A study of the impact of social participation on the subjective well-being of low-vision older adults in western China in the context of healthy aging

doi:10.21203/rs.3.rs-5010951/v1

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A study of the impact of social participation on the subjective well-being of low-vision older adults in western China in the context of healthy aging

https://doi.org/10.21203/rs.3.rs-5010951/v1

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Background Low vision represents a significant global health issue, and its effects on the physical and mental health of the elderly have been extensively researched. However, the relationship between social participation and the subjective well-being of elderly individuals with low vision in China remains underexplored. This study focuses on the elderly with low vision residing in the main urban area of Chongqing, Western China, to investigate the impact and pathways of subjective well-being at both subjective and objective levels of social participation.

Methods Purposive and convenience sampling methods were employed to select 274 elderly individuals with low vision who were monitored at the ophthalmology clinics of two tertiary hospitals in Chongqing, western China, as the subjects of this survey. The study utilized the Memorial University of Newfoundland Happiness Scale, the Social Participation Scale, and the Social Support Scale, along with a visual function-related quality of life scale to collect relevant data. Pearson correlation analysis was conducted to examine the relationships among the research variables. Based on the theoretical model, a multiple mediating effect prediction model was established to assess the impact of social participation on subjective well-being. Linear regression analysis and the Bootstrap method were applied to evaluate the mediating effects within the prediction model.

Results The overall average subjective well-being of elderly individuals with low vision in western China is measured at 24.75 ± 8.02 points, which indicates a lower-middle level of well-being. participation in social activities is a positive predictor of subjective well-being, whereas individuals' subjective feelings of social participation can negatively impact it. social support and quality of life related to visual functioning were identified as mediating factors influencing the relationships between social participation activities, feelings of social participation, and subjective well-being.

Conclusion This study highlights the subjective well-being of elderly individuals with low vision in western China, as well as the pathways influencing the relationship between social participation-both subjective and objective-and their subjective well-being. It is recommended that healthcare professionals prioritize long-term care strategies for elderly patients experiencing low vision.

Low vision

Subjective well-being

Social participation

The elderly

Social support

Vision-related quality of life

Low vision is a type of visual impairment that remains unresponsive to treatments such as medication, standard optometric correction, or surgery^[1]. While the age-standardized prevalence of low vision is currently declining on a global scale, the absolute number of individuals affected continues to rise, driven by factors such as population growth and aging^[2]. The World Health Organization (WHO) estimates that approximately 253 million people worldwide experience visual impairment, with about two-thirds of this demographic being over 60 years old^[3]. In China, the prevalence of visual impairment among middle-aged and elderly individuals is reported to be 6.22%^[4]. Age has been identified as a primary risk factor for the development of low vision^[1]. As China's population continues to age, the proportion of elderly individuals experiencing low vision is projected to increase further^[5].

In older adults with low vision, restricted mobility can lead to altered social participation behaviors, characterized by increased time spent in isolation and decreased social interactions^[6]. Moreover, persistent or progressive vision loss amplifies the fear of further impairment within this demographic, which is associated with a heightened risk of developing anxiety and depression^[7]. Additionally, the negative emotions arising from vision loss may deter older adults from adopting adaptive strategies intended to mitigate the effects of their impairment^[8]. This avoidance exacerbates the impact of negative emotions and complicates efforts to address low vision impairment, ultimately diminishing the Vision Related Quality of Life(VRQOL)^[8]. It is clear that the repercussions of low vision in older adults extend beyond physical health, encompassing significant implications for social functioning and mental well-being.

A substantial body of research has established that social participation positively impacts subjective well-being in older adults. However, the exploration of this relationship among older adults with low vision has received comparatively little attention from Chinese scholars. Previous studies have primarily examined social participation activities as a mediating variable, investigating how these activities may influence the subjective well-being of older adults with low vision through both moderating and mediating mechanisms. In light of the World Health Organization's definition of Healthy Ageing (HA) as “the process of developing and maintaining the functional capacity of older people to achieve a sense of well-being”^[9], this study aims to investigate the effects and pathways of social participation on subjective well-being, specifically focusing on older adults with low vision.

