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Pedroso-Chaparro MDS, Cabrera I, Márquez-González M, Ribeiro Ó, Losada-Baltar A. Comorbid Depressive and Anxiety Symptomatology in Older Adults: The Role of Aging Self-Stereotypes, Loneliness, and Feelings of Guilt Associated with Self-Perception as a Burden. THE SPANISH JOURNAL OF PSYCHOLOGY 2023; 26:e26. [PMID: 37772769 DOI: 10.1017/sjp.2023.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
The main objective of this study was to analyze the differences between older adults' symptom profiles (subclinical, anxiety, depressive, and comorbid) in negative aging self-stereotypes, loneliness, and feelings of guilt associated with self-perception as a burden. Participants were 310 community-dwelling people aged 60 years and over. The sample was grouped into four symptom profiles of older adults: anxiety, depressive, comorbid anxiety-depression, and subclinical symptoms. We carried out multinomial logistic regression analyses to analyze the role of assessed variables in the explanation of the four symptom profiles. Older adults who reported a comorbid symptomatology presented higher negative aging self-stereotypes and feelings of loneliness than the other three profiles. Compared with the subclinical profile, older adults who reported clinical symptomatology (anxiety, depressive, and comorbid profile) presented higher feelings of guilt associated with self-perception as a burden. The findings of this study suggest potential associations that may contribute to understanding and treating comorbid anxiety and depressive symptoms in older adults.
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Yong YM, Wand AP. Falling into an identity crisis: Integrating identity into the assessment and management of falls in older adults. Australas Psychiatry 2022; 30:588-591. [PMID: 35684969 DOI: 10.1177/10398562221106687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This article examines the psychological effects of falls for older adults through the lens of identity and suggests these may be integrated in the assessment and management of older patients within acute care and rehabilitation settings post-fall. An illustrative vignette is described to demonstrate this approach. CONCLUSION Falls in older adults are complex phenomena which can lead to an identity threat, sometimes manifest as psychological symptoms and poor engagement in post-fall rehabilitation. A psychiatric formulation which incorporates an older person's self-identity and agency may inform interventions to address psychological and behavioural sequelae of falls.
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Affiliation(s)
- Yun Ming Yong
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Jara Unit, Older People's Mental Health, 170496Concord Centre for Mental Health, Concord Hospital, Concord, NSW, Australia
| | - Anne Pf Wand
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia; Jara Unit, Older People's Mental Health, 170496Concord Centre for Mental Health, Concord Hospital, Concord, NSW, Australia
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Teo K, Churchill R, Riadi I, Kervin L, Wister AV, Cosco TD. Help-Seeking Behaviors Among Older Adults: A Scoping Review. J Appl Gerontol 2022; 41:1500-1510. [PMID: 35156428 PMCID: PMC9024019 DOI: 10.1177/07334648211067710] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Although older adults may experience health challenges requiring increased care, they often do not ask for help. This scoping review explores the factors associated with the help-seeking behaviors of older adults, and briefly discusses how minority ethnic populations can face additional challenges in help-seeking, due to factors such as language barriers and differing health beliefs. Guided by Arksey and O’Malley’s scoping review framework and the Preferred Reporting Items for Systematic Reviews and Meta-AnalysesScoping Review guidelines, a systematic search of five databases was conducted. Using a qualitative meta-synthesis framework, emergent themes were identified. Data from 52 studies meeting inclusion criteria were organized into five themes: formal and informal supports, independence, symptom appraisal, accessibility and awareness, and language, alternative medicine and residency. Identifying how factors, including independence and symptom appraisal, relate to older adults’ help-seeking behaviors may provide insights into how this population can be supported to seek help more effectively.
