SELF-EFFICACY, RESSILIENCE, ATTACHMENT STYLES AND SOCIAL-MENTAL WELL BEING AMONG THE ELDERLY IN RIVERS STATE

SELF-EFFICACY, RESSILIENCE, ATTACHMENT STYLES AND SOCIAL-MENTAL WELL BEING AMONG THE ELDERLY IN RIVERS STATE

SELF-EFFICACY, RESSILIENCE, ATTACHMENT STYLES AND SOCIAL-MENTAL WELL BEING AMONG THE ELDERLY IN RIVERS STATE

 

BY

 

AMADI, PRISCILLIA C.

 DEPARTMENT OF EDUCATIONAL PSYCHOLOGY, GUIDANCE AND COUNSELLING, UNIVERSITY OF PORT HARCOURT, RIVERS STATE, NIGERIA

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&

 

PROF. BETTY-RUTH N. IRULOH

DEPARTMENT OF EDUCATIONAL PSYCHOLOGY,  GUIDANCE AND COUNSELLING, UNIVERSITY OF PORT HARCOURT, RIVERS STATE, NIGERIA

 

&

 

PROF. I . R. ERNEST-EHIBUDU

DEPARTMENT OF EDUCATIONAL PSYCHOLOGY, GUIDANCE AND COUNSELLING, UNIVERSITY OF PORT HARCOURT, RIVERS STATE, NIGERIA

 

Abstract

 

This study focused on self-efficacy, resilience, attachment styles and social-mental well-being among the elderly in Rivers state. Three specific objectives, research questions and hypotheses guided the study. Correlational research design was used. An age range of 60 years and above estimated at 250, 000 made up the population of study. Six hundred (600) respondents were drawn using multi-stage sampling procedure. Two instruments used were Determinant of Socio-mental Wellbeing Questionnaire (DOSWQ) and “Elderly Socio-Mental Wellness Scale” (ESWS). Validity was done by experts while Cronbach Alpha was used to determine a reliability index ranging from 0.69-0.85 for DOSWQ and 0.83 for ESWS. Simple regression was used to analyze the data. Result showed that resilience, (P =0.000 < 0.05) and attachment styles (P = 0.000 < 0.05) all had significant relationship with social-mental wellbeing among adolescents. On the other hand, self-efficacy (P 0.136 > 0.05) was insignificantly related to socio-mental wellbeing. Recommendation among others was that relatives of the elderly should keep constant checks on the aged. The study contributed to knowledge in that wellness of elderly is dependent on certain factors.

 

Keywords: Self-efficacy, Resilience, Attachment styles, social-mental well-being, Elderly

Introduction

As the world is advancing in science and technology, there is an attendant improvement in the provision of health care with corresponding increase in the life expectancy of individuals. With these achievements in the health delivery system, the population of the elderly is increasing and as such, the interaction between them and others are inevitable. Furthermore, it is noted that the place given to the elderly or aged in the African tradition and culture has been one of great value, respect and of high esteem. This of course is not unconnected with the role the elderly plays in the life of the people in a typical African society. Seefeldt, Richard, Jantz and Kathy (2015) stated that aging is a part of living, as natural as life itself, yet most people tend to view aging and the elderly in negative, stereotypic ways.

 

In contemporary times, it is the expectation of any society or nation that as years go by, and with the emergence of technology, development and modernization, things should improve generally, be it in the health sector, education sector, welfare, standard of living, technology etc. As the population of the elderly increases with these variations in technological advancement, the well-being of the elderly is threatened. Obviously, the elderly are part of a segment of the population with limited opportunities whose dependence on the society is a fundamental characteristic that is embedded with their age. From the geriatric studies, the classification of the elderly includes young-old, middle-old and very old. For some, they could as well be addressed as young-old, old and old-old. It is the age bracket that determines in which of these groupings the elderly belongs (Kinanee, 2020). According to Cress (2010), the increase in the elderly population is the result of several factors. Amongst the main factors, we can point the determinants social, economic, personal, behavioral, environmental, cultural, etc.