2.1 Participants and procedure

This study employed a cross-sectional survey design utilizing both convenience and purposive sampling methods. The target population consisted of older adults with low vision who were followed up at the ophthalmology clinics of two tertiary-level hospitals in Chongqing, Western China, from October 2020 to March 2021. According to the estimation requirements of sample size for cross-sectional surveys, that is, the sample size should be 5–10 times the number of scale items^[10], the scale with the largest number of items in this study is the social participation scale, with a total of 46 items, according to the number of items 5–10 times the estimate, and considering the dropout of the sample size, it was expanded by 10%, and the sample size was estimated to be at least 253 cases. Ultimately, 277 questionnaires were distributed; however, three participants withdrew during the survey, leading to a final count of 274 valid responses.

The inclusion criteria for the study population were as follows: 1) individuals aged 65 years or older; 2) residents of the main urban area of Chongqing City for at least one year; 3) a clear diagnosis of visual impairment in accordance with the 2019 WHO Visual Impairment Classification Criteria^[1], defined as a Presenting Visual Acuity (PVA) in the better eye of less than 0.5 but greater than 0.05); 4) diagnoses related to age-related visual impairment, including macular degeneration, glaucoma, retinal diseases, optic nerve diseases, high myopia fundopathy, and failure to improve visual function following cataract surgery; 5) presence of eye diseases that cannot be treated or corrected through refraction, surgery, or medication; and 6) voluntary participation in the study after a detailed explanation of the informed consent form.

The exclusion criteria included: 1) individuals with severe hearing impairment or concurrent psychological disorders; 2) those with other serious systemic diseases; 3) individuals who required eye surgery in the near future; 4) those in the surgical or terminal stages of illness; and 5) individuals unable to communicate effectively, which hindered their ability to cooperate with the completion of the survey.

Prior to administering the questionnaire survey, the head nurse of the department was contacted to obtain permission and support. The purpose, content, and significance of the study were clearly explained to the respondents who met the criteria for nativity. Following this, the questionnaire was administered in the study room of the ophthalmology outpatient clinic after securing their consent. Given that the respondents were elderly individuals with low vision, which may hinder their ability to read the questionnaire entries, a one-on-one, question-by-question interview format was employed to collect the data. The researcher maintained a neutral tone of voice while reading the questions and accurately recording the responses. This study received approval from the Ethics Committee of the Army Medical University (approval number 2020-013-02).

2.2 Measurements

2.2.1 Sociodemographic characteristics

The socio-demographic characteristics of this study included six dimensions such as gender, literacy, mode of residence, marital status, economic income, and presence of chronic diseases.

2.2.2 Memorial University of Newfoundland Scale of Happiness (MUNSH)

The MUNSH comprises a total of 24 entries, serving as a comprehensive reflection of both the short-term emotional responses and long-term emotional experiences of the study participants across four dimensions: positive affect (PA), negative affect (NA), positive experience (PE), and negative experience (NE)^[11]. Scores of 36 or higher indicate a higher level of subjective well-being (SWB), scores of 12 or lower indicate a low level of SWB, while scores falling between these two thresholds represent a moderate level of SWB^[11]. In this study, the Cronbach's alpha for the scale was 0.899.

2.2.3 Community Participation Index (CPI)

The 46-item scale assesses individual self-reported frequencies of social participation activities alongside subjective feelings regarding social participation^[12]. In this study, the Cronbach's alpha was measured at 0.839. Social participation activities were categorized into three main groups: family activities, social and recreational activities, and work role activities. A score of 0 was assigned for 'no' participation, with higher scores reflecting increased frequency of participation. The subjective feelings of social participation encompass perceived importance and controllability, where higher scores indicate that individuals perceive or experience greater restrictions on social participation, suggesting a poorer overall experience of social participation^[12].

