The Relationship Between Mental Health and Physical Health of Elderly Living in Nursing Homes: The Mediating Role of Feelings of Guilt and Loneliness

Document Type : Original Article

Authors

Dept. of Psychology, Shahrood Branch, Islamic Azad University, Shahrood, Iran

Abstract

Today, paying attention to the elderly and their condition is one of the important and significant issues. Among the important factors influential in this field, paying attention to physical health and its related factors seems highly important. Therefore, this research was conducted with the aim of investigating the relationship between mental health and physical health in the elderly resident of nursing homes with the mediating role of feelings of guilt and loneliness. This was a descriptive study of structural equations modeling (SEM) type. The statistical population of the present study included 3687 people living in nursing homes located in Damghan and Isfahan in 2022, among whom 121 people were selected as the final sample using simple random sampling. Used to collect the research data were Russell et al.’s loneliness, Gokler and Jones' feelings of guilt, Najarian and Davoudi's mental health, and Laali et al.'s physical health scales. The data were analyzed using SEM in Smart PLS-3 software. The results illustrated that mental health has a positive relationship with physical health and this relationship is significantly and reversely mediated by two variables of loneliness and feelings of guilt. According to the obtained results, it is suggested to pay special attention to mental health, loneliness and feelings of guilt among the elderly. The results of this research can be useful for nursing home managers to create better conditions and to maintain people as well as possible.
 
