2020 Editor's Choice Articles From JGMS: Focus on Vulnerable Populations

This symposium will present four 2020 “Editor’s Choice” articles from the Journal of Gerontology Medical Sciences that focus on issues relevant to vulnerable older populations. Justin Golub and colleagues, in their article “Audiometric Age-Related Hearing Loss and Cognition in the Hispanic Community Health Study”, broaden the scope of age-related studies on audiometric hearing loss by using a large Hispanic cohort, a community largely excluded from previous hearing loss studies. By examining audiometrically-defined hearing loss and cognitive measures, Golub found links between hearing loss and lower neurocognition. Janice Atkins and colleagues, in “Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort”, challenge the practice of simple age-based targeting of older adults to prevent severe COVID-19 infections, and show that specific high-risk comorbidities are better indicators of hospitalization and mortality. “Comparison of Recruitment Strategies for Engaging Older Minority Adults: Results from Take Heart”, by Jessica Ramsay and colleagues, examines methods used to recruit older adults of color from primarily low socio-economic households for behavioral and clinical health research. Ryon Cobb and coauthors, in their article “Self-reported Instances of Major Discrimination, Race/Ethnicity, and Inflammation among Older Adults: Evidence from the Health and Retirement Study”, investigate whether self-reported lifetime discrimination is a psychosocial factor influencing inflammation in older adults. Tamara Baker, the discussant, will highlight commonalities and lessons learned from these studies, including links between racial, socio-economic, or disease-related vulnerabilities of older adults and their health status, as well as best practices to account for these factors in future clinical trials.

Bio-psychosocial factor of vaginismus in Iranian women

Background and aim Various physical, psychological, social and cultural factors contribute to vaginismus. Therefore, given the multidimensionality of this disorder and the need to pay more attention to all biological, psychological and social dimensions in its treatment, the present study was conducted to investigate the bio-psychological factors contributing to vaginismus. Methods This descriptive cross-sectional study was conducted on 180 Iranian women with vaginismus who had been referred to sexual health clinics of Tehran province in 2020. Multistage random sampling method was used in this study, and vaginismus was diagnosed in women by a specialist through using a questionnaire. Data collection tools included demographic and obstetric information form, valid and reliable Sexual Function Questionnaire, Depression Anxiety Stress Scales (DASS), Sex Fear Questionnaire, Vaginal Penetration Cognition Questionnaire, Sexual Self-Efficacy Scale, Sexual Knowledge and Attitude Scale, Sexual Quality of Life-Female, Inventory of Sexual Satisfaction, ENRICH Marital Satisfaction Scale, Sexual Intimacy Scale and Questionnaire for Diagnosis of Vaginismus. In order to determine the factors related to vaginismus, multiple linear regression model was used through SPSS software version 25 (SPSS Inc., Chicago, IL). Results Based on the results of the present study, the mean age of women and the mean duration of their marriage were 27.77 ± 5.36 and 4.07 ± 3.87 years respectively. As the results of multiple linear regression revealed, the variables of fear of sex (B = 0.141, P = 0.036), positive cognition (B = 0.197, P = 0.046), self-image (B = 0.651, P = 0.001), sexual intimacy (B = -0.116, P = 0.021), quality of sexual life (B = 0.115, P = 0.002) and education (B = 2.129, P = 0.024) from the bio-psychosocial model were the final predictors of vaginismus diagnosis score in women with this disorder. According to the results of multiple linear regression, 45.5% of the variance of vaginismus diagnosis total score was explained by these variables (R = 0.706, R2 = 0.498 and ADJ.R2 = 0.455). Conclusion The results of the present study showed that the variables of fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education were the final predictors of vaginismus diagnosis score. This disorder is, thus, considered to be multidimensional.

