Social Capital and Depressive Episodes: Gender Differences in the ELSA-Brasil Cohort

Introduction: The association between social capital and depression is a frequent research topic in developed countries, often with inconclusive results. Furthermore, for both social capital and depression, there are gender differences established in the literature. This study investigates gender differences in the association of social capital with the incidence and maintenance of depressive episodes.Methods: Baseline and second wave data (4 years of follow-up) from the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of civil servants with 15,105 workers aged 35–74 years, were used. Social capital was assessed using the Resource Generator, a scale composed of two different dimensions: “social support” and “prestige and education.” Depressive episodes were assessed using the Clinical Interview Schedule - Revised (CIS-R). The statistical analysis was performed using multinomial regression with adjustments for possible confounding factors.Results: Among men, low social capital in the “social support” dimension was associated with the incidence of depressive episodes (RR = 1.66; 95% CI: 1.01–2.72). Among women, social support was associated with the maintenance of depressive episodes (RR = 2.66; 95% CI: 1.61–4.41). Social capital was not associated with the incidence or maintenance of depressive episodes in the “prestige and education” dimension in both genders.Conclusion: The results highlight the importance of the dimension “social support” in both genders in its association with mental health. The resource-based social capital approach proved to be adequate for investigating mental health and confirms the idea that social networks can be useful in the treatment and prevention of depressive episodes.

Validade da estrutura fatorial da escala de capital social utilizada na linha de base no ELSA-Brasil

Resumo: Esta pesquisa tem por objetivo estudar a estrutura fatorial da versão brasileira da escala Resource Generator (RG), utilizando dados da linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Realizou-se validade cruzada com três subamostras aleatórias. A análise fatorial exploratória usando modelos de equação estrutural exploratória foi realizada nas duas primeiras subamostras para diagnóstico da estrutura fatorial e, na terceira, a análise fatorial confirmatória foi utilizada para corroborar o modelo definido pelas análises exploratórias. Com base nos 31 itens iniciais, o modelo de melhor ajuste contemplou 25 itens distribuídos em três dimensões. Todas apresentaram validade convergente (valores acima de 0,50 para a variância extraída) e precisão (valores acima de 0,70 para a confiabilidade composta) satisfatórias. Todas as correlações fatoriais foram abaixo de 0,85, indicando plena validade fatorial discriminante. A escala RG apresenta propriedades psicométricas aceitáveis e pode ser utilizada em populações com características semelhantes.

Individual social capital and health-related quality of life among older rural Chinese

ABSTRACTNo study based on the Resource Generator has explored the association between individual social capital and health-related quality of life among older adults. This study aims to evaluate the validity and reliability of the adapted Resource Generator-China, and examine the association between individual social capital measured by the Resource Generator-China and health-related quality of life of older rural-dwelling Chinese people. A field survey including 975 rural-dwelling people aged between 60 and 75 years was conducted in three counties of the Shandong Province of China in 2013. Quality of life was measured by the Chinese version of the 36-Item Short Form Health Survey (SF-36): scores of Physical Component Summary and Mental Component Summary. Cumulative scale analyses were performed to analyse the homogeneity and reliability of the Resource Generator-China. We constructed generalised linear models by gender to examine the associations of social capital with health-related quality of life. Our findings suggest that the adapted instrument for older rural-dwelling Chinese people can be a reliable and valid measure of access to individual social capital. There were positive associations between individual social capital (total scores and sub-scale scores) and health-related quality of life. Individual social capital had a stronger association with mental health among women than men. Future studies should be improved through a longitudinal design with a larger and randomised sample covering large geographical rural areas in China.

Are the Healthcare Professionals Really Satisfied with What they Cared? Evidence from an Armed Forces Hospital in Taiwan

<p>Squeezed by the new reimbursement policy of the National Health Insurance (NHI) in Taiwan, the Armed Forces Hospitals (AFH) had to serve general citizens as well as military clients. A dual role of military services and resource generator it acts in the current healthcare industry. Consequently, the job satisfaction of hospital staffs had thus been influenced. Taken the importance of the employee’s job satisfaction in customer satisfaction as well as in overall profit into account, the current research wished to reveal the current levels of the hospital employee’s job satisfaction, and to compare the differences of the perceived importance and the actual experience of satisfaction attributes. Main questions this research to answer were “Does the healthcare professionals satisfied with what they perceived important?” and “What are the main discrepancies exist that worth for investing? Using a structural questionnaire as an instrument, 474 valid responses from an armed forces hospital in central Taiwan were used as sample. The study reveals that there are significant differences between perceived importance and experience in each dimension, of which the compensation system was perceived the most important and in the meantime having the biggest gap between expectation and experience. The findings suggest that the hospital managers should re-organize the compensation system by increasing the incentives of bonuses, promotions, while maintain those aspects with smaller differences such as job content and supervision to effectively motivate the hospital employees, and accordingly ameliorating medical service quality.</p>

Capital social no ELSA-Brasil: confiabilidade teste-reteste do Resource Generator scale

OBJETIVO: Estimar a confiabilidade teste-reteste dos itens do Resource Generator scale para avaliação de capital social no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). MÉTODOS: A escala de capital social foi aplicada em subamostra de 281 participantes dos seis Centros de Investigação do ELSA, em duas oportunidades, com intervalo de sete a 14 dias. O instrumento é constituído por 31 itens que representam situações concretas para avaliar o acesso a diferentes tipos de recursos, além de avaliar a fonte dos recursos disponíveis (familiares, amigos ou conhecidos). A análise estatística foi realizada por meio de estatísticas kappa (k) e kappa ajustado pela prevalência (ka). RESULTADOS: Os recursos sociais investigados foram encontrados com grande frequência (acima de 50%). Em relação à presença ou ausência dos recursos, as estimativas de confiabilidade ajustadas pela prevalência (ka) variaram de 0,54 a 0,97. No que se refere à fonte de recurso, essas estimativas variaram de ka = 0,45 (alguém que tenha bons contatos com a mídia) a ka = 0,86 (alguém que se formou no Ensino Médio). CONCLUSÕES: A escala apresentou níveis adequados de confiabilidade, que variaram de acordo com o tipo de recurso.