BACKGROUND AND OBJECTIVES

The built environment or physical environment consists of surroundings and conditions constructed by human activity. It includes urban design, neighborhoods, transportation, and smaller scale structures like the design and layout of rooms within buildings. The built environment can affect the physical, social, and functional wellbeing of older adults, both within their own homes and in the neighborhoods in which they live, and additionally plays a part in promoting healthy aging. This narrative review of the literature aims to present the ways in which the built environment can influence the functional ability of community-dwelling older adults, and affect their ability to live independently and age in place.

Narrative literature review and inductive thematic analysis.

Forty-five full-text, English language publications from peer-reviewed sources were selected for this review, with the majority (35) presenting quantitative research findings and originating from North America (28). Older adults in rural and developing countries were underrepresented in the literature, despite acknowledgement that health of the aging population is a worldwide problem. Three major themes emerged. First, the built environment affects older adults in the most fundamental way at home through design considerations, modifications, and technological advances promoting aging in place and accessibility. Secondly, built environments outside the home can affect older adults’ physical activity and overall function with regard to mobility, transportation, and activities of daily living. The majority (22 of 45 publications) focused on this theme. Finally, the built environment in neighborhoods can affect older adults’ perception of social support, their social participation, and quality of life.

As the built environment is created by humans and can be substantially modified, it possesses considerable potential for enhancing functional ability, social participation, and overall quality of life in community-dwelling older adults. It is possible to design a better person-environment fit, promoting safety, independence, optimal health, and quality of life. In order to support healthy aging, improvements in the built environment need to be accompanied by appropriate health and social policies, systems, and services. These changes require political will, as well as material resources that may not be readily available especially in the global South. A socioecological approach with adequate resources directed to older adults’ health and healthcare is necessary in order to achieve the ultimate goal of healthy aging in this population.

Objective: Exploring the mediating effect of perceived social support between the maternal personality traits and pregnancy-related anxiety. Methods: Singleton pregnant women who underwent antenatal checkups in the obstetrics department of general hospital affiliated to Ningxia Medical University from July to December 2021 were enrolled in this study to investigate perceived social support, pregnancy-related anxiety and conscious personality traits. Pearson correlation analysis was used to analyze the association between the maternal personality traits, perceived social support, and pregnancy-related anxiety, and the mediating effect of perceived social support was analyzed using Bootstrap method. Results: A total of 1 259 subjects were included in the study, of which 170 (13.50%) pregnant women felt introverted. The total score of perceived social support was (46.37±8.38), and 31.45% of pregnant women had high perceived social support. The total score of pregnancy-related anxiety was (21.48±5.53). The score of worry about fetal health was (10.09±3.24), and 368 (29.23%) of pregnant women had pregnancy-related anxiety. Maternal personality traits and pregnancy-related anxiety were negatively correlated (r=-0.076, P<0.05) and positively correlated with perceived social support during pregnancy (r= 0.127, P<0.05). Perceived social support during pregnancy and pregnancy-related anxiety were negatively correlated (r=-0.236, P<0.05). Perceived social support partially mediated the relationship between the maternal personality traits and pregnancy-related anxiety, with a relative effect value of 37.50%. Conclusion: The maternal personality traits, level of perceived social support and pregnancy-related anxiety are all related. Perceived social support could mediate the relationship between the maternal personality traits and pregnancy-related anxiety.
Female ; Pregnancy ; Humans ; Anxiety ; Pregnant Women ; Personality ; Social Support ; Prenatal Care

