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Horgan S, Prorok J, Ellis K, Mullaly L, Cassidy KL, Seitz D, Checkland C. Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:664. [PMID: 38928911 PMCID: PMC11203904 DOI: 10.3390/ijerph21060664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024]
Abstract
This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.
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Affiliation(s)
- Salinda Horgan
- Departments of Rehabilitation Therapy & Psychiatry, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Jeanette Prorok
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Katie Ellis
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Laura Mullaly
- Mental Health Commission of Canada, Ottawa, ON K1R 1A4, Canada; (K.E.); (L.M.)
| | - Keri-Leigh Cassidy
- Department of Psychiatry, Dalhousie University, Dalhousie, NS B3H 2E2, Canada;
| | - Dallas Seitz
- Departments of Psychiatry & Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Claire Checkland
- Canadian Coalition for Seniors’ Mental Health, Markham, ON L3R 9X9, Canada;
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Fry JM, Antoniades J, Temple JB, Osborne RH, Cheng C, Hwang K, Brijnath B. Health literacy and older adults: Findings from a national population-based survey. Health Promot J Austr 2024; 35:487-503. [PMID: 37452578 DOI: 10.1002/hpja.779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/01/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
ISSUE ADDRESSED With an ageing population and growing complexity and fragmentation of health care systems, health literacy is increasingly important in managing health. This study investigated health literacy strengths and challenges reported by older Australians (people aged 65 or over) and identified how socio-demographic and health factors related to their health literacy profiles. METHODS The sample comprised 1578 individuals responding to the Australian Government's 2018 Health Literacy Survey, conducted between January and August. Regression modelling was used to estimate the association between each of nine domains of the Health Literacy Questionnaire (HLQ) and individual socio-demographic and health characteristics. The model allowed for correlation between HLQ scores that was linked to unobserved characteristics of individuals. RESULTS Across the health literacy domains, few individuals received mean scores in the lowest score range. Key individual characteristics associated with higher health literacy were increasing age, English proficiency, higher education levels, better self-assessed health and having certain chronic conditions (cancer, hypertension and arthritis). CONCLUSIONS Our findings suggest that, among those aged 65 or over, being older or living with chronic illnesses were associated with greater confidence in engaging with providers, accessing information and navigating health services compared to individuals aged 65-69 and those older individuals without chronic illness. Lower health literacy was associated with psychological distress and low English proficiency. SO WHAT?: Interventions to improve individual health literacy and organisation health literacy responsiveness to minimise complexity of the Australian health system are required. This may enhance uptake and use of health information and services for the underserviced members of the community.
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Affiliation(s)
- Jane M Fry
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jo Antoniades
- National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
| | - Jeromey B Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Richard H Osborne
- Centre of Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Christina Cheng
- Centre of Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Kerry Hwang
- National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
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Callen EF, Clay T, Alai J, Goodman DW, Adler LA, Faraone SV. The Role of Age in Adult ADHD Quality Care: A Longitudinal Analysis of Electronic Health Record Data. J Atten Disord 2024; 28:913-922. [PMID: 38156704 DOI: 10.1177/10870547231218042] [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] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Several studies have shown that Adult ADHD presents differently in younger and older adults. We sought to assess the difference in care between these two groups using previously identified quality measures (QMs). METHODS Using electronic health record data, we matched a younger group of ADHD patients to an older group. We then assessed the achievement of the QMs using probit models with and without interaction terms. RESULTS The majority of QMs shown an increase in achievement for both groups over time. However, significant differences in quality of care between younger and older adult ADHD patients persisted. By the end of the study period, with the exception of three QMs, younger patients achieved the QMs more. CONCLUSION While, in general, the quality of care for adult ADHD increased from 2010 to 2020, there were still differences in care between younger and older adult ADHD patients.
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Affiliation(s)
- Elisabeth F Callen
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - Tarin Clay
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - Jillian Alai
- American Academy of Family Physicians, Leawood, KS, USA
- DARTNet Institute, Aurora, CO, USA
| | - David W Goodman
- Johns Hopkins School of Medicine, Baltimore, MD, USA
- SUNY Upstate Medical University, Syracuse, USA
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Dumble J, Sadler P, Cottrell T, Planinic A, Perin S, Harrison C, Moss F, Aradhye S, Chong TW. Too late for early intervention? The Healthy Ageing Service's mental health response. Australas Psychiatry 2023; 31:830-834. [PMID: 37915128 DOI: 10.1177/10398562231211669] [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] [Indexed: 11/03/2023]
Abstract
OBJECTIVES This paper describes the rationale for and development of an innovative mental health service for people aged over 65 years living in Northern and Eastern Melbourne, Victoria, Australia. CONCLUSION The Healthy Ageing Service (HAS) was established in July 2020 to provide care for people aged over 65 years experiencing mild-to-moderate mental health concerns. It embraces a prevention and early intervention model of care. It provides primary consultation and brief intervention, secondary consultation, and capacity building to the primary healthcare sector. This innovative service is a Commonwealth-funded partnership between two tertiary mental health service providers that incorporates the recommendations from two major Royal Commissions. It demonstrates a service that acts as a bridge between primary and specialist mental health care, thereby extending mental health services to target the 'missing middle' and is potentially a model for mental health service provision throughout Victoria and Australia.
