Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study

Abstract Determinants of family support for older patients with chronic non-communicable diseases (chronic diseases) are largely unknown. This study aimed to identify the factors related to family support for older patients in Guangzhou, focusing on solitary living conditions and societal expectatio...

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Main Authors: Yingxian Yu, Lulin Yan, Mi Yao, Guoqiang Sun, Lin Xu, Hao Tang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-08354-y
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author Yingxian Yu
Lulin Yan
Mi Yao
Guoqiang Sun
Lin Xu
Hao Tang
author_facet Yingxian Yu
Lulin Yan
Mi Yao
Guoqiang Sun
Lin Xu
Hao Tang
author_sort Yingxian Yu
collection DOAJ
description Abstract Determinants of family support for older patients with chronic non-communicable diseases (chronic diseases) are largely unknown. This study aimed to identify the factors related to family support for older patients in Guangzhou, focusing on solitary living conditions and societal expectations to inform future interventions. The quantitative stage included a sample of 227 people, and the qualitative stage included a sample of 9 people residing alone. Data were collected between December 2021 and December 2022 using the Personal Information Form, the Family Caregiving Index, the Family Support Scale, and the Semi-Structured Interview Form. Descriptive statistics, independent sample t test, one-way analysis of variance (ANOVA), and multiple linear regression analyses were used for quantitative data analysis. Content analysis was performed using the Nvivo12 software for qualitative data analysis. Of the older patients with chronic diseases, 83.7% had good family function, as indicated by an APGAR score of 9 (interquartile range 7–10) or higher. The median self-rating score for family support was 13 (interquartile range 11–14), with 75.8% reporting high family support. After adjusting for sex, age, education level, family type, family power structure, perceived marital quality, perceived filial support, and frequency of contact with children, several factors were found to be significantly associated with poorer family outcomes. For family function, perceived marital quality as average or poor (β = − 1.30, 95% CI: − 2.37 to − 0.24, P = 0.018), having no children (β = 6.35, 95% CI: 2.04 to 10.66, P = 0.005), and low-frequency contact with children (β = − 7.76, 95% CI: − 11.54 to − 3.98, P < 0.001) were significantly associated with lower family function scores. Similarly, for family support, perceived marital quality as average or poor (β = − 1.76, 95% CI: − 3.24 to − 0.28, P = 0.021), no spouse (β = − 2.01, 95% CI: − 3.34 to − 0.68, P = 0.003), no children (β = 8.58, 95% CI: 2.63 to 14.54, P = 0.006), and low-frequency contact with children (β = − 10.06, 95% CI: − 15.30 to − 4.81, P < 0.001) were significantly associated with poorer family support. Qualitative analysis revealed living conditions, family and societal support, and expectations and needs for medical services among solitary older adults. Poor perceived marital quality, lack of spousal support, low filial support from children, and infrequent contact with children are risk factors for poor family functioning and low support among older patients with chronic diseases. Enhanced societal and familial support mechanisms are crucial, especially for older adults living alone.
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spelling doaj-art-a0fc34cdd6af4b959f032df5b133cc042025-08-20T03:03:40ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-08354-yFamily support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods studyYingxian Yu0Lulin Yan1Mi Yao2Guoqiang Sun3Lin Xu4Hao Tang5The First Affiliated Hospital,Sun Yat-sen UniversityThe First Affiliated Hospital,Sun Yat-sen UniversityPEKING UNIVERSITY FIRST HOSPITALBaiyun Street Community Health Service CenterPublic Health School of Sun Yat-sen UniversityThe First Affiliated Hospital,Sun Yat-sen UniversityAbstract Determinants of family support for older patients with chronic non-communicable diseases (chronic diseases) are largely unknown. This study aimed to identify the factors related to family support for older patients in Guangzhou, focusing on solitary living conditions and societal expectations to inform future interventions. The quantitative stage included a sample of 227 people, and the qualitative stage included a sample of 9 people residing alone. Data were collected between December 2021 and December 2022 using the Personal Information Form, the Family Caregiving Index, the Family Support Scale, and the Semi-Structured Interview Form. Descriptive statistics, independent sample t test, one-way analysis of variance (ANOVA), and multiple linear regression analyses were used for quantitative data analysis. Content analysis was performed using the Nvivo12 software for qualitative data analysis. Of the older patients with chronic diseases, 83.7% had good family function, as indicated by an APGAR score of 9 (interquartile range 7–10) or higher. The median self-rating score for family support was 13 (interquartile range 11–14), with 75.8% reporting high family support. After adjusting for sex, age, education level, family type, family power structure, perceived marital quality, perceived filial support, and frequency of contact with children, several factors were found to be significantly associated with poorer family outcomes. For family function, perceived marital quality as average or poor (β = − 1.30, 95% CI: − 2.37 to − 0.24, P = 0.018), having no children (β = 6.35, 95% CI: 2.04 to 10.66, P = 0.005), and low-frequency contact with children (β = − 7.76, 95% CI: − 11.54 to − 3.98, P < 0.001) were significantly associated with lower family function scores. Similarly, for family support, perceived marital quality as average or poor (β = − 1.76, 95% CI: − 3.24 to − 0.28, P = 0.021), no spouse (β = − 2.01, 95% CI: − 3.34 to − 0.68, P = 0.003), no children (β = 8.58, 95% CI: 2.63 to 14.54, P = 0.006), and low-frequency contact with children (β = − 10.06, 95% CI: − 15.30 to − 4.81, P < 0.001) were significantly associated with poorer family support. Qualitative analysis revealed living conditions, family and societal support, and expectations and needs for medical services among solitary older adults. Poor perceived marital quality, lack of spousal support, low filial support from children, and infrequent contact with children are risk factors for poor family functioning and low support among older patients with chronic diseases. Enhanced societal and familial support mechanisms are crucial, especially for older adults living alone.https://doi.org/10.1038/s41598-025-08354-yFamily supportChronic non-communicable diseasesDiabetes mellitusHypertensionFactorsMixed methods
spellingShingle Yingxian Yu
Lulin Yan
Mi Yao
Guoqiang Sun
Lin Xu
Hao Tang
Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study
Scientific Reports
Family support
Chronic non-communicable diseases
Diabetes mellitus
Hypertension
Factors
Mixed methods
title Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study
title_full Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study
title_fullStr Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study
title_full_unstemmed Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study
title_short Family support and its determinants among older patients with chronic diseases in Guangzhou communities: a mixed-methods study
title_sort family support and its determinants among older patients with chronic diseases in guangzhou communities a mixed methods study
topic Family support
Chronic non-communicable diseases
Diabetes mellitus
Hypertension
Factors
Mixed methods
url https://doi.org/10.1038/s41598-025-08354-y
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