BACKGROUND: Individual-level social capital is an important determinant of older adults' long-term care needs; however, there is scant evidence regarding community-level social capital. Therefore, we investigated the association between community-level social capital and the prevalence of the need for long-term care among older adults. METHODS: Between January and February 2018, a cross-sectional survey was conducted among all older adults (n = 13,558) aged 65 to 74 years in a rural municipality in Japan (total population, n = 72,833). A self-reported questionnaire was used to identify community-level social capital, comprising civic participation, social cohesion, and reciprocity. A multilevel logistic regression analysis was performed to estimate the odds ratios of the need for long-term care and a decline in social activity competence as assessed by instrumental activities of daily living. For the analysis, the community levels were divided into 76 voting districts and adjusted for daily life, lifestyle, socioeconomic status, health conditions, and the three social capital subscale scores at the individual level. RESULTS: After adjusting for the covariates, we observed a tendency that a higher community level of reciprocity was associated with a lower prevalence of long-term care needs (OR: 0.86, 95% confidence interval: 0.75-1.00), whereas a high community level of social cohesion was associated with a significantly reduced decline in instrumental activities of daily living (OR per standard deviation increase: 0.87, 95% confidence interval: 0.79-0.96). No significant association was found with civic participation. Similarly, individual-level social capital was associated with the need for long-term care and decline in instrumental activities of daily living. CONCLUSIONS Our findings suggest that good community-level reciprocity or social cohesion as well as good individual social capital status may help prevent the need for long-term care among older adults.
Humans ; Aged ; Interpersonal Relations ; Activities of Daily Living ; Social Participation ; Social Capital ; Multilevel Analysis ; Cross-Sectional Studies ; Long-Term Care ; Japan/epidemiology* ; Social Support

OBJECTIVES: Acute ischemic stroke (AIS) is one of the main causes of disability in middle-aged and elderly people, and early activity plays an important role in functional recovery. This study aims to understand the factors that affect the implementation of early activity in patients with AIS and to provide reference for promoting early activity implementation and developing intervention strategies for AIS patients. METHODS: Using purposive sampling, 19 AIS patients and their caregivers who visited at Stroke Center in the Third Xiangya Hospital of Central South University and the Third Hospital of Changsha from June to December 2021, as well as 19 medical staff, hospital administrators, or community workers providing medical health services to stroke patients, were selected as interviewes. A semi-structured interview was conducted based on the social ecological theory model, and the Colaizzi seven-step method was used to analyze the interview data. RESULTS: According to qualitative interview results, the factors affecting early activity in AIS patients were summarized into 4 themes and 12 sub-themes: medical staff factors (insufficient knowledge and skills, insufficient knowledge of early activity, unclear division of responsibilities), patient factors (severity of the disease, lack of knowledge, psychological pressure, fear of falling), social environmental factors (lack of social support, shortage of human resources and rehabilitation equipment, insufficient medical insurance support), and evidence and norms (the evidence for early activity needs improvement, lack of standardized early activity procedures). CONCLUSIONS Early activity in AIS patients is impacted by factors at multiple levels, including medical staff, patients, social environment, and evidence and norms. Developing comprehensive intervention strategies to address these factors can promote early activity implementation in AIS patients.
Aged ; Middle Aged ; Humans ; Ischemic Stroke ; Accidental Falls ; Fear ; Social Environment ; Stroke

Objective: To explore the relationship of social support to patients with schizophrenia, family burden with patients' quality of life and family life satisfaction. Methods: Multi-stage stratified cluster random sampling was used to select 358 patients with schizophrenia and 358 patients' family members in Gansu Province who met the inclusion criteria were included. The Social Support Rating Scale, Family Burden Scale, Satisfaction with Life Scale and Quality of Life Scale were used in the survey. AMOS 24.0 was used to explore the pathway of influence of family burden on social support to patients with schizophrenia, patients' quality of life and patients' family life satisfaction. Results: There was a two-by-two significant correlation between patients' access to social support, family burden, patients' life quality and family life satisfaction (P<0.05), and the total score of the social support scale negatively predicted the total score of the life quality scale (β=-0.28, P<0.05) and positively predicted the total score of the life satisfaction scale (β=0.52, P<0.05). Family burden was a full mediator between the social support to the patient and the patient's quality of life, and as a partial mediator between the social support to the patient and the family's life satisfaction. Conclusions: Social support to people with schizophrenia is a significant predictor of their quality of life and family life satisfaction. Family burden mediates the relationship of social support to patients with their quality of life and family life satisfaction. Interventions can focus on increasing social support for the patient and reducing the burden on the patient's family to improve the patient's quality of life and increase the satisfaction of the patient's family.
Humans ; Patient Satisfaction ; Quality of Life ; Schizophrenia ; Family Relations ; Social Support

