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Gonçalves C, Alves Freitas M, Lena Mendrano A, Franciny de Souza L, Coan Fontanela L, de Souza Moreira B, Danielewicz AL, de Avelar NCP. Are history of falls and fear of falling associated with mobility in community-dwelling older adults? Physiother Theory Pract 2024; 40:1421-1427. [PMID: 36971200 DOI: 10.1080/09593985.2023.2188941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 03/04/2023] [Indexed: 03/29/2023]
Abstract
Evidence has suggested that a history of falls and fear of falling (FOF) are associated with reduced mobility among older adults. Although many studies have explored the association between the history of falls and FOF in the context of decreased mobility, most have had small sample sizes, limiting the generalizability of the results. Therefore, this study sought to contribute to the body of knowledge around these constructs to further support the previous findings. To investigate the association between a history of falls and FOF with low mobility in community-dwelling older adults. This cross-sectional study included 308 older adults (69.9 ± 7.1 years, 57.8% female). The Timed Up and Go (TUG) test was used to classify mobility limitations in participants and the Falls Efficacy Scale-International - Brazil was used to quantify FOF. Participants were also asked if they had fallen in the previous 12 months. Multivariable logistic regression was used. The prevalence rates of a history of falls and FOF were 32.7 and 48.4%, respectively. Older adults with a history of falls and FOF had 2.20 (95%CI: 1.20; 4.02) and 3.80 (95%CI: 1.90; 7.58) greater odds of presenting low mobility than older adults without these health problems, respectively. History of falls and FOF are associated with higher odds of low mobility in community-dwelling older adults. Therefore, it is of the utmost importance to introduce public health programs aimed at preventing falls in older adults to reduce possible adverse health outcomes, including low mobility.
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Affiliation(s)
- Camila Gonçalves
- Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
| | - Mariana Alves Freitas
- Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
| | - Amanda Lena Mendrano
- Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
| | - Larissa Franciny de Souza
- Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
| | - Laís Coan Fontanela
- Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health, Aging of the Oswaldo Cruz Foundation and Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Lúcia Danielewicz
- Department of Health Sciences, Campus Araranguá, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
- Department of Health Sciences, Campus Araranguá, Post-Graduate Program in Rehabilitation Sciences, Universidade Federal de Santa Catarina, Araranguá, SC, Brazil
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Ickert EC, Hughes T, Berg-Carramusa CA, Dudash S, Kerns L. Overestimation of Balance Ability Among Older Adults at Risk for Falls. J Aging Health 2024; 36:286-298. [PMID: 37358257 DOI: 10.1177/08982643231186630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: This study examined alignment of subjective balance confidence with Stopping Elderly Accidents, Deaths and Injuries (STEADI) fall risk. Methods: Cross-sectional analysis of 155 community-dwelling adults (60 + y/o) from 2016 to 2018 who completed a STEADI fall assessment. Descriptive statistics, Chi-Square analysis, and biserial point correlations were applied. Results: Adults who overestimate balance confidence, 55.6% (n = 50) reported a fall in the past year, 62.2% (n = 56) were worried about falling, 48.9% (n = 44) felt unsteady when standing/walking, and 70.0% (n = 63) had a score of ≥4 on the Stay Independent Questionnaire (SIQ). Physical performance for these adults were mean TUG score 10.9s (SD = 3.4), mean 30 second chair stands 10.8 (SD = 3.5), and mean 4-stage balance score 3.1 (SD = .76). Discussion: Older adults are more likely to overestimate their subjective balance confidence. Individuals are equally likely to have reported a fall in the past year if they were "at fall risk," regardless of their subjective balance confidence.