Again, Okonye and Obikeze (2005), Ajayi (2015) confirms these when they posited that stereotypes generally influences the perception, attitudes and behaviours of people towards members of another group. On this note as reported by Sun Newspaper (2018), this may account for the setting fire on some old men and women in Akwa Ibom State of Nigeria by some young people including undergraduate students who tagged them witches and wizards that has tied down their progress. The W.H.O (2015) report from the Coordinator of Ageing and Life Course Miss Alana Officer asserts that discrimination against the elderly can take various forms; these include portraying the elderly as frail, dependent, wicked etc. by the media or through discriminatory practices and attitudes. Unfortunately, all these and many have a serious effect on the social and mental well-being of the elderly.

Mental wellbeing which will be interchangeably referred to as psychological wellbeing is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. Mental wellbeing includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make psychological choices. Mental wellbeing is important at every stage of life, from childhood and adolescence through adulthood. Research suggests that seniors benefit from supportive social connections and close personal relationships but suffer as a result of disrupted personal ties and loneliness.

Sachs-Ericsson et al. (2014) observed that in old age, people experience profound changes and face important challenges, including modifications in their roles, retirement, and the death of loved ones (friends and family members). These experiences can increase their levels of stress and lead to a decrease in the resources that individuals feel they have in dealing with their daily lives. However, social and mental wellbeing among the elderly could be influenced by a number of factors. Some could be social while others could be psychological.

Self-efficacy refers to an individual's belief in his or her capacity to execute behaviors necessary to produce specific performance attainments (Bandura, 1997). Self-efficacy reflects confidence in the ability to exert control over one's own motivation, behavior, and social environment. These cognitive self-evaluations influence all manner of human experience, including the goals for which people strive, the amount of energy expended toward goal achievement, and likelihood of attaining particular levels of behavioral performance. Unlike traditional psychological constructs, self-efficacy beliefs are hypothesized to vary depending on the domain of functioning and circumstances surrounding the occurrence of behavior. From this definition of self-efficacy, it may not be out of place to state that the belief of the elderly concerning what they can do and what they cannot may be a factor in determining their social and mental wellbeing. It could be that while some elderly may have a good social and mental adjustment as a result of a positive self-efficacy, some on the other hand may have a bad adjustments pattern as a result of poor self-efficacy. Sabouripour, Roslan,Ghiami and Memon (2021) carried out a study on the mediating Role of Self-Efficacy in the Relationship Between Optimism, Psychological Well-Being, and Resilience Among Iranian Students. The study findings presented that self-efficacy mediated the relationship between dimensions of psychological well-being (environmental mastery, autonomy, self-acceptance, positive relations with others, personal growth, and purpose in life) and resilience among Iranian students of UPM. Furthermore, self-efficacy was not observed to mediate the influence of optimism on resilience among Iranian students of UPM. The study’s findings help to understand the interrelationship between self-efficacy, various dimensions of psychological well-being, and resilience. Consequently, counselors, psychologists, and instructors can develop and plan valuable strategies to enhance students’ psychological factors. Similarly Grembowski,  Patrick, Diehr, Durham, Beresford, Kay, and Hecht(1993) Self-efficacy and health behavior among older adults. Results reveal that efficacy and outcome expectations for these health behaviors are not independent.

Resilience is the process of adapting well in the face of difficulties, adversity, trauma, tragedy, threats, or significant sources of stress such as family and relationship problems, serious health problems, or workplace and financial stressors. It is the result of successful adaptation to adversity. It is revealed by an individual’s ability to cope and recover from crises, sustain a sense of purpose and vitality, and emerge stronger from stressful experiences. Resilience is a dynamic characteristic that may shift according to the circumstance. Indeed, it can be manifest in many forms: as an outcome of physical or mental recovery from a traumatic event; as a trait that describes an individual’s enduring ability to cope; or as a process of recovering from a stressful event and moving forward. No matter how resilience is viewed, the resources that lead to resilience can result in positive outcomes. Resilience in older age is the ability to stand up to adversity and to 'bounce back' or return to a state of equilibrium following individual adverse episodes. For continuing adversity it may be a matter of having the ability, or learning how, to cope with or manage that adversity in the longer term. Resilience may be a latent characteristic in some individuals but will only manifest itself when they experience adversity. For older people that adversity may have been life-long, in the case for example of a disability, may be a single life event for example the bereavement of a close friend, spouse or other family member or may be a long term adversity experienced in later life for example the development of a chronic illness. In this light, it is also the suspicion of the researcher that resilience level among the elderly could determine their social and mental adjustments. Gerino, Rollè, Sechi and Brustia (2017) studied Loneliness, Resilience, Mental Health, and Quality of Life in Old Age: A Structural Equation Model. Result showed that the best model we obtained supports the mediation effect of both resilience and mental health between loneliness and mental and physical QoL. These results highlight that loneliness influences mental and physical QoL via two pathways, with the impact of loneliness mediated by mental health and resilience dimensions.

