Subjective perception of health in elderly inpatients

How traditional undergraduate college students define and perceive wellness: A qualitative phenomenological study

OBJECTIVE

To understand college students' perceptions and understanding of wellness.

PARTICIPANTS

A convenience sample of 20 undergraduate students (age 20.6 ± 2.2 years) at a private liberal arts university in Southern California who recently completed a general education health and wellness course.

METHOD

Five focus group sessions were conducted to explore perceptions of wellness among undergraduate college students. Data was analyzed, themed, and coded.

RESULTS

A thematic analysis of the descriptions of wellness revealed 2 higher-ordered themes as whole-person and wellbeing, and 3 lower-ordered themes of balance, interconnectedness, and personalized in relation to participants' understanding of wellness.

CONCLUSIONS

The importance of balance between wellness dimensions and the acknowledgment of the interconnectedness of wellness dimensions are related to quality of life and life satisfaction. A deeper insight is needed to better understand the perceptions of wellness in this population to provide more effective interventions. This can be achieved through the development of enhanced pedagogy, which may improve student health.

Correlations between physical activity and quality of life in entrepreneurs from Wrocław, Poland

BACKGROUND

Limited physical activity is one of the main reasons for the rapid increase in the prevalence of diseases of affluence, which can lead to premature deaths in adults. Quality of life may be one of potential determinants of physical activity. The aim of this article is to identify the relationships between physical activity and quality of life in entrepreneurs from Wroclaw, Poland.

METHODS

A cross-sectional study was conducted on a group of 616 entrepreneurs (216 women and 400 men). A diagnostic survey method was used with a direct interview technique. The research tools included the International Physical Activity Questionnaire Short Form and the World Health Organization Quality of Life Questionnaire.

RESULTS

Among the studied entrepreneurs, along with their higher ratings of overall quality of life, the odds of high rather than low levels of physical activity increased nearly fivefold (OR 4.86, CI 3.34-7.07). Entrepreneurs with higher assessment levels of their perceived health condition were nearly twice as likely to report high rather than low physical activity levels (OR 1.92, CI 1.42-2.59). The conditional probability of high rather than low levels of physical activity also increased in the entrepreneurs with higher assessments of quality of life in the physical, psychological, social, and environmental domains, by 34%, 11%, 5%, and 6%, respectively.

CONCLUSION

Programs promoting physical activity among entrepreneurs, which focus on moderate and high intensity exercise, should be considered desirable in the context of the study findings. Activities aimed at improving quality of life in the physical and psychological domains as a potential determinant of the level of physical activity of entrepreneurs are also worth recommending.

How do individual, social, environmental, and resilience factors shape self-reported health among community-dwelling older adults: a qualitative case study

BACKGROUND

While older adults are living longer, they often face health challenges, including living with multiple chronic conditions. How older adults respond and adapt to the challenges of multimorbidity to maintain health and wellness is of increasing research interest. Self-reported health, emerging as an important measure of health status, has broad clinical and research applications, and has been described as a predictor of future morbidity and mortality. However, there is limited understanding of how individual, social, and environmental factors, including those related to multimorbidity resilience, influence self-reported health among community-dwelling older adults (≥ 65 years).

METHODS

Informed by the Lifecourse Model of Multimorbidity Resilience, this explanatory case study research explored older adults' perceptions of how these factors influence self-reported health. Data were generated through semi-structured telephone interviews with community-dwelling older adults.

RESULTS

Fifteen older adults participated in this study. Four key themes, specific to how these older adults describe individual, social, environmental, and multimorbidity resilience factors as shaping their self-reported health, were identified: 1) health is a responsibility - "What I have to do"; 2) health is doing what you want to do despite health-related limitations - "I do what I want to do"; 3) the application and activation of personal strengths - "The way you think", and; 4) through comparison and learning from others - "Looking around at other people". These themes, while distinct, were found to be highly interconnected with recurring concepts such as independence, control, and psychological health and well-being, demonstrating the nuance and complexity of self-reported health.

CONCLUSIONS

Findings from this study advance understanding of the factors that influence assessments of health among community-dwelling older adults. Self-reported health remains a highly predictive measure of future morbidity and mortality in this population, however, there is a need for future research to contribute additional understanding in order to shape policy and practice.

Factors associated with quality of life in patients with depression: A nationwide population-based study

Background

Depression, one of the most costly and common mental disorders, is reported to be associated with lower quality of life (QoL) in several studies. Improved understanding of the associated factors with QoL is necessary to optimize long-term outcomes and reduce disability in patients with depression. Therefore, the aim of this study was to identify factors that are associated with lower QoL among patients with depression.

