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Migration and health: exploring healthy ageing of immigrants in European societies. Prim Health Care Res Dev 2023; 24:e10. [PMID: 36733211 PMCID: PMC9971849 DOI: 10.1017/s1463423623000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AIM The aim is to identify important factors for immigrants' health and well-being and for their use (or non-use) of primary health care (PHC) and other non-specialised services, and for possible ways that PHC can support healthy ageing of immigrants. BACKGROUND Older persons are an increasing share of the immigrant population in the global north, frequently in contact with various forms of health services, (PHC services most of all. Consequently, PHC services are in a particularly unique position to support healthy ageing of immigrants. METHODS The position paper builds on five international, multi-professional and cross-disciplinary small group discussions as well as an international workshop early summer. During the discussions and the workshop, topics were arrived at as to factors related to the health situation of older immigrants, their needs, and health-seeking behaviour, and to how PHC professionals could support healthy ageing in immigrants. Those main topics in turn guided search for relevant research literature and informed the selection of the main research questions of this paper. FINDINGS Several factors, in addition to culture and cultural differences, are important to for PHC professionals and decision-makers to take into consideration in encounters with older immigrants. The socio-economic position of the older immigrant and close relatives, inter-generational relationships within the immigrant communities, country-specific factors in the host country like health care expenditure, and communication skills in health professionals are all examples of factors playing an important role regarding the health and health-seeking behaviour of older immigrants.
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Hirano YO, Tamagawa R, Matsumoto T. Factors influencing the psychological independence of retired community-dwelling older adults in Japan. Front Psychol 2022; 13:1004645. [PMID: 36591059 PMCID: PMC9797848 DOI: 10.3389/fpsyg.2022.1004645] [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: 07/27/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background In an aging society, it is necessary to promote successful aging by helping older adults maintain engagement in social activities, especially after retirement. Focusing on psychological independence is critical for helping community-dwelling older adults maintain their ability to do things independently and build appropriate relationships with neighbors. However, shifting one's mindset from the workplace to the local community can be difficult, especially for Japanese people who prioritize work over local community activities. Few studies have investigated the factors associated with the psychological independence of community-dwelling older adults, so this study examined the factors influencing the psychological independence of older adults in T town, a typical commuter town in Japan. Methods A self-administered, anonymous questionnaire was distributed to 246 neighborhood association members aged 65 and older. T-test, Pearson's correlation coefficient, Cronbach's alpha, and multiple regression analysis were used to develop a model for predicting psychological independence and its two subconstructs, purposefulness and personal accountability. Results The results demonstrated that psychological independence, purposefulness, and personal accountability were significantly predicted by having abilities that are useful to other people (β = 0.399, p = 0.001; β = 0.277, p = 0.019; and β = 0.394, p = 0.001, respectively). Conclusion The findings suggest that older adults can maintain psychological independence using their existing characteristics, such as hobbies and life skills that are useful to others in the community.
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Affiliation(s)
- Yuko O. Hirano
- Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,*Correspondence: Yuko O. Hirano,
| | - Ranze Tamagawa
- Department of Health Sciences, Faculty of Medicine, Nagasaki University, Nagasaki, Japan
| | - Takako Matsumoto
- Department of Health Sciences, Faculty of Medicine, Nagasaki University, Nagasaki, Japan
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3
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Active Aging and Well-being of Older Northern Women in Finland. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Elmersjö M, Hansen E, Victor ML. Is it normal to be depressed in old age? Needs assessors' conceptions of older people's mental illness. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1182-1188. [PMID: 33955091 DOI: 10.1111/hsc.13390] [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: 09/07/2020] [Revised: 02/09/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
The article contributes to the research on older people's mental illness through its focus on how needs assessors conceive mental illness amongst older people and their strategies for dealing with mental illness within existing organisational frameworks. The contribution is based on an empirical study of the needs assessment in eldercare in Sweden. The article aims to explore needs assessors' conceptions of mental illness amongst older people in relation to intertwining processes of normalisation and organisational and legal constraints. The normalisation principle (NP) proposes that individuals with a disability should have access to the same living conditions as 'others'. The NP can be described as a strategy that highlights equal rights for individuals regardless of their life situation. The main findings are that mental illness is defined by needs assessors on a spectrum of diagnoses from schizophrenia and borderline personality disorder to anxiety and depression. The successful normalisation of mental illness is linked to structural context, attitudes to older people's mental illnesses and ageing, the practise established on a unit and whether needs assessors reproduce ageism or challenge it through the NP by attempting to secure the rights of older people.