 

Sharif, Amiri and Allen, et al. (2021) noted that attachment and support from family and friends are core to the experiences of ageing for older adults. Attachment is a special emotional relationship that involves an exchange of comfort, care, and pleasure. According to Susman (2020), attachment styles are characterized by different ways of interacting and behaving in relationships. During early childhood, these attachment styles are centered on how children and parents interact. In adulthood, attachment styles are used to describe patterns of attachment in romantic relationships. The concept of attachment styles grew out from the attachment theory and research that emerged throughout the 1960s and 1970s. Today, psychologists typically recognize four main attachment styles. As people age, they face challenges that they may never have experienced before. Loss of friends due to death, loss of independence as a result of diminished income, and loss of physical health can all create significant stress in a person’s life. The way that people choose to cope with that stress is directly related to the skills they learned throughout their lives. Attachment styles developed in early childhood can dictate the response people have to a variety of stressors, including ones encountered in later years. Additionally, an individual’s ethnic origin influences how he or she will respond to stress at various stages. Hope is defined as the ability to see a desirable outcome as a genuine possibility (Kwong 2019). Adults in older age groups tend to be less hopeful and satisfied with their lives compared to younger individuals (Bailey, 2007). McGill (1993) indicated that when physical health status diminished in older age, feelings of hope also diminish.

The social-mental wellbeing of the elderly has been a serious concern to the society especially the children of the elderly. These issues have been of serious concern to the society that in some western countries, there is a special home built for the elderly care. In Nigeria on the contrary, the social and mental wellbeing of the elderly seemed to be rested solely on their shoulders. This is because the children of the elderly may only afford to provide for the physical welfare of their parents while they remain isolated, and in few cases left in the mercy of a single caregiver who hardly understand their social and mental needs. The elderly hardly go on family trips or vacations and this lack of social exposure in most cases do affect their wellbeing. Some of them do die before time while some develop serious health challenges as a result of loneliness, ageism and depression. In all these social slack, hardly have studies identified causes and possible solutions to these problems. Hence, to the best of the researchers knowledge, the gap created by lack of studies in this area creates the problem of the present study. Therefore, the gap which the present study intended to fill was to answer the question; are psychological construct related to social- mental wellbeing of the elderly in Rivers state?

Aim and Objectives of the study

The aim of the study generally is to investigate psychological construct and social-mental wellbeing of the elderly. Specifically, the study is designed to achieve the following.

1. Determine if self-efficacy relates with social-mental wellbeing of the elderly in Rivers State.
2. Verify if resilience has a relationship with social-mental wellbeing of the elderly in Rivers State.
3. Determine if attachment style of the elderly relates with social-mental wellbeing of the elderly in Rivers State.

 

Research Questions

The following research questions guided the researcher in the study.

1. To what extent does self-efficacy relate with social-mental wellbeing among the elderly in Rivers State?
2. To what extent does resilience relate with social-mental wellbeing among the elderly in Rivers State?
3. What is the extent to which attachment styles relate with social-mental wellbeing among the elderly in Rivers State?

 

Hypotheses

The following hypotheses were formulated to guide the study;

1. Self-efficacy has no significant relationship with social-mental wellbeing among the elderly in Rivers State.
2. There is no significant relationship between resilience and social-mental wellbeing among the elderly in Rivers State.
3. There is no significant relationship between attachment styles and social-mental wellbeing among the elderly in Rivers State.

