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

Abstract

Background Studies have shown a close association between home and community-based healthcare service (HCBHS) utilization and depressive symptoms in older adults. However, no studies have explored the underlying mechanism of this relationship in rural China. This research 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 5981 rural respondents (≥ 60 years old) were included. Depression scores were calculated using the ten-item Center for Epidemiological Studies Depression Scale. 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 negatively associated with IADL among single but not married respondents. The government should focus on older rural adults, especially those who are single and have poor IADL function, and improve the provision of HCBHS to alleviate depressive symptoms.

Are low academic achievers less resilient? Resilience of low and high academic achievers in Mainland China

“…We believe that HAA have stronger internal support, which contributed to buffering the adverse effects of negative events in their lives (Song et al, 2014). Poor academic performance, on the other hand, could leave children in a state of low confidence and self-doubt and make it difficult to eliminate frustration (Bostani et al, 2014;Zhang et al, 2017), which result in a low level of resilience.…”