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Affiliation(s)
| | - Emelie Hansen
- Department of Social Sciences, Södertörn University, Huddinge, Sweden
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Lucantoni D, Principi A, Socci M, Zannella M, Barbabella F. Active Ageing in Italy: An Evidence-Based Model to Provide Recommendations for Policy Making and Policy Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052746. [PMID: 35270438 PMCID: PMC8910036 DOI: 10.3390/ijerph19052746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/04/2022]
Abstract
In ageing societies, active ageing (AA) has been recognized as a useful conceptual tool due to its holistic approach to social issues and recognised benefits from it at multiple levels (micro, meso and macro) for addressing demographic challenges. However, one of the main problems identified in relation to AA, is to turn into practice, at the policy making level, the many positive aspects that it promises at the conceptual level, as is demonstrated by the available evidence based on experiences carried out in some European countries. As an advancement in this field, through an original research experience carried out in Italy between 2019 and 2021, this study for the first time provides a model for producing recommendations for policy making and policy implementation in the field of AA, by managing the main problematic aspects related to the operationalization, at the policy making level, of the AA concept, with the potential for replication in other countries. The main challenges were identified, as well as the way to deal with them through a model, for a proper operationalization of the AA concept, based, among other aspects, on a solid international framework concerning this matter, on a mainstreaming ageing approach (at the public policy level) and on a wide stakeholder participation through co-decisional tools. A multi-level (national-regional-local) perspective was adopted to consider cultural and geographical diversity, among other challenges.
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Rouis H, Ben Abdelaziz A, Zanina Y, Ben Yahia F, Khelil M, Zoghlami C, Ben Rejeb N, Omezzine A, Bouslama A, Ben Abdelaziz A. Epidemiology of elderly dependency in Tunisia. HSHS study 7. LA TUNISIE MEDICALE 2022; 100:847-862. [PMID: 37551535 PMCID: PMC10500754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
AIM Measure the functional autonomy of elderly people and identify its components and determinants in the HSHS (Hammam-Sousse Sahloul Heart Study) population (phase 2009, Tunisia). METHODS This study was concerned with the quality of life of elderly people aged 65 years or more, living at home from the HSHS cohort divided into two groups: young-old (65-74 years old) and old-old (≥75 years old). The autonomy was assessed using the "Activities of Daily Living" (ADL) scale ranging from 0 to 6, the "Instrumental Activities of Daily Living" (IADL) scale ranging from 0 to 8 and, the combined scale ranging from zero to 14, iso-weighted at one point per activity. Autonomy in daily activities was retained for an ADL score=6, and an IADL score (F=8; H=5). Subjects with an overall score (sum of ADL and IADL) of 10-14 points were considered globally autonomous. RESULTS The population study was predominantly female (sex-ratio=0,6) with an important proportion of old-old (M=43%, F=37%). Autonomy rates were by ADL (M=57.4%, F=36.1%, p < 10-2), IADL (M=16%, F=23.9%), and by combined score (M=60.6%, F=69%, p=NS). The typology of dependency was dominated by transferring (M=35%, F=61%) and bathing (M=14%, F=19%) for ADL activities, and shopping (M=36%, F=49%) and the use of means of transport (M=22%, F=43%) for IADL activities. After adjustment, autonomy in daily activities was attributed to two independent factors: male sex (ORa=3.98, CI95% [1.328-11.971]) and age group 65-75 (ORa=4.04, CI95% [2.039- 8.025]). Autonomy in instrumental activities was associated with age group (ORa=31.5, CI95% [4.087-233.514]). Finally, overall autonomy (current and instrumental) was associated independently after logistic regression, with four independent factors, two of which were not modifiable: being female (ORa=3.1, CI95% [1.2-8.1]) and 65 to 75 years (ORa=6.2, CI95% [3.1-12.3]) and two modifiable factors: no recent hospitalization (ORa=3.8, CI95% [1.4-10.4]) and a sufficient level of physical activity (ORa=2.6, CI95% [1.3-5.3]). CONCLUSION The physical dependency rate of the elderly is very high in Tunisia. The promotion of physical activity, the extension of similar studies and the development of could improve the support of these people.
