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Cho H, Lee H. Latent class analysis of health lifestyle among older adults living alone and associations with life satisfaction and depressive symptoms. J Affect Disord 2024; 361:172-181. [PMID: 38821369 DOI: 10.1016/j.jad.2024.05.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 04/14/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Little is known about the collective patterns of health-related behaviors of older adults living alone. We aimed to identify subgroups of older adults living alone based on their health lifestyle and examine the relationship between these subgroups and sociodemographic characteristics, life satisfaction, and depressive symptoms. METHODS A total of 3137 older adults living alone were sampled from the 2020 National Survey of Older Koreans. Latent class analysis was performed using 11 health-related behaviors: smoking; alcohol consumption; fruit, vegetable, and dairy product consumption; exercise; cultural leisure; social groups; educational activities; health check-ups; and dementia screening. Multinomial logistic and multiple linear regression analyses were performed. RESULTS Three classes were identified: Consistently Healthy (CH), Moderately Healthy but Inactive (MHI), and Unhealthy but Active (UA). Compared to the CH, members of the MHI tend to have no formal education and rarely meet relatives. Members of the UA were more likely to be male and employed. The MHI and UA were more likely to have lower incomes, meet with children less frequently or have no children, and rarely meet friends, neighbors, and acquaintances when compared to the CH. Members of the UA group had the highest risk of reduced life satisfaction and increased depressive symptoms. LIMITATIONS The cross-sectional design precluded causal inferences. CONCLUSION Our study sheds light on the heterogeneity of health lifestyles among older adults living alone and highlights the need for tailored interventions to promote healthy aging in this population.
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Affiliation(s)
- Hyeonmi Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea.
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Hu YL, Junge K, Nguyen A, Hiegel K, Somerville E, Keglovits M, Stark S. Evidence to Improve Physical Activity among Medically Underserved Older adults: A Scoping Review. THE GERONTOLOGIST 2020; 59:e279-e293. [PMID: 29668895 DOI: 10.1093/geront/gny030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Participation in leisure physical activity (PA) and engagement in PA interventions among older adults is influenced by socioeconomic status (SES), race/ethnicity, and environment. However, studies of PA for medically underserved older adults have not yet been systematically evaluated. The objective of this study is to map the nature and extent of research conducted on PA participation, interventions, and components of effective leisure PA programs for medically underserved older adults. RESEARCH DESIGN AND METHODS The five-stage approach was used to conduct this scoping review. We searched PubMed, CINAHL, and Cochrane Library for peer-reviewed studies published between 2006 and 2016. Data extracted from selected studies included study population, study type, purpose of intent, evidence level, barriers to PA participation, and components of PA intervention. RESULTS Three hundred and ninety-two articles were identified, and 60 studies were included in the final data charting. Existing literature showed that most studies remained descriptive in nature, and few intervention studies have achieved a high level of evidence. Among 21 intervention studies, only 4 were explicitly conducted for older adults. Culturally adapted materials, race/ethnicity-specific barriers and facilitators, and form of intervention were important components for intervention programs. DISCUSSION AND IMPLICATIONS Findings indicate that more studies are needed to reduce health disparities related to PA participation for medically underserved older adults. Intervention components such as race/ethnicity-relevant barriers and facilitators and culturally sensitive materials are also needed for PA interventions targeting underserved older adults in order to provide evidence for best practices.
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Affiliation(s)
- Yi-Ling Hu
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kristin Junge
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - An Nguyen
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kelsey Hiegel
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Emily Somerville
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Marian Keglovits
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Susan Stark
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
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Effects of Occupational Health and Safety on Healthy Lifestyle Behaviors of Workers Employed in a Private Company in Turkey. Ann Glob Health 2016; 81:503-11. [PMID: 26709282 DOI: 10.1016/j.aogh.2015.08.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It has been suggested that inappropriate working conditions and unsafe environments at construction sites, longer working hours, and inadequate workplaces adversely affect the health behaviors of workers. OBJECTIVE The aim of this study was to evaluate the effect of occupational health and safety (OHS) practices on healthy lifestyle behaviors of workers employed at a construction site of a private company in Gaziantep, Turkey. METHODS The sampling size of this descriptive study consisted of 400 employees working at the construction site between December 2014 and January 2015. In all, 341 employees still working or participating in the study during the period of this questionnaire study were included in the sampling. Data from the survey were derived from responses to questions regarding sociodemographic characteristics, OHS applications, health state, and working conditions, as well as to the questions in on the Healthy Lifestyle Behaviors Scale (HLBS), under direct surveillance. FINDINGS Male workers with a mean age of 30.61 ± 8.68 years constituted the study population. Of the workers, 41.9% had a primary school education. The majority received professional and OHS training (65.7% and 79.2%, respectively). Although 83.9% reported using personal protective equipment (PPE), only 2.1% said they had experienced an occupational accident. Total mean score of HLBS scale was 116.91 ± 25.62 points. Workers who had positive thoughts about their jobs demonstrated healthy lifestyle behaviors (P = .0001). A positive direct correlation was detected between the training the workers received and the use of PPE (P = .0001). In all, 38.1% of the workers reported experiencing work stress at the time of the study. Mean HLBS scores of those experiencing work stress were lower than the scores for workers not experiencing stress (P < .05). CONCLUSION Receiving OHS and professional training and using of PPE favorably affect healthy lifestyle behaviors.