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Affiliation(s)
- Jessica Dumble
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Eastern Health, Box Hill, VIC, Australia
| | | | - Tanya Cottrell
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | | | - Stephanie Perin
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Chris Harrison
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Francine Moss
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | | | - Terence Wh Chong
- St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Royal Melbourne Hospital, Parkville, VIC, Australia
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Torales J, Aveiro-Róbalo TR, Ríos-González C, Barrios I, Almirón-Santacruz J, González-Urbieta I, Caycho-Rodríguez T, Castaldelli-Maia JM, Ventriglio A. Discrimination, stigma and mental health: what's next? Int Rev Psychiatry 2023; 35:242-250. [PMID: 37267024 DOI: 10.1080/09540261.2023.2186218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 06/03/2023]
Abstract
Stigma and discrimination are a major ongoing problem in the field of mental health as these impact on patient outcomes, access to and acceptability of therapeutic interventions, their quality of life, general wellbeing, social inclusion and opportunities. Social stereotypes, culture and prejudices all contribute to continuing discrimination in mental health. Different settings where people function may also be sources of discrimination such as work and educational environments. The lack of knowledge and understanding of mental health/illness by individuals, their families, carers and policymakers as well as the social media reporting also impact on social attitudes to discrimination. It has been also described a relevant impact of stigma among specific social minorities reporting poor mental health such as elderly people, youths, sexual variants, persons with disability. Educational programs, raising awareness trainings and proper public policies may be developed in order to reduce stigma at social level with favourable outcomes for people with mental illness.
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Affiliation(s)
- Julio Torales
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Telmo Raúl Aveiro-Róbalo
- Department of Research Methodology, School of Medical Sciences, Universidad del Pacífico, Asunción, Paraguay
| | - Carlos Ríos-González
- National Institute of Health, Ministry of Health and Social Welfare, Asunción, Paraguay
| | - Iván Barrios
- Department of Statistics, School of Medical Sciences, National University of Asunción, Santa Rosa del Aguaray Campus, Santa Rosa del Aguaray, Paraguay
| | - José Almirón-Santacruz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | | | | | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Fundação do ABC, Santo André, Brazil
- Department of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Egede C, Dawson AZ, Walker RJ, Garacci E, Campbell JA, Egede LE. Relationship between mental health diagnoses and COVID-19 test positivity, hospitalization, and mortality in Southeast Wisconsin. Psychol Med 2023; 53:927-935. [PMID: 34034845 PMCID: PMC8185414 DOI: 10.1017/s0033291721002312] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/30/2021] [Accepted: 05/23/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is a paucity of literature on the relationship between pre-existing mental health conditions and coronavirus disease-2019 (COVID-19) outcomes. The aim was to examine the association between pre-existing mental health diagnosis and COVID-19 outcomes (positive screen, hospitalization, mortality). METHODS Electronic medical record data for 30 976 adults tested for COVID-19 between March 2020 and 10th July 2020 was analyzed. COVID-19 outcomes included positive screen, hospitalization among screened positive, and mortality among screened positive and hospitalized. Primary independent variable, mental health disorders, was based on ICD-10 codes categorized as bipolar, internalizing, externalizing, and psychoses. Descriptive statistics were calculated, unadjusted and adjusted logistic regression and Cox proportional hazard models were used to investigate the relationship between each mental health disorder and COVID-19 outcomes. RESULTS Adults with externalizing (odds ratio (OR) 0.67, 95%CI 0.57-0.79) and internalizing disorders (OR 0.78, 95% CI 0.70-0.88) had lower odds of having a positive COVID-19 test in fully adjusted models. Adults with bipolar disorder had significantly higher odds of hospitalization in fully adjusted models (OR 4.27, 95% CI 2.06-8.86), and odds of hospitalization were significantly higher among those with externalizing disorders after adjusting for demographics (OR 1.71, 95% CI 1.23-2.38). Mortality was significantly higher in the fully adjusted model for patients with bipolar disorder (hazard ratio 2.67, 95% CI 1.07-6.67). CONCLUSIONS Adults with mental health disorders, while less likely to test positive for COVID-19, were more likely to be hospitalized and to die in the hospital. Study results suggest the importance of developing interventions that incorporate elements designed to address smoking cessation, nutrition and physical activity counseling and other needs specific to this population to improve COVID-19 outcomes.