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Affiliation(s)
- Edmund C Ickert
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Tiffany Hughes
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Cara A Berg-Carramusa
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Shannon Dudash
- Department of Graduate Studies in Rehabilitation Sciences, Youngstown State University, Youngstown, OH, USA
| | - Lucy Kerns
- Department of Mathematics and Statistics, Youngstown State University, Youngstown, OH, USA
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Wang YP, Dai C, Ou-Yang P, Zhao YH, Xu D. Evaluation of a concise fall risk stratification among older adults with cataracts in day surgery settings: A historically controlled study. Jpn J Nurs Sci 2024; 21:e12579. [PMID: 38058225 DOI: 10.1111/jjns.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/22/2023] [Accepted: 11/13/2023] [Indexed: 12/08/2023]
Abstract
AIM This study aimed to evaluate the use of a concise fall risk stratification in assessing and predicting falls compared with the Morse Falls Scale among older adults with cataracts in day surgery settings. METHODS A historically controlled study conducted from July 2020 to June 2022 was used in a municipal ophthalmic hospital in China. The concise fall risk stratification which directly graded fall risk by multifactorial judgment was used during the intervention period, while the Morse Falls Scale which graded fall risk by scale scores was used during the control period. The fall risk levels, fall assessment time, fall rates, fall-related injuries, predictive validity, and patient satisfaction with day surgery care were extracted. Propensity score matching was performed to balance baselines. RESULTS After matching, 4132 patients were included in the final analysis. Compared with the control group, the intervention group had significantly higher assessment results for fall risk level, a significantly shorter (by 48.15%) fall assessment time, and higher patient satisfaction. There were no differences in fall rates and fall-related injuries. Compared with the Morse Falls Scale, the concise fall risk stratification had higher sensitivity and negative predictive validity, and lower specificity and positive predictive validity, while the area under curve did not differ significantly. CONCLUSION The use of the concise fall risk stratification reduced fall assessment time, improved patient satisfaction, and is unlikely to impact falls with an overall predictive performance comparable to that of the Morse Falls Scale for older cataract adults in day surgery settings.
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Affiliation(s)
- Ya-Ping Wang
- Department of Neurology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Can Dai
- Department of Nursing, Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Ping Ou-Yang
- Department of Nursing, Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Yan-Hua Zhao
- Department of Nursing, Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Dan Xu
- Department of Nursing, Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
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Landers MR, Haller AM, Aldaco A, La B, Babarinde AA, Rider JV, Longhurst JK. The psychometric properties of the modified fear of falling avoidance behavior questionnaire in Parkinson's disease and older adults. Arch Physiother 2024; 14:11-19. [PMID: 38707914 PMCID: PMC11067869 DOI: 10.33393/aop.2024.2702] [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: 10/27/2023] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction The Fear of Falling Avoidance Behavior Questionnaire (FFABQ) has good psychometric properties. However, we have recently modified the FFABQ (mFFABQ) to improve the clarity of the questions and Likert responses. This study aimed to examine the reliability and validity of this modified version in older adults and people with Parkinson's disease (PD). Methods A total of 88 participants, 39 with PD (age = 72.2 ± 9.5; 29 males, 10 females) and 49 older adults (age = 72.8 ± 5.0; 13 males, 36 females), answered the mFFABQ twice, separated by 1 week, for test-retest reliability. Construct validity was evaluated through correlational analyses with fall history, Activities-Specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), Timed Up and Go, 30-Second Sit to Stand, Sensory Organization Test, Zung Anxiety Scale, Beck Depression Inventory, Consequences of Falling Questionnaire (CoFQ), and average daily activity levels using an activity monitor. Results The mFFABQ had good overall test-retest reliability (intraclass correlational coefficient [ICC] = 0.822; older adult ICC = 0.781, PD ICC = 0.806). The mFFABQ correlated with fall history (r = -0.430) and exhibited high correlation with the ABC (rho = -0.804) and moderate correlations with CoFQ (rho = 0.582) and BBS (rho = -0.595). The mFFABQ also correlated with time stepping (rho = -0.298) and number of steps (rho = -0.358). Conclusion These results provide supportive evidence for the reliability and validity of the mFFABQ in older adults and people with PD, which supports its suitability as a clinical and research tool for the assessment of fear of falling avoidance behavior.