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Kachan D, Fleming LE, Christ S, Muennig P, Prado G, Tannenbaum SL, Yang X, Caban-Martinez AJ, Lee DJ. Health Status of Older US Workers and Nonworkers, National Health Interview Survey, 1997-2011. Prev Chronic Dis 2015; 12:E162. [PMID: 26402052 PMCID: PMC4584473 DOI: 10.5888/pcd12.150040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Many US workers are increasingly delaying retirement from work, which may be leading to an increase in chronic disease at the workplace. We examined the association of older adults' health status with their employment/occupation and other characteristics. METHODS National Health Interview Survey data from 1997 through 2011 were pooled for adults aged 65 or older (n = 83,338; mean age, 74.6 y). Multivariable logistic regression modeling was used to estimate the association of socioeconomic factors and health behaviors with 4 health status measures: 1) self-rated health (fair/poor vs good/very good/excellent); 2) multimorbidity (≤1 vs ≥2 chronic conditions); 3) multiple functional limitations (≤1 vs ≥2); and 4) Health and Activities Limitation Index (HALex) (below vs above 20th percentile). Analyses were stratified by sex and age (young-old vs old-old) where interactions with occupation were significant. RESULTS Employed older adults had better health outcomes than unemployed older adults. Physically demanding occupations had the lowest risk of poor health outcomes, suggesting a stronger healthy worker effect: service workers were at lowest risk of multiple functional limitations (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71-0.95); and blue-collar workers were at lowest risk of multimorbidity (OR, 0.84; 95% CI, 0.74-0.97) and multiple functional limitation (OR, 0.84; 95% CI, 0.72-0.98). Hispanics were more likely than non-Hispanic whites to report fair/poor health (OR, 1.62; 95% CI, 1.52-1.73) and lowest HALex quintile (OR, 1.21; 95% CI, 1.13-1.30); however, they were less likely to report multimorbidity (OR, 0.78; 95% CI, 0.73-0.83) or multiple functional limitations (OR, 0.82; 95% CI, 0.77-0.88). CONCLUSION A strong association exists between employment and health status in older adults beyond what can be explained by socioeconomic factors (eg, education, income) or health behaviors (eg, smoking). Disability accommodations in the workplace could encourage employment among older adults with limitations.
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Affiliation(s)
- Diana Kachan
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Rm 911, Miami, FL 33136.
| | - Lora E Fleming
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, United Kingdom
| | - Sharon Christ
- Department of Human Development and Family Studies and Statistics, Purdue University, West Lafayette, Indiana
| | - Peter Muennig
- Mailman School of Public Health, Columbia University, New York, New York
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Xuan Yang
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Alberto J Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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Physical activity in older people: a systematic review. BMC Public Health 2013; 13:449. [PMID: 23648225 PMCID: PMC3651278 DOI: 10.1186/1471-2458-13-449] [Citation(s) in RCA: 520] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 04/26/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) in older people is critically important in the prevention of disease, maintenance of independence and improvement of quality of life. Little is known about the physical activity of the older adults or their compliance with current physical activity guidelines. METHODS A systematic literature search of the published literature was conducted. Included were published reports of original research that independently reported: the PA level of non-institutional older adults (aged 60 years and over); and the proportion of older adults in the different samples who met PA recommendations or guidelines. The review was restricted to studies published since 2000 to provide a current picture of older adults' PA levels. RESULTS Fifty three papers were included in the review. The percentage of older adults meeting recommended physical activity ranged from 2.4 - 83.0% across the studies. Definitions of "recommended" physical activity in older adults varied across the studies as did approaches to measurement which posed methodological challenges to data analysis. Older age groups were less likely than the reference group to be regularly active, and women were less likely than men to achieve regular physical activity, especially leisure time physical activity, when measured by both subjective and objective criteria. CONCLUSION The review highlights the need for studies which recruit representative random samples of community based older people and employ validated measurement methods consistently to enable comparison of PA levels over time and between countries.