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Affiliation(s)
- Christine Egede
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI53226, USA
| | - Aprill Z. Dawson
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI53226, USA
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI53226, USA
| | - Rebekah J. Walker
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI53226, USA
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI53226, USA
| | - Emma Garacci
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI53226, USA
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI53226, USA
| | - Jennifer A. Campbell
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI53226, USA
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI53226, USA
| | - Leonard E. Egede
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI53226, USA
- Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI53226, USA
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Braga LDS, Vaz CT, Silva DNM, Machado EL, Friche AADL. [Discrimination perceived by elderly adults in the use of health services: an integrative review]. CIENCIA & SAUDE COLETIVA 2023; 28:155-169. [PMID: 36629561 DOI: 10.1590/1413-81232023281.08662022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/25/2022] [Indexed: 01/11/2023] Open
Abstract
This paper analyzes the current evidence on discrimination perceived by elderly adults (> 50 years) in the use of health services and identifies factors associated with this discriminatory experience. It involved an integrative literature review, carried out on the Biblioteca Virtual de Saúde, CINAHL, Medline, Scopus, and Web of Science search websites, in June/2021. The key words used were social discrimination or ageism; middle-aged, or aged 80 and over or elderly; health services or health services for the elderly, including synonyms, in Portuguese, English, and Spanish. The search strategy identified 1,165 articles; 19 met the eligibility and inclusion criteria and were included in this integrative review. They comprise quantitative and qualitative studies published between 2002 and 2021; about 60% carried out in the United States and Australia. The prevalence of discrimination in the use of health services ranged from 2% to 42%. The report of discriminatory practices was associated with ethnic-racial characteristics, sex, age, sexual orientation, physical appearance, and social class. By giving visibility to the theme, this work aims to stimulate the definition of concrete ways to tackle discrimination, in an attempt to interrupt the perpetration of inequities in the health care area.
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Affiliation(s)
- Luciana de Souza Braga
- Núcleo de Estudos em Envelhecimento e Saúde Pública, Universidade Federal de Minas Gerais e Fiocruz Minas. Av. Professor Alfredo Balena 190. 30130-100 Belo Horizonte MG Brasil. .,Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Camila Teixeira Vaz
- Núcleo de Estudos em Envelhecimento e Saúde Pública, Universidade Federal de Minas Gerais e Fiocruz Minas. Av. Professor Alfredo Balena 190. 30130-100 Belo Horizonte MG Brasil. .,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei. Divinópolis MG Brasil
| | - Danielle Nunes Moura Silva
- Programa de Pós-Graduação em Ciências Fonoaudiológicas, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Elaine Leandro Machado
- Núcleo de Estudos em Envelhecimento e Saúde Pública, Universidade Federal de Minas Gerais e Fiocruz Minas. Av. Professor Alfredo Balena 190. 30130-100 Belo Horizonte MG Brasil. .,Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Amélia Augusta de Lima Friche
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Programa de Pós-Graduação em Ciências Fonoaudiológicas, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
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Boucher E, Honomichl R, Ward H, Powell T, Stoeckl SE, Parks A. The Effects of a Digital Well-being Intervention on Older Adults: Retrospective Analysis of Real-world User Data. JMIR Aging 2022; 5:e39851. [PMID: 36053569 PMCID: PMC9482073 DOI: 10.2196/39851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Digital interventions have been shown to be effective for a variety of mental health disorders and problems. However, few studies have examined the effects of digital interventions in older adults; therefore, little is known about how older adults engage with or benefit from these interventions. Given that adoption rates for technology among people aged ≥65 years remain substantially lower than in the general population and that approximately 20% of older adults are affected by mental health disorders, research exploring whether older adults will use and benefit from digital interventions is needed. OBJECTIVE This study aimed to examine the extent to which older adults engaged with a digital well-being intervention (Happify) and whether engaging with this program led to improvements in both subjective well-being and anxiety symptoms. METHODS In this retrospective analysis, we analyzed data from 375 real-world Happify users aged ≥65 years who signed up for the platform between January 1, 2019, and December 23, 2021. Changes in well-being and anxiety symptoms across 42 to 182 days were assessed using responses to the in-app assessment, which users were prompted to take every 2 weeks, and were compared among users who engaged with the program at the recommended level (ie, 2 or more activities per week) or below the recommended level. RESULTS In all, 30% (113/375) of the sample engaged with the platform at the recommended level (ie, completed an average of 2 or more activities per week), and overall, users completed an average of 43.35 (SD 87.80) activities, ranging from 1 to 786, between their first and last assessment. Users were also active on the platform for an average of 19.36 (SD 27.16) days, ranging from 1 to 152 days. Moreover, older adults who engaged at the recommended level experienced significantly greater improvements in subjective well-being (P=.002) and anxiety symptoms (P<.001) relative to those who completed fewer activities. CONCLUSIONS These data provide preliminary evidence that older adults engage with and benefit from digital well-being interventions. We believe that these findings highlight the importance of considering older adult populations in digital health research. More research is needed to understand potential barriers to using digital interventions among older adults and whether digital interventions should be modified to account for this population's particular needs (eg, ensuring that the intervention is accessible using a variety of devices). However, these results are an important step in demonstrating the feasibility of such interventions in a population that is assumed to be less inclined toward digital approaches.