References
Alavi, M., Jorjoran Shushtari, Z., Noroozi, M., & Mohammadi Shahboulaghi, F. (2018). Mental health and related factors in old population in Tehran 2014-2015. Journal of Mazandaran University of Medical Sciences, 27(158),112-122. [Persian]
Amirbagloie Daryani, M., & Marashi, M. K. (2021). Feeling Guilty and Anxiety in the Elderly: The Role of Existential Concerns. Aging Psychology7(1), 41-29. https://doi.org/10.22126/jap.2021.5827.1480 [Persian]
Azam, M., Sulistiana, R., Fibriana, A. I., Savitri, S., & Aljunid, S. M. (2021). Prevalence of mental health disorders among elderly diabetics and associated risk factors in Indonesia. International Journal of Environmental Research and Public Health18(19), Article 10301.
Colucci, E., Nadeau, S., Higgins, J., Kehayia, E., Poldma, T., Saj, A., & De Guise, E. (2022). COVID-19 lockdowns’ effects on the quality of life, perceived health and well-being of healthy elderly individuals: A longitudinal comparison of pre-lockdown and lockdown states of well-being. Archives of Gerontology and Geriatrics99, Article 104606.
Due, T. D., Sandholdt, H., Siersma, V. D., & Waldorff, F. B. (2018). How well do general practitioners know their elderly patients’ social relations and feelings of loneliness? BMC Family Practice19(1), 1-8.
Freitas, R. A. D., Menezes, T. M. D. O., Santos, L. B., Moura, H. C. G. B., Sales, M. G. S., & Moreira, F. A. (2020). Spirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer. Revista Brasileira de Enfermagem73. 1-7.
Fusar-Poli, P., de Pablo, G. S., De Micheli, A., Nieman, D. H., Correll, C. U., Kessing, L. V., & van Amelsvoort, T. (2020). What is good mental health? A scoping review. European Neuropsychopharmacology, 31, 33-46.
Gournellis, R., Efstathiou, V., Yotsidi, V., Tournikioti, K., Papazahos, C., Ferentinos, P., & Michopoulos, I. (2019). Guilt delusional beliefs increase the risk of suicidal attempt in elderly unipolar psychotic depressives. The Journal of Nervous and Mental Disease207(1), 29-33.
Heidar nattaj, V., Hatami, N., & ahmadi, F. (2021). Determination of Effective Criteria on the Improvement of Seniors’ Mental Health Using Biophilic Design: A Case Study on District 1 of Tehran Municipality. Urban Structure and Function Studies8(28), 243-274. https://doi.org/10.22080/usfs.2021.20613.2097
Hemati Alamdarlo, Ghorban, Deshiri, Gholamreza, Shojaei, Setare, and Hakimi Rad, Elham. (2008). Comparison of feelings of loneliness and general health in elderly people living in families and nursing homes in northern areas of Tehran. Elderly, 3(8), 24-31. [Persian]
Hosseinizare, S. M., Tajvar, M., Abdi, K., Esfahani, P., Geravand, B., & Pourreza, A. (2020). Leisure Spending Patterns and      their Relationship with Mental Health in the Elderly in Iran. Salmand: Iranian Journal of Ageing, 15(3), 366-379. [Persian]
Isik, K., Başoğul, C., & Yildirim, H. (2020). The relationship between perceived loneliness and depression in the elderly and influencing factors. Perspectives in Psychiatric Care, 57(1), 351-357.
Kargarzar, A., Rezaei Monfared, Z., & Tavakoli, A. (1400). Examining the relationship between guilt, shame and emotion suppression with the mental health of adolescents. The 5th International Congress of Psychological Sciences and Education, Tehran. [Persian]
Kavoosian, N., Hosseinzadeh, K., & Kazemi, J. (2016). The Relationship between Spiritual Health and Loneliness among the Elderly in Karaj. Journal of Pizhūhish dar dīn va salāmat. 4(2), 7-15. https://doi.org/10.22037/jrrh.v4i2.17536  [Persian]
Khalvati, M., Babakhanian, M., Khalvati, M., Nafei, A., Khalvati, M., & Ghafouri, R. (2021). Death anxiety in Iranian elderly: a systematic review and meta-analysis. Salamand: Iranian Journal of Geriatrics, 16 (2), 152-171. [Persian]
Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., Suominen, B. S., Oksanen, T., Stenholm, S., Virtanen, M., Marmot, G. M., Singh-Manoux, A., Brunner, J.E., Lindbohm, V.J., Ferrie, E.J., & Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. The Lancet Public Health, 5(3), 140-149.
Lee, H. J., & Lee, D. K. (2019). Do sociodemographic factors and urban green space affect mental health outcomes among the urban elderly population? International Journal of Environmental Research and Public Health16(5), Article 789.
López, J., Perez-Rojo, G., Noriega, C., Carretero, I., Velasco, C., Martinez-Huertas, J. A., & Galarraga, L. (2020). Psychological well-being among older adults during the COVID-19 outbreak: A comparative study of the young–old and the old–old adults. International Psychogeriatrics32(11), 1365-1370.
Lu, J., Zhang, N., Mao, D., Wang, Y., & Wang, X. (2020). How social isolation and loneliness effect medication adherence among elderly with chronic diseases: An integrated theory and validated cross-sectional study. Archives of Gerontology and Geriatrics90, Article 104154.
Mirderikvand, F., Adavi, H., Amirian, L., & khodaie, S. (2017). The Investigation relationship between social support and depression mediated by loneliness between elderly. Journal of Geriatric Nursing, 3 (2), 63-75. [Persian]
Momeni, Kh., Amani, R., Janjani, P., Majzoobi, M. R., & Hadian Hamedani, K. (2021). The Relationship between attachment styles with positive and negative affect in the elderly: The Mediating role of reminiscence styles. Aging Psychology, 7(4), 407-422. [Persian]
Momeni, K., Amani, R., Janjani, P., Majzoobi, M. R., Forstmeier, S., & Nosrati, P. (2022). Attachment styles and happiness in the elderly: The Mediating role of reminiscence styles. BMC Geriatrics, 22, Article 349. https://doi.org/10.1186/s12877-022-03053-z
Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of clinical and diagnostic research: JCDR8(9), WE01.
Nakamura, J. S., Hong, J. H., Smith, J., Chopik, W. J., Chen, Y., VanderWeele, T. J., & Kim, E. S. (2022). Associations between satisfaction with aging and health and well-being outcomes among older US adults. JAMA Network Open5(2), Article 2147797.
O'Súilleabháin, P. S., Gallagher, S., & Steptoe, A. (2019). Loneliness, living alone, and all-cause mortality: The role of emotional and social loneliness in the elderly during 19 years of follow-up. Psychosomatic Medicine81(6), Article 521.
Patel, S. S., & Clark-Ginsberg, A. (2020). Incorporating issues of elderly loneliness into the Coronavirus Disease–2019 public health response. Disaster Medicine and Public Health Preparedness, 14(3), e13-e14.
Sadeghi, M., & Bavazin, F. (2019). Loneliness in the Elderly: Prediction based on mental well-being, psychological capital and spiritual intelligence. Aging Psychology5(1), 41-51. https://doi.org/ 10.22126/jap.2019.1125 [Persian]
Sreelekha, N., & Sia, S. K. (2022). Loneliness and psychological well-being among community-dwelling elderly people: the mediating role of death anxiety. Working with Older People, 25(4), 145-166.
Suzuki, K., Dollery, B. E., & Kortt, M. A. (2021). Addressing loneliness and social isolation amongst elderly people through local co‐production in Japan. Social Policy & Administration55(4), 674-686.
Tarugu, J., Pavithra, R., Vinothchandar, S., Basu, A., Chaudhuri, S., & John, K. R. (2019). Effectiveness of structured group reminiscence therapy in decreasing the feelings of loneliness, depressive symptoms and anxiety among inmates of a residential home for the elderly in Chittoor district. International Journal of Community Medicine and Public Health6(2), 847-854.
Zarghami, E., Olfat, M. (2017). Relationship between physical and mental health, and different housing types for elderly. Payesh, 16 (4), 521-530. [Persian]