OBJECTIVE: To explore potential categories of parental social support for young parents under the coronavirus disease 2019 (COVID-19) epidemic, and to examine correlations of different types of parents' social support with parental burnout. METHODS: In April 2020, we conducted an online voluntary survey among young parents across China with scales and a self-designed questionnaire. The latent profile analysis method was used to analyze parents' received social support and perceived social support. The social support categories were taken as independent variables and parental burnout as dependent variables, and multiple regression analysis was carried out to explore the relationship between received social support, perceived social support and parental burnout. Finally, the moderating effect of resilience between social support groups and parental burnout was discussed. RESULTS: The results of latent profile analysis revealed three potential types of received social support, namely isolate, normal, and multi-support and the proportions of the respondents with the three profiles were 14.1%, 78.0%, and 7.9%. Four potential types of perceived social support, namely, indigent, medium, affluent and divergent and the proportions of the respondents with the four profiles were 13.7%, 29.6%, 25.3%, and 31.3%. Among them, the parents with divergent perceived social support had more perception of social support from the couple, family and relatives, but less perception of social support from net-friend, social organizations and the government. Regression analysis showed that there was no statistically significant correlation between different profiles of received social support and parental burnout, and among the groups of perceived social support, there was a statistically significant correlation between indigent and divergent types of social support and parental burnout. The divergent parents had lower levels of parental burnout compared with indigent (β=-0.120, P=0.003). Also, resilience moderated the effect of divergent perceived social support and parental burnout. Compared with the parents with low resilience, the parents with high resilience perceived divergent social support with lower parenting burnout. CONCLUSION There are prominent latent types of received social support and perceived social support under epidemic. People with divergent perceived social support (more perceived supports from partner, family and friends) are prone to have a relatively lower risk of parental burnout. Parents with higher resilience will be more sensitive to the support of close acquaintances, and can better resist parental burnout.
Burnout, Psychological/epidemiology* ; COVID-19/epidemiology* ; China/epidemiology* ; Humans ; Parents ; Social Support

Objective: To explore the impact of activities of daily living (ADL) on depression in the elderly and the role of social networks and children's support. Methods: Data used in this study were obtained as participants aged 60 and above from the "China Longitudinal Aging Social Survey 2018",with a sample size of 10 215. ADL, social network and depression were measured on scales. The moderated mediation model was used to analyze the role of social networks and children's support. The SPSS 25.0 software was used for statistical analysis, the PROCESS 3.3 macro program was used to test the moderated mediation effect. Results: A total of 10 760 participants aged 60 and above were included. Activities of daily living showed a direct impact on depression in the elderly (β=-0.090, P<0.01), with social network playing a mediating role (β=0.035, P<0.01; β=-0.064, P<0.05) and children's support played a moderating role (β=-0.029, P<0.05) in the relationship between the elderly's ADL and depression. Conclusions: The social network is an essential buffer to declining ADL's negative impact on depression of older adults. Children's support is a powerful supplement to enhance social networks' positive role and reduce the risk of elderly depression. Exerting the combined advantages of social networks and children's support are important ways to maintain the elderly's mental health.
Activities of Daily Living ; Aged ; Aging/psychology* ; Child ; China/epidemiology* ; Humans ; Middle Aged ; Social Networking ; Social Support

To explore the potential associations between perceived stress and health-promoting behaviors based on the theoretical schema of the middle-range theory of adaptation to chronic illness. From January to May 2021, a convenience sampling method was used to recruit 230 young and middle-aged patients with metabolic syndrome who underwent physical examination in the inpatient center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. The Health-Promoting Health Profile-Ⅱ, Chinese Perceived Stress Scale, Coping and Adaptation Processing Scale-Short Form, and Multi-dimensional Scale of Perceived Social Support were used in the cross-sectional study. The chain mediation effect procedure and bootstrap sampling test were used to examine the mediating role of adaptability and social support between perceived stress and health-promoting behaviors. The mean score of health-promoting behaviors was 100.0±14.6, the mean score of perceived stress was 22.0± 6.9, the mean score of adaptability was 47.0±6.1, and the mean score of social support was 63.8±10.8. Perceived stress had a negative impact on patients' health-promoting behaviors (=-0.309, <0.05). The adaptability (effect size= -0.112, 95%:-0.199~-0.038) and social support (effect size= -0.032, 95%:-0.083~played a mediating role and a chain mediating role in the process of perceived stress influencing patients' health-promoting behaviors (effect size= -0.045, 95%:-0.093~-0.020). Adaptability and social support play an intermediary role between perceived stress and health-promoting behaviors in young and middle-aged patients with metabolic syndrome. Healthcare professionals can motivate patients to develop healthy behaviors by developing intervention strategies on adaptability and social support.
Adaptation, Psychological ; Cross-Sectional Studies ; Humans ; Metabolic Syndrome ; Middle Aged ; Social Support ; Stress, Psychological

