Social participation, psychological resilience and depression among widowed older adults in China

Abstract

Background Depression has become a challenging public health problem, and the loss of a spouse is one of the main causes of depression in older adults. Social participation and psychological resilience are protective factors that reduce depressive symptoms in adults. The purpose of this study was to explore the influences of social participation and psychological resilience on the depression of Chinese widowed older adults. Methods We carried out a cross-sectional study on 790 community-dwelling widowed older adults in Shaanxi, China, in 2019. A structured face-to-face interview was used to collect data. We used the ordinary least squares model (OLS), the generalized propensity score matching (GPSM) and the mediation model to test the relationship between social participation, psychological resilience and depression. Results We find a U-shaped relationship between social participation and depression, with the increase in social participation scores, the average depression level decreased and then increased. The psychological resilience of the widowed older adults was negatively associated with depression. The higher their psychological resilience, the lower their depression level. Among the four factors of psychological resilience, factor 2 (optimism and positive acceptance of change) and factor 3 (secure relationships and tolerance of negative affect) of psychological resilience were protective factors for depression after adjusting for demographic variables and physical health conditions. Psychological resilience plays a mediating role, as evident in factor 2 and factor 3 mediating the relationship between social participation and depression. Conclusion An appropriate level of social participation will relieve the depression of widowed older adults. Social participation can reduce the depression level of widowed older adults by improving their psychological resilience. Community and family could reduce depression by intervening in the social participation of widowed older adults. Active social participation is crucial because it has a protective and resilient impact, which can help people recover from the stress of losing a spouse.

Effect of long-term care insurance policy on depression in non-disabled people: evidence from China

“…Activity theory believes that the best way to face aging is achieving different social status or social roles by social participation and maintaining the same lifestyle as middle age[ [ 48 ]. Social participation might support older adults to maintain life independence and live actively in the community, increase optimism acceptance of change, safe relationships and tolerance in older adults, and thus reduce the depression risk [ 10 ]. According to activity theory, people without social participation were more likely to be depressed than people with social participation [ 49 – 53 ].…”

“…According to activity theory, people without social participation were more likely to be depressed than people with social participation [ 49 – 53 ]. Although appropriate social participation was beneficial to improve depression, the U-shaped relationship between social participation and depression also indicates that the absence of social participation may not be frightening [ 10 ]. Through some channels, such as government multimedia policy advocacy in the LTCI policy process, the absence of social participation did not prevent individuals from gaining more health knowledge, attitudes and behaviors than before.…”

“…Previous studies found that young-old adults were associated with more barriers to mental health treatment [ 7 ], female was more likely to be depressed when facing loneliness because of declining estrogen levels in their golden age [ 8 ], and people with secondary and higher education were more likely to seek professional help for depression than those with no formal education [ 9 ]. Appropriate social participation was beneficial to improve depression because of the U-shaped relationship between social participation and depression [ 10 ], and frequent social contact was important to depression improvement for older empty nesters with disabilities [ 11 ]. Previous studies also found that higher community socioeconomic status was associated with lower individual depressive symptom among middle-aged and older adults [ 12 ], depressive risk of the elderly was higher in living alone compared with not living alone in China [ 13 , 14 ], and regular contact with children was important for the mental health of older adults [ 15 ].…”

“…Participation in productive activities was associated with fewer depressive symptoms for older adults with dual sensory loss [ 49 ]. People who were highly active had lower depressive symptoms [ 10 , 11 , 50 ]. After controlling for the confounding effects of aging, individual demographic differences, and health status, continued or initiated participation in social activities later in life was significantly associated with a reduction in depressive symptoms in older adults [ 51 ].Social participation not only regulated depression caused by chronic diseases [ 52 ], but also reduced the depression risk caused by air pollution exposure among older adults [ 53 ].…”

The Effects of a Healthy Lifestyle on Depressive Symptoms in Older Chinese Adults: The Mediating Role of Psychological Resilience

“…Psychological resilience has also been shown to be associated with positive social engagement. It mediates the link between social engagement in older adult depressive symptoms and alleviates stress in widowed older adults [ 27 ]. Despite these insights, scant attention has been devoted to exploring the relationship between healthy lifestyles and psychological resilience.…”