Mediating effects between social capital and health care utilization in Italy–a structural equation model analysis

The purpose of this study was to explore the relationship between social support, health literacy, and health care utilization in older Chinese adults. A cross-sectional survey design was employed. Data were collected from 32 nursing homes from Urumqi in Xinjiang of China. A total of 1486 respondents completed a pack of questionnaires. The average health literacy level of older adults in nursing homes was relatively low, only 73.68 ± 29.42 points; the average social support level was also relatively low, only 31.42 ± 7.12 points (lower than domestic norm of Chinese residents, P < .001). Both values were below the midpoint for the overall population, indicating a sample with below-average levels of healthy literacy and social support. Low social support levels are associated with poor health literacy and greater likelihood of hospital admission (P < .05). Social support was significantly associated with health literacy. Improving the quantity and quality of social support may be an effective means to obtain better health literacy and lower hospital admissions.

Knee osteoarthritis is the most common form of arthritis causing disability among older adults. Proper self-care is vital and achievable with health literacy. Thai older adults with knee osteoarthritis have been found to have inadequate health literacy, and poor selfcare behaviors for this condition. The purpose of this descriptive cross-sectional study was to test a causal model of health literacy in Thai older adults with knee osteoarthritis, depicting relationships among provider-patient communication, patient engagement, cognitive function, knowledge of knee osteoarthritis, Internet use, social support, social participation, and health literacy. Participants comprised 318 older adults with knee osteoarthritis, selected using multi-stage random sampling from nine community hospitals in a northern Thai province. Data were collected using a demographic data form, the European Health Literacy Survey Questionnaire, the Provider-patient Communication Scale, the Patient Health Engagement Scale, the Montreal Cognitive Assessment-Basic, the Arthritis Knowledge Scale, the Internet Use Questionnaire, the Social Support Questionnaire, and the Community Participation of the Elderly Questionnaire. Data were analyzed using descriptive statistics, Pearson’s product moment correlation, and structural equation modeling. The final model fitted with empirical data and explained 36% of the variance in health literacy with Internet use as the strongest predictor directly affecting health literacy. Internet use and social participation had positive direct and indirect effects on health literacy via cognitive function. Cognitive function and social support positively directly affected health literacy. Patient engagement negatively affected health literacy indirectly via Internet use. Knowledge of knee osteoarthritis and provider-patient communication did not affect health literacy directly or indirectly. In conclusion, nurses should design interventions to promote health literacy of this population by highlighting Internet use, social participation, cognitive function, social support, and patient engagement, with testing in clinical practice.

Purpose: This empirical study investigated the relationship between occupational stress and employee performance and the mediating and moderating effects of social support on the relationship between occupational stress and the performance of IT sector employees in Bangalore city. Methodology: A quantitative methodology was used. The data were collected via a questionnaire to measure the three reflective constructs of the study: occupational stress, employee performance, and social support. Factor loadings &gt; 0.5 for the items of all three constructs were considered for analysis. The questionnaire's internal consistency was measured by assessing Cronbach's alpha and the split-half correlation coefficient. SEM analysis was carried out on the valid responses of 500 responses via AMOS version 28. Findings: The results of the Shapiro-Wilk test for normality indicated normally distributed data. Excellent model fit was observed, as indicated by the model fit statistics. A statistically significant direct effect between occupational stress and employee performance and social support was observed, with both the variable performance of occupational stress and social support explaining 28% of the variance in the dependent variable. performance This study also examined the moderating role of social factors in the relationship between occupational stress and employee performance. Social support also moderated the performance of the IT sector employees. Positive and statistically significant moderating effects of social support on the relationship between occupational stress and employee performance were observed. The slope analysis revealed that social support strengthens the relationship between occupational stress and employee performance. The authors suggest that organizations adopt social support strategies, such as breaks, meditation, and yoga, to relieve stress and increase social support among employees. Originality: This study assessed the effects of modeling occupational stress on employee performance with mediating and moderating roles of social support via structural equation modeling analysis and multivariate analysis.

AimThis study aimed to investigate the correlations between depression, social support and social participation among older adults in farming villages and identify their associations with the use of senior leisure and welfare facilities, called kyungro‐dang, so as to provide foundational data for promoting community care in rural farming communities.DesignA cross‐sectional design was used to identify kyungro‐dang use among the 156 participants—older adults aged 65.MethodsData were analysed using descriptive statistics, Pearson's correlation analysis, factor analysis and structural equation modelling.ResultsOlder adults with high social support and social participation tended to use kyungro‐dang less. Our findings contribute foundational data to promote community care through kyungro‐dang. Ministry of Health and Welfare (MoHW) plans to enforce to “Comprehensive community care plan” through kyungro‐dang in rural area. The result of this study shows the relation between Kyungro‐dang and social support, social participation, depression. This study recommends that MoHW in Korea focuses on enhance social support and social participation to gather before policy implications.

