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Webster-Dekker KE, Lu Y, Perkins SM, Ellis J, Gates M, Otis L, Winton R, Hacker E. Factors associated with change in activities of daily living performance in home health care patients with diabetes. Geriatr Nurs 2024; 59:543-548. [PMID: 39153463 DOI: 10.1016/j.gerinurse.2024.07.009] [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: 03/19/2024] [Revised: 06/27/2024] [Accepted: 07/14/2024] [Indexed: 08/19/2024]
Abstract
Older adults with diabetes are at risk for impairments in activities of daily living (ADL) performance. Home health (HH) services help patients regain their ability to perform ADLs following hospitalization, but there may be disparities in ADL improvement. We aimed to identify factors associated with change in ADL performance from the start of HH care to discharge in HH patients with diabetes age ≥65. This secondary analysis used Outcome and Assessment Information Set-D data collected by a HH agency. The sample (n = 1350) had a mean age of 76.3 (SD 7.3). Black/African American race and bowel incontinence/ostomy were associated with less ADL improvement. The following factors were associated with greater ADL improvement: having a caregiver who needed training/support, surgical wounds, pain that interfered with activity, confusion, and better scores in prior functioning. Overall, most patients improved their ADL performance while receiving HH care, but there are disparities that should be addressed.
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Affiliation(s)
| | - Yvonne Lu
- Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46220, USA.
| | - Susan M Perkins
- Indiana University School of Medicine, Department of Biostatistics and Health Data Science, 410W. 10th Street, Indianapolis, IN 46202, USA.
| | - Jennifer Ellis
- Aveanna Healthcare, 400 Interstate N Pkwy #1600, Atlanta, GA 30339, USA
| | - Maria Gates
- Aveanna Healthcare, 400 Interstate N Pkwy #1600, Atlanta, GA 30339, USA
| | - Laurie Otis
- Aveanna Healthcare, 400 Interstate N Pkwy #1600, Atlanta, GA 30339, USA
| | - Rebecca Winton
- CenterWell Home Health, 3350 Riverwood Parkway SE #1400, Atlanta, GA 30339, USA
| | - Eileen Hacker
- The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd., Houston, TX 77230, USA.
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Cao N, Shi T, Pan C. Does long-term care insurance reduce the disability among middle-aged and older adults? Evidence from China. BMC Public Health 2023; 23:1138. [PMID: 37312092 DOI: 10.1186/s12889-023-16057-0] [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: 12/25/2022] [Accepted: 06/06/2023] [Indexed: 06/15/2023] Open
Abstract
This study aimed to examine whether the implementation of Long-Term Care Insurance (LTCI) policy could reduce the disability among middle-aged and older adults in China, and to test the heterogeneity of the effects. Data came from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The Difference-In-Differences (DID) method and the panel data fixed effect model were used to estimate the effect of implementation of LTCI policy on disability among individuals aged 45 years and above. The LTCI policy had a positive impact on reducing disability among middle-aged and older people. Females, younger adults, city dwellers, and individuals living alone benefited the most from LTCI policy. The results provided empirical evidence for the implementation of LTCI policy in China and other similar countries as China. The implementation of LTCI policy should also pay more attention to inequity of the effects on reducing disability among different demographic groups.
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Affiliation(s)
- Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou Medical University Chashan Campus, Wenzhou City, 325035, Zhejiang Province, China
- School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
| | - Tong Shi
- School of Public Health, Wuhan University, Wuhan City, Hubei Province, China
| | - Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou Medical University Chashan Campus, Wenzhou City, 325035, Zhejiang Province, China.
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O’Hoski S, Kuspinar A, Wald J, Richardson J, Goldstein R, Beauchamp MK. People with COPD have greater participation restrictions than age-matched older adults without respiratory conditions assessed during the COVID-19 pandemic. PLoS One 2022; 17:e0275264. [PMID: 36194605 PMCID: PMC9531833 DOI: 10.1371/journal.pone.0275264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Participation restriction has detrimental effects for older adults but it is unknown how participation differs for people with chronic obstructive pulmonary disease (COPD) compared to older adults of the same age without respiratory conditions. We compared scores on the Late Life Disability Instrument (LLDI) between people with COPD (study group) and a random sample of older adults (control group). METHODS Participants with COPD (study group) were recruited from two hospitals in Ontario and age- and sex-matched with a ratio of 1:2 with participants from a random sample of community-dwelling older adults who did not report having respiratory conditions (control group). The study group completed the LLDI prior to the COVID-19 pandemic and the control group completed the LLDI at the end of the first wave of the pandemic. LLDI frequency and limitation scores were compared between groups using Wilcoxon rank-sum tests. RESULTS Forty-six study group participants (mean age 74.2 (SD 5.5) years) and 92 control group participants (mean age 74.4 (SD 5.4) years) were included. Fifty-four percent of the participants were female. The majority of the study group had severe COPD (median forced expiratory volume in one second of 34.5 (25th-75th percentile 27.0-56.0) % predicted). LLDI sores were lower for the study group compared to the control group for both the frequency (median difference -5.4 points, p<0.001) and limitation (median difference -7.6 points, p<0.001) domains. The personal subscale demonstrated the largest magnitude of difference between groups (median difference -13.4 points) and the social subscale demonstrated the smallest magnitude of difference (-5.2 points). CONCLUSION People with COPD had greater participation restrictions than a random sample of older adults without ongoing respiratory conditions. The differences seen in participation between the two groups may have been reduced due to temporal confounding from the COVID-19 pandemic. While participation is relevant to all older adults, our results suggest that it is especially important that it be assessed in those with COPD.