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Lenouvel E, Lornsen F, Schüpbach B, Mattson J, Klöppel S, Pinilla S. Evidence-oriented teaching of geriatric psychiatry: a narrative literature synthesis and pilot evaluation of a clerkship seminar. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc20. [PMID: 35692363 PMCID: PMC9174071 DOI: 10.3205/zma001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The field of geriatric psychiatry has in recent decades developed into an independent discipline, incorporating elements of psychiatry, neurology and internal medicine. In view of demographic changes, this field is becoming increasingly relevant for primary care and undergraduate medical training. So far, however, there is little educational guidance for instructional design of geriatric psychiatry in undergraduate medical education. PROJECT DESCRIPTION A narrative literature review of medical education studies in the field of geriatric psychiatry was conducted. Student evaluations of a geriatric psychiatry clerkship seminar were analyzed, followed by a target group analysis. Results informed the iterative development of new clerkship seminar content and structure. This was implemented and evaluated over several academic cycles. Learning material was made available via the open-source learning management system "ILIAS". RESULTS A total of 29 medical education articles were identified and evaluated. The previous seminar in geriatric psychiatry at our university hospital was rated below average (Likert item overall rating of 4.3/6 compared to other seminars with an average overall rating of 5.2, p<0.001). An evidence-oriented revision of the content and instructional design was implemented. Activation of learners, self-reference effect, and audience questioning were used during the lecture. Additionally, two geriatric psychiatry case scenarios were adapted for discussion. We saw continuous improvement of student evaluations of the revised course, reaching a rating improvement of 5.3 out of 6 (p<0.01, U=135.5 Cohen's d=1.28). CONCLUSION A systematic approach was used to develop a geriatric psychiatry clerkship seminar, based on medical education evidence, for undergraduate medical students, resulting in better student evaluations. The teaching materials can be adapted for local implementation at other teaching hospitals. Future studies should also explore effects regarding higher learning outcomes.
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Affiliation(s)
- Eric Lenouvel
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Finn Lornsen
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Brigitte Schüpbach
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Janet Mattson
- Karolinska Institute, LIME, Department of Learning, Informatics, Management and Ethics, Solna, Sweden
| | - Stefan Klöppel
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
| | - Severin Pinilla
- University of Bern, University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
- University of Bern, Institute for Medical Education, Department for Assessment and Evaluation, Bern, Switzerland
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Ayalon L, Perel-Levin S, Georgantzi N, Lima CDM. Participation of Older Persons With Mental Health Conditions and Psychosocial Disabilities in the Labor Market. Am J Geriatr Psychiatry 2021; 29:1033-1037. [PMID: 34303603 DOI: 10.1016/j.jagp.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/13/2021] [Accepted: 06/16/2021] [Indexed: 10/21/2022]
Abstract
This paper discusses the right to work as a basic human right that should be granted unrelated to chronological age, health or mental health status and disability including declining cognitive functioning. The benefits of continued employment are both at the individual level and at the organizational and societal levels. Nonetheless, there are multiple barriers that prevent older people and particularly older people with mental conditions and psychosocial disabilities from remaining in the workforce and/or from rejoining the workforce. We outline interventions at the organizational, national, and international levels to ensure the full participation of people of all ages and abilities in the workforce. Such interventions should address the intersection between disabilities and advanced age at the global, regional, and country levels.