Role of psychosocial factors on the effect of physical activity on physical function in patients after lumbar spine surgery

Background The purpose of this study was to investigate the longitudinal postoperative relationship between physical activity, psychosocial factors, and physical function in patients undergoing lumbar spine surgery. Methods We enrolled 248 participants undergoing surgery for a degenerative lumbar spine condition. Physical activity was measured using a triaxial accelerometer (Actigraph GT3X) at 6-weeks (6wk), 6-months (6M), 12-months (12M) and 24-months (24M) following spine surgery. Physical function (computerized adaptive test domain version of Patient-Reported Outcomes Measurement Information System) and psychosocial factors (pain self-efficacy, depression and fear of movement) were assessed at preoperative visit and 6wk, 6M, 12M and 24M after surgery. Structural equation modeling (SEM) techniques were utilized to analyze data, and results are represented as standardized regression weights (SRW). Overall SRW were computed across five imputed datasets to account for missing data. The mediation effect of each psychosocial factor on the effect of physical activity on physical function were computed [(SRW for effect of activity on psychosocial factor X SRW for effect of psychosocial factor on function) ÷ SRW for effect of activity on function]. Each SEM model was tested for model fit by assessing established fit indexes. Results The overall effect of steps per day on physical function (SRW ranged from 0.08 to 0.19, p<0.05) was stronger compared to the overall effect of physical function on steps per day (SRW ranged from non-existent to 0.14, p<0.01 to 0.3). The effect of steps per day on physical function and function on steps per day remained consistent after accounting for psychosocial factors in each of the mediation models. Depression and fear of movement at 6M mediated 3.4% and 5.4% of the effect of steps per day at 6wk on physical function at 12M, respectively. Pain self-efficacy was not a statistically significant mediator. Conclusions The findings of this study suggest that the relationship between physical activity and physical function is stronger than the relationship of function to activity. However, future research is needed to examine whether promoting physical activity during the early postoperative period may result in improvement of long-term physical function. Since depression and fear of movement had a very small mediating effect, additional work is needed to investigate other potential mediating factors such as pain catastrophizing, resilience and exercise self-efficacy.

1460Is workplace bullying independently associated with musculoskeletal disorders? A study with Brazilian civil servants

Background Studies from high-income countries suggest that workplace bullying is associated with several occupational diseases and health outcomes, including musculoskeletal disorders (MSD). However, studies on the relationship between bullying and MSD are scarce, particularly in low- and middle-income countries. Therefore, we aimed to investigate the association between workplace bullying and MSD among civil servants from a state in southern Brazil. Methods Cross-sectional study with 1,615 judicial civil servants from a Brazilian state. Data was collected through a web survey. The structured questionnaire included direct questions regarding previous MSD diagnosed by a doctor. Workplace Bullying was measured by the Negative Acts Questionnaire (NAQ-r). Logistic Regression was used to estimate prevalence odds ratios (POR) and test associations of interest. Results The prevalence of workplace bullying was 17.7%, and the prevalence of MSD was 23.1%. After adjustment for sex and age, workplace bullying was strongly associated with MSD (POR=1.76; CI95% 1.32-2.36). In the final multivariate model, after controlling for sex, age, skin colour, body mass index, educational level, job type, ergonomic factors and physical inactivity, the association remained significant. The risk of MSD was 56.0% higher among those exposed to bullying (POR= 1.56; 95%CI: 1.14-2.13), compared to those non-exposed. Conclusions Findings are in line with studies from high-income countries. Bullying should be further investigated as a potential cause of MSD, and longitudinal studies are necessary to examine possible causal paths, mechanisms and mediation, especially in low- and middle-income countries. Interventions to reduce the occurrence of MSD may focus on psychosocial factor at work, particularly bullying. Key messages Besides being an unethical behaviour in workplaces and causing several mental health problems, bullying may also play a role on musculoskeletal disorders, what should be further investigated, particularly in low- and middle-income countries. Interventions to prevent bullying and MSD are needed.

Early Intervention Program Through Bibliotherapy Approach For Reducing Fear In Orientation And Mobility Of Children With Visual Impairment

Orientation and mobility skills are special skills that must be mastered by children with visual impairment, thus an orientation and mobility intervention program is important to develop. Fear or anxiety in children with visual impairment related to orientation and mobility can be caused by fear from within the children or from the environment. Personality, motivation, psychosocial factor, and family and community attitudes all contribute to one's reaction to mobility activities independently. This research aims to reduce the fear of children with visual impairment in performing orientation and mobility activities by implementing an intervention program through bibliotherapy technique. This research is a case study research with a qualitative approach. Bibliotherapy was carried out on two young children with visual impairment. The results of the program implementation show that children's fear or anxiety could be reduced in both cases in this research as seen by autonomous moves of the two children from the mother and caregiver and began to learn to trace the walls of the room.