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Edelstein OE, Vered I, Sarid O. Correlates of participation in physical activity among older women in Israel: does ethno-cultural background matter? Health Promot Int 2021; 36:34-45. [PMID: 32277810 DOI: 10.1093/heapro/daaa030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Osteoporosis and its related fractures are major public health concerns. Physical activity (PA) is crucial for bone density preservation and fractures prevention. Yet, gaps in understanding exist regarding how ethno-cultural backgrounds might shape attitudes, intentions and actual PA participation. Based on the theory of planned behaviour (TPB) for predicting PA, the aims of this study were: (i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across four ethno-cultural groups; (ii) to evaluate the fit of the model we constructed across four ethno-cultural groups of women: Israeli-born Jews and Israeli-born Bedouin-Muslims, immigrants from the Former Soviet Union (FSU) and Ethiopian immigrants. Four hundred women (one hundred from each group), aged >65, completed valid and reliable questionnaires assessing knowledge, TPB components and actual PA. The level of knowledge on osteoporosis was relatively low among all four ethno-cultural groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control and actual PA. The structural equation models (SEMs) revealed that among Israeli-born Jews and Ethiopian immigrants, TPB components mediated the link between knowledge and intention to participate in PA. Among FSU immigrants and Israeli Bedouin-Muslims, the knowledge variable was not included in the final model, as its contribution was not significant. It is essential to better understand and augment interventions that enhance PA in the community, and to address the unique needs of each ethno-cultural group.
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Affiliation(s)
- Offer E Edelstein
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 841050, Israel
| | - Iris Vered
- Division of Endocrinology, Diabetes and Metabolism, The Chaim Sheba Medical Centre, Tel Hashomer 5262000, Israel
| | - Orly Sarid
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 841050, Israel
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Li L, Wiebe C, Fleury C, Sveistrup H, Sheehy L. Impact of an artist-in-residence program in a complex continuing care hospital: a quality improvement investigation. Arts Health 2021; 14:217-236. [PMID: 34210239 DOI: 10.1080/17533015.2021.1948432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: The objective was to assess the impact of an Artist-in-Residence (AiR) program on the quality of life of patients living at a complex continuing care hospital.Methods: In the AiR program, a professional Artist facilitated the creation of community art projects by patients in groups (before COVID-19) and individually (during COVID-19). Four patients, four staff and one family member involved with the program were interviewed to assess their experiences.Results: Themes identified included improvements in spiritual, mental and community health, creation of a sense of community, learning skills and knowledge surrounding art and culture, and the importance of the Artist's personal characteristics/personality. It was recommended to continue and expand the program.Conclusions: The patients deeply enjoyed the AiR program and working with the Artist. Non-patient participants also recognized benefits for the hospital community. Procurement of stable funding and expansion of the program are areas to focus on next.