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Affiliation(s)
- Liat Ayalon
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University (LA), Ramat Gan, Israel.
| | - Silvia Perel-Levin
- International Network for the Prevention of Elder Abuse (INPEA) representative to the UN, NGO Committee on Ageing (SPL), Geneva, Switzerland
| | - Nena Georgantzi
- AGE-Platform Europe, Brussels, Belgium, National University of Ireland Galway (NG)
| | - Carlos de Mendonça Lima
- World Psychiatric Association Section of Old Age Psychiatry (CML), Jorat-Mézières, Switzerland
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Fisher K, Griffith LE, Gruneir A, Kanters D, Markle-Reid M, Ploeg J. Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA). PLoS One 2021; 16:e0255907. [PMID: 34379653 PMCID: PMC8357170 DOI: 10.1371/journal.pone.0255907] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/26/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Increasing multimorbidity is often associated with declining physical functioning, with some studies showing a disproportionate impact on functioning when mental health conditions are present. More research is needed because most multimorbidity studies exclude mental health conditions. OBJECTIVES This study aims to improve our understanding of the association between functional limitation and multimorbidity, including a comparison of those with multimorbidity that includes versus excludes mental health conditions. METHODS This is a population-based, cross-sectional analysis of data from The Canadian Longitudinal Study on Aging. Functional limitation was defined as the presence of any of 14 activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Multimorbidity, measured by the number of chronic conditions, included mood and anxiety disorders. Logistic regression explored the association between multimorbidity (with and without mental health conditions) and functional limitation. Factor analysis identified common condition clusters to help understand clinical complexity in those with mood/anxiety disorders and the potential influences on functional limitation. RESULTS There were 51,338 participants, with a similar proportion of men and women (49% versus 51%) and 42% age 65 years or older. Fifteen percent (15%) had no chronic conditions and 17% had 5+. Ten percent (10%) reported at least one ADL or IADL limitation. Odds ratios (ORs) for functional limitation increased with multimorbidity and were generally higher for those with versus without mental health conditions (e.g., ORs from 1 to 5+ chronic conditions increased 1.9 to 15.8 for those with mood/anxiety disorders versus 1.8 to 10.2 for those without). Factor analysis showed that mood/anxiety conditions clustered with somatic conditions (e.g., migraines, bowel/gastrointestinal disorders). CONCLUSION This study found higher odds of functional limitation for those with multimorbidity that included versus excluded mental health conditions, at all levels of multimorbidity. It highlights the need for concurrent management of mental and physical comorbidities to prevent functional limitations and future decline. This approach is aligned with the NICE clinical assessment and management guidelines for people with multimorbidity.
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Affiliation(s)
- Kathryn Fisher
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Lauren E. Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gruneir
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
- ICES, Toronto, Ontario, Canada
| | - David Kanters
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Maureen Markle-Reid
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Saif-Ur-Rahman KM, Mamun R, Eriksson E, He Y, Hirakawa Y. Discrimination against the elderly in health-care services: a systematic review. Psychogeriatrics 2021; 21:418-429. [PMID: 33634922 DOI: 10.1111/psyg.12670] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023]
Abstract
Ageism in health-care services is a cardinal public health concern in geriatric health. It is important to know the types and extent of discrimination experienced by elderly individuals while seeking health care. This systematic review aimed to explore the available research to identify discrimination of elderly individuals in health-care services. MEDLINE through PubMed, Web of Science, PsycInfo, and Cochrane Database were searched by using a comprehensive search strategy in September 2020 with no limitation in the year of publication and types of publication. Articles published in English focusing on disparities in health-care service among the elderly were included. Two independent authors screened, extracted, and assessed the quality of data using the Joanna Briggs Institute Critical Appraisal Tool. A narrative synthesis was conducted followed by qualitative content analysis to identify themes from the extracted outcomes of the included studies. Of 3117 articles retrieved from the initial search, 21 articles were included. A total of 611 608 participants from 38 countries in four geographic regions were reported. Articles were published between 2003 and 2020. Most of the studies (n = 19) were cross-sectional in design, and the remaining two studies were qualitative. Major themes of discrimination were age-related discrimination, racial discrimination, gender discrimination, wealth-related discrimination, and technology-related discrimination. This systematic review identified the major perspectives on disparities faced by the elderly in accessing health services. There is a huge research gap on this issue. Specific strategies should be incorporated to address the varying types of discrimination experienced by elderly individuals.
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Affiliation(s)
- K M Saif-Ur-Rahman
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Razib Mamun
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Erik Eriksson
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
| | - Yupeng He
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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