2.2.4 Social Support Rating Scale (SSRS)

The Social Support Rating Scale (SSRS) quantitatively evaluates an individual's level of social support across three dimensions: objective support, subjective support, and utilization of support. This scale consists of 10 items, with scores ranging from 12 to 66; higher scores indicate a greater level of social support^[13]. In this study, Cronbach's α was found to be 0.902, reflecting a high level of internal consistency.

2.2.5 National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)

This multidimensional questionnaire evaluates the capacity to perform vision-related activities of daily living and assesses changes in emotional and social functioning following vision loss^[14]. It is generally recommended for studies involving older populations. The questionnaire comprises 25 self-reported items that encompass 12 dimensions. Higher scores reflect a better quality of life associated with visual function^[14]. Due to the fact that individuals with low vision cannot drive^[15], the item regarding driving was excluded from the questionnaire. In this study, Cronbach's α was found to be 0.917.

2.3 Data analysis

Data entry and collation were performed using Epidata 3.1 and Excel software, while the questionnaire data were analyzed with SPSS version 23.0 after thorough verification. The demographic characteristics, subjective well-being, frequency of socially engaged activities, and feelings of social engagement among respondents were statistically analyzed using means and standard deviations. To examine differences in subjective well-being among older adults with low vision across various demographic control variables, t-tests and one-way ANOVA were employed. Pearson correlation analysis was conducted to assess the relationships between social participation activities, subjective feelings of social participation, and each of the study variables individually. Additionally, multiple mediation effects modeling was utilized, grounded in theoretical frameworks regarding the impact of social support and quality of life related to visual function on health outcomes. After controlling for statistically significant demographic variables (p < 0.05), linear regression analysis was performed to evaluate the validity of the predictive model. The bootstrap method was applied to assess the mediating effects, with significance determined when the 95% confidence interval excluded zero. This analysis was executed using SPSS PROCESS version 3.0 software

3.1 Subjective well-being of older people with low vision

In this study, the overall mean score for subjective well-being (SWB) among older adults with low vision was 24.75 ± 8.02 points, which is significantly lower than the Chinese norm^[16] (see Table 1). Notably, 83.21% of participants reported a medium level of subjective well-being, with a mean score of 25.31 ± 6.25 points. Additionally, 6.93% of participants exhibited a higher level of subjective well-being, while 9.85% of participants were classified as having a lower level of subjective well-being.

Table 1

Comparison of Subjective Well-Being Scores of Older Adults with Low Vision to the Norm (n = 274)
groups	Total subjective well-being score	positive emotion	positive experience	negative emotion	negative experience
Older people with low vision	24.75 ± 8.02	4.70 ± 2.50	6.20 ± 2 .90	3.52 ± 1.74	6.64 ± 2.13
normality	28.70 ± 10.72	4.49 ± 2.99	2.66 ± 2.71	7.24 ± 3.98	4.31 ± 3.38
t	-8.154	1.420	20.255	-35.366	18.063
p	< 0.001	0.157	< 0.001	< 0.001	< 0.001

3.2 Analysis of differences in demographic characteristics of subjective well-being among older adults with low vision

The mean age of the subjects in this study was 73.70 ± 6.56 years. Subjective well-being varied significantly across several demographic characteristics, including cultural and educational background (p < 0.05), marital status (p < 0.01), per capita monthly income (p < 0.001), and the presence of other chronic diseases (p < 0.001). These differences were statistically significant(see Tables 2).