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Affiliation(s)
- Lucy Li
- Bruyère Research Institute, Ottawa, Canada
| | - Carol Wiebe
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.,Bruyère Continuing Care, Ottawa, Canada
| | - Cj Fleury
- Bruyère Continuing Care, Ottawa, Canada
| | - Heidi Sveistrup
- Bruyère Research Institute, Ottawa, Canada.,Bruyère Continuing Care, Ottawa, Canada.,Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Samei Sis S, Safaeeian A, Azizi Zeinalhajlou A, Matlabi H. Viewpoints of Older People Toward the Features of Age-Friendly Communities: Map for Charting Progress in Tabriz, Iran. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/26892618.2020.1859037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Siros Samei Sis
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolrasoul Safaeeian
- Department of Epidemiology and Biostatistics, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Akbar Azizi Zeinalhajlou
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Matlabi
- Department of Geriatric Health, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Shooshtari S, Menec V, Swift A, Tate R. Exploring ethno-cultural variations in how older Canadians define healthy aging: The Canadian Longitudinal Study on Aging (CLSA). J Aging Stud 2020; 52:100834. [PMID: 32178804 DOI: 10.1016/j.jaging.2020.100834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 11/25/2022]
Abstract
An understanding of how older adults conceptualize healthy aging is important for the development of policies, programs, and services designed to promote health; this understanding must reflect the ethno-cultural diversity of the population. This pilot study aimed to examine Canadians' definitions of healthy aging and ethno-cultural variations in these definitions. The baseline data for a sub-sample (n = 535) of the Canadian Longitudinal Study on Aging (CLSA) Tracking Cohort (n = 21,241) were examined. Narrative responses to an open-ended question on healthy aging were analyzed using a previously developed coding system. The most common themes for all the ethno-cultural groups were "lifestyle", "physical activity", and "attitude"; other themes varied by ethno-cultural background. These findings demonstrate that older Canadians from various ethno-cultural backgrounds define healthy aging differently. These variations must be taken into consideration for developing culturally sensitive programs to promote healthy aging among all Canadians. Theorizing on healthy (or 'successful') aging must envision it as a subjective and multidimensional concept.
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Affiliation(s)
- Shahin Shooshtari
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
| | - Verena Menec
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
| | - Audrey Swift
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
| | - Robert Tate
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
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Hu YL, Junge K, Nguyen A, Hiegel K, Somerville E, Keglovits M, Stark S. Evidence to Improve Physical Activity among Medically Underserved Older adults: A Scoping Review. THE GERONTOLOGIST 2020; 59:e279-e293. [PMID: 29668895 DOI: 10.1093/geront/gny030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Participation in leisure physical activity (PA) and engagement in PA interventions among older adults is influenced by socioeconomic status (SES), race/ethnicity, and environment. However, studies of PA for medically underserved older adults have not yet been systematically evaluated. The objective of this study is to map the nature and extent of research conducted on PA participation, interventions, and components of effective leisure PA programs for medically underserved older adults. RESEARCH DESIGN AND METHODS The five-stage approach was used to conduct this scoping review. We searched PubMed, CINAHL, and Cochrane Library for peer-reviewed studies published between 2006 and 2016. Data extracted from selected studies included study population, study type, purpose of intent, evidence level, barriers to PA participation, and components of PA intervention. RESULTS Three hundred and ninety-two articles were identified, and 60 studies were included in the final data charting. Existing literature showed that most studies remained descriptive in nature, and few intervention studies have achieved a high level of evidence. Among 21 intervention studies, only 4 were explicitly conducted for older adults. Culturally adapted materials, race/ethnicity-specific barriers and facilitators, and form of intervention were important components for intervention programs. DISCUSSION AND IMPLICATIONS Findings indicate that more studies are needed to reduce health disparities related to PA participation for medically underserved older adults. Intervention components such as race/ethnicity-relevant barriers and facilitators and culturally sensitive materials are also needed for PA interventions targeting underserved older adults in order to provide evidence for best practices.
