| Author: | Zhou, Jiajia |
| Title: | Age-friendly environments (AFEs) and their influence on psychological well-being and mental health among older Chinese adults in Shanghai |
| Advisors: | Bai, Xue (APSS) |
| Degree: | Ph.D. |
| Year: | 2022 |
| Subject: | Barrier-free design for older people Older people -- Mental health -- China -- Shanghai Hong Kong Polytechnic University -- Dissertations |
| Department: | Department of Applied Social Sciences |
| Pages: | xii, 142 pages : color illustrations |
| Language: | English |
| Abstract: | Background: Considerable social transformation of population ageing and urbanisation has attached more implications of AFEs on the well-being of older people. Nevertheless, it remains unclear the extent to which and how, various age-friendliness are linked with psychological well-being (PWB) and mental health of community-dwelling older people in China. Objectives: First, this thesis adapts and validates an AFEs scale in the Chinese context. Second, it examines the association of age-friendliness with the PWB and mental health of older people with various health statuses. Third, underpinning the theoretical framework of person-environment interplay, this thesis investigates the psychological (i.e., sense of community) and behavioural (i.e., activity engagement) pathways that link age-friendliness to PWB and mental health. It also explores the roles of intergenerational relationship quality and urbanisation degree in moderating the nature or strength of the psychological and behavioural pathways, respectively. Methods: In total, 506 community dwellers aged from 50 to 88 years from nine districts of Shanghai participated in this study. Scale validity and reliability were examined to assess the psychometric quality of the AFEs scale in the Chinese context. Multiple linear regression and logistic regression were employed to examine the relationships between age-friendliness domains and the PWB and depressive symptoms, respectively. Path analysis and multiple linear models were employed to test the underlying psychological and behavioural pathways. Results: An appropriate AFEs scale that covers eight domains was validated in Chinese context. Of the eight age-friendliness domains, outdoor spaces, housing, social respect, and employment were revealed to be prominent predictors of the PWB of older adults. In addition, AFEs had higher influence on the PWB of older people when they have good health status. For the outcome of mental health, outdoor spaces, housing, community-based support and services were salient in reducing the severity of depressive symptoms. In analysis stratified by health status, service environments significantly prevented mental disorder among older adults with poor health, and built environments were effective for depressive symptoms among people with good health. For the psychological pathway, the associations between the age-friendliness domains (except housing) and the PWB and depressive symptoms of older adults were partially mediated by sense of community. Moreover, intergenerational relationships moderated the mediating effect, and the indirect effects of age-friendliness gradually attenuated with the enhancement of intergenerational relationships. For the behavioural pathway, activity engagement mediated the influence of social respect and employment on PWB and the influence of community-based support and health services on depressive symptoms. In addition, the degree of urbanisation moderated the mediating effect of activity engagement, and the behavioural pathway was only significant in highly urbanised districts. Conclusions: This thesis provided empirical evidence supporting and expanding the theoretical framework of person-environment interplay. The complex psychological and behavioural pathways reflect the joint dynamics by which family, community, and structural forces shape the PWB and mental health of older adults. Intergenerational relationships and the urbanisation degree should be considered when conducting age-friendly interventions to promote PWB and prevent mental disorders of older adults. |
| Rights: | All rights reserved |
| Access: | open access |
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