Table 2

Differences in SWB on Demographic Factors in Older Adults with Low Vision (n = 274)
item	category	n	Subjective well-being Mean (SD)	Level of subjective well-being (Number of cases/percentage)			F or t	P value
item	category	n	Subjective well-being Mean (SD)	lower	moderate	high	F or t	P value
Gender	male	126	25.01 ± 8.25	13 (4.7)	103 (37.6)	10 (3.6)	0.485	0.628
Gender	female	148	24.53 ± 7.83	14 (5.1)	125 (45.6)	9 (3.3)
Education level	Primary school or below	123	24.37 ± 7.68	12 (4.4)	104 (38.0)	7 (2.6)	2.955	0.033
	junior high school	85	23.92 ± 8.22	13 (4.7)	67 (24.5)	5 (1.8)
	Senior high school	32	24.44 ± 7.87	1 (0.4)	29 (10.6)	1 (0.7)
	College and above	34	28.50 ± 8.16	1 (0.4)	28 (10.2)	2 (0.7)
Living arrangement	Live with a spouse only	148	24.82 ± 7.96	14 (5.1)	123 (44.9)	11 (4.0)	1.288	0.275
	Live with children/grandchildren only	40	22.78 ± 8.66	5 (1.8)	33 (12.0)	2 (0.7)
	Live With spouse and children	61	26.30 ± 7.35	3 (1.1)	53 (19.3)	5 (1.8)
	Live to an institution for the elderly	6	23.17 ± 6.65	1 (0.4)	5 (1.8)	0 (0.0)
	live alone	19	23.95 ± 9.17	4 (1.5)	14 (5.1)	1 (0.4)
Marital status	unmarried	1	32.00 ± 0.00	0 (0.0)	1 (0.4)	0 (0.0)	3.982	0.008
	married	212	25.27 ± 7.75	17 (6.2)	179 (65.3)	16 (5.8)
	divorcee	11	28.36 ± 8.43	1 (0.4)	8 (2.9)	2 (0.7)
	bereaved of one's spouse	50	21.62 ± 8.34	9 (3.3)	40 (14.6)	1 (0.4)
Monthly household income per capita (RMB)	< 1000	18	20.94 ± 5.80	2 (0.7)	16 (5.8)	0 (0.0)	12.456	< 0.001
	1000–2999	122	22.23 ± 7.82	20 (7.3)	98 (35.8)	4 (1.5)
	3000–4999	98	27.23 ± 7.51	5 (1.8)	82 (29.9)	11 (4.0)
	≥ 5000	36	28.44 ± 7.48	0 (0.0)	32 (11.7)	4 (1.5)
other chronic disease	Yes	180	23.27 ± 8.03	22 (8.0)	147 (53.6)	11 (4.0)	4.366	< 0.001
other chronic disease	No	94	27.59 ± 7.22	5 (1.8)	70 (25.5)	19 (6.9)

3.3 Social participation, social support, and visual function-related quality of life for older adults with low vision

Mean values for social participation, social support, and visual function-related quality of life for older adults with low vision are specified in Tables 3

Table 3

Social Participation, Social Support, and Visual Function-Related Quality of Life for Older Adults with Low Vision (n = 274)
independent variable	minimum value	maximum values	Mean ± standard deviation	Average score per entry/dimension
Social participation activities	2	39	17.30 ± 7.15	0.87 ± 0.36
Feelings of social participation	66	134	111.16 ± 17.93	4.12 ± 0.66
social support	15	42	25.53 ± 7.45	2.55 ± 0.75
visual function-related quality of life score	24	66	45.55 ± 8.05	3.79 ± 0.67

3.4 Correlation analysis of research variables

he results of the correlation analysis indicated that social participation activities exhibited moderate positive correlations with subjective well-being (r = 0.695, p < 0.01), social support (r = 0.740, p < 0.01), and quality of life related to visual functioning (r = 0.604, p < 0.01); Conversely, feelings of social participation were found to have moderate negative correlations with subjective well-being (r=- 0.809, p < 0.01), social support (r=-0.885, p < 0.01), and quality of life related to visual functioning (r = -0.674, p < 0.01). These correlations provide empirical support for the proposed mediation effect model.