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Affiliation(s)
- Yi-Ling Hu
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kristin Junge
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - An Nguyen
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Kelsey Hiegel
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Emily Somerville
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Marian Keglovits
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
| | - Susan Stark
- Washington University School of Medicine, Program in Occupational Therapy, Saint Louis, Missouri
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Gallardo-Peralta LP, Sánchez-Moreno E. Successful ageing in older persons belonging to the Aymara native community: exploring the protective role of psychosocial resources. Health Psychol Behav Med 2019; 7:396-412. [PMID: 34040858 PMCID: PMC8114412 DOI: 10.1080/21642850.2019.1691558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives: The aim of this study is to analyse the process of successful ageing in older persons who state their belonging to a native Chilean ethnic group. There has recently been a notable increase in interest regarding analysis of the cultural processes and variables associated with successful ageing. However, there is a lack of studies analysing successful ageing in native ethnic groups; that is, ethnic communities living in their natural environmental surroundings. Methods: A cross-sectional research design was used. The sample was composed by 232 indigenous Aymara persons aged over 60 years who live in the far north of Chile. Data were collected using a questionnaire made up of validated measurement scales for successful ageing, community support, quality of life, religiousness/spirituality, and health. Results: The results suggest that indigenous persons age successfully, particularly in the context of physical functionality. Successful ageing is positively related with community integration, social support from informal systems (social groups), quality of life, and religiousness (forgiveness). In contrast, successful ageing is negatively related with depression. Conclusions: Cultural practices and an active lifestyle are ethnic cultural resources enabling persons to successfully cope with ageing. The results suggest that interventions would benefit from incorporating actions within a context of community integration. Particular attention to preventing deterioration in mental health would help to foster a successful ageing process.
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Affiliation(s)
- Lorena P Gallardo-Peralta
- Faculty of Social Work, Universidad Complutense, Madrid, Spain.,School of Social Work, University of Tarapacá, Arica, Chile
| | - Esteban Sánchez-Moreno
- Research Institute for Development and Cooperation (IUDC), Universidad Complutense, Madrid, Spain
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The association between frailty and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka: a cross-sectional study. Qual Life Res 2019; 28:2057-2068. [PMID: 30810884 DOI: 10.1007/s11136-019-02137-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The objective of this study was to estimate the cross-sectional association of frailty status with overall and domain-specific quality of life (QoL) in rural community-dwelling older adults in Kegalle district of Sri Lanka. METHODS A population-based cross-sectional study was conducted with 746 community-dwelling older adults aged ≥ 60 years living in the rural areas of Kegalle district of Sri Lanka in 2016. A three-stage probability sampling design was used to recruit participants. Frailty and QoL were assessed using the Fried phenotype and Older People's Quality of Life Questionnaire, respectively. Multivariable linear regression was used to estimate the association of frailty with QoL after accounting for the complex sampling design. RESULTS The median (IQR) age of the sample was 68 (64:75) years and comprised of 56.7% women. 15.2% (95% CI 12.4%, 18.7%) were frail and 48.5% (95% CI 43.9%, 53.2%) were pre-frail. The unadjusted means (SE) of the total QoL score for the robust, pre-frail and frail groups were 139.2 (0.64), 131.8 (1.04) and 119.2 (1.35), respectively. After adjusting for covariates in the final multivariable model, the estimated differences in mean QoL were lower for both frail and pre-frail groups versus robust. The estimated reduction in the total QoL score was 7.3% for those frail and 2.1% for those pre-frail. All QoL domains apart from 'social relationships and participation', 'home and neighbourhood' and 'financial circumstances' were associated with frailty. CONCLUSIONS Frailty was associated with a small but significant lower quality of life in this rural Sri Lankan population, which appears largely explained by 'health' and 'independence, control over life and freedom' QoL domains. Interventions aiming to improve quality of life in frail older adults should consider targeting these aspects.
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Abstract
AbstractA key issue in understanding the social lives of older people is how active they are in coping with the demands of ageing. Often the ‘successfulness’ of ageing is measured with medical and biological criteria. While the notion of ‘active ageing’ is more appealing and neutral, its meaning is often obscured, fragmented or inconsistent. Our aims in this study were to establish ‘active ageing’ as a process in which older people try to take control of their lives by conforming to or resisting different social imaginaries of later life, and to explore individuals’ strategies for making the best use of available resources and fending off potential risks of social exclusion. We adopted a two-stage research design. First, we produced artistic images that corresponded to social imaginaries of tensions in ageing in three social domains (politics, mass media and older people). Then, we used these images as stimuli in interviews with a balanced sample of 32 middle-aged and older residents of Santiago, Chile, to discover their strategies for coping with these tensions. Although imaginaries of ageing tended to describe ageing in terms of restrictions and stereotypes, we found diverse and increasingly flexible life projects and expectations of activity in later life.
