Post-pandemic aging in Taiwan: Social networks, intergenerational relationships, and quality of life

In Taiwan's post-COVID-19 context, universal National Health Insurance (NHI) and broad provider choice may contribute to information asymmetries that influence how older adults seek and navigate care. This cross-sectional study examined the associations among social network support (SNS), intergenerational relationships (IRs), healthcare-seeking behavior attitudes (HSBA), and quality of life (QoL) in community-dwelling older adults in northern Taiwan.

A total of 150 participants (mean age = 73.5 ± 5.9 years) completed a newly developed and validated HSBA scale, a validated SNS instrument culturally adapted for older adults, a culturally adapted and validated IR measure, and a Taiwan-specific QoL measure. Analyses included descriptive statistics, Pearson correlations, prespecified subgroup comparisons, and multivariable linear regression analyses (two-tailed α = .05).

All variables were positively correlated. QoL showed the strongest association with SNS (r = 0.64, p < .001), followed by IRs (r = 0.51) and HSBA (r = 0.29). In the multivariable models, regular exercise independently predicted higher HSBA, SNS, and QoL, whereas stronger IRs were associated with having more grandchildren and receiving daily telephone contact from non-cohabiting children.

Among community-dwelling older adults in northern Taiwan, SNS was the strongest correlate of QoL. The findings support the inclusion of social connectedness, exercise participation, and intergenerational contact in routine gerontological nursing assessment. Because this study used a cross-sectional design, no causal or intervention-related interpretations can be made.