Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T04:50:36.910Z Has data issue: false hasContentIssue false

Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study

Published online by Cambridge University Press:  01 March 2017

YuanYuan Zhao
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China The Fifth Sanatorium for Retired Cadres, Anhui Provincial Military Region, Hefei 230032, China
CaiYun Hu
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
Fang Feng
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
Fengfeng Gong
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
ShanShan Lu
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
ZhenZhong Qian
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
YeHuan Sun*
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
*
Correspondence should be addressed to: Ye-Huan Sun, M.S., Ph.D., Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan road, Hefei, Anhui 230032, China. Phone and Fax: 86-551-65167725. Email: [email protected].
Get access

Abstract

Background:

Elder self-neglect (ESN) has become a public health issue globally. Limited studies have focused on ESN, as well as the relationship between ESN and quality of life (QoL) in developing countries. The study's objective is to explore the association between ESN and QoL among rural elderly in China.

Methods:

A cross-sectional study was conducted among 3,182 elder adults aged 60 years or older, using a cluster-sampling technique in one township in Dangtu, a county in Anhui province. All participants completed face-to-face interview in their household. QoL was assessed using a brief form of the World Health Organization's quality of life questionnaire (WHOQOL-BREF), and ESN was assessed using the Scale of the Elderly Self-neglect (SESN). Hierarchical linear regression models were used to analyze the associations between the ESN scores and QoL scores after adjusting for sociodemographic, social support, and physical and psychological variables.

Results:

The scores of overall ESN and five domains were significantly correlated with the scores of four QoL domains (p < 0.001). After adjusting for sociodemographic characteristics, social support, and physical and psychological health characteristics, elders who reported higher overall self-neglect scores had significantly lower scores in the four QoL domains (p < 0.001). Education, economic level, physical health, ADL, depression, and cognitive function are consistent predictors across all QoL domains.

Conclusions:

ESN is an independent risk factor for poor QoL in elderly people in rural China. Understanding the role of ESN and its influence on QoL is important for the management of and intervention in ESN.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abrams, R., Lachs, M., McAvay, G., Keohane, D. and Bruce, M. (2002). Predictors of self-neglect in community-dwelling elderly. American Journal of Psychiatry, 159, 17241730.CrossRefGoogle Scholar
Bozinovski, S. D. (2000). Older self-neglecters: interpersonal problems and the maintenance of selfcontinuity. Journal of Elder Abuse & Neglect, 12, 3756.Google Scholar
Braye, S., Orr, D. and Preston-Shoot, M. (2011). Conceptualising and responding to self-neglect: the challenges for adult safeguarding. The Journal of Adult Protection, 13, 182183.Google Scholar
Buckley, T. et al. (2012). Predictors of quality of life ratings for persons with dementia simultaneously reported by patients and their caregivers: the cache county (Utah) study. International Psychogeriatrics, 24, 10941102.CrossRefGoogle ScholarPubMed
Chan, A. C. M. (1996). Clinical validation of the geriatric depression scale (GDS). Journal of Aging and Health, 8, 238.CrossRefGoogle ScholarPubMed
Chang, Y. C., Yao, G., Hu, S. C. and Wang, J. D. (2015). Depression affects the scores of all facets of the WHOQOL-BREF and may mediate the effects of physical disability among community-dwelling older adults. PLoS One, 10, e0128356.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd ed.. Hillsdale, New Jersey: Lawrence Earlbaum Associates.Google Scholar
Day, M. R. (2010). Self-neglect: a challenge and a dilemma. Archives of Psychiatric Nursing, 24, 7375.Google Scholar
Day, M. R., Leahy-Warren, P. and McCarthy, G. (2016). Self-neglect: ethical considerations. Annual Review of Nursing Research, 34, 89107.CrossRefGoogle ScholarPubMed
Dong, X. et al. (2009). Elder self-neglect and abuse and mortality risk in a community-dwelling population. Journal of American Medical Association, 302, 517526.Google Scholar
Dong, X. (2014). Self-neglect in an elderly community-dwelling U.S. Chinese population: findings from the population study of Chinese elderly in Chicago study. Journal of the American Geriatrics Society, 62, 3912397.Google Scholar
Dong, X. and Simon, M. A. (2015). Prevalence of elder self-neglect in a Chicago Chinese population: the role of cognitive physical and mental health. Geriatrics & Gerontology International, 16, 10511062.Google Scholar
Dong, X., Simon, M. and Evans, D. (2010). Cross-sectional study of the characteristics of reported elder self-neglect in a community-dwelling population: findings from a population-based cohort. Gerontology, 56, 325–34.Google Scholar
Dyer, C. B., Goodwin, J. S., Pickens-Pace, S., Bumett, J. and Kelly, P. A. (2007). Self neglect among the elderly: a model based on more than 500 patients seen by a geriatric medicine team. American Journal of Public Health, 97, 16711676.Google Scholar
Faul, F., Erdfelder, E., Lang, A.-G. and Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175191.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Franzini, L. and Dyer, C. B. (2008). Healthcare costs and utilization of vulnerable elderly people reported to adult protective services for self-neglect. Journal of the American Geriatrics Society, 56, 667–676.Google Scholar
Garin, N. et al. (2014). Impact of multimorbidity on disability and quality of life in the Spanish older opopulation. PLoS One, 9, e111498.Google Scholar
Gibbons, S., Lauder, W. and Ludwick, R. (2006). Self-neglect: a proposed new NANDA diagnosis. International Journal of Nursing Terminologies and Classification, 17, 1018.Google Scholar
Hao, Y. T. and Fang, J. Q. (2000). To be introduce usage of WHOQOL instrument in Chinese. Modem Rehabilitation, 4, 11271129.Google Scholar
Health Service Executive (HSE). (2014). Open your eyes. There is no excuse for elder abuse. Available at: http://www.bit.ly/1OULe6t; last accessed 11 December 2015.Google Scholar
Iris, M., Conrad, K. J. and Ridings, J. (2014). Observational measure of elder self-neglect. Journal of Elder Abuse & Neglect, 26, 365397.CrossRefGoogle ScholarPubMed
Iris, M., Ridings, J. W. and Conrad, K. J. (2010). The development of a conceptual model for understanding elder self-neglect. The Gerontologist, 50, 303315.Google Scholar
Lauder, W. (1999). A survey of self-neglect in patients living in the community. Journal of Clinical Nursing, 8, 95102.Google Scholar
Lauder, W. (2001). The utility of self-care theory as a theoretical basis for self-neglect. Journal of Advanced Nursing, 34, 545551.Google Scholar
Lauder, W., Anderson, I. and Barclay, A. (2002). Sociological and psychological theories of self-neglect. Journal of Advanced Nursing, 40, 331338.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179186.Google Scholar
Lee, M. and Kim, K. (2014). Prevalence and risk factors for self-neglect among older adults living alone in South Korea. International Journal of Aging & Human Development, 78, 115131.Google Scholar
Liang, Y. and Wu, W. (2014). Exploratory analysis of physical health quality of life among the empty-nest elderly in rural China: an empirical study in three economically developed cities in eastern China. Health and Quality of Life Outcomes, 12, 59.Google Scholar
Liu, J. W., Li, F. Y. and Lian, Y. L. (2008). Investigation of reliability and validity of the social support scale. Journal of Xinjiang Medical University, 31, 13.Google Scholar
Lv, X. L. et al. (2013). Short form 36-item health survey test result on the empty nest elderly in China: a meta-analysis. Archives of Gerontology and Geriatrics, 56, 291297.Google Scholar
National Center on Elder Abuse Website. (2006). NCEA: the basics. Available at: http://elderabusecenter.org/pdf/research/apsreport030703.pdf; last accessed 24 May 2013.Google Scholar
Netuveli, G., Wiggins, R. D., Hildon, Z., Montgomery, S. M. and Blane, D. (2006). Quality of life at older ages: evidence from the english longitudinal study of aging (wave 1). Journal of Epidemiology & Community Health, 60, 357363.Google Scholar
Orley, J., Saxena, S. and Herrman, H. (1998). Quality of life and mental illness. Reflections from the perspective of the WHOQOL. The British Journal of Psychiatry, 172, 291293.Google Scholar
Papaioannou, E. S., Räihä, I. and Kivelä, S. L. (2012). Self-neglect of the elderly. An overview. European Journal of General Practice, 18, 187190.Google Scholar
Patrick, D. L. and Erickson, P. (1993). Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. New York, NY: Oxford University Press.Google Scholar
Reijneveld, S. A., Spijker, J. and Dijkshoom, H. (2007). Katz'ADL index assessed functional performance of Turkish, Moroccan, and Dutch elderly. Journal of Clinical Epidemiology, 60, 382388.CrossRefGoogle ScholarPubMed
Reyes-Ortiz, C. A., Burnett, J. B., Flores, D. V., Halphen, J. M. and Dyer, C. B. (2014). Medical implications of elder abuse: self-neglect. Clinical Geriatric Medicine, 30, 807823.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165173.Google Scholar
Shrestha, S. et al. (2015). Predictors of change in quality of life in older adults with generalized anxiety disorder. International Psychogeriatrics, 27, 12071215.Google Scholar
Spensley, C. (2008). The role of social isolation of elders in recidivism of self-neglect cases at San Francisco adult protective services. Journal of Elder Abuse & Neglect, 20, 4361.Google Scholar
The WHOQOL Group (1998). Development of the world health organization WHOQOL-BREF quality of life assessment. Psychology Medicine, 28, 551558.CrossRefGoogle Scholar
Wang, L. J. (2007). Research on Quality of Life and its Influencing Factors of the Elderly Staying in Rural Areas of JiNing. JiNan, SD: ShanDong University.Google Scholar
Webb, E., Blane, D., McMunn, A. and Netuveli, G. (2011). Proximal predictors of change in quality of life at older ages. Journal of the Epidemiology & Community Health, 65, 542547.Google Scholar
WHO. (1993). Development of the WHO: Quality of Life Assessment Instrument. Genva: WHO: 1.Google Scholar
Xiao, S. Y. (1994). The theoretical basis and research application of social support rating scale. Journal of Clinical Psychiatry, 4, 98100.Google Scholar
Zhou, B., Chen, K., Wang, J., Wang, H., Zhang, S. and Zheng, W. (2011). Quality of life and related factors in the older rural and urban Chinese populations in Zhejiang province. Journal of Applied Gerontology, 30, 199225.Google Scholar
Zung, W. W. K. (1971). A rating instrument for anxiety disorders. Paychosomatics, 12, 371379.Google Scholar
Supplementary material: File

Zhao supplementary material

Table S1

Download Zhao supplementary material(File)
File 17.4 KB