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Affiliation(s)
- Kelly Teo
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Ryan Churchill
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Indira Riadi
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Lucy Kervin
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada
| | - Andrew V Wister
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada.,Gerontology Research Centre, 416185Simon Fraser University, Vancouver, BC, Canada
| | - Theodore D Cosco
- Department of Gerontology, 33507Simon Fraser University, Vancouver, BC, Canada.,Oxford Institute of Population Ageing, 416185University of Oxford, Oxford, UK
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Dendle K, Buys L, Vine D, Washington T. Fears and freedoms: A qualitative analysis of older adults' basic psychological needs for autonomy, competence, relatedness and beneficence. Australas J Ageing 2021; 41:229-236. [PMID: 34921484 DOI: 10.1111/ajag.13009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/24/2021] [Accepted: 09/11/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Self-determination theory posits three universal psychological needs: autonomy, competence and relatedness. Beneficence has recently been proposed as an important behaviour for improved well-being and eudaimonia. This study sought to qualitatively examine older adults' experiences of basic psychological needs satisfaction and frustration. METHODS Three separate and simultaneous national online focus groups were undertaken over four consecutive days. Older Australians (n =103) explored home and community life. Themes were identified using reflexive thematic analysis. RESULTS Older adults are challenged in satisfying their psychological needs, especially around the time - and after- they retire and as mobility decreases. Beneficence emerged as important for well-being, congruent with evidence that beneficence influences well-being beyond basic psychological need fulfilment. CONCLUSIONS Satisfactions and frustration may manifest differently for older adults than for other groups. Thus, their experiences may not adequately be captured by self-report measures. Novel themes of 'fears and freedoms' were identified in the study. Fear pertained to the loss of autonomy and the freedom to spend time as one wishes.
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Affiliation(s)
- Kelli Dendle
- School of Design, Queensland University of Technology, Brisbane, Qld, Australia
| | - Laurie Buys
- Institute for Future Environments, Queensland University of Technology, Brisbane, Qld, Australia
| | - Desley Vine
- Institute for Future Environments, Queensland University of Technology, Brisbane, Qld, Australia
| | - Tracy Washington
- School of Built Environment, Queensland University of Technology, Brisbane, Qld, Australia
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Tennent E. Identity and action: Help-seeking requests in calls to a victim support service. BRITISH JOURNAL OF SOCIAL PSYCHOLOGY 2021; 60:1241-1261. [PMID: 33576530 DOI: 10.1111/bjso.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 01/10/2021] [Indexed: 12/01/2022]
Abstract
The nature of the link between identity and action is a fundamental question for social science. One focus in psychology is how actions like seeking help are implicated in matters of identity. This paper presents a discursive psychology study of identity and help in social interaction. Drawing on a corpus of nearly 400 recorded calls to a victim support helpline, I analysed how participants oriented to the link between identity and help. With attention to epistemic, deontic, and affective relations between participants, I analysed how identity was demonstrably relevant and procedurally consequential for building and interpreting help-seeking requests. Participants displayed an understanding that seeking help from Victim Support necessarily implicates identity. Callers' identities as victims or clients rendered their help-seeking accountable and invoked identities for call-takers as representatives of a support service. The findings show that identity and help are mutually constitutive. Seeking help constituted callers' identities as victims; and their identities as victims constituted their requests for help. I suggest that analysing identity and help in social interaction provides evidence for the mutually constitutive link between identity and action.
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Bødker MN, Christensen U, Langstrup H. Home care as reablement or enabling arrangements? An exploration of the precarious dependencies in living with functional decline. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:1358-1372. [PMID: 31020676 DOI: 10.1111/1467-9566.12946] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The threat to welfare societies posed by population ageing has urged high-income countries to rethink the provision of social and healthcare services for the ageing population. One widely implemented policy solution is 'reablement': short-term home-based training programmes focusing on re-enabling older people to carry out activities of daily living independently. Drawing on empirical material from multisited ethnographic fieldwork of reablement practices in a Danish municipality we explore how the assumptions about independence embedded in the concept's linguistic parts - 're', 'able' and 'ment' - map onto lives characterised by functional decline. We find that home care applicants: (i) are often too deeply dependent on the capacities of others in order to have their independence restored; (ii) negotiate individual meanings of independence to maintain their identity as able human beings; and (iii) might possibly gain new capacities through reablement, yet these are not individual and stable achievements, but rather temporary effects of the care relations with eldercare professionals. Rather than reablement we, therefore, suggest the term 'enabling arrangements' as more appropriate for capturing independence as a distributed, negotiated and continuous accomplishment. Finally, we discuss the practical and ethical implications of this term.
