Exposure to Violence in Social Unrest, Resilience, and Mental Health of Older People in Hong Kong.

OBJECTIVE: Older adults are prone to the negative effects of exposure to violence on their mental health. This study aimed to examine the impact of exposure to violence during social unrest and the role of resilience in the mental health of older people. DESIGN: A total of 1,203 people aged 65 years or older were randomly selected for a telephone survey using the random digit dialing numbering method in Hong Kong. MEASUREMENTS: A 13-item scale was developed to measure exposure to violence. The Chinese versions of the Connor-Davidson Resilience Scale and the Startle, Physiological Arousal, Anger, and Numbness scales for measuring mental health status were adopted in the survey. RESULTS: The results showed that the more frequently older people were exposed to information, the more negative mental health status they had. However, exposure to witnessing and experiencing violence was not significantly associated with mental health status. Older adults' level of resilience had a moderating effect between exposure to information and mental health, whereas the effect of exposure to information on mental health was stronger for respondents with lower resilience. CONCLUSION: This study showed that emotional problems caused by exposure to related information among older people should be properly addressed during massive social unrest and conflict. Their resilience capacity is an important moderating factor. Future interventions and support services should focus on enhancing the resilience of older people to better equip them with overcoming problems related to macro-social issues.

Exposure to socio-political unrest and wellbeing of older people in Hong Kong.

BACKGROUND: The social unrest in the second half of 2019 in Hong Kong came with conflicts, confrontations, and violence which affected almost everyone in the city. The destruction and disruption of the urban facilities have undoubtedly had a significant impact on the lives and mental well-being of the public, and the older people are even more vulnerable. This study examined the impacts of the social unrest on the wellbeing of older people, an area that was seldomly addressed in the public discourse and literature. METHODS: Narrative interviews were conducted to capture older people's lived experiences and ways of making sense of the unrest in Hong Kong. A total of 63 participants aged 60 and above was recruited through personal networks of the research team, and referrals by participants who took part in the interviews. Qualitative semi-structure interviews was conducted one on one via telephone. RESULTS: Thirty-three male and 30 female participants took part in the interview. The number of participants from different risk zones affected by political unrest was comparable. Three themes were generated. Participants experienced challenges during the social unrest, including disturbance to family and social life, reduced incomes which affect quality of life, and difficulties in socializing with friends and accessing medical services. The social unrest caused emotional disturbance, giving rise to feelings of panic, fear, insomnia, depression, annoyance, and anger. Participants reported different coping strategies, ranging from moving to other places, to avoiding going to risky areas and watching news. CONCLUSION: Social unrest brings emotional distress to older people. In many cases, older people cope with challenges in different ways, whether active or passive. Social workers and other professionals should give more support to older people to encourage them to overcome their difficulties. The stakeholders' awareness of the problem and mental health promotion is required to alleviate the multiple layers of negative impacts.

Perceived victimization risk, avoidance behavior, and health of community-dwelling older adults in urban China.

Objectives: This study examined the associations between perceived crime-specific victimization risk, avoidance behavior, and their relationships with health of older adults.Method: A representative sample of 453 Chinese aged 60 and older from Kunming provided information on their socio-demographic characteristics, perceived crime victimization risk, avoidance behavior, physical and mental health.Results: Avoidance behavior was common among participants, with 61.4% avoiding unsafe areas and 42.2% avoiding social activities. Path analyses showed that perceived risk of vandalism was associated with avoiding participating in social activities, while perceived risk of attack was related to avoiding unsafe areas during the day. Meanwhile, avoiding social activities and perceived risk of vandalism were significant predictors of poor mental health, and avoiding unsafe areas was a salient predictor of poor physical health. Perceived risk of attack had an indirect effect on physical health through avoiding unsafe areas during the day.Conclusion: Study findings highlight the importance of addressing perceived victimization risk in encouraging social participation and mobility among older adults.

Interpreting SF-12 mental component score: an investigation of its convergent validity with CESD-10.

OBJECTIVE: To examine the convergent validity of Mental Component Scale of the Short-Form 12 (SF-12 MCS) with the Center for Epidemiologic Studies Depression Scale (CESD-10). The CESD-10 is a screening tool for probably clinically significant depression in the Chinese population. METHODS: Data were obtained from a household survey carried out in Hong Kong. A two-stage stratified sampling method successfully interviewed 1795 adult subjects from 1239 households. Data on SF-12 MCS and the CESD-10 were extracted. Receiver operating characteristics (ROC) analyses were performed to examine the convergent validity of SF-12 MCS against the CESD-10 threshold for probably clinically significant depression for the younger to middle-aged, late middle-aged and older population cohorts. RESULTS: ROC analysis indicated the excellent convergent validity of SF-12 MCS with the CESD-10 threshold for identifying probably clinically significant depression, with the area under curve ranged from 0.81 to 0.85. The optimal cutoff scores for depression among the younger to middle age group, late middle age group and older age group were 48.1, 50.2 and 50.2, respectively, with sensitivities ranged from 77 to 83 % and specificities ranged from 73 to 78 %. Bootstrapping estimates of the mean difference indicated no significant difference in the optimal cutoff scores between these age cohorts. CONCLUSION: SF-12 is a widely adopted measure to capture the health profile of Chinese population. The study findings indicated the satisfactory performance of the SF-12 MCS in identifying probably clinical depression. Future study is warrant to examine the diagnostic validity of the SF-12 MCS by using gold standard to assess clinical depression.

