Psychache status and associated contributing factors among the Hakka elderly in Fujian, China

Little is known about the state of psychological distress of the elderly in China, and research on specific subgroups such as Hakka older adults is almost lacking. This study investigates psychache and associated factors among Hakka elderly in Fujian, China.

The data analysed in this study were derived from China's Health-Related Quality of Life Survey for Older Adults 2018. The Chinese version of the Psychache Scale (PAS) was used to assess the frequency and intensity of psychache in Hakka older adults. Generalized linear regression analysis was conducted to identify the main socio-demographic factors associated with psychache overall and its frequency and intensity.

A total of 1,262 older adults participated, with mean scores of 18.27 ± 6.88 for total PAS, 12.50 ± 4.79 for PAS-Frequency and 5.77 ± 2.34 for PAS-Intensity. On average, females scored higher than males on PAS-Frequency (β = 0.84, 95% CI = 0.34, 1.35) and PAS-Intensity (β = 0.48, 95% CI = 0.22, 0.73). Older adults currently living in towns (β = -2.18, 95% CI = -2.81, -1.54), with their spouse only (β = -3.71, 95% CI = -4.77, -2.65), or with children (β = -3.24, 95% CI = -4.26, -2.22) were more likely to score lower on PAS-Frequency. Conversely, older adults who were regular sleepers (β = -1.19, 95% CI =-1.49, -0.88) or lived with their spouse only (β = -1.25, 95% CI = -1.78, -0.72) were more likely to score lower on PAS-Intensity.

Among Hakka elderly, we found a higher frequency and greater intensity of psychache in females, those with poor health status, irregular sleepers, rural residents, solo dwellers, those with below CNY 10,000 in personal savings, and the medically uninsured. The study's findings indicate that policymakers should give more attention to the susceptible population and implement practical interventions to reduce their psychological burden.