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Affiliation(s)
- Sachi O’Hoski
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Respiratory Research, West Park Healthcare Centre, Toronto, ON, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Joshua Wald
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Firestone Institute for Respiratory Health, St. Joseph’s Healthcare, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Roger Goldstein
- Respiratory Research, West Park Healthcare Centre, Toronto, ON, Canada
| | - Marla K. Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Respiratory Research, West Park Healthcare Centre, Toronto, ON, Canada
- Firestone Institute for Respiratory Health, St. Joseph’s Healthcare, Hamilton, ON, Canada
- * E-mail:
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Chaoping P, Cen W, Kelifa MO, Xuyang L, Wang P. Gender disparity in disability among Chinese oldest-old: Age and cohort trends. J Women Aging 2022; 35:243-258. [PMID: 35201970 DOI: 10.1080/08952841.2022.2031711] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed at exploring gender disparity in disability and identifying related disablement process factors among Chinese oldest-old. Data came from eight waves of the Chinese Longitudinal Healthy Longevity Study (CLHLS). A hierarchical logistic Age-Period-Cohort (A-P-C) model was used to estimate the trend of gender disparity, and related disablement process factors were further decomposed by the Oaxaca-Blinder decomposition. Our results found that women had higher disabilities than men. The age-based trend of gender disparity in Instrumental Activities of Daily Living (IADL) continued to decline; that in Functional Limitation (FL) increased at first and then declined. The cohort-based trend of gender disparity in IADL showed a decreasing trend with each subsequent cohort; that in FL showed an increasing trend. Among the disablement process factors, health behaviors and social supports were the most important contributors to gender disparity in disability. The disability was higher for women than men, and the gender differences were attenuated at very old ages. To reduce gender disparities in disability, more attention should be paid to relevant factors of gender disparity in disability.
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Affiliation(s)
- Pan Chaoping
- School of Public Health, Wuhan University, Wuhan, China
| | - Wang Cen
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Li Xuyang
- School of Public Health, Wuhan University, Wuhan, China
| | - Peigang Wang
- School of Public Health, Wuhan University, Wuhan, China
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Seo Y, Wang J, Barnes D, Barshikar S. Heart Failure and Disability in Community-Dwelling Older Adults in the United States-1999 to 2018: Data From National Health and Nutrition Examination Survey. Clin Nurs Res 2021; 31:571-578. [PMID: 34866420 DOI: 10.1177/10547738211061620] [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] [Indexed: 11/16/2022]
Abstract
To examine the associations of heart failure (HF) with five domains of disability while controlling for covariates. Subjects with HF and aged ≥ 50 years were selected from the 1999 to 2018 National Health and Nutrition Examination Survey data. Five domains of disability were measured with 19 physical tasks. Logistic regression with adjustment for covariates was conducted. The prevalence of HF in 27,185 adults aged ≥ 50 years was 6.37%. After controlling for demographics and smoking, logistic regression showed that HF was associated with 2.8 to 3.4 times increased odds of all domains of disability compared to adults without HF, but with additional adjustments of covariates, the association was attenuated indicating the mediating effects of covariates. The future study may examine the mediating effects of covariates when intervening difficulties with lower extremity mobility and activities of daily living while considering in community-dwelling older adults with HF.
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Affiliation(s)
| | - Jing Wang
- University of Texas at Arlington, USA
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Canbolat Seyman C, Uzar Ozcetin YS. "I Wish I Could Have My Leg": A Qualitative Study on the Experiences of Individuals With Lower Limb Amputation. Clin Nurs Res 2021; 31:509-518. [PMID: 34612075 DOI: 10.1177/10547738211047711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Amputation is commonly regarded as a lifesaving procedure. However, the loss of a body part can lead to permanent disability that can impact patients physically, psychologically, and socially. The aim of this study was to describe and understand the perspectives of patients with lower limb amputation (LLA) about their condition. The study uses a descriptive phenomenological design. Data were collected from 12 patients. The researchers conducted interviews using semi-structured questions. MAXQDA was used for qualitative software support in managing the interview data. Data were transcribed. The participants were aged 61.3 ± 10.8 years. Three themes emerged from the qualitative data: (i) losing control over one's own life, (ii) dreams versus the realities of life, and (iii) future perceptions. Most of the participants emphasized that they face undesirable experiences in their post-amputation lives. The findings of the present study provide novel insight into how individuals subjectively experience life after LLA.
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