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.