 

Methodology

The study adopted the Correlational research design. Kpolovie (2010) stated that correlational design allows the researcher to ascertain the direction and magnitude of the relation that exist between two or more variables. The population of the study consisted of elderly people who are above 60 years and who can read and respond to the instrument of the study. This population was drawn from selected organizations like churches, religious places, hospitals and institutions of higher learning, home for the elderly etc in Rivers State. As at the time of the study, due to the infinite nature of population, Nwankwo (2016) maintained that where the population is infinite, a researcher can have an estimated population. Since the projected population of Rivers State (2016) is 7, 303, 900, the researcher thereby estimated the population of the elderly persons above 60 years of age who can read and write to be 250, 000. A sample of 600 respondents was used for the study. The researcher relied on multi-stage sampling procedure in the process of drawing these respondents. First, there are 23 LGA in the entire Rivers State. The researcher used the simple random sampling procedure to draw five LGAs by writing all the names of the LGAs in piece of paper and folding them. From here the researcher handpicked five which revealed the names of the five LGAs to be used. Secondly, the researcher used purposive restrict sampling to only urban areas in these LGAs. The researcher used two instruments for the study. These included the “Determinants of Socio-Mental Wellbeing Questionnaire” (DOSWQ), and the “Elderly Socio-Mental Wellness Scale” (ESWS). While the DOSWQ is self-developed questionnaire designed using the SA-SD options of the 5-point Likert Scale design. The instrument for the study passed through face and content validity. The reliability of both instruments was determined using Cronbach Alpha method with reliability indices being 0.71, 0.82 and 0.69 respectively for self-efficacy, resilience, attachment style. Also, the “Elderly Socio-Mental Wellness Scale” (ESWS) had a reliability index of 0.83. These coefficient indices showed that the instruments were highly reliable. Simple regression was used to analyze the data generated.

Results

Research Question One: To what extent does self-efficacy relate with social-mental wellbeing among the elderly in Rivers State?

Hypothesis One: Self-efficacy has no significant relationship with social-mental wellbeing among the elderly in Rivers State.

Table 1:          Simple Liner regression showing relationship between self-efficacy and social-mental wellbeing among the elderly in Rivers State.

 

R			R Sq.	Adjusted R Sq.		Unstand. B
.061			.004	.002		0.28
Model		Sum of Sq.	Df	Mean Sq.	Alpha	F	Sig.	Result
1	Regression	362.072	1	362.072	0.05	2.224	.136b	Insignificant
	Residual	97357.261	598	162.805
	Total	97719.333	599

 

Table 1 showed that self-efficacy has a relationship of 0.061 with social-mental wellbeing among the elderly in Rivers state. Calculated R² is 0.004, adjusted R² was 0.002 while unstandardized B value is 0.28. From the R² value, it is an indication that Self-efficacy account for about 0.4% (0.004 × 100) of social-mental wellbeing among the elderly in Rivers state. The unstandardized B value also indicates that as the value of self-efficacy increases or decreased by one unit, there will be a corresponding increase or decrease of 0.28 unit in their level of social-mental wellbeing. The calculated F was 2.224 while Sig. value was 0.136. Hence, since sig (p=0.136>0.05) is greater than 0.05, the null hypotheses was retained meaning that there is an insignificant relationship between self-efficacy and social-mental wellbeing elderly in Rivers State.

Research Question Two: To what extent does resilience relate with social-mental wellbeing among the elderly in Rivers State?

Hypothesis Two: Resilience has no significant relationship with social-mental wellbeing among the elderly in Rivers State.

Table 2:          Simple Liner regression showing relationship between resilience and social-mental wellbeing among the elderly in Rivers State.

 

R			R Sq	Adjusted R Sq.		UnStd. B
.262			.068	.067		1.07
Model		Sum of Sq	Df	Mean Sq.	Alpha	F	Sig.	Result
1	Regression	6687.749	1	6687.749	0.05	43.93	. 000	Significant
	Residual	91031.584	598	152.227
	Total	97719.333	599

 

Table 2 shows that resilience has a relationship of 0.262 with social-mental wellbeing among the elderly in Rivers state. The calculated R² is 0.068, adjusted R² was 0.067 while unstandardized B value is 1.07. From the R² value, it is an indication that resilience account for about 6.8% (0.068 × 100) of social-mental wellbeing among the elderly in Rivers state. The unstandardized B value also indicates that as the value of resilience increases or decreased by one unit, there will be a corresponding increase or decrease of 1.07 units in their level of social-mental wellbeing. Calculated F was 43.93 while Sig. value was 0.000. Hence, since sig (p=0.000<0.05) is less than 0.05, the null hypotheses was rejected meaning that there is a significant relationship between resilience and social-mental wellbeing elderly in Rivers State.

