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Reciprocal relationship between pain and depression in elderly Chinese primary care patients
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(10), October 2005, pp.945-952.
- Publisher:
- Wiley
This study examines the reciprocal relationship between pain and depression and to identify whether social support, functional disability or social functioning mediated the link between pain and depression among Hong Kong Chinese elderly primary care patients. Three hundred and eighteen patients were assessed by a trained assessor with MDS-HC at baseline and these subjects were randomly selected from attendants of three randomly selected elderly health centers in Hong Kong. These patients were re-assessed one year after baseline evaluation. Multiple regression analyses revealed that pain at baseline significantly predicted depression at 12-month follow-up assessment when age, gender, martial status, education, and depression at baseline were adjusted for, but depression at baseline was not associated with pain at 12-months after baseline measure while controlling for age, gender, martial status, education, and pain at baseline. However, depression did predict the onset of pain. Moreover, social support, physical disability or social functioning did not mediate the impact of pain on depression. These data suggest that pain is an important predictor of depression in elderly primary care patients. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.
Reciprocal relationship between fear of falling and depression in elderly Chinese primary care patients
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.587-594.
- Publisher:
- Taylor and Francis
The objective of the current study is to investigate the link between depression and fear of falling in Hong Kong Chinese older adults in primary are settings. Using longitudinal data collected on 321 Chinese primary care patients 65 years of age and older, the authors investigated the reciprocal relationship between fear of falling and depression and examined whether functional disability and social functioning mediated the link between fear of falling and depression. Participants were recruited from three primary care units in Hong Kong. Subjects were assessed in Cantonese by two trained assessors with Minimum Data Set-Home Care twice over a period of one year. Findings revealed that fear of falling at baseline significantly predicted depression at 12 month follow-up assessment after age, gender, marital status, education and depression at baseline were adjusted, but depression at baseline did not predict fear of falling at 12 months after fear of falling at baseline was adjusted. Moreover, social functioning mediated the impact of fear of falling on depression. The findings presented here indicate that fear of falling potentially increases the risk of depression in Chinese older adults in primary care settings.
Economic status of the elderly in Hong Kong: homogeneous or heterogeneous?
- Authors:
- CHOU Kee-Lee, CHOW Nelson W. S., CHI Iris
- Journal article citation:
- International Social Work, 49(2), March 2006, pp.218-232.
- Publisher:
- Sage
This article examines the economic status of elderly people in Hong Kong based on data collected by the government. The Hong Kong elderly population is not a homogeneous group, as their economic status is significantly related to their gender, age, marital status, education and employment status.
Prevalence of depression among elderly Chinese with diabetes
- Author:
- CHOU Kee-Lee
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(6), June 2005, pp.570-575.
- Publisher:
- Wiley
This study aimed to examine the association between diabetes and depression among older Chinese and to determine the extent to which depression is mediated by physical disability and diabetes-related comorbid conditions. The study used a cross-sectional analysis of data from a population-based study composed of a representative sample of 2003 non-institutionalized older adults aged 60 and older living in Hong Kong who agreed to participate in the study. The relation between diabetes and depression (measured with the Geriatric Depression Scale) was examined. Results found 12 percent of the older adults reported physician-diagnosed diabetes and amongst these older persons with diabetes, 26 precent of them reported elated level of depressive symptoms. Logistic regression analyses revealed that diabetes was significantly related to depression even when controlling for age, gender, marital status, and education. More importantly, adjusted for self-reported disability in three domains including self-care, mobility, and higher functioning did not attenuate this association but the association disappeared after adjustment for four diabetes-related complications including heart disease, high blood pressure, stroke, and vision problems had been made.
Poverty, deprivation and life satisfaction among Hong Kong older persons
- Authors:
- CHEUNG Kelvin Chi-Kin, CHOU Kee-Lee
- Journal article citation:
- Ageing and Society, 39(4), 2019, pp.703-721.
- Publisher:
- Cambridge University Press
This investigation examines the association of four measures of poverty (income-based, expenditure-based and asset-based poverty, and material deprivation) with life satisfaction. Perceived life satisfaction was measured among 1,410 older Chinese persons aged 65 and over. Besides life satisfaction and measures of poverty, the study assessed socio-demographic variables, financial strain, health indicators, and social and community resources. Those who faced expenditure-based poverty, material deprivation and asset-based poverty reported a significantly lower level of perceived life satisfaction, while the association between expenditure-based poverty and life satisfaction was found to be the strongest. Other factors that had an impact on life satisfaction included gender, education and marital status; financial strain; social support; the number of close family members and friends; self-rated health; functional capacity; perceived memory; pain; sleep quality; neighbourhood collective efficacy; and engagement in cultural and entertainment activities. From the theoretical perspective, the findings have strong implications for the understanding of the factors that shape the perception of quality of life in old age. Our results also have important policy implications for the official measurement of poverty, monitoring of the poverty situation and the development of anti-poverty measures to help older persons living in poverty to improve the quality of their lives. (Edited publisher abstract)
Immigration, living arrangement and the poverty risk of older adults in Hong Kong
- Authors:
- CHAN Lih-Shing, CHOU Kee-Lee
- Journal article citation:
- International Journal of Social Welfare, 25(3), 2016, p.247–258.
