Risk factors for depression in older adults include significant interpersonal losses, increasing social isolation, and deteriorating physical abilities and health that require healthcare. The effects of unmet healthcare needs on depression in older adults are understudied. This study aimed to analyze the association between unmet healthcare needs and symptoms of depression, sleep, and antidepressant medication while controlling for other significant factors among older adults. For this study, we used a multinational database from The Survey of Health, Ageing and Retirement in Europe (SHARE), containing data of individuals aged 50 and older. The final sample used in this research consisted of 39,484 individuals from 50 to 100 years (mean − 71.15, SD ± 9.19), 42.0 percent of whom were male. Three path models exploring relationships between symptoms of depression at an older age and unmet healthcare needs were produced and had a good model fit. We found that unmet healthcare needs were directly related to depression, activity limitations were related to depression directly and through unmet healthcare needs, whereas financial situation mostly indirectly through unmet healthcare needs. We discuss how depression itself could increase unmet healthcare needs.

Santrauka. Straipsnyje analizuojamos Pasaulio sveikatos organizacijos (PSO) Tarptautinės funkcionavimo klasifikacijos (TFK) biopsichosocialinės prieigos taikymo senatvės ir senų žmo-Per pastaruosius du dešimtmečius labai suintensyvėjo senatvės tyrimai visais lygmenimis: kū-niškuoju, psichologiniu ir socialiniu ekonominiu. Tai rodo gausybė senatvės problematikai skirtų žurnalų, knygų, dėstomų dalykų. Netgi Lietuva -neturtinga šalis randa lėšų senatvės tyrimams finansuoti -Lietuvos mokslų tarybos (LMT) parengta Nacionalinė programa Sveikas senėjimas. Finansiškai remiami senatvės tyrimams skirti projektai ir pagal kitas nacionalines ar žinybų programas. Lietuva tolydžio įsitraukia į Europos periodinių senėjimo ir išėjimo pensijon tyrimų programą SHARE (Survey of Health, Ageing, and Retirement in Europe). Plėtojantis senatvės tyrimams, kuriant tokių tyrimų priemones ar pateikiant viešam diskursui jų rezultatus, būtina susitarti dėl tam skirtų terminų vartojimo, tyrimo planavimo, leidžiančių palyginti gautus rezultatus su jau atliktais ar kitose šalyse vykdomais tyrimais. Tiek biomedicinoje, tiek psichologijoje

Tiek empiriniai tyrimai, tiek teorinės prielaidos rodo, kad gerovė yra sudėtingas, daugiamatis konstruktas. Tyrimais nustatyta, kad su gerove siejasi daugybė veiksnių, o tarp jų ypač svarbūs yra ir sveikatos veiksniai. Gerovės ir sveikatos tarpusavio ryšių tyrimą apsunkina tai, kad egzistuoja daug kitų kintamųjų, kurie gali keisti ryšio pobūdį. Iki šiol nėra aiškaus atsakymo, kaip kinta vyresnio amžiaus žmonių gerovė jų senėjimo eigoje, koks sveikatos veiksnių vaidmuo šiame kitime. Dar vienas svarbus tyrimų faktas – gerovė ir sąsajos tarp sveikatos ir gerovės gali priklausyti nuo šalies ar kultūros, todėl yra svarbu žinoti, kokie vyresnio amžiaus asmenų sveikatos ir gerovės sąsajų tyrimai atlikti Lietuvoje. Todėl tyrimo tikslas – naudojant sisteminės analizės metodą, išanalizuoti Lietuvoje atliktus vyresnio amžiaus asmenų sveikatos ir gerovės sąsajų tyrimus. Straipsnių paieška atlikta duomenų bazėse PsychInfo, Academic Search Complete, MEDLINE, SocINDEX with Full Text, ERIC, Science direct ir Lituanistika. Iš viso rasti 897 straipsniai. Remiantis pavadinimu, atrinkti 274 straipsniai, remiantis santrauka ir visu tekstu, galutinai analizėje liko 16 straipsnių. Analizuoti tyrimai rodo, kad sirgimas viena ar kita liga (vėžiu, Parkinsono liga, išemine širdies liga, reumatoidiniu artritu, kepenų ciroze ar šlapimo nelaikymu) yra susijęs su žemesne gerove. Taip pat yra įrodymų, kad ligai progresuojant, gerovė prastėja. Prastesnė gerovė siejasi ir su psichikos sveikatos problemomis. Analizuoti tyrimai pasižymi metodologiniais trūkumais – tyrimų dalyvių imčių reprezentatyvumo stoka, ribotais gerovės tyrimo instrumentais bei dažniausiai ribotu daugiamatės statistinės analizės taikymu. Atlikta sisteminė analizė leidžia teigti, kad Lietuvoje trūksta longitudinių, gyventojų struktūrą reprezentuojančių, lyginančių skirtingas sveikatos būkles skirtingomis gyvenimo aplinkybėmis, taikančių šiuolaikinius daugiamatės statistikos metodus, gerovės tyrimų.