Coping strategies and postpartum depressive symptoms: A structural equation modelling approach

Health literacy as predictors of fluid management in people receiving hemodialysis in China: A structural equation modeling analysis

Background: People often overlook social health, believing it is less significant for humans. Family types may influence social participation and support during a disaster. In addition, members of the joint family experience more mental pressure during a crisis than members of the nuclear family. Objectives: This study aimed to assess the impact of family type on their social health, particularly social participation and social support. Methods: This study follows the survey research design to collect data from 480 waterlogged farmers using simple random sampling. I have formed a social health scale based on a 4-point Likert scale encompassing social participation and support. I performed the Mann-Whitney U test and multinomial logistic regression to indicate the differences in the influences of family type and its extension on social health. Results: Most of the waterlogged farmers did not participate in social activities, but they received support from their family members. More than 50% of the farmers had medium (11–15) social participation during waterlogging. However, 56% of them received high (12≥) social support from their family. Statistically significant differences were found between farmers' family type and their political participation (z =- 4.204), religious congregation (z=-5.376), and watching television (z=-4.964). However, for social support, reliance on family members at the time of having a serious problem (z=-5.376) showed a difference between the issues. In terms of the social health scale, the social participation (z=-4.726, p&lt;0.001) of the farmers who lived in joint families differed more than that of social support (z=-2.038, p&lt;0.05). Joint families influenced farmers with low social participation (B =.814, CI, 955 to 5.329) 2.25 times more and farmers with low social support (B=1.03, CI, .325 to 22.395) 2.81 times more. Conclusion: Joint families impacted farmers' social health more than nuclear families. Family treatment should be considered an important source of social health protection, particularly in disaster situations. Keywords: Family Type, Social Participation, Social Support, Waterlogging, Social Health

Loneliness is especially frequent among older people in Southern Europe. Furthermore, promoting social capital to tackle loneliness and its health effects is an understudied intervention strategy. Therefore, a complex intervention was piloted in Spain in a pre-post study with a 2-year follow-up. Its aims were to explore the feasibility of the intervention and its short- and long-term effects. It was conducted in one mixed rural-urban and two urban areas of diverse socioeconomic levels from 2011 to 2012. The intervention framework was based on social capital theory applying a behaviour change model and care co-ordination. The intervention comprised: (i) a co-ordinated action aimed at building a network between primary healthcare centres and community assets in the neighbourhood and (ii) a group-based programme, which promoted social capital among lonely older people, especially social support and participation. Older people active in senior centres volunteered as gatekeepers. The main outcome domain was loneliness. Secondary outcome domains were participation, social support, self-perceived health, quality of life, depressive symptoms and use of health resources. Pre-post changes were assessed with t-test, Wilcoxon signed-rank test and McNemar's test. Differences between the three time points were assessed with a one-way ANOVA with repeated measures. Social workers and nurses were successfully involved as group leaders, 10 volunteers took part and 38 participants were included. After the intervention, loneliness decreased while social participation and support significantly increased. Furthermore, the number of visits to nurses increased. Exactly 65.8% of the participants built social contacts within the group and 47.4% became engaged in new activities. Two years later, social effects were maintained and depressive symptoms had decreased. Exactly 44.7% of the participants continued to be in contact with at least one person from the group and 39.5% continued participating. The intervention contributes a novel and feasible social capital-based approach for alleviating loneliness among older adults while prompting meaningful changes in their lives.

