scholarly journals Bathing and toileting difficulties of older adults in rural China: the role of environment

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Changxi Liu ◽  
Joelle H. Fong ◽  
Jasmon W. T. Hoh ◽  
Hailin Wu ◽  
Yunsheng Dong ◽  
...  

Abstract Background For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). This study aims to examine how environmental factors are associated with difficulty of bathing and toileting among older adults in rural China. Method The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. Logistic regressions were applied to examine how difficulty of bathing and toileting was related to environmental factors such as geographic location, neighbourhood amenity, and related facilities of bathing and toileting. Results Older adults living in the Southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling for other confounders. Better neighbourhood conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without showering facilities, in public facilities, and outdoors were significantly more likely to have bathing disability than those who showered indoors with facility. Rural older adults who used pedestal pans and indoor buckets for toileting were more likely to have toileting disability than those who used indoor squatting facilities. Conclusion Environmental barriers were associated with functional disability among older adults in rural China, but the disabled individuals may change their environments to adapt to their functional capabilities. Our findings suggest that it is imperative to promote the use of showering facilities and pedestal pans for toileting in rural China.

2020 ◽  
Author(s):  
Changxi Liu ◽  
Joelle H. Fong ◽  
Jasmon W. T. Hoh ◽  
Hailin Wu ◽  
Yunsheng Dong ◽  
...  

Abstract Background: For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). This study aims to examine how environmental factors are associated with difficulty of bathing and toileting among older adults in rural China. Method: The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. Logistic regressions were applied to examine how difficulty in bathing and toileting was related to environmental factors such as geographic location, neighbourhood amenity, and related facility of bathing and toileting. Results: Older adults living in the southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling on other confounders. Better neighbourhood conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without shower facilities, in public facility, and outdoors were significantly more likely to have bathing disability than those who showered indoors. Rural older adults who used pedestal pan and indoor bucket for toileting were more likely to have toileting disability than those who used indoor squatting facilities. Conclusion: Environmental barriers were associated with functional disability among older adults in rural China, but these individuals may also change their environment to adapt to their functioning. Our findings suggest it is imperative to promote the use of showering facilities and pedestal pans for toileting in rural China


2020 ◽  
Author(s):  
Changxi Liu ◽  
Joelle H. Fong ◽  
Jasmon W. T. Hoh ◽  
Hailin Wu ◽  
Yunsheng Dong ◽  
...  

Abstract Background: For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). Few studies, however, have investigated how the built environment and other environmental factors affect bathing and toileting in later life. This study aims to fill this gap. Method: The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. The multinomial logistic regressions were applied to examine how difficulty in bathing and toileting was related to environmental factors such as geographic location, community amenity, and built environment of bathing and toileting. Results: Older adults living in the southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling on other confounders. Better community conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without shower facilities, in public facility, and outdoors were significantly more likely to have bathing disability than those who showered indoors. Rural older adults who used pedestal pan and indoor bucket for toileting were more likely to have toileting disability than those who used indoor squatting facilities. Conclusion: Environmental factors are strongly associated with functional disability among older adults, but the relationship is not unidirectional. Having a showering facility could reduce difficulties of bathing for rural Chinese. Very frail older persons may actively choose to change their environmental settings to suit their needs, for instance, by using a pedestal pan or bucket for toileting as an alternative to squatting. There is an urgent need to promote the use of showering facilities and pedestal pans for toileting in rural China.


2020 ◽  
Author(s):  
Jian Rong ◽  
Yanhong Ge ◽  
Xueqin Wang ◽  
Guimei Chen ◽  
Hong Ding

Abstract Background: The association between functional disability and depressive symptoms among elderly people in rural China is not clear. This study explored the relationship between functional disability and depressive symptoms, focusing on whether an interactive association between functional disability, demographic characteristics and depressive symptoms exists among older adults in rural Anhui, China.Methods: A cross-sectional survey study was conducted with multi-stage stratified random sampling. The 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. The data were analyzed using SPSS statistics 25.0 program with chi-square test, Mann-Whitney U test, binary logistic regression analysis, and classification and regression tree model.Results: The prevalence of depressive symptoms in 3336 older people was 52.94%. After adjustment, subjects who had problems in participation (adjusted odds ratio [AOR]=3.499, 95% confidence interval [CI]: 2.385-4.987), life activities (AOR=1.683, 95% CI: 1.370-2.066), getting along (AOR=1.616, 95% CI: 1.299-2.010), and mobility (AOR=1.842, 95% CI: 1.503-2.258) had an increased depressive symptoms risk. However, cognition (AOR=0.785, 95% CI: 0.647-0.953) negatively correlated with depressive symptoms. Additionally, the interactive association between functional disability dimensions, various variables and depressive symptoms were identified for the first time. Those who had problems in mobility, getting along and were unemployed, the possibility of having depressive symptoms was the highest.Conclusions: Special attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along, and mobility and no problems in cognition to maintain a good psychological state. Our findings may be greatly significant for developing more targeted and effective mental health prevention and intervention measures for older adults in rural areas.


