Journal Article

The relationship between home and community-based healthcare services utilization and depressive symptoms in older adults in rural China: a moderated mediation model

Zhang, Jiayun, Chen, Chun, Zhang, Xiangyang, Wang, Shanshan, Gui, Jia, Zhang, Rujia, Huang, Zishuo, Xu, Tingke, Fu, Yating, Zhang, Xinxin, Yang, Qingren

2023

Overview

Background Studies have shown a close association between home and community-based healthcare services (HCBHS) utilization and depressive symptoms in older adults. However, no studies have explored the underlying mechanism of this relationship in rural China. This study was designed to evaluate the roles of instrumental activities of daily living (IADL) and marital status in the association between HCBHS utilization and depressive symptoms in Chinese rural older adults. Methods Data were obtained from the 2018 China Health and Retirement Longitudinal Study, and 5,981 rural respondents (≥ 60 years old) were included. Depression scores were calculated using the ten-item Center for Epidemiological Studies Depression Scale. Moderated mediation analysis was carried out applying Hayes’ PROCESS macro (Model 7). Results HCBHS utilization had a direct and negative effect on depressive symptoms. Furthermore, marital status moderated the association between HCBHS utilization and IADL, which belonged to the indirect influence of the first half on the association between HCBHS utilization and depressive symptoms. HCBHS utilization was associated with IADL in single but not in married respondents. Conclusion The results demonstrated that marital status moderated the indirect relationship between HCBHS utilization and depressive symptoms, with HCBHS utilization being negatively associated with IADL among single but not married respondents. The government should focus on rural older adults, especially those who are single and have poor IADL function, and improve the provision of HCBHS to alleviate depressive symptoms.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Activities of daily living / Adults / Biostatistics / Care and treatment / Community health services / Depression in old age / Depressive symptoms / Environmental Health / Epidemiology / Health aspects / Health care / Health services / Home and community-based healthcare services utilization / Home care services / Home care services industry / Instrumental activities of daily living / Loneliness / Longitudinal studies / Low income groups / Marital status / Medicine / Medicine & Public Health / Mental depression / Mental disorders / Mental health / Middle age / Moderated mediation model / Older people / Personal health / Psychological aspects / Public Health / Risk factors / Rural aged / Rural areas / Social aspects / Social support / Socioeconomic factors / Urban areas / Utilization / Vaccine