The Mediating Effect of Resilience on the Relationship between Depression and Ego-Integrity in Community-Dwelling Elderly Women

2021 ◽  
Vol 15 (2) ◽  
pp. 67-78
Author(s):  
Hye Sun Hyun ◽  
◽  
Yunyoung Kim
Keyword(s):  
Elderly Women ◽  
Community Dwelling ◽  
Mediating Effect ◽  
Ego Integrity ◽  
The Relationship

Developing a model of the determinants of medication nonadherence in older community-dwelling patients

2019 ◽  
Vol 53 (11) ◽  
pp. 942-954 ◽  
Author(s):  
Affraic McLoughlin ◽  
Kathleen Bennett ◽  
Caitriona Cahir
Keyword(s):  
Root Mean Square ◽  
Direct Relationship ◽  
Community Dwelling ◽  
Mediating Effect ◽  
World Health ◽  
Mean Square ◽  
Medication Nonadherence ◽  
Related Factors ◽  
Older Populations ◽  
The Relationship

Abstract Medication nonadherence is associated with adverse health outcomes in older populations. The aim of this study was to develop a model that describes the relationship between the determinants of nonadherence, per the World Health Organization (WHO) model of nonadherence and the necessity–concerns framework (NCF) and nonadherence in a cohort of older community-dwelling patients. A retrospective cohort study of 855 community-dwelling patients aged ≥70 years from 15 practices. Medication nonadherence was assessed by (i) medication possession ratio (MPR < 80%) and (ii) the median MPR across all drugs dispensed. Patient questionnaires, interviews, and medical records measured the determinants of nonadherence per the WHO and NCF frameworks. Confirmatory factor analysis (CFA) was undertaken to generate the model of best fit. Two structural equation models (SEM) were developed to evaluate the relationship between the WHO factors, the NCF, and nonadherence (Model 1: MPR < 80%, Model 2: median MPR). The CFA produced a reasonable fit (χ2(113) = 203, p < .001; root mean square error of approximation = 0.03; comparative fit index = 0.98, and weighted root mean square residual = 0.97) and adequate internal consistency (r = .26–.40). SEM analysis (Model 1) showed a significant direct relationship between patient-related (β = 0.45, p < .01), socioeconomic (β = 0.20, p < .01), and therapy-related factors (β = −0.27, p < .01) and nonadherence (MPR < 80%). Similar results were found for Model 2 (median MPR). There was a significant direct relationship between medication concerns (β = −0.13, p < .01) and nonadherence. Therapy-related (β = −0.04, p < .05) and patient-related factors (β = −0.06, p < .05) also had a significant mediating effect on nonadherence through medication concerns. Health care professionals need to address medication concerns and management of adverse effects in older populations to improve adherence and clinical outcomes.

scholarly journals Mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kuen Tai Lee ◽  
Shih Kai Lee ◽  
Mei Jou Lu ◽  
Wen Ling Hsieh ◽  
Wen I. Liu
Keyword(s):  
Reliability And Validity ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Mediating Effect ◽  
Mediation Effect ◽  
Sectional Study ◽  
Personal Recovery ◽  
Cross Sectional ◽  
Global Function ◽  
The Relationship

Abstract Background Functional degradation among community-dwelling patients with schizophrenia can negatively influence their recovery. Given the importance of patient empowerment during recovery, this study examined the mediating effect of empowerment on the relationship between global function and personal recovery among community-dwelling patients with schizophrenia. Methods This cross-sectional study recruited community-dwelling patients with schizophrenia from northern and central Taiwan. Questionnaires with verified reliability and validity were provided and collected on site by trained nurses. Global function, empowerment, and personal recovery were measured using the Global Assessment of Functioning (developed by the American Psychiatric Association), Empowerment Scale, and Questionnaire on the Process of Recovery, respectively. The causal steps approach proposed by Baron and Kenny and the Sobel test were utilized to verify the mediation effect. The causal steps approach tested the four following pathways (regression coefficients): global function on empowerment (Path a), global function and empowerment as predictors of personal recovery (Path b), global function on personal recovery (Path c), and global function and empowerment on personal recovery (Path c’). Results A total of 373 participants completed the survey. After controlling for factors associated with recovery, Paths a (β = .24, p < .001), b (β = .68, p < .001), and c (β = .19, p < .001) were found to be significant; however, Path c’ was not significant (β = .03, p = .452). Empowerment was determined to exert “full mediation” over the effects of global function on personal recovery, and the Sobel test indicating significant mediation (Z = 3.61, p < .001). Conclusions Empowerment fully mediates the association between global function and personal recovery. This study suggested that offering empowerment-oriented care services may be more effective than global function improvement in recovery among these patients.

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