Grief, Social Support, Spirituality, and Depressive Symptoms Among Older Adults in Assisted Living in Kansas.

PURPOSE: The purpose of this study was to explore the roles of grief, social support, as well as spirituality on the depressive symptoms of older adults in assisted living in Kansas. This study tested three hypotheses: a high level of grief will be related to a high level of depressive symptoms; high levels of social support (family, friends, and significant persons) will be associated with a low level of depressive symptoms; and high levels of spiritual experience and coping will be associated with a low level of depressive symptoms. METHODS: This study recruited 316 older adult residents aged 65 or over from seven assisted living facilities in Kansas. This cross-sectional survey was done by face-to-face interviews using the purposive sampling method. Hierarchical multiple regression was used to test the three sets of variables in relation to depressive symptoms: socio-demographics, social support factors, and spiritual factors. RESULTS: Participants' mean age was 82.6 years, ranging from 65 to 102; 70.9% were female. Married participants consisted of 18.7%, and over 64% were widowed. Hierarchical multivariate regression results indicated that a high level of grief was significantly related to a high level of depressive symptoms. On the other hand, high levels of social support from friends and spiritual coping were significantly associated with a low level of depressive symptoms. DISCUSSION AND CONCLUSION: Assisted living facilities may consider developing appropriate bereavement, social support, and spiritual intervention programs, which will alleviate the depression issues of older adult residents after the COVID-19 pandemic.

Andersen's Behavioral Model to Identify Correlates of Cervical Cancer Knowledge among American Indian Women.

OBJECTIVE: Using the Andersen's behavioral model of health services use as a framework, this study aims to examine factors (predisposing, needs, and enabling) related to American Indian (AI) women's cervical cancer knowledge. METHODS: Andersen's behavioral model of health services was used to examine factors predisposing, needs, and enabling related to AI women's cervical cancer knowledge. A sample of 259 AI women residing in the Northern Plains was recruited using a convenience sampling strategy. Cervical cancer knowledge was measured using guidelines from the American Cancer Society. Three predisposing factors, six enabling factors, and four need factors were observed.  Result: The mean score of knowledge was 9.11 out of 13. Higher cancer knowledge was associated with 3 enabling factors (higher education, higher HPV knowledge, and use of TV/radio to gain health literacy) and one needs factor (experience in hospitalization). CONCLUSION: Our findings indicate that culturally sensitive educational interventions, especially those using media, to increase cervical cancer knowledge are needed among AI women.

Risk and protective factors for depressive symptoms among the youth living with HIV in Namibia.

BACKGROUND: : Namibia has one of the highest HIV prevalence rates among young people living with HIV and AIDS. The study of mental well-being among this vulnerable population is emerging as an important area of public health research. METHODS: : This study examined how gender, social support, food insecurity, HIV-related stigma, HIV treatment adherence and HIV transmission knowledge are related to depressive symptoms among young people living with HIV in rural northern Namibia. Data were collected from 188 participants from the Zambezi region. RESULTS: : The hierarchical regression analysis revealed that being a female infected with HIV, having perceived food insecurity, experiencing more HIV-related stigma and having low levels of social support can exacerbate the severity of depressive symptoms in this sample of Namibian youth. DISCUSSION: : Our findings point to the need to expand social support interventions, enhance socio-economic programmes and reduce HIV-related stigma among young people living with HIV, especially those residing in rural, HIV endemic, resource-limited communities in developing countries.

The impact of depressive symptoms and social support on resilience among older adult caregivers.

In this study the authors explored how depressive symptoms and social support were related to the resilience of older caregivers (N = 117) caring children affected by HIV/AIDS in rural Northern Namibia, Africa. Our findings showed that lower levels of depressive symptoms and high levels of social support from significant others and family were statistically associated with increased resilience in older caregivers. There is a need for mental health services and social supports to improve the resilience of older caregivers caring for children affected by HIV and AIDS. There is an increasing need for more vigorous and concerted efforts from public and private sector practitioners and policy makers to expand social protection safety nets and develop more targeted economic interventions aimed at enhancing the resilience of older caregivers, especially those residing in rural HIV endemic communities in Namibia.

Depressive symptoms among older adults with HIV in Namibia: the role of social support and spirituality.

Background: More than 60% of older adults living with HIV reside in sub-Saharan Africa. Namibia has one of the highest HIV/AIDS prevalence rates. This study examined the association between social support, spirituality and depressive symptoms.Method and results: The sample consisted of 147 Oshiwambo-speaking older adults (mean age = 61 years, SD = 6.92 years) with HIV in Namibia. By utilising a hierarchical multivariate regression method, this study found that social support from friends and spirituality showed a significant negative relationship to depressive symptoms. In addition, self-rated health status and alcohol use were significant sociodemographic predicitive factors of depressive symptoms.Conclusion: This study suggests the need to develop interventions and support programmes that incorporate peer support and spiritual practice to promote health and well-being among older persons living with HIV in Namibia.

HIV stigma, resilience and depressive symptoms among older adults living with HIV in rural Namibia.