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Helmkamp JC, Lincoln JE, Sestito J, Wood E, Birdsey J, Kiefer M. Risk factors, health behaviors, and injury among adults employed in the transportation, warehousing, and utilities super sector. Am J Ind Med 2013; 56:556-68. [PMID: 23255331 PMCID: PMC4539136 DOI: 10.1002/ajim.22148] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND The TWU super sector is engaged in the movement of passengers and cargo, warehousing of goods, and the delivery of services. The purpose of this study is to describe employee self-reported personal risk factors, health behaviors and habits, disease and chronic conditions, and employer-reported nonfatal injury experiences of workers in the TWU super sector. METHODS National Health Interview Survey (NHIS) data for 1997-2007, grouped into six morbidity and disability categories and three age groups, were reviewed. Demographic characteristics and prevalence estimates are reported for workers in the TWU super sector and the entire U.S. workforce, and compared with national adult population data from the NHIS. Bureau of Labor Statistics employer-reported TWU injury data from 2003 to 2007 was also reviewed. RESULTS An average of 8.3 million workers were employed annually in the TWU super sector. TWU workers 65 or older reported the highest prevalence of hypertension (49%) across all industry sectors, but the 20% prevalence is notable among middle age workers (25-64). TWU workers had the highest prevalence of obesity (28%), compared to workers in all other industry sectors. Female TWU workers experienced the highest number of lost workdays (6.5) in the past year across all TWU demographic groups. CONCLUSIONS Self-reported high proportions of chronic conditions including hypertension and heart disease combined with elevated levels of being overweight and obese, and lack of physical activity-particularly among TWUs oldest workers-can meaningfully inform wellness strategies and interventions focused on this demographic group. Am. J. Ind. Med. 56:556-568, 2013. © 2012 Wiley Periodicals, Inc.
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Affiliation(s)
- James C Helmkamp
- Western States Office, National Institute for Occupational Safety and Health, Denver Federal Center, PO Box 25226, Denver, CO 80225, USA.
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Tannenbaum SL, Kachan D, Fernandez CA, McClure LA, LeBlanc WG, Arheart KL, Lee DJ. State variations of chronic disease risk factors in older Americans. Prev Chronic Dis 2012; 9:E177. [PMID: 23256910 PMCID: PMC3528304 DOI: 10.5888/pcd9.120143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The objective of this study was to examine and compare 3 key health behaviors associated with chronic disease (ie, risky drinking, smoking, and sedentary lifestyle). We used data from the National Health Interview Survey from 1997 through 2010 to calculate the prevalence of these behaviors among older Americans and rank each state, and we analyzed overall trends in prevalence for each behavior over the 14 years. Older adults residing in Arkansas and Montana had the worst chronic disease risk profile compared with other states. These findings indicate the need for improved or increased targeted interventions in these states.
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Affiliation(s)
- Stacey L Tannenbaum
- University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL 33136, USA.
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Occupational gradients in smoking behavior and exposure to workplace environmental tobacco smoke: the multi-ethnic study of atherosclerosis. J Occup Environ Med 2012; 54:136-45. [PMID: 22261926 DOI: 10.1097/jom.0b013e318244501e] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study examines associations of occupation with smoking status, amount smoked among current and former smokers (number of cigarettes per day and lifetime cigarette consumption (pack-years)), and workplace exposure to environmental tobacco smoke (ETS) independent from income and education. METHODS This is a cross-sectional analysis of data from a community sample (n = 6355, age range: 45-84) using logistic and multinomial regression. All analyses were stratified by sex and adjusted for socio-demographic variables. RESULTS Male blue-collar and sales/office workers had higher odds of having consumed more than 20 pack-years of cigarettes than managers/professionals. For both male and female current or former smokers, exposure to workplace ETS was consistently and strongly associated with heavy smoking and greater pack-years. CONCLUSIONS Blue-collar workplaces are associated with intense smoking and ETS exposure. Smoking must be addressed at both the individual and workplace levels especially in blue-collar workplaces.
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Lee DJ, Fleming LE, LeBlanc WG, Arheart KL, Ferraro KF, Pitt-Catsouphes M, Muntaner C, Fernandez CA, Caban-Martinez AJ, Davila EP, Bandiera FC, Lewis JE, Kachan D. Health status and risk indicator trends of the aging US health care workforce. J Occup Environ Med 2012; 54:497-503. [PMID: 22446575 PMCID: PMC3323772 DOI: 10.1097/jom.0b013e318247a379] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To describe the health status and risk indicator trends in a representative sample of US health care workers aged 45 years and older. METHODS Using pooled data from the 1997 to 2009 National Health Interview Survey, logistic regression analyses were performed to determine whether age-group specific morbidity risks differed within occupational subgroups of the health care workforce (N = 6509). Health and morbidity trends were examined via complex survey adjusted and weighted chi-squared tests. RESULTS Rates of functional limitation and hypertension increased among diagnosing/assessing health care workers. The prevalence of hearing impairment, cancer, and hypertension was two to three times greater in health-diagnosing/assessing workers aged 60 years and older than in younger workers. Health care service workers were up to 19 times more likely to be obese than workers who diagnose/assess health. CONCLUSIONS Healthier workplaces and targeted interventions are needed to optimize the ability to meet health care demands of this aging workforce.
