scholarly journals Decomposing differences in depressive symptoms between older rural-to-urban migrant workers and their counterparts in mainland China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Yang ◽  
Dan Li ◽  
Jianmin Gao ◽  
Xiaojuan Zhou ◽  
Fuzhen Li

Abstract Background There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie’s decomposition was used to parse out differences into observed and unobserved components. Results After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie’s decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents. Conclusions Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers’ depressive symptoms.

Author(s):  
Dan Li ◽  
Zhongliang Zhou ◽  
Chi Shen ◽  
Jian Zhang ◽  
Wei Yang ◽  
...  

Background: China’s older rural-to-urban migrant workers (age 50 and above) are growing old, but comparative health research on older rural-to-urban migrants in China is still in its infancy. The aim is to explore the health status of older rural-to-urban migrant workers in China; as well as to identify health disparity between older rural-to-urban migrant workers and older rural dwellers. Methods: This study employed self-assessed health status (SAH) and chronic disease condition to explore the health status. Coarsened exact matching (CEM) was employed to improve estimation of causal effects. Fairlie’s decomposition analysis was conducted to find the health disparity. Results: Older rural-to-urban migrant workers were more prone to suffer from chronic diseases, but they had higher SAH when comparing older rural dwellers. Fairlie’s decomposition analysis indicated 10.44% of SAH disparities between two older groups can be traced to bath facility; 31.34% of chronic diseases disparities can be traced to educational attainment, sleeping time and medical scheme. Conclusions: This is the first comparative study examining health disparity focusing on older rural-to-urban migrant workers. Our study highlighted substantial health disparities between older rural-to-urban migrant workers and their older rural dwellers. Based on the contributing factors, government should take the drivers of health disparities into consideration in policy setting.


2021 ◽  
Author(s):  
Dan Li ◽  
Jian Zhang

Abstract Background: In recent years, the widening gap of health service utilization between different groups in mainland China has become an important issue that cannot be avoided. Yet the related study on the health services utilization for older rural-to-urban migrant workers and comparative study on older rural-to-urban migrants in China is still in its infancy. Our study explored the health service utilization of the older rural-to-urban migrant workers based on a sinicization of the latest Andersen model, by comparison with the older rural dwellers. Further, our study revealed the facets and causes by decomposing the differences in the health service utilization into determinants.Methods: The data of China Labor-Force Dynamic Survey in 2016, the data of Urban Statistical Yearbook in 2016, and Statistical Bulletin were used. Our study applied the lasted Andersen Model according to China's currency situation. Before we studied the health service utilization, we used Coarsened Exact Matching to control the confounding factors to enhance the comparability of the two groups. The matched data were used to analyze the influencing factors. Fairlie decomposition method was used to analyze the differences and the sources of health service utilization between older rural-to-urban migrant workers and their rural counterparts.Results: After matching, the probability of two weeks outpatient of older rural-to-urban migrant workers (5.59%) was significantly lower than older rural dwellers (7.57%). The probability of inpatient of older rural migrant workers (5.59%) was significantly lower than older rural dwellers (9.07%). 17.98% of the total difference of two weeks outpatient utilization was due to the observed influence factors. 71.88% of the total difference of inpatient utilization was due to the observed influence factors. Income quantiles (49.57%), self-assessed health (80.91%), and sex ratio in the community (-102.29%) were significant in the differences of inpatient utilization.Conclusions: The findings have important implications for the difference in the health services utilization between older rural-to-urban migrant workers and older rural residents in China, urging the government to take full account of the heterogeneity. The results provide references for the healthcare policy reform in the process of active ageing in China.


2019 ◽  
Vol 31 (11) ◽  
pp. 1665-1674 ◽  
Author(s):  
Sheung-Tak Cheng ◽  
Phoon Ping Chen ◽  
Yu Fat Chow ◽  
Joanne W. Y. Chung ◽  
Alexander C. B. Law ◽  
...  

ABSTRACTObjective:The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.Design:Cross-sectional survey.Setting:Social centers for older people.Participants:664 Chinese older adults with chronic pain.Measurements:Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.Results:For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.Conclusions:The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.


2007 ◽  
Vol 25 (15) ◽  
pp. 2093-2099 ◽  
Author(s):  
Carolyn Cook Gotay ◽  
Carol M. Moinpour ◽  
Joseph M. Unger ◽  
Caroline S. Jiang ◽  
Dorothy Coleman ◽  
...  