Reliability, validity, and cut scores of the south oaks gambling screen (SOGS) for Chinese.

We examined the reliability, validity, and classification accuracy of the South Oaks Gambling Screen (SOGS) when adopted for use in Chinese. The DSM-IV criteria for pathological gambling served as the standard against which the classification accuracy of the SOGS was tested. A total of 283 Chinese adults in the community and 94 Chinese treatment-seeking gamblers were recruited. The internal reliability of the SOGS was satisfactory for the general sample and acceptable for the gambling sample. The SOGS was correlated with the DSM-IV criteria items as well as psychosocial and gambling-related problems. Relative to the DSM-IV criteria, the SOGS tended to overestimate the number of pathological gamblers in both samples. In general, we were relatively confident that individuals were not pathological gamblers if the SOGS scores were between 0 and 4 and were pathological gamblers if the SOGS were between 11 and 20. There was about 50-50 chance of being pathological gamblers if the SOGS scores were between 8 and 10. However, the probability of individuals being pathological gamblers was about 0.30 if the SOGS scores were between 5 and 7. We proposed a SOGS cut score of 8 to screen for probable pathological gambling in Chinese societies.

Family Support and Preparation for Future Care Needs Among Urban Chinese Baby Boomers.

Objectives: Little is reported about the family's role in preparation for future care (PFC) before the onset of care needs. The primary aim was to examine the relationships between PFC and different types of family support exchanged with generations both above and below. Method: Path analysis was conducted on 516 Chinese baby boomers aged 45-65 to examine the associations between PFC (care expectation, awareness, information gathering, and decision making) and 4 types of family support (instrumental support, financial assistance, information and appraisal, and emotional support) when the covariates were controlled for. Results: The current planning status and planning paths are consistent with those of the U.S. and European populations. Providing instrumental support to a parent was positively associated with awareness of care needs. Providing emotional support to a child was negatively associated with information gathering. In general, receiving support from a child facilitated PFC. Although those receiving emotional support from an adult child had less awareness of care needs, they displayed more information gathering. Discussion: The role of family support in PFC is more subtle than simply increasing and decreasing resource volumes. Future research is needed to better understand this complexity.

Measuring Filial Piety in the 21st Century: Development, Factor Structure, and Reliability of the 10-Item Contemporary Filial Piety Scale.

The experience and practice of filial piety have evolved in modern Chinese societies, and existing measures fail to capture these important changes. Based on a conceptual analysis on current literature, 42 items were initially compiled to form a Contemporary Filial Piety Scale (CFPS), and 1,080 individuals from a representative sample in Hong Kong were surveyed. Principal component analysis generated a 16-item three-factor model: Pragmatic Obligations (Factor 1; 10 items), Compassionate Reverence (Factor 2; 4 items), and Family Continuity (Factor 3; 2 items). Confirmatory factor analysis revealed strong factor loadings for Factors 1 and 2, while removing Factor 3 and conceptually duplicated items increased total variance explained from 58.02% to 60.09% and internal consistency from .84 to .88. A final 10-item two-factor structure model was adopted with a goodness of fit of 0.95. The CFPS-10 is a data-driven, simple, and efficient instrument with strong psychometric properties for assessing contemporary filial piety.

Post-retirement voluntary work and psychological functioning among older Chinese in Hong Kong.

This study examined demographic and psychosocial differences between older Chinese volunteers and non-volunteers. The influences of work-related factors on older Chinese volunteers' post-retirement psychological functioning and life satisfaction were also explored. A total of 501 older Chinese in Hong Kong were individually interviewed. About 65% of them were involved in community voluntary work since their retirement, with an average of four hours per week. Compared to those without voluntary work experiences, older Chinese volunteers had higher educational attainment and reported better physical health, higher self-efficacy, greater life satisfaction, and less psychological distress. Results from hierarchical regression analyses showed that salient correlates of a low level of psychological distress in older Chinese volunteers were high educational attainment, high self-efficacy, perceived good physical health, and high levels of perceived rewards and satisfaction from voluntary work. Self-efficacy and perceived rewards from voluntary work were also salient correlates of life satisfaction for older Chinese volunteers. As hypothesized, work-related factors of perceived rewards and work satisfaction remained significant correlates of older volunteers' psychological well-being, even after controlling for demographic and individual psychosocial factors. Limitations and implications of the study were also discussed.

Psychosocial correlates of death anxiety among Chinese college students.

This study aims to explore various psychosocial correlates associated with how Chinese react to death and dying. A total of 282 Chinese college students participated in this study. They completed the Death Anxiety Scale, the Revised Death Anxiety Scale, and the Multidimensional Fear of Death Scale, as well as measures on self-efficacy and health locus of control. Results showed that younger as compared with older participants and women as compared with men tended to be more death anxious. Those with low levels of self-efficacy and external health control orientations were more likely to report a high level of death anxiety. Only a weak association was found between internal health locus of control and fear of conscious death. Limitations of the study were also discussed.