3.5 Impact of social participation on subjective well-being

This study explores predictive modeling of social support-mediated mediation effects, utilizing convoy modeling theory to examine the impact of social support on health^[17]. The predictive model specifically addresses the mediating effect of visual function-related quality of life, drawing upon Lazarus and Folkman's stress response model^[18] as a foundational framework.

3.5.1 Relationship between the effects of social participation activities and subjective well-being

The regression analysis conducted between the variables indicated that the overall effect of social engagement activities on subjective well-being was significant, with coefficients of B = 0.771, t = 13.418, and p < 0.001. Specifically, both social support (B = 0.563, t = 10.494, p < 0.001) and visual function-related quality of life (B = 0.313, t = 7.487, p < 0.001) emerged as significant positive predictors of subjective well-being. The results from the Bootstrap method used to test for mediating effects demonstrated that social support (Boot 95%CI = 0.339 to 0.542) and visual function-related quality of life (Boot 95%CI = 0.150 to 0.287) significantly mediated the relationship between social participation activities and subjective well-being, with effect sizes of 56.29% and 27.89%, respectively(refer to Table 4 and Fig. 1).

Table 4

Social Support, VRQOL-Mediated Social participation Activities, and Subjective Well-Being Model Effect Values by Path (n = 274)
	efficiency value	Boot SE	Boot LLCI	Boot ULCI	counterpart efficiency value
aggregate effect	0.771	0.056	0.665	0.888	-
direct effect	0.123	0.051	0.023	0.219	15.95%
Total indirect effect	0.649	0.060	0.537	0.772	84.18%
Indirect effect 1: Social participation activities→ SSRS → SWB	0.434	0.052	0.339	0.542	56.29%
Indirect effect 2: Social participation activities →VRQOL→SWB	0.215	0.035	0.150	0.287	27.89%

3.5.2 Effect relationship between feelings of social participation and subjective well-being

Regression analysis revealed a significant total effect of feelings of social participation on subjective well-being (B = -0.349, t = -20.058, p < 0.001).Furthermore, the direct effect of feelings of social participation on subjective well-being remained significant after controlling for social support and quality of life related to visual functioning (B = -0.111, t = -3.450, p < 0.01).social support (B = 0.417, t = 5.584, p < 0.001) and quality of life related to visual functioning (B = 0.295, t = 7.074, p < 0.001) emerged as significant positive predictors of subjective well-being. The bootstrap method for testing mediating effects indicated that social support (Boot 95% CI = -0.202 to -0.100) and quality of life related to visual functioning (Boot 95% CI = -0.114 to -0.060) had significant mediating effects between feelings of social participation and subjective well-being, with effect sizes of 43.55% and 24.64%, respectively (see Table 5 and Fig. 2).

Table 5

Social Support, VRQOL-Mediated Feelings of social participation and Subjective Well-Being Model Effect Values by Path (n = 274)
	efficiency value	Boot SE	Boot LLCI	Boot ULCI	oppose efficiency value
aggregate effect	-0.349	0.017	-0.382	-0.314	-
direct effect	-0.111	0.030	-0.173	-0.055	31.81%
Total indirect effect	-0.238	0.027	-0.290	-0.184	68.19%
Indirect effect 1: Feelings of social participation → SSRS → SWB	-0.152	0.026	-0.202	-0.100	43.55%
Indirect effect 2: Feelings of social participation → VRQOL → SWB	-0.086	0.014	-0.114	-0.060	24.64%

To the best of our knowledge, this study represents the first comprehensive exploration of the effects and pathways through which social participation influences subjective well-being, examining both objective and subjective dimensions. It assesses the mechanisms linking social participation to subjective well-being specifically in older adults with low vision, offering a more nuanced analysis than previous research. The findings of this study not only broaden the understanding of subjective well-being within the aging population but also provide a reliable and detailed foundation for caregivers to develop and implement health care strategies tailored to older adults with low vision.