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Affiliation(s)
- Merrill R. Landers
- Department of Physical Therapy, School of Integrated Health Sciences, University of Nevada, Las Vegas, Nevada - USA
| | - Ash M. Haller
- Sequoia Hospital, Dignity Health, Redwood City, California - USA
| | - Arturo Aldaco
- Sunrise Hospital and Medical Center, Las Vegas, Nevada - USA
| | - Billy La
- FYZICAL Balance and Therapy Centers – Buffalo, Las Vegas, Nevada - USA
| | - Adetayo A. Babarinde
- School of Integrated Health Sciences, University of Nevada, Las Vegas, Nevada - USA
| | - John V. Rider
- School of Occupational Therapy, Touro University Nevada, Henderson, Nevada - USA
| | - Jason K. Longhurst
- Department of Physical Therapy and Athletic Training, Doisy College of Health Sciences, Saint Louis University, St. Louis, Missouri - USA
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Li M, Li C, Huang Q, Zhou H, Xie L, Chen F, Lin S, Yang J. Refining and psychometric evaluation of the falling risk assessment tool in ophthalmology inpatients. Nurs Open 2023; 10:6912-6922. [PMID: 37458186 PMCID: PMC10495720 DOI: 10.1002/nop2.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 06/07/2023] [Accepted: 07/07/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties. DESIGN A cross-sectional design was used. METHODS A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis. RESULTS Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I-CVI was 0.75-1.00, the S-CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients. PATIENT OR PUBLIC CONTRIBUTION After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions.
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Affiliation(s)
- Muling Li
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Chunmei Li
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Qinghui Huang
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Hongzhen Zhou
- Department of NursingNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Ling Xie
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Fangni Chen
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Shaoqin Lin
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Juan Yang
- Department of OphthalmologyNanfang Hospital, Southern Medical UniversityGuangzhouChina
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Guerrero K, Umagat A, Barton M, Martinez A, Ho KY, Mann S, Hilgenkamp T. The effect of a telehealth exercise intervention on balance in adults with Down syndrome. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:385-393. [PMID: 36585748 DOI: 10.1111/jar.13068] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND People with Down syndrome often present with balance deficits, which compromise safety during daily activity. While evidence shows that exercise can improve balance in the Down syndrome population, it is unclear if a telehealth method will elicit similar benefits. We aimed to examine the effects of a virtual exercise program on balance in adults with Down syndrome. METHODS Eighteen low-active participants with Down syndrome completed a 12-week telehealth exercise program based on the Mann Method. Balance testing took place before and after the intervention, which included: TUG, MCTSIB, FICSIT-4, and FRT. This study was registered as a clinical trial on ClinicalTrials.gov, identifier: NCT04647851. RESULTS Significant improvement was seen in the TUG (p = .043), FICSIT-4 (p = .019) and FRT (p = .019). All participants achieved maximum scores on the MCTSIB in pre- and post-testing. CONCLUSIONS Balance in low-active adults with Down syndrome significantly improved following the telehealth exercise program, which we attribute to the tailored exercises that address visual/vestibular deficits and hip muscle weakness.
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Affiliation(s)
- Kristina Guerrero
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Alexandria Umagat
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Mark Barton
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Andrew Martinez
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
| | - Sarah Mann
- Mann Method PT and Fitness, Arvada, Colorado, USA
| | - Thessa Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, Nevada, USA
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The mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in older adults admitted to hospital. Geriatr Nurs 2022; 48:132-138. [PMID: 36219931 DOI: 10.1016/j.gerinurse.2022.09.010] [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: 07/26/2022] [Revised: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 12/14/2022]
Abstract
The aim of this research was to determine the mediator role of frailty in the effect of fear of falling avoidance behavior on quality of life in the older adults. This descriptive and cross-sectional study was conducted with 312 individuals in Istanbul between June-October 2021. The Edmonton Frail Scale (EFS) score was 7.06±3.69, Fear of Falling Avoidance Behavior Questionnaire (FFABQ) score was 17.84±15.3. Quality of Life Scale (SF-12) physical component score was 34.21±25.12 and mental component score was 41.81±17.87. EFS plays a mediating role in the effect of FFABQ on SF-12 and strengthens its negative effect on SF-12. The frailty severity of the participants was moderate, activity limitation and participation restriction due to fear of falling were low, and their quality of life in physical and mental components was low. Avoidance behavior has a direct effect on quality of life and an indirect effect with the role of frailty.