Keywords


References
Alavi, M., Jorjoran Shushtari, Z., Noroozi, M., & Mohammadi Shahboulaghi, F. (2018). Mental health and related factors in old population in Tehran 2014-2015. Journal of Mazandaran University of Medical Sciences, 27(158),112-122. [Persian]
Amirbagloie Daryani, M., & Marashi, M. K. (2021). Feeling Guilty and Anxiety in the Elderly: The Role of Existential Concerns. Aging Psychology7(1), 41-29. https://doi.org/10.22126/jap.2021.5827.1480 [Persian]
Azam, M., Sulistiana, R., Fibriana, A. I., Savitri, S., & Aljunid, S. M. (2021). Prevalence of mental health disorders among elderly diabetics and associated risk factors in Indonesia. International Journal of Environmental Research and Public Health18(19), Article 10301.
Colucci, E., Nadeau, S., Higgins, J., Kehayia, E., Poldma, T., Saj, A., & De Guise, E. (2022). COVID-19 lockdowns’ effects on the quality of life, perceived health and well-being of healthy elderly individuals: A longitudinal comparison of pre-lockdown and lockdown states of well-being. Archives of Gerontology and Geriatrics99, Article 104606.
Due, T. D., Sandholdt, H., Siersma, V. D., & Waldorff, F. B. (2018). How well do general practitioners know their elderly patients’ social relations and feelings of loneliness? BMC Family Practice19(1), 1-8.
Freitas, R. A. D., Menezes, T. M. D. O., Santos, L. B., Moura, H. C. G. B., Sales, M. G. S., & Moreira, F. A. (2020). Spirituality and religiousity in the experience of suffering, guilt, and death of the elderly with cancer. Revista Brasileira de Enfermagem73. 1-7.
Fusar-Poli, P., de Pablo, G. S., De Micheli, A., Nieman, D. H., Correll, C. U., Kessing, L. V., & van Amelsvoort, T. (2020). What is good mental health? A scoping review. European Neuropsychopharmacology, 31, 33-46.
Gournellis, R., Efstathiou, V., Yotsidi, V., Tournikioti, K., Papazahos, C., Ferentinos, P., & Michopoulos, I. (2019). Guilt delusional beliefs increase the risk of suicidal attempt in elderly unipolar psychotic depressives. The Journal of Nervous and Mental Disease207(1), 29-33.
Heidar nattaj, V., Hatami, N., & ahmadi, F. (2021). Determination of Effective Criteria on the Improvement of Seniors’ Mental Health Using Biophilic Design: A Case Study on District 1 of Tehran Municipality. Urban Structure and Function Studies8(28), 243-274. https://doi.org/10.22080/usfs.2021.20613.2097
Hemati Alamdarlo, Ghorban, Deshiri, Gholamreza, Shojaei, Setare, and Hakimi Rad, Elham. (2008). Comparison of feelings of loneliness and general health in elderly people living in families and nursing homes in northern areas of Tehran. Elderly, 3(8), 24-31. [Persian]
Hosseinizare, S. M., Tajvar, M., Abdi, K., Esfahani, P., Geravand, B., & Pourreza, A. (2020). Leisure Spending Patterns and      their Relationship with Mental Health in the Elderly in Iran. Salmand: Iranian Journal of Ageing, 15(3), 366-379. [Persian]
Isik, K., Başoğul, C., & Yildirim, H. (2020). The relationship between perceived loneliness and depression in the elderly and influencing factors. Perspectives in Psychiatric Care, 57(1), 351-357.
Kargarzar, A., Rezaei Monfared, Z., & Tavakoli, A. (1400). Examining the relationship between guilt, shame and emotion suppression with the mental health of adolescents. The 5th International Congress of Psychological Sciences and Education, Tehran. [Persian]
Kavoosian, N., Hosseinzadeh, K., & Kazemi, J. (2016). The Relationship between Spiritual Health and Loneliness among the Elderly in Karaj. Journal of Pizhūhish dar dīn va salāmat. 4(2), 7-15. https://doi.org/10.22037/jrrh.v4i2.17536  [Persian]
Khalvati, M., Babakhanian, M., Khalvati, M., Nafei, A., Khalvati, M., & Ghafouri, R. (2021). Death anxiety in Iranian elderly: a systematic review and meta-analysis. Salamand: Iranian Journal of Geriatrics, 16 (2), 152-171. [Persian]
Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., Suominen, B. S., Oksanen, T., Stenholm, S., Virtanen, M., Marmot, G. M., Singh-Manoux, A., Brunner, J.E., Lindbohm, V.J., Ferrie, E.J., & Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. The Lancet Public Health, 5(3), 140-149.
Lee, H. J., & Lee, D. K. (2019). Do sociodemographic factors and urban green space affect mental health outcomes among the urban elderly population? International Journal of Environmental Research and Public Health16(5), Article 789.
López, J., Perez-Rojo, G., Noriega, C., Carretero, I., Velasco, C., Martinez-Huertas, J. A., & Galarraga, L. (2020). Psychological well-being among older adults during the COVID-19 outbreak: A comparative study of the young–old and the old–old adults. International Psychogeriatrics32(11), 1365-1370.
Lu, J., Zhang, N., Mao, D., Wang, Y., & Wang, X. (2020). How social isolation and loneliness effect medication adherence among elderly with chronic diseases: An integrated theory and validated cross-sectional study. Archives of Gerontology and Geriatrics90, Article 104154.
Mirderikvand, F., Adavi, H., Amirian, L., & khodaie, S. (2017). The Investigation relationship between social support and depression mediated by loneliness between elderly. Journal of Geriatric Nursing, 3 (2), 63-75. [Persian]
Momeni, Kh., Amani, R., Janjani, P., Majzoobi, M. R., & Hadian Hamedani, K. (2021). The Relationship between attachment styles with positive and negative affect in the elderly: The Mediating role of reminiscence styles. Aging Psychology, 7(4), 407-422. [Persian]
Momeni, K., Amani, R., Janjani, P., Majzoobi, M. R., Forstmeier, S., & Nosrati, P. (2022). Attachment styles and happiness in the elderly: The Mediating role of reminiscence styles. BMC Geriatrics, 22, Article 349. https://doi.org/10.1186/s12877-022-03053-z
Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of clinical and diagnostic research: JCDR8(9), WE01.
Nakamura, J. S., Hong, J. H., Smith, J., Chopik, W. J., Chen, Y., VanderWeele, T. J., & Kim, E. S. (2022). Associations between satisfaction with aging and health and well-being outcomes among older US adults. JAMA Network Open5(2), Article 2147797.
O'Súilleabháin, P. S., Gallagher, S., & Steptoe, A. (2019). Loneliness, living alone, and all-cause mortality: The role of emotional and social loneliness in the elderly during 19 years of follow-up. Psychosomatic Medicine81(6), Article 521.
Patel, S. S., & Clark-Ginsberg, A. (2020). Incorporating issues of elderly loneliness into the Coronavirus Disease–2019 public health response. Disaster Medicine and Public Health Preparedness, 14(3), e13-e14.
Sadeghi, M., & Bavazin, F. (2019). Loneliness in the Elderly: Prediction based on mental well-being, psychological capital and spiritual intelligence. Aging Psychology5(1), 41-51. https://doi.org/ 10.22126/jap.2019.1125 [Persian]
Sreelekha, N., & Sia, S. K. (2022). Loneliness and psychological well-being among community-dwelling elderly people: the mediating role of death anxiety. Working with Older People, 25(4), 145-166.
Suzuki, K., Dollery, B. E., & Kortt, M. A. (2021). Addressing loneliness and social isolation amongst elderly people through local co‐production in Japan. Social Policy & Administration55(4), 674-686.
Tarugu, J., Pavithra, R., Vinothchandar, S., Basu, A., Chaudhuri, S., & John, K. R. (2019). Effectiveness of structured group reminiscence therapy in decreasing the feelings of loneliness, depressive symptoms and anxiety among inmates of a residential home for the elderly in Chittoor district. International Journal of Community Medicine and Public Health6(2), 847-854.
Zarghami, E., Olfat, M. (2017). Relationship between physical and mental health, and different housing types for elderly. Payesh, 16 (4), 521-530. [Persian]