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Affiliation(s)
- Malene N Bødker
- Center for Healthy Aging, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Langstrup
- Centre for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Understanding the educational and support needs of informal care-givers of people with dementia attending an outpatient geriatric assessment clinic. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000971] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
AbstractInformal (unpaid) care-givers of older people with dementia experience stress and isolation, causing physical and psychiatric morbidity. Comprehensive geriatric assessment clinics represent an important geriatrician-led model of dementia care. Our qualitative study examined the educational and support needs of care-givers of people diagnosed with dementia at a geriatric assessment clinic, resources used to address those needs and challenges experienced in doing so. We conducted structured thematic analysis of interviews with 18 informal care-givers. Participants’ narratives reflected four themes. First, care-givers sought information from varied sources, including the Alzheimer Society, the internet and clinic staff. Responsive behaviours, the expected progression of dementia and system navigation were topics of particular interest. Second, care-givers obtained assistance from public, for-profit and voluntary sources. Third, care-givers received little assistance. Two-thirds received fewer than four hours of help weekly from all sources combined, and none more than 15. Several received no assistance whatsoever. Publicly funded support workers’ tasks, and their timing, were often unhelpful. Finally, while numerous care-givers felt physical and emotional strain, and worried about how poor health impaired their care-giving, many hesitated to seek help. The needs of this unique population of informal care-givers can be met by improved home-care service flexibility, and access to trustworthy information about the expected progression of dementia and skills for managing behavioural and psychological symptoms.
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Bergeron CD, Hilfinger Messias DK, Friedman DB, Spencer SM, Miller SC. Involvement of Family Members and Professionals in Older Women's Post-Fall Decision Making. HEALTH COMMUNICATION 2018; 33:246-253. [PMID: 28033475 DOI: 10.1080/10410236.2016.1255844] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This exploratory, descriptive study examined involvement of family members and professionals in older women's post-fall decision making. We conducted semistructured interviews with 17 older women who had recently fallen and 11 individuals these women identified as being engaged in their post-fall decision-making processes. Qualitative data analysis involved open and axial coding and development of themes. After experiencing a fall, these older women's openness to others' opinions and advice; their assessments of types and credibility of potential information sources; and the communication practices they established with these sources influenced how they accessed, accepted, or rejected information from family members and professionals. Increased awareness of the involvement of others in post-fall decision making could enhance communication with older women who fall. Developing and implementing practical strategies to help family members and professionals initiate and engage in conversations about falls and their consequences could lead to more open decision making and improved post-fall quality of life among older women.
