Andy H. Y. Ho

Does mood state change risk taking tendency in older adults

No study has been conducted to evaluate the influences of age differences on specific moods for risk taking tendencies. This study examined the patterns of risk taking tendencies among younger and older persons in 3 transient affective states: positive, neutral, and negative moods. By means of viewing happy, neutral, or sad movie clips, participants were induced to the respective mood. Risk taking tendencies were measured with decision tasks modified from the Choice Dilemmas Questionnaire (N. Kogan & M. A. Wallach, 1964). Consistent with the affect infusion model (J. P. Forgas, 1995), risk taking tendency was greater for those individuals who were in a happy mood than for those who were in a sad mood, for both young and older participants. However, an asymmetrical effect of positive and negative mood on risk taking tendency was identified among both the young and older participants, but in opposite directions. These results are consistent with the predictions of the negativity bias and the positivity effect found in young and older adults, respectively, and are interpreted via information processing and motivation effects of mood on the decision maker.

Living alone and depression in Chinese older adults

Western literature has repeatedly indicated a strong relationship between living alone and depression among the aged population, however, studies among the Chinese population are scarce. In this paper, we examine whether the association between living alone and depression is independent of health status, social support and financial strain among Chinese older adults, and subsequently assess whether such association persists after adjusting these variables. Cross-sectional data drawn from the Hong Kong Population Census consisting of 2,003 Chinese elderly people aged 60 or over were analyzed. Chi-square tests and logistic regression analyses revealed that living alone results in higher levels of depressive symptoms for older women but not for older men. This relationship remained significant even when socio-demographic variables, health indicators, social support, and financial strains were adjusted; yet, the impact of living alone with depression disappeared when all variables were controlled. In summary, this paper is the first to report that living alone is an independent risk factor contributing to depression among Chinese older women, as well as identifying certain significant factors including social support and health indicators that can affect and explain the link between living alone and depression. Preventive measures and related issues were discussed.

Posttraumatic stress disorder symptoms among adult survivors of the 2008 Sichuan earthquake in China

This study examined the estimated prevalence rate of posttraumatic stress disorder (PTSD) symptoms and associated risk factors among Chinese adult survivors 7 to 8 months after the 2008 Sichuan earthquake. The sample was recruited from 2 areas close to the epicenter but of different distances. The estimated rate of PTSD symptoms was 55.6% and 26.4% respectively in the two areas. Loss of a child was a strong predictive factor for PTSD symptoms for the parents. Other predictive factors included female gender, loss of a parent, loss of friends or neighbors, residential house damage or collapse, and proximity to the epicenter. Effective and sustainable mental health services are needed and should be directed particularly to bereaved survivors.

Symptoms of posttraumatic stress disorder and depression among bereaved and non-bereaved survivors following the 2008 Sichuan earthquake

Many studies have suggested that unexpected death of a loved one is an important risk factor of posttraumatic stress disorder (PTSD) and depression among disaster survivors, but few have examined the magnitude of psychiatric morbidities among bereaved survivors. This study examined the prevalence rates of clinically significant PTSD and depressive symptoms and their associated risk factors among Chinese adult survivors following the 2008 Sichuan earthquake. Two hundred and fifty-one bereaved adults were compared with 1474 non-bereaved adult survivors. The estimated rates of PTSD and depressive symptoms were 65.6% and 64.8% for those who lost first-degree family members, 34.1% and 45.5% for those who lost second-degree relatives, and 27.1% and 37.5% for non-bereaved survivors respectively. Loss of a child was a significant predictor of psychopathological symptoms. The results suggested that effective and sustainable mental health services were required, especially for bereaved single-child parents.

A Systematic Review of the Effectiveness of Qigong Exercise in Cardiac Rehabilitation

The objective of this study was to assess evidence for the efficacy and effectiveness of Chinese qigong exercise in rehabilitative programs among cardiac patients. Thirteen databases were searched through to November 2010, and all controlled clinical trials on Chinese qigong exercise among patients with chronic heart diseases were included. For each included study, data was extracted and validity was assessed. Study quality was evaluated and summarized using both the Jadad Scale and the criteria for levels of evidence. Seven randomized controlled trials (RCTs) and one non-randomized controlled clinical trial (CCT) published between 1988 and 2007 met the inclusion criteria. In total, these studies covered 540 patients with various chronic heart diseases including atrial fibrillation, coronary artery disease, myocardial infarct, valve replacement, and ischemic heart disease. Outcome measures emerged in these studies included subjective outcomes such as symptoms and quality of life; and objective outcomes such as blood pressure, ECG findings, and exercise capacity, physical activity, balance, co-ordination, heart rate, and oxygen uptake. Overall, these studies suggest that Chinese qigong exercise seems to be an optimal option for patients with chronic heart diseases who were unable to engage in other forms of physical activity; however, its efficacy and effectiveness in cardiac rehabilitation programs should be further tested.

