BACKGROUND: Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly. METHODS: We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively. RESULTS: After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes. CONCLUSIONS Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.
Adult ; Aged ; Aged, 80 and over ; China ; Female ; Health Personnel ; psychology ; statistics & numerical data ; Hospice Care ; psychology ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasms ; therapy ; Patients ; psychology ; statistics & numerical data ; Quality of Health Care ; statistics & numerical data ; Social Work

PURPOSE: The purpose of this study is to test a model linking infant health problem, mother's depression and marital relationship to infant abuse. METHODS: This study employed a cross-sectional survey design. Data were collected from 2009 Data of Index Studies for Korean Children and Adolescents Development. Survey data from 1,060 infants and their mothers (including infant health status and infant physical illness scale, depression scale, marital relationship scale, and child abuse scale) were used to test the model. The model was tested using path analysis techniques within structural equation modeling. RESULTS: The model fit indices suggested that the original hypothesized model adequately fit the data (chi2 = .33, df = 5, p = .84, Tucker-Lewis Index = 1.04, Comparative Fit Index = 1.00, Root Mean Square Error of Approximation = .00). Infant health problem and mother's depression had a negative direct effect on marital relationship, which in turn had a direct negative effect on infant abuse. Infant health problems directly affected infant abuse and also influenced infant abuse indirectly through the marital relationship. Mother's depression had significant direct effects on infant abuse and also influenced infant abuse indirectly through the marital relationship. CONCLUSION: The findings from this study demonstrate the fundamental importance of infant health as linked to the mother's mental health, and marital relationship and increasing the quality of marital relationship may be the key to infant abuse prevention.
Adult ; Child Abuse/*psychology/statistics & numerical data ; Cross-Sectional Studies ; Depressive Disorder/epidemiology/*psychology ; Female ; *Health Status ; Humans ; Infant ; Infant Welfare/*psychology/statistics & numerical data ; Marriage/*psychology/statistics & numerical data ; Middle Aged ; Models, Psychological ; Mothers/*psychology ; Questionnaires ; Republic of Korea/epidemiology

OBJECTIVETo identify the most common life events that occurred prior to suicide in elderly individuals and the relationship of these life events to depressive symptoms.

METHODSA detailed study considering life events in the year prior to death, the presence of mental illness at the time of death and the level of depressive symptoms in the 2 weeks prior to death was undertaken with the family members and other associates of 304 persons at 55 years of age and older who died of suicide.

RESULTSThe three most common negative life events were acute or chronic physical illness or injury (59.2%), major changes in diet, sleeping or other daily routines (37.8%) and financial difficulties (34.5%). The severity of depressive symptoms was significantly greater among persons who had experienced these life events both for persons with or without definite mental illness.

CONCLUSIONMost elderly persons who died of suicide events had experienced multiple negative life events in the year prior to death and these life events were closely related to the severity of depressive symptoms at the time of death.

Aged ; psychology ; statistics & numerical data ; China ; Depression ; psychology ; Humans ; Life Change Events ; Quality of Life ; Retrospective Studies ; Risk Factors ; Suicide ; psychology

Adaptation, Psychological ; Adult ; Anxiety ; epidemiology ; psychology ; Depression ; epidemiology ; psychology ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Nurses ; psychology ; statistics & numerical data ; Physicians ; psychology ; statistics & numerical data ; Prevalence ; Singapore ; epidemiology ; Stress Disorders, Post-Traumatic ; epidemiology ; psychology ; Young Adult

BACKGROUNDDementia is a chronic progressive disease seriously affecting the patient's daily life and working skills and may cause the patient disability and dependence. Thus, caring for dementia patients inevitably falls on families in the mainland of China. Unfortunately, there are rarely enough reports available about mental health and social support in family caregivers for domestic dementia patients. This study aimed to investigate the changes in psychological status and social support in domestic dementia family caregivers and hope the government and relevant departments pay more attention to the family caregiver's psychological change, which may be better for dementia patients.

