[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
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.
[Show abstract][Hide abstract] ABSTRACT: Late-life depression is a common condition and a challenging public health problem. A lack of social support is strongly associated with psychological distress. Senior centres seem to be suitable arenas for community-based health promotion interventions, although few studies have addressed this subject. The objectives were to examine the effect of a preventive senior centre group programme consisting of weekly meetings, on social support, depression and quality of life.
A questionnaire was sent to a random sample of 4,000 persons over 65 in Oslo, and a total of 2,387 completed questionnaires were obtained. These subjects served as a basis for recruitment of participants for a trial, with scores on HSCL-10 being used as a main inclusion criterion. A total of 138 persons were randomized into an intervention group (N = 77) and control group (N = 61). Final analyses included 92 persons. Social support (OSS-3), depression (BDI), life satisfaction and health were measured in interviews at baseline and after 12 months (at the end of the intervention programme). Perceptions of benefits from the intervention were also measured. Mean scores, SD, SE and CI were used to describe the changes in outcomes. Effect sizes were calculated based on the original scales and as Cohen’s d. Paired sample tests and ANOVA were used to test group differences.
There was an increase in social support in both groups, but greatest in the intervention group. The level of depression increased for both groups, but more so in the control than the intervention group. There was a decrease in life satisfaction, although the decrease was largest among controls. There were almost no differences in reported health between groups. However, effect sizes were small and differences were not statistically significant. In contrast, most of the participants said the intervention meant much to them and led to increased use of the centre.
In all probability, the intervention failed to meet optimistic targets, but possibly met quite modest ones. Since intention-to-treat analysis was not possible, we do not know the effect on the intervention group as a whole. A further evaluation of these programmes is necessary to expand the group programme. For the depressed, more specialized programmes to cope with depression may be a more appropriate intervention.
DRKS00003120 on DRKS
[Show abstract][Hide abstract] ABSTRACT: The senior centre is the only welfare service in Norwegian elder care serving both fit and less functional pensioners over 65 years. The aim of the study was to determine the socio-demographic, psychosocial and health characteristics of users of the senior centres in relation to non-users in order to find out who can benefit from the senior centre service.
Data was collected from the Population Register for all persons living at home over 65 years in two municipal districts in Oslo. A random sample was drawn limited to 4,000 of the total number of residents over 65 years, 2,000 from each district. Questionnaires were sent by post. The response rate was 64% (n = 2,387). Psychological ailments were assessed using Hopkins Symptom Checklist-10 and social support with Oslo-3 Social Support Scale.
The percentage of users was 44 among the survey respondents. Age was the most significant variable explaining use of the senior centre; increased age led to greater use. Single women used the senior centre more than married women while single men used it less than married men. Other predictors for women included osteoporosis, memory impairment and participation/interest from others. Memory impairment was a predictor for men.
High age and specific health problems led to increased use. Living alone predicted greater use among women but less use among men. The association with age could not be explained through socio-demographic, psychosocial or health variables.
Scandinavian Journal of Public Health 07/2010; 38(5):508-17. DOI:10.1177/1403494810370230 · 1.83 Impact Factor