Research Question Three: What is the extent to which attachment styles relate with social-mental wellbeing among the elderly in Rivers State?

Hypothesis Three: There is no significant relationship between attachment styles and social-mental wellbeing among the elderly in Rivers State.

Table 4.3:       Simple Liner regression showing relationship between attachment styles and social-mental wellbeing among the elderly in Rivers State.

R			R Square	Adjusted R Sq.		Unstand. B
.150			.022	.021		0.66
Model		Sum of Sq	Df	Mean Sq.	Alpha	F	Sig.	Result
1	Regression	2197.347	1	2197.347	0.05	13.756	.000b	Significant
	Residual	95521.986	598	159.736
	Total	97719.333	599

 

From table 3, it is shown that attachment style has a relationship of 0.150 with social-mental wellbeing among the elderly in Rivers state. The calculated R² value is 0.022, adjusted R² was 0.021 while unstandardized B value is 0.66. The R² value is an indication that attachment styles account for about 2.2% (0.022 × 100) of social-mental wellbeing among the elderly in Rivers state. The unstandardized B value also indicates that as the value of attachment styles increases or decreased by one unit, there will be a corresponding increase or decrease of 0.66 units in their level of social-mental wellbeing. Calculated F was 13.75 while Sig. value was 0.000. Hence, since sig (p=0.000<0.05) is less than 0.05, the null hypotheses was rejected meaning that there is a significant relationship between attachment style and social-mental wellbeing elderly in Rivers state.

Discussion of Findings

From research findings one, it is revealed that there is an insignificant relationship between self-efficacy and social-mental wellbeing of the elderly in Rivers State. This finding means that the mental perception of an individual concerning his capabilities do not relate in any way with the way and manner they cope socially and mentally.  In other words, the mental picture of what an individual thinks he can do does not relate in any way regarding his social or mental well-being. The finding also implies that the believe of an individual concerning what they can do will not necessarily predict how well such individual will be socially and mentally. In another sense it also implies that even if individuals may have a very high or positive mental picture of themselves, even if they may see themselves as being capable of dealing with all situations that may arise, this will not in any way mean that naturally they will have some level of social and mental satisfaction or well-being. The findings of the study may come because the social and mental well-being of an individual is totally dependent on the psychological process that goes on within such individuals and not on what an individual may think he or she can do. The finding may also come because majority of the respondents are aware that having a mere mental picture of what they can do does not really implies that they have social and mental satisfaction. The finding of the study is a little bit surprising to the researcher. It is surprising in the sense that both self-efficacy and social and mental well-being has to do with perception of what an individuals can or cannot do. Another word to the belief of the researcher it was certain that what I mean we don't perceive that he can do will give him some sense of confidence some sense of social ability as well as mental ability or mental satisfaction. The finding of the study is also surprising to the researcher because as an educationist student who always have high perception of the abilities do normally have hey hi or positive self-image which is good for their well-being. The finding of the study however is in disagreement with that reported earlier why Abang (2021) who in their findings they reported result indicating that self-efficacy is positively related we emotional social and mental well-being individuals.

From research finding two, it is indicated that resilience is significantly related to the Social and mental well-being of the elderly in Rivers State. The finding of the study means that the ability of an individual to persist or to show some level of grit in whatever they do will certainly give such individual some social and mental satisfaction. The finding of the study also implies that individuals who are socially and mentally balance certainly have the ability to be consistent and persistent in achieving their set goals. The finding of the study may come because majority of individuals who responded to the item are aware that resilience and persistence do boost the confidence and mental image of individuals. In this regard, it therefore means that the finding of the study is expected by the researcher because to the best of her knowledge, individuals who are psychological and emotional balance also have the ability to persist in the tasks that they do. In other words, if individuals are not psychologically and emotionally balanced, they may seem distracted and will not have the temerity to persist in any tasks that they do. The findings of the study is also in line with that reported by Jerry (2017), Costa (2017) and Kim (2021) who all reportedly that residence is significantly related to the social and mental well-being of individuals.