- Publisher:
- Wiley
Using 2011 census data, this study investigated how living arrangement affects disparities in poverty between older adults (aged 65 and older) who migrated to Hong Kong from Mainland China and those who were born in Hong Kong. The sample consisted of 29,987 immigrants and 9,398 natives, all of whom were ethnic Chinese and living in Hong Kong at the time of the census. The authors found higher poverty rates among older immigrants than among natives, a disparity that persisted even after adjusting for living arrangement, human capital characteristics, assimilation-related variables, household composition and demographic characteristics. The authors also found that living arrangement moderated the impact of immigrant status on the poverty risk among older adults, and that the impact was due mainly to the number of earners in the household. The implications of the results with respect to poverty among older adults and anti-poverty measures are discussed. (Edited publisher abstract)
The temporal relationship between falls and fear-of-falling among Chinese older primary-care patients in Hong Kong
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- Ageing and Society, 27(2), March 2007, pp.181-193.
- Publisher:
- Cambridge University Press
Although the association between falls and fear-of-falling has been established by previous studies, the temporal ordering of the two is uncertain. Moreover, the common and unique risk factors that contribute to falls and to fear-of-falling have not been investigated in either primary health-care settings or Asian societies. The aims of this study were to examine the temporal sequencing of fear-of-falling and a fall, and to identify the risk factors associated with the two. A prospective cohort study with three six-month measurement waves was conducted in primary-care settings in Hong Kong. The sample was derived from the waiting list control group of a randomised clinical trial, and 321 respondents participated in the three waves. They were evaluated with the Minimum Data Set for Home Care. It was found that falls and fear-of-falling at baseline were not independent predictors of respectively developing a fear-of-falling and becoming a faller, but that age was a common independent predictor for falls and the onset of a fear-of-falling. Individuals with a fear-of-falling were at risk of both falling and a fear-of-falling at 12 months. The good news is that no vicious cycle of falls and fear-of-falling was found, and modifiable risk factors, including IADL limitations, environmental hazards, and fear-of-falling were identified, so that effective prevention programmes for falls and for fear-of-falling can be designed.
Leisure participation amongst Hong Kong Chinese older adults
- Authors:
- CHOU Kee-Lee, CHOW Nelson W. S., CHI Iris
- Journal article citation:
- Ageing and Society, 24(4), July 2004, pp.617-629.
- Publisher:
- Cambridge University Press
Gerontologists have recognised the important influence of leisure activity on the mental and physical health of older adults. To date, however, there have been few studies of the patterns of participation in leisure activity among older adults in Hong Kong. This study examines a large representative sample of Hong Kong older adults and the associations between their socio-economic and health characteristics and their leisure activities. The data are from a cross-sectional survey of 2,180 respondents aged 60 or more years, conducted in 2000 by the Hong Kong Census and Statistics Department. There were full records for 2,144 respondents. Among the participation rates in the seven categories of leisure activities, watching television or listening to radio was the highest, while the lowest was for playing mahjong or cards. The characteristics that significantly correlated with the level of participation differed by the activity. Although no consistent pattern emerged, gender, education, employment status, receiving welfare benefits, self-rated health and functional impairment were the strongest correlates for most types of leisure activity. The paper is concluded by comparing the results with previous findings, and by discussing the service implications of the findings, the limitations of the study, and directions for future research.
Childlessness and psychological well-being in Chinese older adults
- Authors:
- CHOU Kee-Lee, CHI Iris
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(5), May 2004, pp.449-457.
- Publisher:
- Wiley
Childless older adults will increase rapidly in the coming future due to delayed marriage, infertility, and high divorce rate. The authors examined whether childlessness is significantly related to loneliness and depression and whether the effect of childlessness persisted even when other factors including gender, marital status, age, education, self-rated health status and financial strain were controlled for. This article analyzes cross-sectional data collected from a representative community sample of 2003 Chinese elderly people aged 60 or above in Hong Kong. Respondents were interviewed in face-to-face format and data including socio-demographic variables, health indicators, loneliness and depression were obtained. Logistic regression analyses revealed that childlessness was significantly related to loneliness and depression even after marital status, gender, age, education, self-reported health status, and financial strain were controlled for. The impact of childlessness on psychological well-being among elderly Chinese is more robust than that found in older Americans. Moreover, consistent with the findings of previous studies, we found that the effect of childlessness on psychological well-being has to be investigated in the context of marital status. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.
Filial support legislation in Hong Kong: a sensible and practical policy?
- Authors:
- SUM Yeung, CHOU Kee-Lee
- Journal article citation:
- Asia Pacific Journal of Social Work, 11(1), March 2001, pp.131-140.
- Publisher:
- Times Academic
There has been controversy in Hong Kong over whether the government should enact filial support legislation so the burden of caring for elderly dependents could be shared between the government and adult children. Briefly discusses the theoretical framework for the relationship between family and state welfare. Reviews how legislation was implemented in other countries and their experiences in practicing the law. Availability of family care in Hong Kong might decrease due to industrialisation and urbanisation in terms of the change of family structure and household size, the increasingly aged population, more active participation in the labour force by women, and the dying-out of traditional values of filial piety towards the elderly. On the other hand, studies have shown that family care is still the major care provider for Hong Kong elderly. Reviews the pros and cons of filial responsibility law and considers that education is a better alternative to legislation.