In sub-Saharan Africa, HIV-positive older adults aged 50 years and older experience complex psychosocial issues in addition to dealing with their HIV status and the ageing process. This study focused on the association between HIV stigma, resilience, and depressive symptoms among 147 older adults from the Oshana and Ohangwena health facilities in rural Namibia. The study used the hierarchical multivariate regression analysis method to reveal that there was a positive association between HIV stigma (negative self-perceptions) and depression as well as a negative relationship between resilience and depression. In addition, being female and higher education were protective factors, and disclosure of HIV status was a risk factor to predict depressive symptoms among the target population. In order to reduce HIV stigma and enhance resilience among older adults living with HIV in Africa, this study suggests the need to develop evidence-based interventions to increase coping strategies and resilience.

Living With Intelligent Sensors: Older Adult and Family Member Perceptions.

This qualitative study is part of a larger randomized prospective intervention study that examined the clinical and cost effectiveness of using sensor data from an environmentally embedded sensor system for early illness recognition. It explored the perceptions of older adults and family members on the sensor system's usefulness, impact on daily routine, privacy, and sharing of health information. This study was conducted in 13 assisted-living facilities in Missouri, and 55 older adults were interviewed. Data were collected over five points in time with a total of 188 interviews. From these five participant interview iterations, the following themes emerged: (1) understanding and purpose, (2) daily life and benefits, (3) impact on privacy, and (4) sharing of information. Three themes emerged from one round of family interviews: (1) benefits of bed sensors, (2) family involvement/staff interaction, and (3) privacy protection versus sensor benefits. The sensor suite was regarded as helpful in maintaining independence, health, and physical functioning. Responses suggest that the willingness to adopt the sensor suite was motivated by both a decline in functional status and a desire to remain independent. Participants were willing to share their health data with providers and select family members. Recommendations for future practice are provided.

Breast cancer literacy and health beliefs related to breast cancer screening among American Indian women.

The purpose of this article is to examine the health beliefs and literacy about breast cancer and their relationship with breast cancer screening among American Indian (AI) women. Using the Health Belief Model (HBM) and hierarchical logistic regression with data from a sample of 286 AI female adults residing in the Northern Plains, we found that greater awareness of breast cancer screening was linked to breast cancer screening practices. However, perceived barriers, one of the HBM constructs, prevented such screening practices. This study suggested that culturally relevant HBM factors should be targeted when developing culturally sensitive breast cancer prevention efforts.

Mental Health, Substance Abuse, and Suicide Among Homeless Adults.

This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.

A Comparison of Risk and Protective Factors Related to Depressive Symptoms among American Indian and Caucasian Older Adults.

Despite efforts to reduce health disparities, many American Indian and Alaska Native (AI/AN) populations, including older adults, experience elevated levels of depression and associated suicide. Although adverse childhood experiences (ACEs) and social support are well-documented risk and protective factors for depression in the general population, little is known about AI/AN populations, especially older adults. The purpose of this study was to examine factors related to depression among a sample of AI older adults in the Midwest. Data were collected using a self-administered survey completed by 479 AI and Caucasian respondents over the age of 50. The survey included standardized measures such as the Geriatric Depression Scale-Short Form, ACE Questionnaire, and Multidimensional Scale of Perceived Social Support. Hierarchical multivariate regression analyses were conducted to evaluate the main hypotheses of the study. Results indicate that two dimensions of ACEs (childhood neglect and household dysfunction) were positively associated with depressive symptoms; social support was negatively associated with depressive symptoms. Perceived health and living alone were also significant predictors of depressive symptoms. ACEs may play a significant role in depression among AI/AN populations across the life course and into old age. Social support offers a promising mechanism to bolster resilience among AI/AN older adults.

Older Adults' Perceptions of and Preferences for a Fall Risk Assessment System: Exploring Stages of Acceptance Model.

Aging in place is a preferred and cost-effective living option for older adults. Research indicates that technology can assist with this goal. Information on consumer preferences will help in technology development to assist older adults to age in place. The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study examined the perceptions, attitudes, and preferences of 13 older adults and five family members about their experience living with the fall risk assessment system during five points in time. Themes emerged in relation to preferences and expectations about the technology and how it fits into daily routines. We were able to capture changes that occurred over time for older adult participants. Results indicated that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation. Identified themes, stages of acceptance, and design and development considerations are discussed.

Stress and Spirituality on the Depressive Symptoms of Older Adults in Assisted Living: Gender Differences.

In this study the authors explore the effects of stress and spirituality on the depressive symptoms of 92 older adult men and 224 older adult women who reside in assisted living facilities. Hierarchical regression reveals that stress was related to increases in depressive symptoms. The stress of women was more strongly associated with depressive symptoms than found among men. In contrast, spiritual coping was associated with a decrease in depressive symptoms among all older adults in assisted living. The spiritual coping of older adult women was not a significant predictor of decreased depressive symptoms. Through this study the authors support the use of spiritual interventions to alleviate depressive symptoms experienced by older adults in assisted living.