4.1Current status of subjective well-being among older adults with low vision

The findings of this study indicate that the subjective well-being of older adults with low vision falls within the lower middle range, contrasting with the results of previous research^[18–20]. Earlier studies have demonstrated a correlation between low vision and reduced levels of subjective well-being. The discrepancy in findings may be attributed to factors such as emotional adaptation and the use of varying evaluative indicators.Schilling et al.^[21] investigated the evolution of positive and negative emotions over time in older adults with age-related macular degeneration. They discovered that positive emotions exhibited a significant and nonlinear relationship with the duration of the disease; specifically, positive emotions were markedly lower during the initial stages of vision loss, gradually increased over time, and then stabilized after reaching a certain duration. Adaptation theory posits that, despite experiencing a decline in physical functioning, older adults' subjective well-being tends to stabilize over time^[22].Previous research on the theories of adaptation in late-life happiness has found that negative affective influences on well-being are more pronounced when specific measures related to visual functioning are employed to assess subjective well-being. In contrast, the differences in effect sizes for well-being components are less pronounced when emotional experience is utilized as an assessment tool for subjective well-being in older adults with low vision^[23].The Memorial University of Newfoundland Happiness Scale, selected for this study, primarily evaluates subjective well-being through the lenses of emotional experience and life satisfaction, which may explain the deviation from the findings of earlier studies.

4.2The effect of social participation activities on the subjective well-being of older adults with low vision

The analysis of the impact relationship model developed in this study revealed that social participation activities positively predict the subjective well-being of older adults with low vision, aligning with findings from previous studies^{[24, 25]}. Furthermore, the mediation effect model suggests that the social support and the VRQOL mediate the relationship between socially engaged activities and subjective well-being. The theoretical framework regarding the impact of social support on health posits that social support serves as a buffer during stressful events, thereby safeguarding overall health^[26]. Gong et al^[24] examined the potential connection between social support and depression in older adults with visual impairment, demonstrating that positive social support correlates with a reduced risk of depression in this population. Paul et al^[27]investigated older adults with sensory impairments and found that diminished social support was linked to heightened feelings of loneliness among older adults with visual impairment. the stress coping model posits that low vision constitutes a stressful event in the lives of older adults, with visual function-related quality of life being influenced by coping strategies^[28].Research has demonstrated that adaptive coping strategies, such as orientation and mobility training, enhance the independence of older adults with low vision in daily activities, thereby reducing limitations and fostering greater social participation^[29].A survey conducted by Xu et al^[30] on patients with age-related macular degeneration revealed that appropriate support and low-vision rehabilitation significantly improved visual function-related mobility, thereby helping to maintain a satisfactory quality of life.In summary, social support exerts a buffering effect on negative emotions in older adults with low vision. While visual function-related quality of life is a modifiable factor intricately linked to functional abilities for social participation and serves as a crucial determinant of emotional well-being^[28]. The findings of this study indicate that the relationship between social support and visual function-related quality of life significantly influences subjective well-being. This path is consistent with prior research

4.3The effect of feelings of social participation on subjective well-being

The perception of social participation is a subjective experience that reflects the perceived or experienced limitations individuals face in engaging socially^[31]. This perception arises from the dynamic interaction between the individual and their environment^[31]. The biopsychosocial model serves as a theoretical framework to explain these perceptions. Environmental factors in social interactions, such as perceived or experienced public discrimination against low vision, affect the social participation feelings of low vision elderly people, such as social exclusion, marginalization, etc., which will cause low vision elderly people to give up opportunities for social participation^[32],while reduced social participation is associated with increased social isolation and loneliness^[33]. The above research results can explain the negative impact of social participation feelings on the subjective well-being of low-vision elderly people in the results of this study. The results of the path analysis prediction model established in this study show that social support and VRQOL play a partial mediating role between feelings of social participation and subjective well-being. A relevant theoretical model can elucidate the findings of this study, The public's stereotype regarding low vision reflects the social participation pressures experienced by elderly individuals with low vision, where social support can serve a useful buffering role during stressful events^[34]. The limited independence and mobility of elderly individuals with low vision act as barriers to social participation. When they perceive challenges related to their visual function as uncontrollable, they may resort to avoidant coping strategies. Research indicates that negative coping strategies, such as avoidance, hinder the maintenance and enhancement of both independence and mobility, thereby adversely affecting the quality of life associated with visual function^[35]. This, in turn, can lead to an increase in negative emotion^[28].