Purpose A first breast cancer recurrence creates considerable distress, yet few psychosocial interventions directed at this population have been reported. The Southwest Oncology Group conducted a phase III randomized trial to evaluate the effectiveness of a brief telephone intervention. Patients and Methods Three hundred five women experiencing a first recurrence of breast cancer were randomly assigned to standard care or intervention. The intervention consisted of four to eight telephone calls delivered over a 1-month period. The calls were conducted by trained peer counselors at a breast cancer advocacy organization, the Y-ME National Breast Cancer Organization, and followed a standard curriculum. Psychosocial distress (Cancer Rehabilitation Evaluation System–Short Form [CARES-SF]) and depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) outcomes were assessed at baseline and 3 and 6 months. The 3-month assessment was the primary end point and is the focus of this article. Results Analysis revealed no differences in distress or depressive symptoms at 3 months between the intervention and control groups; at 3 months, 70% of control patients and 66% of intervention patients reported psychosocial distress, and 40% of control patients and 47% of intervention patients exhibited depressive symptoms. Conclusion Telephone peer counseling did not lead to better psychosocial outcomes. The persistent distress in these women supports the urgent need for the development and testing of more intensive or different supportive interventions for this group of patients.


2011 ◽  
Vol 26 (S2) ◽  
pp. 837-837
Author(s):  
D. Ignjatovic Ristic ◽  
V. Janjic ◽  
B. Ristic ◽  
B. Radmanovic

IntroductionDepression is often occurred after surgical interventions and may have serious consequences on postoperative recovery. The treatment of early discovered depressive symptoms may have strong influence on the recovery of operated orthopedic patients.Simple and quick instrument for detection and evaluation of depressive symptoms could be of great use to doctors.Work objectives are1) determine the prevalence of depressiveness in preoperative period in patients with scheduled surgical interventions, and2) validation of Geriatric Depression Scale - short form (GDS-SF) in detection of depressiveness.MethodA sample of 120 orthopedic patients is the part of larger sample in prospective research of depressiveness in patients in preoperative period with scheduled surgical interventions (except cardio-surgical). For estimation of depressiveness we used battery of tests (GDS-SF, BDI - Beck's depression scale, MDI - major depressive disorder questionnaire), and patients were tested 3 times: to 14 days prior the surgery, 7 and 90 days after the surgery. Validation of GDS-SF was examined compared to BDI according to age and gender of examinees.ResultsIn preliminary sample of 120 orthopedic patients with scheduled orthopedic interventions, prevalence of depressiveness is greater than prevalence of depressiveness in general population (p < 0.001). Depressiveness is much more present in women than in men (p < 0.001). Correlation of depressive scores in BDI and in GDS-SF is satisfactory for all age groups.ConclusionPreliminary results indicate on further research of depressiveness in preoperative period in order to confirm validation of GDS-SF as simpler alternative for early detection of depressiveness.


2020 ◽  
Vol 66 (8) ◽  
pp. 799-809
Author(s):  
Miriam Engel ◽  
Karl-Heinz Jöckel ◽  
Nico Dragano ◽  
Miriam Engels ◽  
Susanne Moebus

Background: Depressive symptoms are volatile over time but empirical studies of intra-individual variations of depressive symptoms over longer periods are sparse. Aims: We aim to examine fluctuation patterns of depressive symptoms and to investigate the possible influence of age, sex and socioeconomic factors on fluctuation in a population-based sample over a period of 13 years. Methods: We used data of 4,251 participants (45–75 years; 51.0% women at baseline) of the Heinz Nixdorf Recall Study with at least two of nine possible measurements obtained in the period between 2000 and 2017. Depressive symptoms were assessed via the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Based on the individual mean values and standard deviation from all measurements, we categorized participants as G1 ‘stable low’, G2 ‘stable high’, G3 ‘stable around cutoff’ and G4 ‘large fluctuations’. Results: Most participants (82.3%) showed stable low depressive symptoms (G1), whereas 2.3% performed stable high values (G2), 6.9% stable around the cutoff (G3) and 8.6% large fluctuations (G4). Conclusion: Our longitudinal results reveal that almost 18% (G2, G3 and G4) of the participants have an increased depression score or strong fluctuations at times. According to our classification, a higher proportion of the participants show anomalies with regard to depression compared to a simple classification into depressed and nondepressed, especially if this is based on a single measurement. Thus, longitudinal measurements of depression can prevent misclassification and provide valuable information about the course of depressive symptoms for a better understanding of the changes of depression.


