Skip to main content Accessibility help
×
Home

Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study

  • YuanYuan Zhao (a1) (a2), CaiYun Hu (a1), Fang Feng (a1), Fengfeng Gong (a1), ShanShan Lu (a1), ZhenZhong Qian (a1) and YeHuan Sun (a1)...

Abstract

Background:

Elder self-neglect (ESN) has become a public health issue globally. Limited studies have focused on ESN, as well as the relationship between ESN and quality of life (QoL) in developing countries. The study's objective is to explore the association between ESN and QoL among rural elderly in China.

Methods:

A cross-sectional study was conducted among 3,182 elder adults aged 60 years or older, using a cluster-sampling technique in one township in Dangtu, a county in Anhui province. All participants completed face-to-face interview in their household. QoL was assessed using a brief form of the World Health Organization's quality of life questionnaire (WHOQOL-BREF), and ESN was assessed using the Scale of the Elderly Self-neglect (SESN). Hierarchical linear regression models were used to analyze the associations between the ESN scores and QoL scores after adjusting for sociodemographic, social support, and physical and psychological variables.

Results:

The scores of overall ESN and five domains were significantly correlated with the scores of four QoL domains (p < 0.001). After adjusting for sociodemographic characteristics, social support, and physical and psychological health characteristics, elders who reported higher overall self-neglect scores had significantly lower scores in the four QoL domains (p < 0.001). Education, economic level, physical health, ADL, depression, and cognitive function are consistent predictors across all QoL domains.

Conclusions:

ESN is an independent risk factor for poor QoL in elderly people in rural China. Understanding the role of ESN and its influence on QoL is important for the management of and intervention in ESN.

Copyright

Corresponding author

Correspondence should be addressed to: Ye-Huan Sun, M.S., Ph.D., Department of Epidemiology and Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan road, Hefei, Anhui 230032, China. Phone and Fax: 86-551-65167725. Email: yhsun_ahmu_edu@yeah.net.

