School of Social Work, Massey University, Palmerston North, New Zealand.
School of Health Sciences, Massey University, Palmerston North, New Zealand.
Disabil Rehabil. 2022 Mar;44(5):768-780. doi: 10.1080/09638288.2020.1783375. Epub 2020 Jul 6.
In older people with diabetes, multimorbidity is highly prevalent and it can lead to poor quality of life. The overall purpose of this study was to examine the association between the social environment, psychosocial support and constraints, and overall quality of life among older people with and without with diabetes and multiple chronic illnesses.
Self-reported data from participants in a cohort study of older New Zealanders was analysed. Responses from 380 older people diagnosed with diabetes and multiple chronic illnesses were compared with 527 older people with no health issues on indicators related to the associations of neighbourhood, health and ageing, using structural equation modelling.
The final model suggests that social provision, purpose in life and capabilities mediated between the social environment and quality of life, indicate that older people with positive social environment (i.e., neighbourhood advantage, residential stability) are much less likely to experience depression due to having good social support, meaningful life purpose and opportunities to engage.
Perceived neighbourhood advantages, such as positive neighbourhood qualities, social cohesion and housing satisfaction, along with the focus on increasing social support, enhancing purpose in life and supporting one's capability to achieve, may serve as protective factors against depression.IMPLICATIONS FOR REHABILITATIONEnvironmental and personal circumstances can contribute to quality of life among older people with diabetes and multimorbidity.By providing older people with diabetes and multiple chronic illnesses a socially just environment that challenges ageism and other forms of oppression, this could reduce social disparities in health, improve inclusion and access to resources.Social and healthcare professionals are encouraged to design clinical care guidelines and rehabilitation goals from a wholistic and person/client centred approach to support older people with diabetes and multiple chronic illnesses.
在患有糖尿病的老年人中，多病共存的现象非常普遍，这可能导致生活质量下降。本研究的总体目的是探讨社会环境、心理社会支持和限制因素与患有和不患有糖尿病及多种慢性疾病的老年人整体生活质量之间的关系。
对新西兰老年人队列研究的参与者进行了自我报告数据的分析。使用结构方程模型，将 380 名被诊断患有糖尿病和多种慢性疾病的老年人与 527 名无健康问题的老年人的邻里、健康和老龄化相关指标的反应进行了比较。
最终模型表明，社会供给、生活目标和能力在社会环境和生活质量之间起中介作用，这表明积极的社会环境（即邻里优势、居住稳定）的老年人由于获得了良好的社会支持、有意义的生活目标和参与机会，不太可能因抑郁而感到沮丧。
感知到的邻里优势，如积极的邻里质量、社会凝聚力和住房满意度，以及增加社会支持、增强生活目标和支持个人实现能力的重点，可能是预防抑郁的保护因素。
环境和个人情况可能会影响患有糖尿病和多种慢性病的老年人的生活质量。通过为患有糖尿病和多种慢性疾病的老年人提供一个公正的社会环境，挑战年龄歧视和其他形式的压迫，可以减少健康方面的社会差距，提高包容性和获得资源的机会。鼓励社会和医疗保健专业人员从整体和以个人/客户为中心的方法来设计临床护理指南和康复目标，以支持患有糖尿病和多种慢性疾病的老年人。
