アシス エドワード ルゴ

As people age, they are expected to experience adverse life conditions and major life events. These circumstances might have a significant impact on their subjective well-being. This study investigated the factors associated with subjective well-being among community-dwelling Filipino senior citizens. We conducted a cross-sectional study among 1021 senior citizens (68.5% women) aged 60 and above and identified the factors independently associated with their subjective well-being using multiple linear regression analysis. We also used hierarchical regression analysis for model prediction. In the hierarchical regression analysis, psychological resilience was found as the most powerful predictor of subjective well-being. Loneliness, however, was the only psychosocial factor not associated with it. Both men and women with positive self-rated health and had higher psychological resilience and perceived social support showed a higher level of subjective well-being. Women who were separated and received pension and men who were uneducated showed a lower level of subjective well-being. Psychological resilience, positive self-rated health, and perceived social support might be protective factors for low subjective well-being. To improve the subjective well-being of Filipino senior citizens, we should build psychological resilience and social support networks in the community.

INTRODUCTION: Little is known about community-based interventions for geriatric depression in low-resource settings. This study assessed the effectiveness of 3-month-duration interventions with peer counseling, social engagement, and combination vs. control in improving depressive symptoms of community-dwelling Filipino senior citizens. METHODS: We conducted an open (non-blinded), non-randomized trial of senior citizens at risk for depression. Three different 3-month interventions included peer counseling (n = 65), social engagement (n = 66), and combination (n = 65) were compared with the control group (n = 68). We assessed geriatric depression, psychological resilience, perceived social support, loneliness, and working alliance scores at baseline and three months after the intervention. This trial was registered with ClinicalTrials.gov, identifier: NCT03989284. RESULTS: Geriatric depression score over three months significantly improved in all intervention groups (control as reference). Significant improvements were also seen in psychological resilience and social support. Not all interventions, however, significantly improved the loneliness score. The combination group showed the largest effect of improving depressive symptoms (d = -1.33) whereas the social engagement group showed the largest effect of improving psychological resilience (d = 1.40), perceived social support (d = 1.07), and loneliness (d = -0.36) among senior citizens. CONCLUSION: At the community level, peer counseling, social engagement, and combination interventions were effective in improving depressive symptoms, psychological resilience, and social support among Filipino senior citizens. This study shows that it is feasible to identify senior citizens at risk for depression in the community and intervene effectively to improve their mental health. Further studies are required to target loneliness and investigate the long-term benefits of the interventions. CLINICAL TRIAL: ClinicalTrials.gov: NCT03989284.

OBJECTIVE: This study explored the phenomenological experiences of migrant care workers working in the formal long-term care setting in Japan and identified their stressors on caregiving. METHODS: We collected data using in-depth interviews among Filipino (n = 21), Indonesian (n = 6), and Vietnamese (n = 4) migrant care workers. We conducted the interviews in either their native language or in Japanese. All interviews were audiotaped and transcribed verbatim. We analyzed the transcripts using thematic analysis. We used qualitative data analysis software NVivo 10Ⓡ to code and manage the data. RESULTS: Six key themes emerged that were related to stressors on caregiving. These include (1) coworker relationship, (2) language barrier, (3) work-life balance, (4) health concerns, (5) physical environment, and (6) patient relationship. Migrant care workers struggled with Kanji (Chinese characters) and verbal communication. Most of them shared having fatigue and chronic back pain. A few also mentioned about anxiety and depression. The low salary and heavy workload have made caregiving jobs unattractive to them. Workplace discrimination, patients' attitude, and a hostile work environment were part of their stressors at work. DISCUSSION: This study is the first step in highlighting the current issues being faced by migrant care workers in Japan. The stressors were the identified psychosocial issues of migrant care workers. The Japanese government is suggested to amend their care work policy and provide psychosocial support explicitly tailored for migrant care workers.

Senior volunteers represented a significant, mostly untapped lay resource of informal social care. In this study, we evaluated the effectiveness of the training program on improving senior volunteers' competency toward peer counseling, and explored its impact on their well-being after three months of the program implementation. We conducted a pre- and post-intervention analysis among 60 senior volunteers aged 60-82 years. They participated in 40 h of training and performed weekly peer counseling home visits for three months. We evaluated the program using survey questionnaires, trainer observation and debriefing, and focus group discussions. After the training, peer counselors showed a significant improvement (p < 0.001) in knowledge (17.1 versus 22.3) and skills (17.0 versus 17.9). All of them met the minimum required passing level of 70% for the knowledge test, and their overall performance was satisfactory as rated by two independent trainers. After three months, peer counselors showed a significant improvement (p < 0.001) in their subjective well-being (d = 0.69) and depressive symptoms (d = -0.67). Filipino senior volunteers could be trained to serve as peer counselors in their communities. This program improved their competency and well-being. Future research is warranted to determine whether the provision of counseling by them will affect the health outcomes of the target population.

The Philippine government is facing a burden of improving health and social services for both the growing elderly and young population. The extent of discussion on aging issues and concerns, however, is minimal at best. Therefore, this study aimed to examine the perceptions of unmet needs and to explore the coping mechanisms of senior citizens across local stakeholders in an urban area in the Philippines. In this qualitative study, we collected data using focus group discussions among senior citizens (n = 4) and health providers (n = 4) as well as in-depth interviews among local administrators (n = 7). We analyzed the data through thematic analysis using the social determinants of health as the theoretical framework. We used qualitative research software NVivo10® to track the coding and manage the data. Four major themes related to unmet needs emerged in the analyses: (1) financial security, (2) health care services, (3) age-friendly environment, and (4) family support. Senior citizens responded either positively or negatively to cope with the challenges associated with aging. The government must then revisit existing national policies to address their unmet needs. Actions should be taken to strengthen positive coping and modifying the negative coping mechanisms, with a particular focus on community and family interventions.

OBJECTIVE: This study investigated the factors associated with depressive symptoms among community-dwelling Filipino senior citizens. METHODS: We conducted a cross-sectional study among 1021 Filipino senior citizens aged 60-91 years. We used multiple linear regression analysis to identify the factors independently associated with levels of depressive symptoms. We predicted the model using hierarchical regression analysis. RESULTS: Both men and women who had higher subjective psychological well-being showed a lower level of depressive symptoms while those who had negative self-rated health and reported to be lonely showed a contrasting result. Among women, those who reported positive self-rated health, and had higher psychological resilience and social interaction, showed a lower level of depressive symptoms. Moreover, among women, those who had chronic diseases showed a higher level of depressive symptoms. Hierarchical regression analysis revealed that loneliness was the most powerful predictor of depressive symptoms among Filipino senior citizens. DISCUSSION: Loneliness and chronic diseases are the major risk factors for depressive symptoms while a higher level of subjective psychological well-being is the primary protective factor against it among Filipino senior citizens. To be free from depression, their psychological well-being should be strengthened through active social engagement and healthcare service improvement.