2016 ◽  
Vol 29 (7) ◽  
pp. 1182-1213 ◽  
Author(s):  
Qian Song

Objective: When examining the depressive symptoms of left-behind elderly, this article goes beyond a focus on disruption to traditional patterns of living arrangements and investigates the heterogeneities in the patterns of migration distance, as well as the role of community contexts in buffering the loss of migrant children’s support. Method: This study uses the first wave of the China Health and Retirement Longitudinal Survey, and employs random effects multi-level modeling. Results: Having migrant children is associated with increased depressive symptoms among older adults, above and beyond living arrangements. Having their migrant children all live outside the province further puts older adults in disadvantaged mental conditions. This disadvantage can be further compounded by residence in impoverished communities. Discussion: In assessing depression among rural older adults in China, examination of living arrangements may be insufficient. It may be necessary to reference to children’s migration status as well as community poverty levels.


2020 ◽  
Author(s):  
Jian Rong ◽  
Yanhong Ge ◽  
Xueqin Wang ◽  
Guimei Chen ◽  
Hong Ding

Abstract Background: The association between functional disability and depressive symptoms among elderly people in rural China is not clear. This study explored the relationship between functional disability and depressive symptoms, focusing on whether an interactive association between functional disability, demographic characteristics and depressive symptoms exists among older adults in rural Anhui, China.Methods: A cross-sectional survey study was conducted with multi-stage stratified random sampling. The 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. The data were analyzed using SPSS statistics 25.0 program with chi-square test, Mann-Whitney U test, binary logistic regression analysis, and classification and regression tree model.Results: The prevalence of depressive symptoms in 3336 older people was 52.94%. After adjustment, subjects who had problems in participation (adjusted odds ratio [AOR]=3.499, 95% confidence interval [CI]:2.385-4.987), life activities (AOR=1.683, 95% CI: 1.370-2.066), getting along (AOR=1.616, 95% CI: 1.299-2.010), and mobility (AOR=1.842, 95% CI: 1.503-2.258) had an increased depressive symptoms risk. However, cognition (AOR=0.785, 95% CI: 0.647-0.953) negatively correlated with depressive symptoms. Additionally, the interactive association between functional disability dimensions, various variables and depressive symptoms were identified for the first time. Those who had problems in mobility, getting along and were unemployed, the possibility of having depressive symptoms was the highest.Conclusions: Special attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along, and mobility and no problems in cognition to maintain a good psychological state. Our findings may be greatly significant for developing more targeted and effective mental health prevention and intervention measures for older adults in rural areas.


Author(s):  
Liping Ye ◽  
Xinping Zhang

This study aimed to identify social network types among older adults in rural China, to explore the relationship between social network types and the health of the older adults, and further, to examine the mediating role of social support in this relationship. A cross-sectional survey method was employed to investigate the health of adults aged 60 or older in rural areas of Hubei Province from 5 September 2018 to 15 October 2018; 405 samples were obtained. First, using k-means clustering analysis, we found five robust network types: diverse, restricted, family, friends and a specific type—family-restricted. Second, the results of multiple linear regression analysis showed that social network types were significantly associated with depressive symptoms and self-rated health in older adults. Older people with diverse friend networks were significantly associated with lower levels of depressive symptoms, whereas those with restricted and family-restricted networks were significantly associated with higher levels of depressive symptoms and lower levels of self-rated health. Finally, the results of multiple linear regression analysis confirmed that social support partially mediated the association of the identified social network types with depressive symptoms and self-rated health. Enriching the social network relationships of older adults and providing them with more social support should be conducive to promoting their mental and physical health.


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