American elders. Also age and education were significantly associated with depression. Based on the findings, the study indicates the importance of developing preventive strategies to reduce the depression issue using culturally tailored programs to the study population.

Subjective Well-Being in Older Chinese and Korean Immigrants in the United States: Effects of Self-Rated Health and Employment Status.

This study examined the effects of association between self-rated health and employment status on subjective well-being among older Chinese and Korean immigrants in the United States. Data were collected from 171 Chinese and 205 Korean older adult immigrants living in Los Angeles County. The primary variables included demographic data, subjective index of well-being, self-rated health, and employment status. Data support the association between self-rated health and subjective well-being for both groups. Employment, education, and age were associated with the level of subjective well-being only for older Korean immigrants. Similarities and differences were noted in these two Asian American subgroups. Findings suggest the need to develop health promotion services for both populations and employment opportunities targeted more so for Korean older immigrants to further support their subjective well-being. Results may have implications for other for older immigrants.

The Moderation of Blood Alcohol Levels on Higher Odds of Survival among American Indians with Violent, Blunt-Force Traumatic Brain Injuries.

This study assessed the moderation of blood alcohol level (BAL) and American Indian race on survival of patients with violent traumatic brain injury (TBI). An initial logistic regression model indicated that those who were American Indian and insured had higher odds of survival and those with higher injury severity scores and low-medium BAL were less likely to survive. A second logistic regression model including a relationship between American Indians and BAL found that American Indians had a higher odds of survival which tripled when they have no BAL. Low-medium and high BAL were associated with less likelihood of survival among White patients.