Methods

The study was based on the Korea National Health and Nutrition Examination Survey, a cross-sectional health examination, years 2008 to 2014. The final analyzed sample consisted of a total of 1,502 study subjects who had been diagnosed by clinicians as having depression. A multivariate logistic regression model was performed to exam the association between the clinical characteristics (age, sex, demographic and health-related characteristics) and QoL. Analysis of covariance was also used to analyze EQ-5D according to mental health.

Results

Older age, lower level of education, lower income, worse subjective perception of health, unemployment, obesity and mental health struggles were found to be significantly associated with low QoL in depressive individuals after adjustment for multiple covariates.

Conclusions

This study has outlined grounding data in identifying patients who are at risk of QoL impairment. Policy makers should direct their interests to these individuals and provide appropriate management.

Very Low Volume High-Intensity Interval Exercise Is More Effective in Young Than Old Women

We investigated the acute neuromuscular and stress responses to three different high-intensity interval training sessions in young (age 19.5 ± 1.3 years) and older (age 65.7 ± 2.8 years) women. Cycling exercise comprised either 6 × 5 s or 3 × 30 s all-out, or 3 × 60 s submaximal, efforts each performed 5 weeks apart in randomized order. Peak and average power was higher in young than in older women and was largest during the 6 × 5 s strategy in both groups (p < 0.05). The decrease in the ratio of torques evoked by 20 and 100 Hz electrical stimulation, representing low-frequency fatigue, was more evident after the 3 × 30 and 3 × 60 s than the 6 × 5 s bout in both groups and was larger in young than in older women (p < 0.05). Both groups preferred 6 × 5 s cycling for further training. In conclusion, in young women, very low volume (6 × 5 s) all-out exercise induces significant physiological stress and seems to be an effective means of training. For older women, longer exercise sessions (3 × 60 s) are more stressful than shorter ones but are still tolerable psychologically.

Physical Activity as a Determinant of Quality of Life in Working-Age People in Wrocław, Poland

Regular physical activity can greatly contribute to the improvement of physical fitness and performance, reduction of the incidence risk of some occupational diseases, and as a consequence, to a general improvement of quality of life in terms of health status. The aim of the article was to assess relationships between the quality of life and physical activity of a working-age population. The study material comprised 4460 residents of the city of Wrocław, Poland (2129 men, 2331 women) aged 18-64 years. The study was a questionnaire survey using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and The World Health Organization Quality of Life (WHOQOL-BREF) questionnaires. The highest levels of overall quality of life and its four particular domains (physical, psychological, social, and environmental), as well as perceived health conditions were found among the most physically active respondents. Furthermore, the odds of high assessment of perceived overall quality of life were shown to increase with the increasing levels of physical activity. Activities aimed at the improvement of the quality of life of working-age people should involve programs enhancing the development of physical activity.

Patient-Reported Quality of Life in the Highest Functioning Patients With Treacher Collins Syndrome

BACKGROUND

Treacher Collins syndrome has a wide variation of clinical presentation, including airway obstruction and hearing loss. The objective of this study was to assess patient-rated quality of life in Treacher Collins syndrome, who received multidisciplinary treatment at a specialized craniofacial hospital, and to compare their quality of life with a control sample.

METHODS

Treacher Collins patients under treatment in a multidisciplinary setting were assessed with the World Health Organization Quality of Life (WHOQOL-100) questionnaire. The Siviero scale was used to classify quality of life as unsatisfactory (scores below 25), intermediate (scores between 25 and 75), and satisfactory (scores above 75). Quality of life comparison between Treacher Collins patients and 2342 unaffected individuals from a previous database was performed using the analysis of variance test. Differences were considered significant at P < 0.05.

RESULTS

Treacher Collins patients demonstrated an overall intermediate and satisfactory (score >60%) quality of life in almost all WHOQOL-100 facets and domains. The comparison of the scores between unaffected individuals and Treacher Collins patients demonstrated a significant difference (P < 0.05) in the environment domain.

CONCLUSION

The highest functioning Treacher Collins syndrome patients under multidisciplinary treatment presented intermediate and satisfactory quality of life, consistent with quality of life scores of unaffected controls. In the environment domain, Treacher Collins patients presented even higher scores of quality of life than the control group.

CLINICAL QUESTION/LEVEL OF EVIDENCE

Therapeutic, III.