METHODSFifty-eight immediate family caregivers (family group) for dementia patients, including 21 Alzheimer's disease (AD) and 37 vascular dementia inpatients, were recruited for interview. Fifty-eight age- and sex-matched normal volunteers (control group) were also interviewed in the same period. The psychiatric distress was assessed by the Symptom Checklist 90 (SCL-90), family functioning was assessed by the Family Assessment Device (FAD), and the social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Group differences were analyzed using unpaired t test for comparison of SCL-90, FAD, and MSPSS mean scores. Pearson's correlation coefficient was used to find the association between the various dimensions of FAD and the social support from dementia family caregivers.

RESULTSExcept phobic anxiety dimension, the other dimensions of SCL-90 mean scores were significantly higher in the family group than those in the control group (P < 0.05). In the family group, except affective involvement dimension, the other dimensions of FAD mean scores were within the scope of unhealthy family functioning. Significant differences in problem solving, communication, roles, affective responsiveness, behavioral control, general functioning, and the total MSPSS mean scores were seen between the family group and the control group (P < 0.01). Except affective involvement dimension, the other dimensions of the family functioning correlated with the perceived social support in the family group (P < 0.05 or 0.01).

CONCLUSIONSDementia patients have a negative effect on families' mental health in the mainland of China. Dementia family caregivers experience defected family functioning and low levels of social support.

Adult ; Aged ; Caregivers ; statistics & numerical data ; China ; Dementia ; psychology ; Family ; psychology ; Female ; Humans ; Male ; Middle Aged ; Social Support ; Stress, Psychological ; psychology ; Surveys and Questionnaires

BACKGROUND: As society is aging, the number of elderly patients with psychiatric disorder, such as dementia, is increasing. The hospitalization period of elderly patients in psychiatric wards tends to be prolonged. In this study, we have determined the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients in Japan. METHODS: The information was collected from patients admitted to our hospital's emergency ward for elderly patients with psychiatric disorders between May 2015 and April 2016. We compared various factors between the early discharge group and the non-early discharge group. In addition, we used a multiple logistic regression model to clarify the risk factors for non-early discharge. RESULTS: Of the 208 elderly patients, body mass index (BMI) and serum albumin level were significantly lower in the non-early discharge group. In addition, we also showed that higher serum C-reactive protein (CRP) (> 0.5 mg/dL) and use of seclusion or physical restraint significantly inhibited the early discharge of patients. The results of multiple logistic analysis showed that the BMI ≤ 17.5 kg/m (OR, 2.41 [95% confidence interval (CI) 1.06-5.46]), serum albumin level ≤ 30 g/L (OR, 3.78 [95% CI 1.28-11.16]), and use of seclusion or physical restraint (OR 3.78 [95% CI 1.53-9.37]) are particularly important explanatory factors. CONCLUSIONS Hypoalbuminemia, low BMI, and the use of seclusion or physical restraint were identified as the factors that inhibit early discharge from the psychiatric emergency ward for elderly patients. These factors reflect malnutrition and extremely serious psychiatric symptoms.
Aged ; Aged, 80 and over ; Dementia ; diagnosis ; psychology ; therapy ; Emergency Service, Hospital ; statistics & numerical data ; Female ; Hospitalization ; statistics & numerical data ; Hospitals, Psychiatric ; statistics & numerical data ; Humans ; Japan ; Length of Stay ; statistics & numerical data ; Male ; Patient Discharge ; statistics & numerical data ; Risk Factors

PURPOSE: To identify the relationship between organizational culture and experience of workplace bullying among Korean nurses. METHODS: Participants were 298 hospital nurses in Busan, South Korea. We assessed nursing organizational culture and workplace bullying among nurses using structured questionnaires from July 1 through August 15, 2014. RESULTS: Most participants considered their organizational culture as hierarchy-oriented (45.5%), followed by relation-oriented (36.0%), innovation-oriented (10.4%), and task-oriented (8.1%). According to the operational bullying criteria, the prevalence of workplace bullying was 15.8%. A multivariate logistic regression analysis revealed that the odds of being a victim of bullying were 2.58 times as high among nurses in a hierarchy-oriented culture as among nurses in a relation-oriented culture [95% confidence interval (1.12, 5.94)]. CONCLUSIONS: The results suggest that the types of nursing organizational culture are related to workplace bullying in Korean nurses. Further research is needed to develop interventions that can foster relationoriented cultures to prevent workplace bullying in nurses.
Adult ; Aged ; Attitude of Health Personnel ; Bullying/*statistics & numerical data ; Female ; Health Facility Size/statistics & numerical data ; Humans ; Middle Aged ; Nurses/*psychology/statistics & numerical data ; Nursing Staff, Hospital/*psychology/statistics & numerical data ; *Organizational Culture ; Republic of Korea ; Salaries and Fringe Benefits/statistics & numerical data ; Workplace/psychology/*statistics & numerical data ; Young Adult