From research findings three, it is revealed that attachment styles have a significant relationship with social and mental well-being of the elderly. It is noteworthy to refresh our mind that attachment styles are the various ways in which parents are attached to their children or loved once. In other words, the finding of the study notifies that the kind of attachment styles that parent adopt with regards to their children training will certainly determine if they will be socially and mentally balanced. For instance, it should be noted that if parents are not securely attached to their children, they may develop some psychological imbalance which in turn will affect their social and mental well-being. Studies have revealed over the years that parents who have strong inclination to their children have some psychological and social satisfaction which keep them going in compare to those that do not have no children who may be psychological and socially detached from people. The finding of the study is also not surprising to the researcher in any sense. This is because to the best of her knowledge, she is aware that parent who have children who are caring and who are also in good terms with them do have a good social relationship and a good mental well-being. The finding of the study is also in line with that reported by Chetah (2021), Platin (2006), as well as Uzor (2017). They all reported findings stating that the attachment styles of parent is significantly and positively related with social and psychological well-being of the elderly.

Recommendations

Based on the findings of the study, the following recommendations are made;

1. Since there is a relationship between self-efficacy and social-mental wellbeing of elderly, it is recommended that counsellors and relatives should work to improve the self-efficacy of the elderly. Also, it is recommended that the children or relatives of the elderly should keep constant check on the elderly especially those with low self-esteem.
2. Equally, since there was found a significant relationship between resilience and social-mental wellbeing elderly, it is recommended that counsellors and relatives should work to improve the resilience level of the elderly. For elderly with less resilience, it is recommended that they should be helped.
3. Since there is a significant relationship between attachment style and social-mental wellbeing of the elderly, it is recommended that individuals right from the youthful age should be mind the of attachment style they adopt taking into consideration the behaviours of their children of wards. This means that they should be too securely attached to children who does not care or mind their wellbeing as this may hurt them the more.

Conclusion

Old age is one of the stages in human lives that requires greater care and attention. During this stage, the social and mental wellbeing of the elderly is very important. A lot of factors also account for the social or mental state of the elderly. These factors include resilience, attachment styles and feeling of ageism. In all of this while the elderly are expected to develop a strong mental and social wellbeing, a good identification of the limitations to these wellbeing should be upheld by them.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Freeman.

Gerino, E., Rollè, L., Sechi, C & Brustia, P.  (2017). Loneliness, resilience, mental health, and quality of life in old age: A Structural Equation Model.

 

Grembowski, D., Patrick, D., Diehr, P., Durham, M., Beresford, S., Kay, E., & Hecht, J. (1993). Self-efficacy and health behavior among older adults. Journal of Health and Social Behavior, 34(2), 89–104. https://doi.org/10.2307/2137237

 

Kinanee, J. B. (2020). Emotional profile of pandemic survivors and their psychological management. In D. I. Denga, H. M. Denga, & F. Undiyaundeye (Eds.), Counselling: The psychological oxygen for mental health management of COVID-19 victims (pp. 186-214). Calabar: Rapid Educational Publishers Limited.

 

Kinanee, J.B. (2020). Understanding ageing: Psychological and health perspectives. Port Harcourt. Emmanest Global Ventures.

 

Okoye, U &. Obikeze, D. S. (2005). Stereotypes and perceptions of the elderly by the youth in Nigeria: Implications for social policy. Journal of Applied Gerontology 24(5):439-452 DOI:10.1177/0733464805278648.

 

Sabouripour, F., Roslan, S., Ghiami, Z & Memon, N., A. (2021). Mediating role of self-efficacy in the relationship between optimism, psychological well-being, and resilience among iranian students. Front. Psychol., 14 June Clinical Trial

 

Sachs-Ericsson, N., Kendall-Tacket, K. A., Sheffler, J., Arce, D., Rushing, N. C., and Cosentino, E. (2014). The influence of prior rape on the psychological and physical health functioning of older adults. Aging Mental Health 18, 717–730. doi: 10.1080/13607863.2014.884538.

 

Seefeldt C., Galper, A., Kathy S.  Jantz, R. K. (2013). The coming of age in children's Literature. https://doi.org/10.1080/00094056.1978.10728379.

 

Sharif, P., & Amiri, S., Allen, M. et al. (2021).  Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults.  Health Qual Life Outcomes 19, (5) 7

 

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