Older adults' definitions of health: A metasynthesis

BACKGROUND

Despite many gerontological studies focusing on the health of older adults, little attention has been paid to their perceptions of health. Understanding older adults' health perceptions is important because their self-perceptions are important predictors of and strongly related to survival and mortality. Older adults have different perceptions of health compared with younger adults because of their age-related changes, diseases, and limitations. There are also differences between older adults' and health professionals' perceptions of health.

OBJECTIVES

The purpose of this systematic review was to analyze and synthesize qualitative studies that have explored older adults' perceptions of health.

METHODS

Four electronic databases were searched for qualitative studies published from the earliest year to 2013, revealing 12 studies for inclusion. The systematic review employed three components of the meta-study including meta-data-analysis, meta-method, and meta-theory.

RESULTS

Five health themes are identified from the included studies: ability to do something independently, absence or management of symptoms, acceptance and adjustment with optimism, connectedness with others, and feeling enough energy.

CONCLUSION

Future gerontological research should use appropriate existing health theories and develop new health theories specific to older adults. Healthcare providers should evaluate and revise their health definitions according to older adults' health perceptions and provide appropriate health interventions. Policymakers should have an in-depth understanding of older adults' health perceptions to establish effective older-adult-centered health policies.

Brain aging and dementia during the transition from late adulthood to old age: design and methodology of the "Invece.Ab" population-based study

BACKGROUND

Developed countries are experiencing an unprecedented increase in life expectancy that is accompanied by a tremendous rise in the number of people with dementia. The purpose of this paper is to report on the study design and methodology of an Italian population-based study on brain aging and dementia in the elderly. This multi-domain study is structured in two phases. Our goal is to gather sufficient data to estimate the prevalence (phase I: cross-sectional study), the incidence and the progression of dementia and its subtypes as well as cognitive impairment (phase II: follow-up study) and to identify socio-demographic, clinical, and lifestyle factors associated with dementia and the quality of brain aging in people aged 70-74 years, a crucial point between late adulthood and old age.

METHODS/DESIGN

We chose to contact all 1773 people born between 1935-39 residing in Abbiategrasso, Milan, Italy. Those who agreed to participate in the "Invece.Ab" study were enrolled in a cross-sectional assessment and will be contacted two and four years after the initial data collection to participate in the longitudinal survey. Both the cross-sectional and longitudinal assessments include a medical evaluation, a neuropsychological test battery, several anthropometric measurements, a social and lifestyle interview, blood analyses, and the storage of a blood sample for the evaluation of putative biological markers.

DISCUSSION

Now at the end of the recruitment phase, the evaluable population has amounted to 1644 people. Among these, 1321 (80.35%) of the participants have completed phase I. This high return rate was likely due to the style of recruitment and personalization of the contacts.

Celiac disease in elderly adults: clinical, serological, and histological characteristics and the effect of a gluten-free diet

OBJECTIVES

To compare celiac disease (CD) in older and younger adults and to assess the effects of a gluten-free diet (GFD).

DESIGN

Retrospective retrieval of information prospectively entered into a structured database.

SETTING

CD clinic, University and Spedali Civili, Brescia, Italy.

PARTICIPANTS

Two cohorts were identified (older, Group A, n = 59, >65; younger, Group B, n = 1,166, 18-64), and Group B was subgrouped (B1, n = 600, 18-34; B2, n = 440, 35-49; and B3, n = 26, 50-64).

MEASUREMENTS

Clinical, serological, and histological characteristics of individuals with CD studied before and during a GFD.

RESULTS

At presentation, weight loss (37% vs 21%, P = .005) and dyspepsia (22% vs 12%, P = .04) were more frequent in older than younger participants. Incidence at diagnosis of non-Hodgkin's lymphoma (NHL) was much higher in older (5%) than younger participants (0.3%, P = .003). Prevalence of osteoporosis was 67% in older and 14% in younger male participants and 70% in older and 9% in younger female participants ( P < .001). During treatment, adherence to a GFD was 90%, normal villous structure was reconstituted, and t-transglutaminase antibodies were negative in 80% of older and younger participants. Lumbar-sacral and femoral T scores increased significantly during a GFD in pooled results of 48 older and younger participants studied before and during GFD.

CONCLUSION

NHL is already present at CD diagnosis in most cases in individuals aged 50 and older, emphasizing the importance of early diagnosis. Older and younger individuals are equally adherent and equally benefit from a GFD, indicating that older age is not a barrier to dietary treatment.