BACKGROUNDDomestic violence (DV) is not only a devastating societal problem, but also a severe medical and mental health problem worldwide. Our previous study has shown that perpetrators were with higher prevalence of self-reported symptoms than that of controls. This study based on our former large scale population-based samples is aimed to further explore the correlations between the symptoms and psychosocial factors of the perpetrators with DV. It was helpful to provide some insight into possible strategies for clinicians to reduce the symptoms of the perpetrators with DV in China.

METHODSFrom our former population-based epidemiological samples, 1098 households with a history of DV in preceding year, 318 perpetrators with DV were randomly selected. Face-to-face interviews were conducted. Symptom Checklist-90 (SCL-90) was administrated to check and classify the symptoms of perpetrators, Eysenck's personality questionnaire (EPQ), trait coping style questionnaire (TCSQ), life events scale (LES) and social supporting rating scale (SSRS) were administrated to evaluate the psychosocial factors of perpetrators. The correlation analysis was used to analyze the relationships between the symptoms and psychosocial factors of perpetrators of DV.

RESULTSThe global and all subscale scores of SCL-90 were significantly positively correlated with EPQ-N, negative TCSQ and negative LES scores (P < 0.01). The global score of SCL-90 was negatively correlated with both objective and subjective SSRS (P < 0.01). The negative LES and negative TCSQ were significantly positively correlated with EPQ-N (P < 0.01). Negative TCSQ was significantly positively correlated with negative LES and negatively correlated with subjective SSRS (P < 0.01).

CONCLUSIONSThe self-reported symptoms of perpetrators with DV were strongly correlated with their psychosocial factors, such as the neurotic personality, negative coping style, more negative life events and less subjective social supports. It suggested bio-psycho-socially oriented interventions were necessary to buffer the symptoms of perpetrators with DV.

Adult ; China ; Domestic Violence ; psychology ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires

OBJECTIVES: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). METHODS: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The mean scores of QOL among all the subjects was 55.4 +/- 15.62 (Grade I: 49.7 +/- 14.17, Grade II: 56.8 +/- 14.62, Grade III: 59.4+/-16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). CONCLUSIONS: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).
Activities of Daily Living/psychology ; Aged ; Depression/psychology ; Female ; *Health Status ; Humans ; Insurance, Long-Term Care/*statistics & numerical data ; Long-Term Care/*psychology/*statistics & numerical data ; Male ; *Mental Health ; Quality of Life/*psychology ; Residence Characteristics ; Socioeconomic Factors

PURPOSE: The purpose of this study was to identify the factors affecting the unmet healthcare needs of married immigrant women. METHODS: This study was a secondary data analysis using data from the 2009 National Survey of Multicultural Families. Data collected from 58,735 married immigrant women who had spouses were analyzed using descriptive statistics, Chi-square test, and logistic regression. RESULTS: Overall, 9.9% of married immigrant women have unmet healthcare needs. The significant predictors related to unmet healthcare needs were young age, high level of education, employed, country of origin, long period of residence, low income, uninsured, urban area, low level of subjective health status, and illness experience over past two weeks. In particular, four variables (long period of residence, low income, subjective health status, and illness experience over past two weeks) significantly predicted unmet healthcare needs for women from all countries of origin. CONCLUSION: The results of the study indicate that common predictors related to unmet healthcare needs of married immigrant women are a long period of residence, low income, subjective health status, and illness experience over past two weeks. Therefore intervention strategies to decrease unmet healthcare needs should focus on these significant predictors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Emigrants and Immigrants/*psychology/*statistics & numerical data ; Female ; *Health Services Needs and Demand ; Health Status ; Humans ; Logistic Models ; Middle Aged ; Odds Ratio ; Questionnaires ; Socioeconomic Factors ; Spouses/psychology/*statistics & numerical data ; Women/*psychology ; Young Adult