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Álvarez-García J, Durán-Sánchez A, Del Río-Rama MDLC, García-Vélez DF. Active Ageing: Mapping of Scientific Coverage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122727. [PMID: 30513943 PMCID: PMC6313563 DOI: 10.3390/ijerph15122727] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 11/16/2022]
Abstract
Population ageing is one of humanity's greatest achievements with the elderly who offer valuable resources and make an important contribution to the structure of our societies. At the same time, this ageing population poses great challenges, as it requires greater economic and social needs. Institutions such as the World Health Organization (WHO) are promoting policies that aim at promoting active ageing, which is understood as the process of optimizing health, participation and security opportunities in order to improve people's quality of life as they get older. The main objective of this study is to identify scientific production related to the area of Active Ageing. The work methodology used is the bibliometric analysis of the articles indexed in the multidisciplinary databases WoS and Scopus. There were 171 articles in WoS and 234 in Scopus that were selected, with a time limit in 2017. In the analysis carried out it is observed that active ageing is a topic that has aroused interest among researchers in recent years, proof of this is the increase both in the number of articles published in scientific journals and in the citations received. The Scopus database presents a greater coverage of the subject. The Overlap Index shows that Scopus covers 90.06% of the WoS articles and its Single Documents index is 34.19% versus 9.94% of WoS.
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Affiliation(s)
- José Álvarez-García
- Financial Economy and Accounting Department, Faculty of Business, Finance and Tourism, University of Extremadura, 10071 Cáceres, Spain.
| | - Amador Durán-Sánchez
- Faculty of Business, Finance and Tourism, University of Extremadura, 10071 Cáceres, Spain.
| | - María de la Cruz Del Río-Rama
- Business Organisation and Marketing Department, Faculty of Business Administration and Tourism, University of Vigo, 32004 Ourense, Spain.
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Abstract
The concept of ‘Active Aging’ emerged in the 1990s, reflecting a growing emphasis on the relationships between health, participation, aging, and independence. The concept focuses on encouraging the participation of older adults in society and it recognizes the competence and knowledge that older people possess. The Active Aging discourse developed as a broad political response to demographic aging, one which promotes a cultural shift in what ‘old age’ may mean, by providing older people with new roles. The initiative “Age-Friendly Cities and Communities”, which was launched by the WHO in 2007, was developed with the aim of applying this paradigm into practice at the local level. Its purpose was to promote a movement of citizen participation where older people have a leading role as generators of well-being, and tackling the barriers of Active Aging. This paper provides a theoretical reflection concerning the development of the concept of Active Aging and how this has led to new ways of active citizenship in later life. New generations of older people demand a space where they can develop and contribute to society, regardless of their age. The aging of the population poses challenges and opportunities, which we can and must take advantage of in order to build a better and more egalitarian society, one that recognizes the value of diversity.
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Accepting, active and in control: older women's experiences of ageing with peripheral arterial disease. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x1800065x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe population of Australia is ageing, with women being the primary beneficiaries of this increase in longevity. Increasingly older individuals are being diagnosed with different chronic illnesses such as peripheral arterial disease (PAD) which causes blockages of the blood vessels in the legs resulting in pain, non-healing ulcers, immobility and the potential amputation of the threatened limb. PAD has been traditionally thought to affect men more than women. Resultingly, women have been under-represented in clinical trials of PAD and under-diagnosed in the health-care setting. However, it has recently been acknowledged that women are indeedmorelikely to suffer from PAD than men due to increased presence of disease and survival advantage. As such, very little is known about women's understanding of and the meaning they create of their experiences of PAD. Therefore, how older women with PAD experience the ageing process is the focus of this qualitative research project. Interviews were conducted with 11 women from Sydney, Australia aged over 65 years who had been diagnosed with PAD. The interviews were analysed using an inductive thematic analysis. Three manifest themes were constructed: independence and control, active and involved, and the acceptance of ageing. These findings emphasised the idea that despite the presence of a chronic illness and increased age, remaining independent and engaged with life was vital to these women's wellbeing. Their subjective experiences of ageing reflect the fact that by adapting to the physical, mental and social changes that come with growing older, the focus does not need to be on loss and decline but rather can be about the continuation of life that can be both positive and meaningful.