Objective: Quality of transitional care is associated with important health outcomes such as rehospitalization, increased medical errors, and costs. A widely used measure of the construct, the Care Transitions Measure (CTM-15), was developed and validated with relatively small samples and classical test theory approach. The short version of the measure (CTM-3) was recently included in the CAHPS® Hospital Survey. We aimed to conduct a psychometric evaluation of the CTM-15 in a large sample and evaluate whether an item response theory (IRT) based scoring would lead to better measurement precision. Methods: As part of TRACE-CORE 1545 participants were interviewed during hospitalization for ACS providing information on general health status (SF-36). At 1 month following discharge, patients completed CTM items, health utilization and care process questions. We evaluated the psychometric properties of the CTM using descriptive statistics, factor analyses, and item response theory analyses. We compared the measurement precision of CTM-15, CTM-3, and a CTM-IRT based score using relative validity (RV) coefficients. Results: Participants were 79% non-Hispanic white, 67% male, 27% with a college education or higher (27%) and average age of 62 years. The CTM scale had good internal consistency (Cronbach’s alpha=0.95), but demonstrated strong acquiescence bias (8.7% participants responded “Strongly agree”, 19% “Agree” to all 15 items) and limited score variability (5% &lt;50score). A bi-factor model with one general factor with high item loadings and four secondary factors with lower item loadings, fit the data best supporting the assumption of essential unidimensionality of the measure. Review of item characteristic curves indicated presence of non-discriminating response categories in all items. IRT based item parameters were estimated for all items, but for five of the items there was evidence for model misfit. The CTM-15 differentiated between groups of patients defined by self-reported health status, health care utilization, and care transition process indicators. Differences between groups were small (2-3 points). There was no gain in measurement precision for the scale from IRT scoring. The CTM-3 was not significantly lower for patients reporting rehospitalization or emergency department visits. Conclusion: We identified psychometric challenges of the CTM, which may limit its value in research and practice. The strong acquiescence bias in the measure leads to highly skewed, clustered scores with restricted score variance and makes it difficult to differentiate between levels of care transition quality. In the absence of guidelines on meaningfully important differences, it is hard to determine whether detected statistically significant differences in care transition quality are important. These results are in line with emerging evidence of gaps in the validity of the measure.

Background Healing tourism, as a positive psychological intervention strategy, can improve individual mental health through emotion regulation, cognitive reshaping, and social interaction. However, existing research largely focuses on the direct impact of tourism experiences on subjective well-being, with insufficient attention paid to the internal mechanisms of mental health in young people, particularly the mediating role of perceived social support. Therefore, this study explores the impact of healing tourism consumption on the mental health of young people and systematically verifies the mediating effect of perceived social support in this relationship, aiming to provide empirical evidence for youth mental health intervention and tourism management policies. Methods This study employed a combination of cross-sectional questionnaires and Structural Equation Modeling (SEM) analysis. A total of 420 young participants aged 18-30 years were recruited, including university students and young professionals. Participants were categorized into high-spending, medium-spending, and low-spending groups based on the frequency and type of their healing tourism spending over the past 12 months. Mental health was assessed using the Mental Health Inventory (MHI-5), and perceived social support was measured using the Perceived Social Support Scale (PSSS). Control variables included gender, age, income level, and place of residence. Data analysis was conducted using SPSS 27 and AMOS 26 to examine the significance of direct, indirect, and mediating effects. Results Descriptive statistics showed that the mental health level of the high-consumption group (MHI-5: 74.3 ± 8.5) was significantly higher than that of the medium-consumption group and the low-consumption group, with a significant difference between groups (p&amp;lt;.001). Perceived social support also showed an increasing trend: the PSSS of the high-consumption group was 68.5 ± 7.4, the PSSS of the medium-consumption group was 61.9 ± 7.8, and the PSSS of the low-consumption group was 55.2 ± 8.1 (p&amp;lt;.001). SEM analysis further showed that the standardized coefficient of the direct effect of therapeutic tourism consumption on youth mental health was 0.42 (p&amp;lt;.01), and the mediating effect of perceived social support was 0.18 (p&amp;lt;.01), accounting for 30.0% of the total effect. Therefore, perceived social support plays a partial mediating role in the process of therapeutic tourism consumption improving mental health; that is, tourism consumption indirectly promotes youth mental health by enhancing perceived social support. Furthermore, between-group effect analysis showed that perceived social support accounted for 34% of the mediating effect on improved emotional stability, indicating that social interaction and emotional support are important mechanisms by which therapeutic tourism improves mental health. Discussion Healing tourism consumption can significantly improve the mental health of young people, with perceived social support playing a partial mediating role in this process. Tourism activities indirectly improve mental health by enhancing social interaction and emotional support, significantly impacting emotional stability and psychological vitality. This finding provides empirical evidence for the theoretical value of healing tourism in youth mental health intervention and offers some reference for policymakers and tourism managers in designing psychologically beneficial tourism projects. Future research could combine longitudinal designs and physiological and psychological indicators to further verify the long-term effects and mechanisms of healing tourism.