This study has several limitations. Due to constraints in time, energy, and resources, a convenience sampling method was employed to conduct a cross-sectional survey at only two tertiary hospitals in Chongqing City. Consequently, the sample size was limited, and the findings may not accurately represent the overall population of older adults with low vision in China, thereby affecting the generalizability of the results. Future research should aim to expand the sample size and geographic scope, employing stratified and random sampling techniques to enhance sample representativeness. Furthermore, the current study evaluated subjective well-being using a singular approach, which may introduce self-report bias. Future studies should consider incorporating multiple indicators related to subjective well-being, such as quality of life and depression, to provide a more comprehensive assessment of the subjective well-being of older adults with low vision.

This study revealed that the subjective well-being of older adults with low vision is positioned at a moderately low level. Furthermore, it identified that social support and the quality of life related to visual functioning partially mediate the relationship between socially engaged activities, subjective perceptions of social engagement, and subjective well-being. It is recommended that specialized caregivers and community health care providers prioritize a continuum of care for older adults with low vision. This approach should encompass not only specialized treatment for ophthalmic diseases but also the development of care interventions that promote overall health by optimizing participation. Such interventions may include encouraging older adults with low vision to adopt positive coping strategies, utilize visual assistive technology, and engage in rehabilitative training. By enhancing their sense of control over social participation, it is possible to improve their subjective well-being. Additionally, government and community healthcare organizations should focus on delivering emotional and instrumental support related to social engagement for older individuals with low vision. This support will aid them in maintaining independence through the effective use of their existing visual functions, thus promoting both social participation and subjective well-being, while also offering new insights into the formulation of family care strategies.

Funding:

There is no funding for this research.

Author Contribution

Y L, Z Z,and X L had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Z Z and X L contributed equally to this study. Y L, Z Z and X L contributed to the conception and design of the study. Statistical analysis: Z Z, X L,JY HandYJ L. Draft the original manuscript: Z Z and X L. All authors contributed to the edit of the manuscript.

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No competing interests reported.

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Editorial decision: Revision requested
05 Sep, 2024
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A study of the impact of social participation on the subjective well-being of low-vision older adults in western China in the context of healthy aging

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Abstract

Figures

1. Background

2. Methoods

2.1 Participants and procedure

2.2 Measurements

2.2.1 Sociodemographic characteristics

2.2.2 Memorial University of Newfoundland Scale of Happiness (MUNSH)

2.2.3 Community Participation Index (CPI)

2.2.4 Social Support Rating Scale (SSRS)

2.2.5 National Eye Institute Visual Function Questionnaire (NEI-VFQ-25)

2.3 Data analysis

3. Results

3.1 Subjective well-being of older people with low vision

3.2 Analysis of differences in demographic characteristics of subjective well-being among older adults with low vision

3.4 Correlation analysis of research variables

3.5 Impact of social participation on subjective well-being

3.5.1 Relationship between the effects of social participation activities and subjective well-being

3.5.2 Effect relationship between feelings of social participation and subjective well-being

4. Discussion

4.1Current status of subjective well-being among older adults with low vision

4.2The effect of social participation activities on the subjective well-being of older adults with low vision

4.3The effect of feelings of social participation on subjective well-being

5. Limitations and future research

6. Conclusions

Declarations

Funding:

Author Contribution

References

Additional Declarations

Status:

Version 1