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Campos ACV, Ferreira e Ferreira E, Vargas AMD. [Determinants of active aging according to quality of life and gender]. CIENCIA & SAUDE COLETIVA 2017; 20:2221-37. [PMID: 26132262 DOI: 10.1590/1413-81232015207.14072014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/15/2014] [Indexed: 11/22/2022] Open
Abstract
The scope of this study was to construct an indicator of active aging and assess its association with quality of life and possible determinants according to gender. The AGEQOL (Aging, Gender and Quality of Life) study was used to interview 2052 individuals aged 60 years and older residing in Sete Lagoas in the State of Minas Gerais. The association between active aging, quality of life and possible determinants was performed by multiple logistic regression with a 5% level of statistical significance separately for each gender. Most men were in the active aging group (58%), and 51.8% of women were in the normal aging group (p < 0.001). The quality of life in the Physical, Psychological, and total Score domains remained associated with the outcome in the final model for both genders. Among the men, the behavioral and community participation factors were positive predictors of active aging. Women with higher incomes, who did not suffer falls and engaged in community participation, had a better chance of belonging to the active aging group. The conclusion drawn is that quality of life and participation in groups are the main determinants of active aging, and the other factors associated with active aging are different for each gender.
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Affiliation(s)
- Ana Cristina Viana Campos
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil,
| | - Efigenia Ferreira e Ferreira
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil,
| | - Andréa Maria Duarte Vargas
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil,
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Jaworski M, Rzadkiewicz M, Adamus M, Chylinska J, Lazarewicz M, Haugan G, Lillefjell M, Espnes GA, Wlodarczyk D. Primary care patients' expectations regarding medical appointments and their experiences during a visit: does age matter? Patient Prefer Adherence 2017; 11:1221-1233. [PMID: 28761335 PMCID: PMC5522818 DOI: 10.2147/ppa.s133390] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION There is evidence that meeting patients' expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit. PATIENTS AND METHODS The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients. RESULTS We observed differences related to age in patients' expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients' appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and postvisit measurements were statistically significant in all age-groups. Patients who received less than they expected from doctors outnumbered those who received what they expected or more in all the groups. CONCLUSION Patients' expectations toward medical visits are conditioned by age. Therefore, doctors should pay more attention to requirements related to age in their effort to identify and satisfy expectations. This is particularly important in light of the discrepancy between previsit expectations and the actual experiences of patients evaluated after the visit.
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Affiliation(s)
- Mariusz Jaworski
- Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Correspondence: Mariusz Jaworski, Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, ZJAM Building–First Floor, 81 Zwirki i Wigury Street, Warsaw 02-091, Poland, Tel +48 22 572 0533, Fax +48 22 572 0542, Email
| | - Marta Rzadkiewicz
- Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Miroslawa Adamus
- Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Chylinska
- Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Lazarewicz
- Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Monica Lillefjell
- Department of Neuromedicine and Movement Science, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Dorota Wlodarczyk
- Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
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Fernández-Mayoralas G, Rojo-Pérez F, Martínez-Martín P, Prieto-Flores ME, Rodríguez-Blázquez C, Martín-García S, Rojo-Abuín JM, Forjaz MJ. Active ageing and quality of life: factors associated with participation in leisure activities among institutionalized older adults, with and without dementia. Aging Ment Health 2015; 19:1031-41. [PMID: 25584744 DOI: 10.1080/13607863.2014.996734] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Active ageing, considered from the perspective of participation in leisure activities, promotes life satisfaction and personal well-being. The aims of this work are to define and explain leisure activity profiles among institutionalized older adults, considering their sociodemographic characteristics and objective and subjective conditions in relation to their quality of life. METHODS Two samples of institutionalized people aged 60 and over were analysed together: 234 older adults without dementia and 525 with dementia. Sociodemographic, economic, family and social network, and health and functioning variables were selected. Cluster analysis was applied to obtain activity profiles according to the leisure activities, and ordinal regression models were performed to analyse factors associated to activity level. RESULTS The sample was clustered into three groups of people: active (27%), moderately active (35%) and inactive people (38%). In the final regression model (Nagelkerke pseudo R(2) = 0.500), a higher level of activity was associated with better cognitive function (Pfeiffer scale), self-perceived health status and functional ability, as well as with a higher frequency of gathering with family and friends, and higher educational level. CONCLUSION The decline in physical and mental health, the loss of functional capabilities and the weakening of family and social ties represent a significant barrier to active ageing in a context of institutionalization.