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Fenwick EK, Lim B, Man REK, Baskaran M, Nongpiur ME, Sng CCA, Iyer JV, Husain R, Perera SA, Wong TT, Low JR, Shimin OH, Lun K, Aung T, Lamoureux EL. The development of a glaucoma-specific health-related quality of life item bank supporting a novel computerized adaptive testing system in Asia. J Patient Rep Outcomes 2022; 6:107. [PMID: 36219349 PMCID: PMC9554106 DOI: 10.1186/s41687-022-00513-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
Background A glaucoma-specific health-related quality of life (HRQoL) item bank (IB) and computerized adaptive testing (CAT) system relevant to Asian populations is not currently available. We aimed to develop content for an IB focusing on HRQoL domains important to Asian people with glaucoma; and to compare the content coverage of our new instrument with established glaucoma-specific instruments.
Methods In this qualitative study of glaucoma patients recruited from the Singapore National Eye Centre (November 2018-November 2019), items/domains were generated from: (1) glaucoma-specific questionnaires; (2) published articles; (3) focus groups/semi-structured interviews with glaucoma patients (n = 27); and (4) feedback from glaucoma experts. Data were analyzed using the constant comparative method. Items were systematically refined to a concise set, and pre-tested using cognitive interviews with 27 additional glaucoma patients.
Results Of the 54 patients (mean ± standard deviation [SD] age 66.9 ± 9.8; 53.7% male), 67 (62.0%), 30 (27.8%), and 11 (10.2%) eyes had primary open angle glaucoma, angle closure glaucoma, and no glaucoma respectively. Eighteen (33.3%), 11 (20.4%), 8 (14.8%), 12 (22.2%), and 5 (9.3%) patients had no, mild, moderate, severe, or advanced/end-stage glaucoma (better eye), respectively. Initially, 311 items within nine HRQoL domains were identified: Visual Symptoms, Ocular Comfort Symptoms, Activity Limitation, Driving, Lighting, Mobility, Psychosocial, Glaucoma management, and Work; however, Driving and Visual Symptoms were subsequently removed during the refinement process. During cognitive interviews, 12, 23 and 10 items were added, dropped and modified, respectively.
Conclusion Following a rigorous process, we developed a 221-item, 7-domain Asian glaucoma-specific IB. Once operationalised using CAT, this new instrument will enable precise, rapid, and comprehensive assessment of the HRQoL impact of glaucoma and associated treatment efficacy.
Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00513-3.
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Affiliation(s)
- Eva K. Fenwick
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.4280.e0000 0001 2180 6431Duke–NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Belicia Lim
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore
| | - Ryan E. K. Man
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.4280.e0000 0001 2180 6431Duke–NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Mani Baskaran
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.414795.a0000 0004 1767 4984Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Monisha E. Nongpiur
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore
| | - Chelvin C. A. Sng
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.410759.e0000 0004 0451 6143National University Health System, Singapore, Singapore
| | - Jayant V. Iyer
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore
| | - Rahat Husain
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore
| | - Shamira A. Perera
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore
| | - Tina T. Wong
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.4280.e0000 0001 2180 6431Duke–NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Jin Rong Low
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore
| | - Olivia Huang Shimin
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.4280.e0000 0001 2180 6431Duke–NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Katherine Lun
- grid.414795.a0000 0004 1767 4984Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Tin Aung
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.4280.e0000 0001 2180 6431Duke–NUS Medical School, National University of Singapore, Singapore, Singapore ,grid.410759.e0000 0004 0451 6143National University Health System, Singapore, Singapore
| | - Ecosse L. Lamoureux
- grid.272555.20000 0001 0706 4670Singapore National Eye Centre, Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856 Singapore ,grid.4280.e0000 0001 2180 6431Duke–NUS Medical School, National University of Singapore, Singapore, Singapore ,grid.1008.90000 0001 2179 088XThe University of Melbourne, Melbourne, Australia
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Li S, Wang AP. Demand preferences for health management services in a population of older adults with visual impairment in China: a conjoint analysis. BMC Geriatr 2022; 22:252. [PMID: 35346071 PMCID: PMC8962070 DOI: 10.1186/s12877-022-02957-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/17/2022] [Indexed: 01/15/2023] Open
Abstract