Many countries of the world consider the well-being of citizens to be one of their most important goals. Nowadays there is a growing concern about the well-being of older people. Considering the aging population, there is a call for social policies aimed at strengthening the well-being of older people. Therefore, recommendations were prepared for policymakers on possible ways to strengthen the well-being of the older age Lithuanian population. The recommendations are based on data from the 7th wave of the Survey of Health, Aging, and Retirement in Europe (SHARE). There were 2014 persons aged 50 and older interviewed in Lithuania in the 7th wave of the SHARE survey. Data on various aspects of well-being, health, work and economic situation, childhood circumstances, experiences of discrimination were analyzed. Based on different aspects of well-being it was found, that respondents can be grouped into high, low, and medium well-being clusters, moreover the analysis showed that the Lithuanian population has relatively low well-being compared to other countries. Recommendations were formulated covering possible measures for chronic diseases, co-morbid mental health disorders, work, economic situation, childhood environment, and personal life history. The recommendations are addressed to health, social and employment, education, and science policymakers.

In this paper, using data obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE), previously experienced unemployment links to the subjective well-being of older adults in the Baltic States are analyzed. One of the global challenges faced by a considerable number of countries is the aging of society. Subjective well-being of older adults and its factors are becoming one of the fundamental issues of the research as older adults are becoming a bigger part of society, and it becomes critical to understand what makes their lives wholesome. According to the life course perspective, human development is a lifelong process, and various events, personal life experiences may shape people and their lives. Therefore, it can be assumed that such a significant event as previously experienced unemployment may be related to the subjective well-being at older ages. Thus, this study aims to analyze the links between previously experienced unemployment and the subjective well-being of life of older adults in the Baltic States. Data obtained from the 7th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) was used for the analysis (Bergmann et al., 2019; Börsch-Supan, 2020). Two thousand eight hundred five responses of Estonians, 941 of Lithuanians, and 809 of Latvians over the age of 50 were analyzed. The subjective well-being, previously experienced unemployment, socio-demographic, personality, and health factors were analyzed. Research results show that many factors predict the subjective well-being of older adults in the three Baltic States: sociodemographic data can explain around 11% of the variance of the subjective well-being. Income additionally explains 2%, factors related to a person’s health adds 11% to the explanation, personality traits – also 11%, previously experienced unemployment – less than 1%. In the model containing all the factors, the most important predictor was personality trait neuroticism, and the model explained 35% of the variance of the subjective well-being. The subjective well-being was not linked only to gender and living with a partner. By analyzing the links between previously experienced unemployment and subjective well-being, we found that these links are relatively weak, although they remain even when controlling a range of factors of subjective well-being.

Medication non-adherence among patients with hypertension is one of the main reasons for poor treatment efficacy, higher healthcare costs, increased patient morbidity and mortality. Despite numerous attempts to explain and improve adherence to long-term treatment regimen, the prevalence of non-adherence is still very common. Moreover, treatment adherence research rarely includes environmental variables as proposed by the ecological model. The aim of this study is to analyze the role of patient-level and micro-level variables in predicting medication non-adherence among patients with hypertension. Method. 101 hypertensive outpatients aged 33-93 (M = 60.13; SD = 11.85) volunteered to participate in the study. A self-report questionnaire was constructed to assess subjects’ adherence to medication regimen. Pivotal socioeconomic variables were recorded as well as treatment-related information, illnessrelated beliefs, perceived social support and satisfaction with the healthcare provider. Results show that perceived longer illness duration and higher satisfaction with the healthcare provider predict lower levels of intentional medication non-adherence. Younger age, higher intensity of side effects and lower levels of perceived social support predict higher unintentional medication non-adherence. Amount of prescribed medication has no direct effect on unintentional medication non-adherence, but is mediated through intensity of side effects. Results of this study emphasize the importance of environmental variables and recognition of various patterns of medication non-adherence, which provide additional understanding of the complexity of this health-related behavior.

The life course perspective raised many discussions about continuity, types of threads linking different developmental stages, and ways to identify these links. The aim of this study was to evaluate the significance of childhood family circumstances and family repression / discrimination experiences in predicting psychological well-being in later life. The Survey of Health, Ageing and Retirement in Europe (SHARE) wave 7 data was used; 1985 respondents aged 50+ (M = 66.23, SD = 10.52) living in Lithuania (63.8 % – female) provided retrospective information on their early life circumstances, including home environment, relationships with family / friends, family persecution. Psychological well-being was assessed with a 12-item Control, Autonomy, Self-Realization, and Pleasure (CASP) scale. Results of the hierarchical regression analysis showed that the inclusion of family persecution and other childhood factors increases the prognostic value of the model by 8 percent. Relationships with mother and friends, self-rated health, perceived abilities, number of books at home, and physical harm by others significantly predicted psychological well-being among older adults, even after controlling pivotal sociodemographic variables. These results suggest that creating a caring, safe, and cognitively stimulating childhood environment can promote better development in early stages and contribute to greater psychological well-being in later life.