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Affiliation(s)
- David J. Lee
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 St, Room #1530, Miami, FL 33136, Tel: (305) 243-6980
| | - Lora E. Fleming
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1074, Miami, FL 33136, Tel: (305) 243-5912
| | - William G. LeBlanc
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1075, Miami, FL 33136, Tel: (305) 243-3222
| | - Kristopher L. Arheart
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1067, Miami, FL 33136, Tel: (305) 243-3488
| | - Kenneth F. Ferraro
- Center on Aging and the Life Course, Purdue University, 155 S. Grant Street, Young Hall, West Lafayette, IN 47907-2114, Tel: (765) 494-4707
| | - Marcie Pitt-Catsouphes
- Center on Aging & Work/Workplace Flexibility, Boston College, 308 McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, Tel: (617) 552-4033
| | - Carles Muntaner
- Department of Nursing, University of Toronto, 155 College Street, Rm. 386, Toronto ON M5T 1P8 Canada, Tel: (416) 978-5502
| | | | - Alberto J. Caban-Martinez
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1075, Miami, FL 33136, Tel: (305) 243-7565
| | - Evelyn P. Davila
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1073, Miami, FL 33136, Tel: (305) 243-3222
| | - Frank C. Bandiera
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1073, Miami, FL 33136, Tel: (305) 243-3222
| | - John E. Lewis
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1474, Miami, FL 33136, Tel: (305) 243-6227
| | - Diana Kachan
- Department of Epidemiology & Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room #1073, Miami, FL 33136, Tel: (305) 243-3222
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McCollister KE, Arheart KL, Lee DJ, Fleming LE, Davila EP, LeBlanc WG, Christ SL, Caban-Martinez AJ, West JP, Clark JE, Erard MJ. Declining health insurance access among US Hispanic workers: not all jobs are created equal. Am J Ind Med 2010; 53:163-70. [PMID: 19565629 DOI: 10.1002/ajim.20720] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Approximately 18% of the U.S. population are uninsured, a proportion that may continue to rise, particularly among Hispanics, as the cost of medical care increases faster than the growth in wages. METHODS Health insurance trends were analyzed by race-ethnic category, and among Hispanic workers by occupation type and industrial sector, using data on employed respondents > or =18 years from 1997 to 2007 National Health Interview Survey (NHIS) (mean annual n = 17,392, representing 123 million US workers on average over this 11 year period). RESULTS From 1997 to 2007, the relative decline in health insurance coverage for US workers was greatest among Hispanics (7.0%). Hispanic workers in the Construction and Services industries had the greatest overall decline in coverage (24.9% and 14.7%), as well as Hispanic blue collar workers (14.0%). CONCLUSION Hispanic workers in general, and those employed in blue collar, construction, and services sectors in particular, are at greater risk for poor access to health care due to a lack of health insurance coverage.
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Affiliation(s)
- Kathryn E McCollister
- Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer, Miami, Florida 33136, USA.
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Munir F, Khan HTA, Yarker J, Haslam C, Long H, Bains M, Kalawsky K. Self-management of health-behaviors among older and younger workers with chronic illness. PATIENT EDUCATION AND COUNSELING 2009; 77:109-115. [PMID: 19356885 DOI: 10.1016/j.pec.2009.02.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2008] [Revised: 01/15/2009] [Accepted: 02/21/2009] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To examine the self-management of health behaviors carried out by older (aged 50-69 years) and younger workers (aged 20-49 years) with a chronic illness. METHODS Questionnaire data was collected from 759 employees with a diagnosed chronic illness. Four categories of self-managing health behaviors were examined: using prescribed medication, monitoring and responding to symptoms, managing an appropriate diet and exercising. RESULTS The majority of participants (56-97%) reported being advised to carry out health behaviors at home and at work. Controlling for confounding factors, medication use was associated with younger and older workers. Managing an appropriate diet was associated with younger workers with asthma, musculoskeletal pain or diabetes. Exercising was associated with younger workers with asthma and with older workers with heart disease, arthritis and rheumatism or diabetes. CONCLUSIONS The findings indicate that there are differences in diet and exercise activities among younger and older workers. PRACTICE IMPLICATIONS To increase self-management in health behaviors at work, improved communication and understanding between the different health professions and the patient/employee is required so that different tailored approaches can be effectively targeted both by age and within the context of the working environment, to those managing asthma, heart disease, diabetes and arthritis and rheumatism.
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Affiliation(s)
- Fehmidah Munir
- Department of Human Sciences, Brockington Building, Loughborough University, Leicestershire, UK.
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