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Evolutionary theory predicts that returns on investments in family relations will vary by sex and life stage and that there can be a trade-off between mating and (grand)parenting. Family sociology has shown that whereas couple relations are central to happiness in older age, the effects of grandparenting are more mixed and context dependent. Here, we merge these two perspectives and study how partnership histories over the life course relate to happiness among Europeans aged 50+ and whether grandparental investment moderates these associations. Of particular interest is whether there are signs of trade-offs, cumulative benefits, or compensatory benefits between the type of couple relations and grandparenting in postreproductive age.We employed the Survey of Health, Ageing and Retirement in Europe with data from 26 European countries and Israel for the years 2004–2020. The analyses distinguish between respondents who are in their first, second, or third union through marriage or cohabitation; are divorced; are widowed; are living apart from a partner; or are single. We investigated how quality of life and life satisfaction are associated with these seven types of partnership histories and whether the associations are moderated by grandparental status and provision of grandchild care.Europeans with a partner, and especially those in their first union, were happier than those in other partnership groups, and grandparents were happier than individuals without grandchildren. Grandparental investment was associated with being happier in most partnership groups. The “grandparenting bonus” was greatest among unpartnered respondents, suggesting a compensatory effect. We found no signs of a cumulative effect, nor of costs to happiness from grandchild care.Our results illustrate how reproductive strategies over the life course shape happiness returns to grandparenting. Being a grandparent and, especially, providing care for grandchildren may compensate for the lower happiness associated with the loss or lack of a partner.
Evolutionary theory predicts that returns on investments in family relations will vary by sex and life stage and that there can be a trade-off between mating and (grand)parenting. Family sociology has shown that whereas couple relations are central to happiness in older age, the effects of grandparenting are more mixed and context dependent. Here, we merge these two perspectives and study how partnership histories over the life course relate to happiness among Europeans aged 50+ and whether grandparental investment moderates these associations. Of particular interest is whether there are signs of trade-offs, cumulative benefits, or compensatory benefits between the type of couple relations and grandparenting in postreproductive age.We employed the Survey of Health, Ageing and Retirement in Europe with data from 26 European countries and Israel for the years 2004–2020. The analyses distinguish between respondents who are in their first, second, or third union through marriage or cohabitation; are divorced; are widowed; are living apart from a partner; or are single. We investigated how quality of life and life satisfaction are associated with these seven types of partnership histories and whether the associations are moderated by grandparental status and provision of grandchild care.Europeans with a partner, and especially those in their first union, were happier than those in other partnership groups, and grandparents were happier than individuals without grandchildren. Grandparental investment was associated with being happier in most partnership groups. The “grandparenting bonus” was greatest among unpartnered respondents, suggesting a compensatory effect. We found no signs of a cumulative effect, nor of costs to happiness from grandchild care.Our results illustrate how reproductive strategies over the life course shape happiness returns to grandparenting. Being a grandparent and, especially, providing care for grandchildren may compensate for the lower happiness associated with the loss or lack of a partner.
Patient satisfaction is crucial for evaluating healthcare quality and guiding continuous quality improvement. Globally, patient satisfaction has been extensively studied; however, there is limited research on this topic in Bhutan, where the healthcare system is in the early stages of developing a quality-oriented culture. To address this gap, we aimed to evaluate patient satisfaction levels among different socio-demographic and clinical groups and identify the predictors of patient satisfaction in Bhutan. We retrospectively analysed archived patient satisfaction data from two tertiary healthcare centres in Bhutan: Mongar Eastern Regional Referral Hospital and Gelephu Central Regional Referral Hospital. The routine survey was conducted throughout April 2024 using a modified version of the Patient Satisfaction Questionnaire 18. The data were analysed using descriptive statistics, one-way ANOVA, and binary logistic regression. Our study revealed significant variations in patient satisfaction across socio-demographic and clinical groups. Ethnicity, occupation, and education level emerged as significant predictors of satisfaction. Sharchop and other ethnic groups; farmers, religious personnel, and other occupational groups; and illiterate individuals exhibited significantly higher satisfaction levels. While patient type, age, and marital status influenced satisfaction levels, they did not emerge as significant predictors when considering other variables. Overall, patient satisfaction in Bhutan was high, particularly in the financial domain; however, accessibility and convenience scored the lowest. Our findings underscore the importance of addressing socio-demographic disparities in patient satisfaction. With anticipated changes in the socio-demographic characteristics of the Bhutanese population, satisfaction levels may decline. Therefore, healthcare policy and decision-makers should implement targeted interventions to address these shifts. To enhance overall satisfaction, healthcare policymakers should focus on improving accessibility and convenience. Strategies such as establishing dynamic limits on free services, exploring private sector engagement in high-end services, and strengthening the healthcare workforce are essential for sustainable and quality healthcare service delivery.
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