The impact of spirituality on health-related quality of life among Chinese older adults with vision impairment

The goals of this study were to examine the impact of spirituality on both generic and vision-specific health-related quality of life (HRQOL) and the role of spirituality in the linkage between vision impairment and HRQOL outcomes among Chinese older adults with visual problems. A sample of 167 urban older adults with visual problems were interviewed using a structured questionnaire to assess self-reported visual functioning, general health, spirituality and both generic and vision-specific HRQOL. Objective visual function was clinically measured by ophthalmologists in terms of distance visual acuity. It was found in the study that spirituality was positively associated with both general physical health and general mental health, with a higher correlation with general mental health than that with general physical health. Moreover, spirituality was associated significantly with vision-specific HRQOL, including multiple domains. The results showed that spirituality played a mediating role in the linkage between vision impairment and general mental health. These results suggest that spirituality is significantly associated with multiple domains of HRQOL and may play an important role in the process of adaptation to age-related vision loss among Chinese older adults with vision impairment.

The Blessings and the Curses of Filial Piety on Dignity at the End-of-Life: Lived Experience of Hong Kong Chinese Adult Children Caregivers

This study critically examines the evolving nature of filial piety and the role that it plays in the contemporary experience of “living and dying with dignity” among Hong Kong Chinese families facing the end of life. Meaning-oriented interviews were conducted with a purposive sample of 15 adult-children caregivers, ages 30 to 62, to elicit their narratives and stories in caring for a dying elderly parent. Qualitative content analysis reveals that although traditional filial beliefs provided motivation for family caregiving, the regrets of unfulfilled filial responsibilities create emotional distance between parents and adult children, which acts as a cultural barrier for reconciliation and contentment at lifes final margin. These findings underscore the importance of intergenerational dynamics and interactions in the transformation of filial attitudes and behaviors, highlighting the importance of reciprocal relationships (versus authority relationship), mutual support (versus complete obedience), compassionate duty (versus obligatory duty), emotional connection (versus task fulfillment), and appreciation and forgiveness (versus guilt and shame) in the promotion of dignity at the end of life. Policy and clinical implications are discussed.

Neighborhood support network, perceived proximity to community facilities and depressive symptoms among low socioeconomic status Chinese elders.

Objectives: Depressive symptoms are common in older people; most previous research on elderly depression focused on individual-level characteristics or neighborhood socioeconomic status. Modifiable neighborhood characteristics of older people dwelling in low-income communities are under-studied. This study aims to identify potentially modifiable social and physical neighborhood characteristics that influence depressive symptoms independent of individual-level characteristics among older Chinese. Method: Data came from a cross-sectional survey conducted in four low-income public rental housing estates in Hong Kong in 2012. We interviewed a total of 400 elderly residents. The structured questionnaire covered demographics, activities of daily living, recent fall history, neighborhood support networks, and perceived proximity by walk to community facilities. Multiple regression was used to test whether inclusion of neighborhood factors in addition to individual characteristics increases model fit in explaining depressive symptoms in elders with low socioeconomic status. Results: At individual level, activities of daily living and income significantly predicted depressive symptoms. Receiving support from friends or neighbors is associated with fewer depressive symptoms. However, participants who received organizational support had a 1.17 points of increase on the 15-item Geriatric Depression Scale (GDS-15). At-ease walkable proximity to medical facilities was positively associated with a better GDS score. Conclusion: Neighborhood support networks and perceived proximity by walk to community facilities contribute significantly to depressive symptoms among low-income elders. Programs and policies that facilitate neighborhood support and commuting or promote facility accessibility may help ameliorate depressive symptoms common among low-income elders.

Measuring Filial Piety in the 21st Century Development, Factor Structure, and Reliability of the 10-Item Contemporary Filial Piety Scale

The experience and practice of filial piety have evolved in modern Chinese societies, and existing measures fail to capture these important changes. Based on a conceptual analysis on current literature, 42 items were initially compiled to form a Contemporary Filial Piety Scale (CFPS), and 1,080 individuals from a representative sample in Hong Kong were surveyed. Principal component analysis generated a 16-item three-factor model: Pragmatic Obligations (Factor 1; 10 items), Compassionate Reverence (Factor 2; 4 items), and Family Continuity (Factor 3; 2 items). Confirmatory factor analysis revealed strong factor loadings for Factors 1 and 2, while removing Factor 3 and conceptually duplicated items increased total variance explained from 58.02% to 60.09% and internal consistency from .84 to .88. A final 10-item two-factor structure model was adopted with a goodness of fit of 0.95. The CFPS-10 is a data-driven, simple, and efficient instrument with strong psychometric properties for assessing contemporary filial piety.

Prevalence and determinants of depression among survivors 8 months after the Wenchuan earthquake.

Abstract The current study assessed the estimated rate of depression and associated risk factors among survivors 8 months after the 2008 Wenchuan earthquake in China. A stratified random sample of 1514 participants was recruited from all temporary camp communities in a county town 45 km away from the epicenter. The estimated rate of depression was 35.7%. The severity of depressive symptoms was significantly associated with female sex, perceived livelihood security, loss of a family member, residential house damage or collapse, and not living in an urban area, whereas married status is a protector against depressive symptoms. The results suggest that community-based effective, sustainable, and culturally sensitive interventions and services are warranted and should be directed to the groups at high risk for mental health problems.