Objective: To systematically evaluate the correlation between professional quality of life and social support of Chinese nurses based on Pearson and Spearman correlation coefficients. Methods: In databases including PubMed, Cochrane Library, CINAHL, Medline, CBM, CNKI、Wanfang, and other databases were searched by computer for the literatures on correlation between Chinese nurses' professional quality of life and social support from January 2005 to July 2020. The Chinese and English search terms are "nurse" "professional quality of life" "empathy satisfaction" "empathy fatigue" "professional quality of life" "ProQOL" "comparison satisfaction" "comparison fatigue" "social support" "competent social support" "SSRS" "PSSS", etc. Literatures were screened according to the inclusion and exclusion criteria. After evaluating quality and extracting data, meta-analysis was conducted using RevMan 5.3 software. Results: A total of 12 studies were included. The meta analysis showed that nurses' compassion satisfaction, burnout, secondary traumatic stress were related to social support, summary r were 0.35, -0.26 and -0.23 respectively. The correlation between compassion satisfaction and social support were increased with sample, the south was higher than the north, and comprehensive departments were higher than other departments (P<0.05) . The correlation between burnout and social support were increased with time and sample, and the south was higher than the north, oncology was higher than others, non-random sampling was higher than random sampling, using ProQOL and Perceived Social Support Scale (PSSS) was higher than Professional Quality of Life Scale (ProQOL) and Social Support Racting Scale (SSRS) (P<0.05) . The correlation coefficient between secondary traumatic stress and social support in oncology was higher than others, random sampling was higher than non-random sampling, using ProQOL and PSSS was higher than ProQOL and SSRS (P<0.05) . Conclusion: There is a positive and weak correlation between compassion satisfaction and social support, and a negative and weak correlation between burnout and secondary traumatic stress and social support. There are differences in different time, research design, region and department.
Burnout, Professional ; China ; Cross-Sectional Studies ; Humans ; Job Satisfaction ; Nurses ; Quality of Life ; Social Support ; Surveys and Questionnaires

Objective To explore the impact of pressure and social support on the quality of life of non-surgical gastric cancer patients. Methods A total of 158 non-surgical patients diagnosed with gastric cancer by gastroscopy from June to August in 2021 were included in this study.The perceived stress scale,multidimensional scale of perceived social support,and the 36-item short form health survey questionnaire [including the physical composite score (PCS) and mental composite score (MCS)] were used for the evaluation of perceived stress,social support,and quality of life,respectively.Spearman correlation analysis was conducted.Mann-Whitney U test,Kruskal-Wallis H test or one-way analysis of variance was employed for the comparison between groups.Bivariate Logistic regression was employed for multiple comparisons. Results Gender (P<0.001),marriage (P=0.022),age (P=0.022),and sickness symptoms (P=0.009) affected the PCS of non-surgical gastric cancer patients.Gender (P=0.016),income (P=0.012),and sickness symptoms (P=0.038) influenced the MCS of non-surgical gastric cancer patients.Perceived pressure was negatively correlated with PCS and MCS (all P<0.001).The three factors of social support were positively correlated with PCS and MCS (all P<0.001).The PCS was associated with gender (OR=0.219,95%CI=0.091-0.525,P=0.001),age (OR=0.969,95%CI=0.942-0.998,P=0.035),sickness symptoms (OR=1.142,95%CI=1.013-1.287,P=0.030),perceived stress (OR=0.921,95%CI=0.860-0.987,P=0.019),and family support (OR=1.195,95%CI=1.064-1.343,P=0.003).The MCS was associated with gender (OR=0.169,95%CI=0.062-0.459,P<0.001),perceived pressure (OR=0.910,95%CI=0.844-0.981,P=0.013),and other support (OR=1.136,95%CI=1.002-1.288,P=0.046). Conclusions The quality of life of the patients with non-surgical gastric cancer was related to perceived pressure and social support.Female and elderly patients have lower quality of life,which requires more attention in clinical work.
Aged ; Female ; Health Surveys ; Humans ; Quality of Life/psychology* ; Social Support ; Stomach Neoplasms ; Surveys and Questionnaires