The aim of this study is to analyze the invariance of the estimated parameters in regard to Item Response Theory (IRT) applications within different dimensionality and sample characteristics. To realize this aim, students' answers in test booklet 'A' of the first stage of TEOG, Secondary Education Placement Test applied by the Ministry of Education in Turkey, in 2015 were used as the data. The population size of the study was determined as 63,871. The groups of 50, 100, 200, 500, 1000 and 5000 people who were randomly selected from the population comprised the sample of the study. One-dimensional mathematics subtest and artificially formed two-dimensional test results were used within IRT applications. As a result of the findings obtained from the study within the analysis of the one-dimensional test in regard to one-dimensional nonparametric IRT (ODNPIRT), item parameter invariance was obtained from the sample size 200. When it was analyzed in regard to one-dimensional parametric IRT (ODPIRT), it was found that at least a sample size of 1000 has to be used for item parameter estimations nearly as high as the population value (parameter). It was found that invariance for item parameters was not obtained by analyzing the two-parameter test in regard to ODPIRT, ODNPIRT and Multidimensional IRT (MDIRT).

Family relationships play a central role in wellbeing among older adults in Chile. Based on the theory of social production functions, this study examined the relationship between perceived social support from children, partners and relatives, family functioning, self-perceived health and quality of life (QoL) among Chilean older adults. The study used a multi-ethnic sample of Chilean older adults living in rural areas in the regions of Arica and Parinacota (north) and Araucanía (south). A model was analyzed that emphasizes relationships differentiated by the source of support, family functioning and self-perceived health in the explanation of QoL. The results obtained from the structural equation modelling (SEM) analysis showed the existence of indirect relationships of social support from children, partners and other family members via family functioning, while self-perceived health was directly associated with QoL. The findings indicate that family functioning is a main variable in the contrasted model, in addition to confirming the importance of distinguishing the role of the various sources of support. Research is needed to examine in detail intergenerational relationships and other relationships with family members who are significant in the wellbeing of older adults. This research corroborates that family relationships have a specificity that needs to be addressed in gerontological social intervention, as well as continuing along the lines of strengthening or improving existing family ties (more quality) over the quantity of social relationships.

Cross-sectional study. (1) To examine the association between social participation (SP) and social support (SS) with self-rated health and dietary satisfaction and (2) to explore the joint association and interactions of SP and SS with self-rated health and dietary satisfaction in community-dwelling adult men with spinal cord injury. Members of the Spinal Injuries Japan organization. We sent questionnaires to 2731 registered members of Spinal Injuries Japan via mail. Responses from 625 men aged ⩾40 years were analyzed. Respondents were categorized into four groups: SP/sufficient SS, SP/insufficient SS, no SP/sufficient SS and no SP/insufficient SS. Logistic regression analysis was used to examine the odds ratios for self-rated health and dietary satisfaction according to the SP/SS categories. Relative to participants in the no SP/insufficient SS category, those in the SP/sufficient SS group demonstrated significantly better self-rated health and dietary satisfaction after adjusting for sociodemographic variables. There was no interaction between SP and SS in self-rated health or dietary satisfaction. SP was associated with high self-rated health without SS, and sufficient SS was associated with high dietary satisfaction without SP. Relative to other groups, participants with SP/sufficient SS demonstrated higher self-rated health and dietary satisfaction. Sufficient SS was associated with high dietary satisfaction without SP. This study suggested the importance of addressing aspects of both SP and SS using self-rated health and dietary satisfaction as outcome measures in health promotion programs.

Health status and health care utilization profiles of adolescents with disabilities

ABSTRACTObjectives: The aim of this study was to test a conceptual model designed to promote the understanding of factors influencing subjective well-being (SWB) in old age. Within this framework, we evaluated the relative influences on elderly Israelis' SWB of health and/or function, personal resources, coping behaviors (reactive and proactive), and changes in all of these factors over time.Method: At baseline, 1216 randomly selected elderly persons (75+) were interviewed at home (T1) and 1019 one year later (T2). The conceptual model was evaluated by Structural Equation Modeling (SEM) analysis using AMOS 18.Results: After one year, a relatively high percentage of participants reported decline in health/function (DHF) and in personal resources. The effects of the study variables on T2-SWB were evaluated by a SEM analysis, resulting in a satisfying fit: χ2 = 279.5 (df = 102), p < .001, CFI = .970, NFI = .954, TLI = .955, RMSEA = .046. In addition to significant direct effects of health/function on T2-SWB, health/function was found to indirectly influence T2-SWB. Our analysis showed that health/function had a negative influence on the positive effects of personal resources (function self-efficacy, social support) and the diverse effects of the coping patterns (goal-reengagement – positive; expectations for future care needs – negative; having concrete plans for future care – positive).Conclusion: Personal resources and use of appropriate coping behaviors enable elderly people to control their well-being even in the presence of DHF. Evidence-based interventions can help older people to acquire and/or strengthen effective personal resources and coping patterns, thus, promoting their SWB.