References

Hide All
Abrams, R., Lachs, M., McAvay, G., Keohane, D. and Bruce, M. (2002). Predictors of self-neglect in community-dwelling elderly. American Journal of Psychiatry, 159, 17241730.
Bozinovski, S. D. (2000). Older self-neglecters: interpersonal problems and the maintenance of selfcontinuity. Journal of Elder Abuse & Neglect, 12, 3756.
Braye, S., Orr, D. and Preston-Shoot, M. (2011). Conceptualising and responding to self-neglect: the challenges for adult safeguarding. The Journal of Adult Protection, 13, 182183.
Buckley, T. et al. (2012). Predictors of quality of life ratings for persons with dementia simultaneously reported by patients and their caregivers: the cache county (Utah) study. International Psychogeriatrics, 24, 10941102.
Chan, A. C. M. (1996). Clinical validation of the geriatric depression scale (GDS). Journal of Aging and Health, 8, 238.
Chang, Y. C., Yao, G., Hu, S. C. and Wang, J. D. (2015). Depression affects the scores of all facets of the WHOQOL-BREF and may mediate the effects of physical disability among community-dwelling older adults. PLoS One, 10, e0128356.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd ed.. Hillsdale, New Jersey: Lawrence Earlbaum Associates.
Day, M. R. (2010). Self-neglect: a challenge and a dilemma. Archives of Psychiatric Nursing, 24, 7375.
Day, M. R., Leahy-Warren, P. and McCarthy, G. (2016). Self-neglect: ethical considerations. Annual Review of Nursing Research, 34, 89107.
Dong, X. et al. (2009). Elder self-neglect and abuse and mortality risk in a community-dwelling population. Journal of American Medical Association, 302, 517526.
Dong, X. (2014). Self-neglect in an elderly community-dwelling U.S. Chinese population: findings from the population study of Chinese elderly in Chicago study. Journal of the American Geriatrics Society, 62, 3912397.
Dong, X. and Simon, M. A. (2015). Prevalence of elder self-neglect in a Chicago Chinese population: the role of cognitive physical and mental health. Geriatrics & Gerontology International, 16, 10511062.
Dong, X., Simon, M. and Evans, D. (2010). Cross-sectional study of the characteristics of reported elder self-neglect in a community-dwelling population: findings from a population-based cohort. Gerontology, 56, 325–34.
Dyer, C. B., Goodwin, J. S., Pickens-Pace, S., Bumett, J. and Kelly, P. A. (2007). Self neglect among the elderly: a model based on more than 500 patients seen by a geriatric medicine team. American Journal of Public Health, 97, 16711676.
Faul, F., Erdfelder, E., Lang, A.-G. and Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175191.
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.
Franzini, L. and Dyer, C. B. (2008). Healthcare costs and utilization of vulnerable elderly people reported to adult protective services for self-neglect. Journal of the American Geriatrics Society, 56, 667–676.
Garin, N. et al. (2014). Impact of multimorbidity on disability and quality of life in the Spanish older opopulation. PLoS One, 9, e111498.
Gibbons, S., Lauder, W. and Ludwick, R. (2006). Self-neglect: a proposed new NANDA diagnosis. International Journal of Nursing Terminologies and Classification, 17, 1018.
Hao, Y. T. and Fang, J. Q. (2000). To be introduce usage of WHOQOL instrument in Chinese. Modem Rehabilitation, 4, 11271129.
Health Service Executive (HSE). (2014). Open your eyes. There is no excuse for elder abuse. Available at: http://www.bit.ly/1OULe6t; last accessed 11 December 2015.
Iris, M., Conrad, K. J. and Ridings, J. (2014). Observational measure of elder self-neglect. Journal of Elder Abuse & Neglect, 26, 365397.
Iris, M., Ridings, J. W. and Conrad, K. J. (2010). The development of a conceptual model for understanding elder self-neglect. The Gerontologist, 50, 303315.
Lauder, W. (1999). A survey of self-neglect in patients living in the community. Journal of Clinical Nursing, 8, 95102.
Lauder, W. (2001). The utility of self-care theory as a theoretical basis for self-neglect. Journal of Advanced Nursing, 34, 545551.
Lauder, W., Anderson, I. and Barclay, A. (2002). Sociological and psychological theories of self-neglect. Journal of Advanced Nursing, 40, 331338.
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179186.
Lee, M. and Kim, K. (2014). Prevalence and risk factors for self-neglect among older adults living alone in South Korea. International Journal of Aging & Human Development, 78, 115131.
Liang, Y. and Wu, W. (2014). Exploratory analysis of physical health quality of life among the empty-nest elderly in rural China: an empirical study in three economically developed cities in eastern China. Health and Quality of Life Outcomes, 12, 59.
Liu, J. W., Li, F. Y. and Lian, Y. L. (2008). Investigation of reliability and validity of the social support scale. Journal of Xinjiang Medical University, 31, 13.
Lv, X. L. et al. (2013). Short form 36-item health survey test result on the empty nest elderly in China: a meta-analysis. Archives of Gerontology and Geriatrics, 56, 291297.
National Center on Elder Abuse Website. (2006). NCEA: the basics. Available at: http://elderabusecenter.org/pdf/research/apsreport030703.pdf; last accessed 24 May 2013.
Netuveli, G., Wiggins, R. D., Hildon, Z., Montgomery, S. M. and Blane, D. (2006). Quality of life at older ages: evidence from the english longitudinal study of aging (wave 1). Journal of Epidemiology & Community Health, 60, 357363.
Orley, J., Saxena, S. and Herrman, H. (1998). Quality of life and mental illness. Reflections from the perspective of the WHOQOL. The British Journal of Psychiatry, 172, 291293.
Papaioannou, E. S., Räihä, I. and Kivelä, S. L. (2012). Self-neglect of the elderly. An overview. European Journal of General Practice, 18, 187190.
Patrick, D. L. and Erickson, P. (1993). Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation. New York, NY: Oxford University Press.
Reijneveld, S. A., Spijker, J. and Dijkshoom, H. (2007). Katz'ADL index assessed functional performance of Turkish, Moroccan, and Dutch elderly. Journal of Clinical Epidemiology, 60, 382388.
Reyes-Ortiz, C. A., Burnett, J. B., Flores, D. V., Halphen, J. M. and Dyer, C. B. (2014). Medical implications of elder abuse: self-neglect. Clinical Geriatric Medicine, 30, 807823.
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165173.
Shrestha, S. et al. (2015). Predictors of change in quality of life in older adults with generalized anxiety disorder. International Psychogeriatrics, 27, 12071215.
Spensley, C. (2008). The role of social isolation of elders in recidivism of self-neglect cases at San Francisco adult protective services. Journal of Elder Abuse & Neglect, 20, 4361.
The WHOQOL Group (1998). Development of the world health organization WHOQOL-BREF quality of life assessment. Psychology Medicine, 28, 551558.
Wang, L. J. (2007). Research on Quality of Life and its Influencing Factors of the Elderly Staying in Rural Areas of JiNing. JiNan, SD: ShanDong University.
Webb, E., Blane, D., McMunn, A. and Netuveli, G. (2011). Proximal predictors of change in quality of life at older ages. Journal of the Epidemiology & Community Health, 65, 542547.
WHO. (1993). Development of the WHO: Quality of Life Assessment Instrument. Genva: WHO: 1.
Xiao, S. Y. (1994). The theoretical basis and research application of social support rating scale. Journal of Clinical Psychiatry, 4, 98100.
Zhou, B., Chen, K., Wang, J., Wang, H., Zhang, S. and Zheng, W. (2011). Quality of life and related factors in the older rural and urban Chinese populations in Zhejiang province. Journal of Applied Gerontology, 30, 199225.
Zung, W. W. K. (1971). A rating instrument for anxiety disorders. Paychosomatics, 12, 371379.

Keywords

Type Description Title
WORD
Supplementary materials

Zhao supplementary material
Table S1

 Word (17 KB)
17 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed