The Effects of Social Networks of the Older Adults with Limited Instrumental Activities of Daily Living on Unmet Medical Needs
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Data and Ethical Considerations
2.3. Measurements
2.3.1. Experience of Unmet Medical Needs
2.3.2. Social Networks
2.3.3. Covariate
2.4. Data Analysis
3. Results
3.1. Differences in the Experience of Unmet Medical Needs According to the Limited IADL
3.1.1. Characteristics of the Subjects’ Unmet Medical Needs
3.1.2. Differences in the Experience of Unmet Medical Needs According to IADL Items
3.2. Effects of a Social Network on Unmet Medical Needs
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Dimension | Variables | Categories (Range) | Unmet Medical Needs | |||||
---|---|---|---|---|---|---|---|---|
Males (n = 616) | χ2 or t | Females (n = 1665) | χ2 or t | |||||
No (n = 538) | Yes (n = 80) | No (n = 1395) | Yes (n = 281) | |||||
n (%) or Mean ± SD | n (%) or Mean ± SD | |||||||
Covariate | Age (years) | 77.65 ± 7.35 | 78.81 ± 7.09 | −1.32 | 78.47 ± 7.01 | 78.35 ± 6.61 | 0.27 | |
Educational level | No education | 127 (23.6) | 18 (22.5) | 0.05 | 853 (61.5) | 190 (68.3) | 7.18 * | |
Elementary school | 173 (32.2) | 26 (32.5) | 350 (25.3) | 66 (23.7) | ||||
≥Middle school | 238 (44.2) | 36 (45.0) | 183 (13.2) | 22 (7.9) | ||||
Household income (10,000 won/year) | Q1 (≤686) | 178 (33.1) | 44 (55.0) | 15.63 *** | 381 (27.3) | 116 (41.6) | 24.18 *** | |
Q2 (687–991) | 149 (27.7) | 18 (22.5) | 440 (31.5) | 81 (29.0) | ||||
Q3 (992–1470) | 130 (24.2) | 13 (16.3) | 343 (24.6) | 52 (18.6) | ||||
Q4 (≥1471) | 80 (14.9) | 5 (6.3) | 231 (16.6) | 30 (10.8) | ||||
Number of chronic diseases | (0–14) | 3.22 ± 2.04 | 3.36 ± 1.72 | −0.61 | 3.64 ± 1.89 | 4.17 ± 2.16 | −4.16 *** | |
Structure | Living arrangement | Couple | 346 (64.4) | 53 (67.9) | 0.39 | 350 (25.2) | 46 (16.4) | 12.90 ** |
Living alone | 87 (16.2) | 11 (14.1) | 538 (38.8) | 135 (48.6) | ||||
Living with others | 104 (19.4) | 14 (17.9) | 499 (36.0) | 97 (34.9) | ||||
Contact with friend and neighbor | 1.43 ± 2.20 | 0.65 ± 1.30 | 4.51 *** | 1.57 ± 2.20 | 1.03 ± 1.47 | 5.07 *** | ||
Social activity | Yes | 325 (60.4) | 28 (35.4) | 17.54 *** | 1052 (75.8) | 203 (73.0) | 1.00 | |
No | 213 (39.6) | 51 (64.6) | 335 (24.2) | 75 (27.0) | ||||
Function | Emotional support | 2.69 ± 0.68 | 2.74 ± 0.64 | −0.49 | 2.82 ± 0.68 | 2.55 ± 0.78 | 5.20 *** | |
Instrumental support | 2.72 ± 0.66 | 2.72 ± 0.70 | 0.10 | 2.53 ± 0.78 | 2.38 ± 0.78 | 2.87 ** | ||
Physical support | 2.58 ± 0.75 | 2.50 ± 0.80 | 0.90 | 2.53 ± 0.84 | 2.40 ± 0.87 | 2.30 * | ||
Financial support | 3.77 ± 0.26 | 3.79 ± 0.25 | −0.63 | 3.80 ± 0.84 | 3.77 ± 0.28 | 1.31 |
Variables | Unmet Medical Needs | ||||||
---|---|---|---|---|---|---|---|
IADL Limitation | Males (n = 616) | χ2 | Females (n = 1665) | χ2 | |||
No (n = 538) | Yes (n = 80) | No (n = 1395) | Yes (n = 281) | ||||
n (%) | n (%) | ||||||
Grooming | Yes | 104 (19.3) | 14 (17.7) | 0.12 | 152 (11.0) | 48 (17.3) | 8.72 ** |
No | 434 (80.7) | 65 (82.3) | 1235 (89.0) | 230 (82.7) | |||
Household chores | Yes | 377 (70.1) | 63 (79.7) | 3.15 | 797 (57.5) | 175 (62.9) | 2.87 |
No | 161 (29.9) | 16 (20.3) | 590 (42.5) | 103 (37.1) | |||
Meal preparation | Yes | 364 (67.8) | 63 (79.7) | 4.63 * | 605 (43.7) | 133 (47.8) | 1.65 |
No | 173 (32.2) | 16 (20.3) | 781 (56.3) | 145 (52.2) | |||
Laundry | Yes | 328 (61.1) | 58 (73.4) | 4.48 * | 659 (47.5) | 149 (53.4) | 3.23 |
No | 209 (38.9) | 21 (26.6) | 728 (52.5) | 130 (46.6) | |||
Taking medications | Yes | 55 (10.2) | 12 (15.2) | 1.74 | 94 (6.8) | 25 (9.0) | 1.71 |
No | 482 (89.8) | 67 (84.8) | 1293 (93.2) | 253 (91.0) | |||
Financial management | Yes | 148 (27.5) | 25 (31.6) | 0.58 | 510 (36.8) | 130 (46.6) | 9.42 ** |
No | 390 (72.5) | 54 (68.4) | 876 (63.2) | 149 (53.4) | |||
Walking outdoors | Yes | 90 (16.8) | 21 (26.6) | 4.50 * | 213 (15.4) | 54 (19.4) | 2.85 |
No | 447 (83.2) | 58 (73.4) | 1174 (84.6) | 224 (80.6) | |||
Purchasing products | Yes | 85 (15.8) | 20 (25.3) | 4.38 * | 209 (15.1) | 54 (19.4) | 3.21 |
No | 452 (84.2) | 59 (74.7) | 1178 (84.9) | 225 (80.6) | |||
Using the telephone | Yes | 211 (39.3) | 29 (36.7) | 0.19 | 761 (54.9) | 173 (62.2) | 5.10 * |
No | 326 (60.7) | 50 (63.3) | 626 (45.1) | 105 (37.8) | |||
Using public transportation | Yes | 273 (50.8) | 52 (65.8) | 6.21 * | 765 (55.2) | 190 (68.1) | 15.91 *** |
No | 264 (49.2) | 27 (34.2) | 622 (44.8) | 89 (31.9) |
Dimension | Variables | Categories | B | OR (95% CI) | p |
---|---|---|---|---|---|
Covariate | Age (years) | 0.01 | 1.01 (0.97–1.04) | 0.803 | |
Educational level | No education | −0.25 | 0.78 (0.40–1.50) | 0.454 | |
Elementary school | −0.01 | 0.99 (0.56–1.78) | 0.983 | ||
≥Middle school | 1 (referent) | ||||
Household income (10,000 won/year) | Q1 (≤686) | 1.36 | 3.91 (1.35–11.31) | 0.012 | |
Q2 (687–991) | 0.59 | 1.79 (0.59–5.43) | 0.300 | ||
Q3 (992–1470) | 0.15 | 1.16 (0.37–3.64) | 0.794 | ||
Q4 (≥1471) | 1 (referent) | ||||
Number of chronic diseases | 0.05 | 1.05 (0.93–1.19) | 0.429 | ||
Structure | Living arrangement | Couple | 1 (referent) | ||
Living alone | 0.24 | 1.27 (0.55–2.92) | 0.572 | ||
Living with others | 0.24 | 1.27 (0.63–2.58) | 0.503 | ||
Contact with friend and neighbor | −0.17 | 0.84 (0.71–1.01) | 0.063 | ||
Social activity | Yes | 1 (referent) | |||
No | 0.99 | 2.69 (1.57–4.61) | <0.001 | ||
Function | Emotional support | 0.30 | 1.35 (0.84–2.17) | 0.211 | |
Instrumental support | 0.08 | 1.09 (0.64–1.85) | 0.766 | ||
Physical support | −0.49 | 0.62 (0.38–0.98) | 0.044 | ||
Financial support | 0.72 | 2.05 (0.72–5.82) | 0.180 | ||
(Constant) | −6.10 | ||||
Correct prediction (%) | 87.1 | ||||
Hosmer-Lemeshow test | x2 = 11.52, df = 8, p = 0.174 | ||||
Nagelkerke R2 | 0.138 |
Dimension | Variables | Categories | B | OR (95% CI) | p |
---|---|---|---|---|---|
Covariate | Age (years) | −0.02 | 0.98 (0.96–1.01) | 0.246 | |
Educational level | No education | 0.29 | 1.34 (0.81–2.22) | 0.252 | |
Elementary school | 0.21 | 1.23 (0.72–2.11) | 0.444 | ||
≥Middle school | 1 (referent) | ||||
Household income (10,000 won/year) | Q1 (≤686) | 0.86 | 2.35 (1.47–3.77) | <0.001 | |
Q2 (687–991) | 0.26 | 1.30 (0.81–2.10) | 0.276 | ||
Q3 (992–1470) | 0.15 | 1.16 (0.71–1.90) | 0.559 | ||
Q4 (≥1471) | 1 (referent) | ||||
Number of chronic diseases | 0.14 | 1.15 (1.08–1.23) | <0.001 | ||
Structure | Living arrangement | Couple | 1 (referent) | ||
Living alone | 0.71 | 2.04 (1.37–3.04) | <0.001 | ||
Living with others | 0.65 | 1.92 (1.26–2.91) | 0.002 | ||
Contact with friend and neighbor | −0.14 | 0.87 (0.80–0.95) | 0.003 | ||
Social activity | Yes | 1 (referent) | |||
No | 0.04 | 1.04 (0.76–1.41) | 0.826 | ||
Function | Emotional support | −0.36 | 0.70 (0.57–0.86) | 0.001 | |
Instrumental support | −0.02 | 0.98 (0.77–1.24) | 0.849 | ||
Physical support | −0.03 | 0.97 (0.78–1.20) | 0.780 | ||
Financial support | 0.21 | 1.23 (0.70–2.16) | 0.470 | ||
(Constant) | −1.55 | ||||
Correct prediction (%) | 83.3 | ||||
Hosmer-Lemeshow test | x2 = 10.59, df = 8, p = 0.226 | ||||
Nagelkerke R2 | 0.096 |
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Jang, H.-Y.; Ko, Y.; Han, S.-Y. The Effects of Social Networks of the Older Adults with Limited Instrumental Activities of Daily Living on Unmet Medical Needs. Int. J. Environ. Res. Public Health 2021, 18, 27. https://doi.org/10.3390/ijerph18010027
Jang H-Y, Ko Y, Han S-Y. The Effects of Social Networks of the Older Adults with Limited Instrumental Activities of Daily Living on Unmet Medical Needs. International Journal of Environmental Research and Public Health. 2021; 18(1):27. https://doi.org/10.3390/ijerph18010027
Chicago/Turabian StyleJang, Hye-Young, Young Ko, and Song-Yi Han. 2021. "The Effects of Social Networks of the Older Adults with Limited Instrumental Activities of Daily Living on Unmet Medical Needs" International Journal of Environmental Research and Public Health 18, no. 1: 27. https://doi.org/10.3390/ijerph18010027