Psychosocial Factors in the Experience of Epilepsy: A Qualitative Analysis of Narratives

Introduction. Epilepsy is a complex disease. The consequences of epilepsy are varied and manifested in all aspects of people with epilepsy’s (PWE) lives. The purpose of this study was to define individual experiences of epilepsy, expressed in narratives, and to find the stem of each narrative—a core event in the PWE’s experience of the disease around which they structure their overall narrative. Method. A qualitative, phenomenological research method was used. We conducted semistructured interviews with 22 PWE and analysed the content using a combination of inductive and deductive methods, based on which we determined the stem narratives. Results. The stem narrative of the epilepsy narrative is an important life experience of PWE. We divided the stem narratives into four groups: lifestyle changes, relationship changes, the consequences of the inciting incident, and the limitations of the disease. In our study, we found that the stem narrative was, in all but one case, a secondary (psychosocial) factor resulting from epilepsy, but not its symptom (epileptic seizure). The stem narrative, where aspects of life with epilepsy are exposed, points to a fundamental loss felt by PWE. Conclusion. The narrative of the experience of epilepsy has proven to be an important source of information about the disease and life of PWE and also about the aspects at the forefront of life with epilepsy. The secondary epilepsy factors that we identified in the stem narratives were the greatest burden for PWE in all cases but one.

EXAMINATION OF SECONDARY SCHOOL TEACHERS SELF-ESTEEM AS A DETERMINANT OF THEIR MARITAL ADJUSTMENT IN ANAMBRA STATE

Self-esteem as a psychosocial factor that is likely to foretell outcomes like academics, happiness, marital satisfaction and relationships is also a construct that could lead to marital success and happiness. This study examined secondary school teachers’ self-esteem as a determinant of their marital adjustment in Anambra state. Three research questions were posed to guide the study while one null hypothesis was tested at a 0.05 level of significance. A correlational research design was adopted for the study. A sample size of 1,408 married teachers was drawn from a population of 6,987 married teachers. A multi-stage sampling procedure was followed in selecting the study sample. Two instruments: The marital Adjustment Scale (MAS), and Self- Esteem Scale (SES) were used for data collection. The instruments were duly validated by experts in measurement and evaluation and Guidance and Counselling. The reliability coefficient was established thus; 0.85 for the Self-esteem questionnaire, and 0.74 for the Marital Adjustment Questionnaire. Data was collected through a direct delivery approach and was analysed using SPSS version 23. Range of aggregate scores and Pearson correlation coefficients were used to answer research questions and while a t-test was used to test the hypotheses. Findings of the study showed among others there is a non-significant very low positive relationship existing between married teachers’ Self-esteem and their marital adjustment in secondary schools in Anambra State. Based on the study’s findings, it was suggested, among other things, that school Guidance Counsellors organise workshops and seminars for married teachers aimed at fostering healthy self-esteem for successful marital adjustment. KEYWORDS: self-esteem, marital adjustment, married, teachers, school

Relative deprivation and phubbing: Fear of missing out as a mediator

Phubbing, defined as paying attention to one's smartphone instead of interacting with other people in social contexts, has become a common phenomenon. However, the determinants of this behavior remain unclear. Therefore, we explored whether fear of missing out mediates the relationship between relative deprivation and phubbing. A sample of 858 college students completed measures to assess relative deprivation, fear of missing out, and phubbing. The results show that relative deprivation was positively correlated with phubbing. Further, fear of missing out fully mediated the relationship between relative deprivation and phubbing, which indicates that college students who perceived more relative deprivation tended to be more prone to experiencing fear of missing out, and thus more vulnerable to phubbing. Our findings extend understanding of the antecedents of phubbing from the individual microlevel to the psychosocial factor macrolevel.