Abstract

BackgroundThe elderly population is rising globally, especially in China where a large population base causes the largest number of older adults in the world. Notably, Shidu people who are over the age of 60 and have lost their only child have drawn great public attentions as they become more elderly, medically unstable and worse mentally unhealthy. Posttraumatic stress disorder (PTSD) is one of the most common consequences resulted from the loss of the only child. However, few previous studies have examined PTSD in Shidu older aldults, and the risk factors are a relatively understudied area. Our study aims to estimate the prevalence and potential risk factors of PTSD and improve the possibility of early identifying the high-risk Shidu parents with PTSD, and successively provide timely and effective interventions.MethodBased on the register of population statistic information provided by the health family planning commission, 149 participants were enrolled randomly. Data was collected by interviews and questionnaires. Socio-demographic and bereavement-related information and physical health outcomes were obtained. PTSD Checklist-Civilian Version was used to screen for bereavement-related PTSD.ResultThe morbidity of PTSD reached 30.9%, while in the group of age over 60 the morbidity reached 31.6%. Stratified by potential demographic risk factors, SDPs have significant between-group differences of PTSD. Specially, being women, higher income, losing the single child at older age, more serious medical conditions and being Shidu for a shorter period indicated higher severity of PTSD in SDPs. The single child dying at a older age and from accidence were also significant indicators. Regression analysis showed the gender of SDPs, hospital visits, and the cause of child death significantly predicted the severity of PTSD.ConclusionWith the accelerate process of aging, especially in China, Shidu older adults become a group deserved more attentions. PTSD is clearly a possible reaction to the loss of the only child. The gender and hospital visits of the Shidu older adults and the causes of their child’s death significantly related to the prevalence of PTSD, which could help to improve the possibility of early intervening.

Highlights

  • The elderly population is rising globally, especially in China where a large population base causes the largest number of older adults in the world

  • The gender and hospital visits of the Shidu older adults and the causes of their child’s death significantly related to the prevalence of Posttraumatic stress disorder (PTSD), which could help to improve the possibility of early intervening

  • To further explore the potential risk factors of PTSD in the Shidu older adults, we investigated a group of the aging Shidu parents (SDPs), who were unique and unaccessible, to estimate the prevalence and potential risk factors of PTSD

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Summary

Introduction

The elderly population is rising globally, especially in China where a large population base causes the largest number of older adults in the world. A special cohort old Chinese people, referred to “Shidu” old adults, who are over the age of 60 and have lost their only child (Shidu is the Chinese transliteration for ‘losing the only child’ and over 60 is an acknowledged age distinguishing the young and the old due to the retiring age in China set at 55), have aroused great concerns in the society The majority of these people with the one-child family in response to Chinese family planning policy in the early twentieth century have been into their old age without their only child, who is supposed to act in the role of the care provider to their aging parents. The number of families with the loss of the only chcild in China will increase gradually along with the process of aging and the aggravation of the trend of low fertility rate, which underlies the social endowment issues

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