Background Visual impairment (VI) seriously affects the quality of life of the older adults. It is important to formulate appropriate health management strategies for the older adults with VI to help delay the disease development and progression, and improve life quality. The aim of this study was to understand the demand preference for health management services of the older adults with VI, and to provide a reference for the development of future health management strategies in this population. Methods The conjoint analysis method was used to analyze demand preferences for health management services of the older adults with VI. 11 keywords were extracted after literature analyzed, 6 keywords were selected as the attributes of health management strategy after expert discussion and the level of each attribute was determined. Then 18 representative virtual health management strategies were formed by combination of different attribute levels through orthogonal design, and older adults with VI were asked to score. A total of 334 older adults with VI who attended the ophthalmology department of the First Affiliated Hospital of China Medical University and the Fourth People's Hospital of Shenyang from February 27, 2021 to June 30, 2021were enrolled in this study by stratified sampling. Of the 334 included people, 80 had grade 1 VI, 80 had grade 2 VI, 84 had grade 3 VI, and 90 had grade 4 VI. Results The relative importance of health management services ranked by older adults with VI was continuing care (24.033%), visual aid application (19.61%), health education (16.241%), preventive healthcare (15.667%), safety management (12.757%), and rehabilitation training (11.392%). The utility values of each level of continuing care, safety management and preventive healthcare were positive, whereas the utility values of each level of visual aid application, health education and rehabilitation training were negative. The relative importance and utility values of health management services were different for the older adults with different grades of VI. Conclusions From the whole group, the older adults with VI have a higher preference for continuing care and a lower preference for rehabilitation training. The preference of the older adults with different grades of VI is different, so medical workers can formulate corresponding health management strategies according to their different demand preferences, and carry out hierarchical health management. Services that they preferred should be satisfied as much as possible in the health management strategy, while the reasons for the services with lower preference can be explored and make targeted improvement to meet the demand preferences of them.
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Zhou Y, Hu Y, Luo J, Li Y, Liu H, Sun X, Zhou M. Association Between Sensory Loss and Falls Among Middle-Aged and Older Chinese Population: Cross-Sectional and Longitudinal Analyses. Front Med (Lausanne) 2022; 8:810159. [PMID: 35096898 PMCID: PMC8793905 DOI: 10.3389/fmed.2021.810159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/17/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction: Previous studies have suggested that sensory loss is linked to falls. However, most of these studies were cross-sectional designed, focused on single sensory loss, and were conducted in developed countries with mixed results. The current study aims to investigate the longitudinal relationship between hearing loss (HL), vision loss (VL) and dual sensory loss (DSL) with falls among middle-aged and older Chinese population over 7 years. Methods: The data was obtained from the China Health and Retirement Longitudinal Survey (CHARLS). In total, 7,623 Chinese older adults aged over 45 were included at baseline 2011 in this study. Self-reported falls and HL/VL/DSL were accepted. Other confounding variables included age, sex, BMI, educational level, marital status, various physical disorders and lifestyles. The impact of baseline sensory status on baseline prevalence of falls and incident falls over 7 years were assessed using logistic regression analyses. A logistic mixed model was used to assess the association between time-varying sensory loss with incident falls over 7 years after adjusted with multi-confounding factors. Results: Single and dual sensory loss groups had significantly higher prevalence of falls compared to no sensory loss (NSL) group (DSL: 22.4%, HL: 17.4%, VL: 15.7%, NSL: 12.3%). Baseline HL (OR: 1.503, 95% CI: 1.240-1.820), VL (OR: 1.330, 95% CI: 1.075-1.646) and DSL (OR: 2.061, 95% CI: 1.768-2.404) were significantly associated with prevalence of falls. For longitudinal observation over 7 years, baseline HL/DSL and persistence of all types of sensory loss were associated with incidence of falls. Time-varying HL (OR: 1.203, 95% CI: 1.070-1.354) and DSL (OR: 1.479, 95% CI: 1.343-1.629) were associated with incident falls after adjusted with multi-confounders, while VL was not. Conclusion: HL and DSL are significantly associated with both onset and increased incidence of falls over 7 year's observation in middle-aged and elderly Chinese population. Persistence or amelioration of sensory loss status could exert divergent influences on incidence of falls, which should be considered in the development of falls-prevention public health policies for aging population.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Putuo People's Hospital, Tongji University, Shanghai, China
| | - Yanping Hu
- Shanghai Putuo Center for Disease Control and Prevention, Shanghai, China
| | - Jianfeng Luo
- School of Public Health, Fudan University, Shanghai, China
| | - Yinwen Li
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Haiyun Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
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