2017 ◽  
Vol 52 (4-6) ◽  
pp. 315-327 ◽  
Author(s):  
Karolina Schantz ◽  
Chelsea Reighard ◽  
James E Aikens ◽  
Amparo Aruquipa ◽  
Bismark Pinto ◽  
...  

Objective We assessed the validity and reliability of the Center for Epidemiologic Studies-Depression scale (CES-D) short form and the Patient Health Questionnaire-8 (PHQ-8) (two measures of depressive symptoms) among urban, low-income patients from a heavily indigenous area of Andean Latin America. This is a patient population that is in many ways culturally distinct from the populations that have been included in previous Spanish language validation studies of these instruments. Methods We administered the CES-D Yale version short form and the PHQ-8 to 107 outpatients at public hospitals in La Paz and El Alto, Bolivia. We conducted exploratory factor analysis, checked internal reliability, and examined concordance between the two measures in identifying patients with clinically significant depressive symptoms. Results Internal reliability was high for both scales: PHQ-8 (Cronbach’s α = 0.808) and CES-D (α  = 0.825). A one-factor solution for the PHQ-8 was maintained after the removal of one poorly loading item. The CES-D showed a two-factor solution, with items for somatic symptoms and interpersonal problems loading on the same factor as negative affect. Using both the cutoff for depression recommended in prior studies and a sample specific cutoff of ≥1 standard deviation above the mean, the two scales demonstrated only moderate agreement (κ = 0.481–0.486). Conclusions The PHQ may be more appropriate for clinical use in the Andean region, given its greater specificity; however, lower than expected agreement between the scales suggests that they also measure different elements of depression. Irregularities with the factor structure of both scales suggest that further research with this population is needed to better understand depressive symptomology and improve screening in the region.


2004 ◽  
Vol 34 (4) ◽  
pp. 623-634 ◽  
Author(s):  
RAMIN MOJTABAI ◽  
MARK OLFSON

Background. Although major depression is a common condition across the age range, there is some evidence from clinical studies that it may be more persistent and disabling in older adults. This study examined the demographic, socio-economic and clinical factors associated with major depression and with persistence of depressive symptoms at 2- and 4-year follow-ups in a large population sample of middle-aged and older adults.Method. In a sample of 9747 participants aged over 50 in the 1996 wave of the US Health and Retirement Study, the authors assessed the 12-month prevalence of major depression using the Composite International Diagnostic Interview – Short Form (CIDI-SF). Significant depressive symptoms at the time of 1996, 1998 and 2000 interviews were assessed using a short form of the Center for Epidemiological Studies Depression Scale (CES-D).Results. The 12-month prevalence of CIDI-SF major depression was 6·6%. With age, prevalence declined, but the likelihood of significant depressive symptoms at follow-ups increased. Both prevalence and persistence of significant depressive symptoms at follow-ups were associated with socio-economic disadvantage and physical illness. Persistence of depressive symptoms at follow-ups was also associated with symptoms of anhedonia, feelings of worthlessness, and thoughts of death at baseline.Conclusions. Sociodemographic, physical health and a specific profile of depressive symptoms are associated with a poorer course of major depression in the middle-aged and older adults. These indicators may identify a subgroup of patients in need of more careful follow-up and intensive treatment.


2019 ◽  
Vol 75 (7) ◽  
pp. 1494-1503
Author(s):  
Katrina M Walsemann ◽  
Jennifer A Ailshire ◽  
Caroline Sten Hartnett

Abstract Objectives More parents are borrowing to help their children pay for college. These loans may be a source of financial stress and worry, which could influence parents’ mental health. We determine whether child-related educational debt is associated with worse mental health among parents and if fathers are more sensitive to this debt than mothers, given potential gender differences in financial decision-making and relationships with adult children. Method Data come from the National Longitudinal Survey of Youth 1979, a nationally representative sample of persons born between 1957 and 1964. We used the Center for Epidemiologic Studies Depression Scale and the Short Form-12 Mental Health Component Score to assess mental health. We restricted our sample to parents who had at least one biological child attend college and who were interviewed at age 50, when mental health was assessed (n = 3,545). Results Among fathers, having any child-related educational debt versus none was associated with fewer depressive symptoms, but having greater amounts of child-related educational debt was associated with more depressive symptoms and worse mental health. No relationship was found for mothers. Discussion Our findings indicate that the student debt crisis may also have mental health implications for aging parents, particularly for fathers.


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