Vidutiniškai penktadalis moterų po gimdymo patiria įvairių psichologinių ir emocinių sunkumų, o tai savo ruožtu neigiamai veikia pačios moters savijautą, vaiko raidą bei santykius su vaiku ir šeima. Iki šiol nebuvo prieita prie vienodos nuomonės, kokie rizikos veiksniai reikšmingai nulemia moters depresiškumą laikotarpiu po gimdymo. Tyrėjų išvadose apie demografinių veiksnių, socialinės paramos, gimdymo ypatumų, patiriamo streso, emocinės ir fizinės būsenos bei kitų kintamųjų sąsajas su moters depresiškumu laikotarpiu po gimdymo yra prieštaravimų. Šio tyrimo tikslas – išsiaiškinti, kokie demografiniai, socialiniai, psichologiniai ir sveikatos veiksniai reikšmingai prognozuotų moters depresiškumą laikotarpiu po gimdymo. Tyrimas yra prospektyvus ir ilgalaikis – tiriamosios apklaustos nėštumo metu, pirmą mėnesį ir pusė metų po gimdymo. Tyrime analizuojami 66 savanoriškai sutikusių dalyvauti visuose trijuose tyrimo etapuose moterų duomenys. Tyrimo rezultatai, apskaičiuoti taikant struktūrinių lygčių modeliavimo metodą, leidžia teigti, kad vienintelis moters depresiškumą laikotarpiu po gimdymo prognozuojantis veiksnys, turintis tiesioginę reikšmę, yra moters depresiškumo vertinimas nėštumo metu. Taip pat daugiau depresijos simptomų laikotarpiu po gimdymo turi moterys, kurios prasčiau vertina savo pasiruošimą motinystei, jaučia stipresnį nerimą dėl gimdymo, mažiau patenkintos savo santykių su vyru kokybe, patyrė daugiau stresą keliančių gyvenimo įvykių ar laukiasi pirmo vaiko, tačiau prognostinis šių veiksnių ir moters depresiškumo laikotarpiu po gimdymo ryšys yra netiesioginis, o pasireiškia šių veiksnių įtaka depresiškumui nėštumo metu.Pagrindiniai žodžiai: depresiškumas po gimdymo, Edinburgo pogimdyminės depresijos skalė (EPDS), pasiruošimas motinystei.Predictors of women’s depression during postpartumperiod Zamalijeva O., Jusienė R. SummaryApproximately 20 percent of women suffer from postpartum depression after childbirth, which, in turn, negatively affects women’s well-being, child’s development and interactions with the child and family. Risk factors, which most significantly influence postpartum depression, have been analyzed by numerous researchers, seeking to make it possible to predict and identify women at risk before the onset of symptoms. Nevertheless, the data obtained is inconclusive and research results are contradictory. The most inconclusive results are those related to demographic and socioeconomic characteristics and their impact on depressive symptoms during postpartum period. Moreover, there are inconsistencies in conclusions concerning social support, pregnancy and delivery-related factors, stressful life events, emotional and physical health and their influence on postpartum depression. The goal of this research is to identify demographic, social, psychological and health related variables that could reliably predict women’s depression half year after delivery. This research is prospective and longitudinal, participants were interviewed at several assessment points – during pregnancy, the first month and half a year postpartum. The complete data about 66 women are analyzed in this article. The results of structural equation modeling (SEM), indicate that the only significant predictor of women’s depressive symptoms during postpartum period, having direct effect, is depression during pregnancy, i.e. women who report more depressive symptoms during pregnancy are significantly more likely to be depressed during postpartum period. Women who rated their subjective readiness for motherhood as lower, also with high anxiety concerning delivery, poor quality of relationship with a partner, and who reported more stressful life events, as well as primiparous women are at greater risk postpartum depression; however these variables and depressive symptoms during postpartum period are not directly related. The readiness for motherhood and anxiety concerning delivery predicts depression during pregnancy. The quality of relationships with partner, in turn, predicts both readiness for motherhood and anxiety concerning delivery. Finally, the readiness for motherhood could also be predicted by stressful life events and primiparity. The results of our study support the necessity of psychological interventions during the pregnancy in order to prevent postpartum depression.Keywords: perinatal depression, EPDS, readiness for motherhood.