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Affiliation(s)
| | | | - Daniela B Friedman
- c Department of Health Promotion, Education, and Behavior and Statewide Cancer Prevention and Control Program , University of South Carolina
| | - S Melinda Spencer
- d Department of Health Promotion, Education, and Behavior and Institute for Southern Studies , University of South Carolina
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Gettens S, Fulbrook P, Jessup M, Low Choy N. The patients' perspective of sustaining a fall in hospital: A qualitative study. J Clin Nurs 2017; 27:743-752. [PMID: 28926152 DOI: 10.1111/jocn.14075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 01/03/2023]
Abstract
AIMS AND OBJECTIVES To understand the patient's perspective of falling in hospital. BACKGROUND A fall in hospital can affect a patient physically and psychologically, increasing their hospital length of stay and potentially putting them at risk of further complications. Despite a wealth of literature on falls that focuses on risk assessment, preventive interventions and cost, very little research has focused on the experience of the patient that has fallen, particularly within the acute hospital setting. DESIGN A qualitative phenomenological design was used to investigate the experience of falling in hospital. METHODS Twelve hospital inpatients that had recently fallen were interviewed while in hospital using unstructured interviews. The methodology was guided by Van Manen's approach to data collection and analysis. FINDINGS Three key themes emerged from the analysis: Feeling safe, Realising the risk and Recovering independence and identity. These themes describe a continuum whereby falling was not initially a concern to participants, who trusted staff to keep them safe, and tended to not seek assistance. As participants began to appreciate the reality of their falls risk, they felt disempowered by their loss of independence but were more receptive to receiving assistance. Finally, as participants recovered, their desire to regain independence increased. They wanted others to perceive them as physically competent, rather than as a frail older person, meaning they were more willing to take risks with mobility. CONCLUSION The participants' perspective of falling describes a continuum of responses with participants positioned at different psychosocial standpoints: from initial denial of their risk of falling to realisation of the importance of their fall and acceptance of its repercussions. RELEVANCE TO CLINICAL PRACTICE By understanding the patient's perspective of falling, nurses and other health professionals conducting risk assessment can tailor their discussions and interventions to the patient's perceptions and needs.
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Affiliation(s)
- Stephanie Gettens
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Banyo, QLD, Australia
| | - Paul Fulbrook
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Banyo, QLD, Australia
| | - Melanie Jessup
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Banyo, QLD, Australia
| | - Nancy Low Choy
- Department of Physiotherapy, The Prince Charles Hospital, Brisbane, QLD, Australia.,School of Physiotherapy, Australian Catholic University, Banyo, QLD, Australia
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Charlton K, Murray CM, Kumar S. Perspectives of older people about contingency planning for falls in the community: A qualitative meta-synthesis. PLoS One 2017; 12:e0177510. [PMID: 28562596 PMCID: PMC5451003 DOI: 10.1371/journal.pone.0177510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/30/2017] [Indexed: 11/19/2022] Open
Abstract
Objective Despite consistent evidence for the positive impact of contingency planning for falls in older people, implementation of plans often fail. This is likely due to lack of recognition and knowledge about perspectives of older people about contingency planning. The objective of this research was to explore the perspectives of older people living in the community about use of contingency planning for getting help quickly after a fall. Method A systematic literature search seeking qualitative research was conducted in April 2014, with no limit placed on date of publication. Medline, EMBASE, Ageline, CINAHL, HealthSource- Nursing/Academic Edition, AMED and Psych INFO databases were searched. Three main concepts were explored and linked using Boolean operators; older people, falls and contingency planning. The search was updated until February 2016 with no new articles found. After removal of duplicates, 562 articles were assessed against inclusion and exclusion criteria resulting in six studies for the meta-synthesis. These studies were critically appraised using the McMaster critical appraisal tool. Bespoke data extraction sheets were developed and a meta-synthesis approach was adopted to extract and synthesise findings. Findings Three themes of ‘a mix of attitudes’, ‘careful deliberations’ and ‘a source of anxiety’ were established. Perspectives of older people were on a continuum between regarding contingency plans as necessary and not necessary. Levels of engagement with the contingency planning process seemed associated with acceptance of their risk of falling and their familiarity with available contingency planning strategies. Conclusion Avoiding a long lie on the floor following a fall is imperative for older people in the community but there is a lack of knowledge about contingency planning for falls. This meta-synthesis provides new insights into this area of health service delivery and highlights that implementation of plans needs to be directed by the older people rather than the health professionals.
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Affiliation(s)
- Kimberly Charlton
- Domiciliary Care, Department of Communities and Social Inclusion, South Australian Government, Northfield, South Australia, Australia
| | - Carolyn M. Murray
- School of Health Sciences, University of South Australia, Sansom Institute for Health Research, Adelaide, South Australia, Australia
- * E-mail:
| | - Saravana Kumar
- School of Health Sciences, University of South Australia, Sansom Institute for Health Research, Adelaide, South Australia, Australia
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