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Affiliation(s)
- Gloria Fernández-Mayoralas
- a Institute of Economics, Geography and Demography (IEGD) , Spanish National Research Council (CSIC) , Madrid , Spain
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Aird RL, Buys L. Active Aging: Exploration into Self-Ratings of "Being Active," Out-of-Home Physical Activity, and Participation among Older Australian Adults Living in Four Different Settings. J Aging Res 2015; 2015:501823. [PMID: 26346381 PMCID: PMC4541011 DOI: 10.1155/2015/501823] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/25/2014] [Indexed: 11/28/2022] Open
Abstract
We examined whether self-ratings of "being active" among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of "being active" were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments. The findings suggest that additional strategies to the creation of "age-friendly" environments are needed if older people are to increase their levels of outdoor physical activity. "Active aging" promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group.
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Affiliation(s)
- Rosemary L. Aird
- School of Design, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - Laurie Buys
- School of Design, Queensland University of Technology, Brisbane, QLD 4001, Australia
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Lai CKY, Chan EA, Chin KCW. Who are the healthy active seniors? A cluster analysis. BMC Geriatr 2014; 14:127. [PMID: 25443864 PMCID: PMC4265530 DOI: 10.1186/1471-2318-14-127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 11/19/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This paper reports a cluster analysis of a sample recruited from a randomized controlled trial that explored the effect of using a life story work approach to improve the psychological outcomes of older people in the community. METHODS 238 subjects from community centers were included in this analysis. After statistical testing, 169 seniors were assigned to the active ageing (AG) cluster and 69 to the inactive ageing (IG) cluster. RESULTS Those in the AG were younger and healthier, with fewer chronic diseases and fewer depressive symptoms than those in the IG. They were more satisfied with their lives, and had higher self-esteem. They met with their family members more frequently, they engaged in more leisure activities and were more likely to have the ability to move freely. CONCLUSION In summary, active ageing was observed in people with better health and functional performance. Our results echoed the limited findings reported in the literature.
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Affiliation(s)
- Claudia K Y Lai
- />School of Nursing (SN), The Hong Kong Polytechnic University (PolyU), Hung Hom, Kowloon, Hong Kong Special Administrative Region (HKSAR), Kragujevac, China
| | | | - Kenny C W Chin
- />SN, PolyU, Hung Hom, Kowloon, HKSAR, Kragujevac, China
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Thanakwang K, Isaramalai SA, Hatthakit U. Development and psychometric testing of the active aging scale for Thai adults. Clin Interv Aging 2014; 9:1211-21. [PMID: 25092971 PMCID: PMC4116362 DOI: 10.2147/cia.s66069] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Active aging is central to enhancing the quality of life for older adults, but its conceptualization is not often made explicit for Asian elderly people. Little is known about active aging in older Thai adults, and there has been no development of scales to measure the expression of active aging attributes. Purpose The aim of this study was to develop a culturally relevant composite scale of active aging for Thai adults (AAS-Thai) and to evaluate its reliability and validity. Methods Eight steps of scale development were followed: 1) using focus groups and in-depth interviews, 2) gathering input from existing studies, 3) developing preliminary quantitative measures, 4) reviewing for content validity by an expert panel, 5) conducting cognitive interviews, 6) pilot testing, 7) performing a nationwide survey, and 8) testing psychometric properties. In a nationwide survey, 500 subjects were randomly recruited using a stratified sampling technique. Statistical analyses included exploratory factor analysis, item analysis, and measures of internal consistency, concurrent validity, and test–retest reliability. Results Principal component factor analysis with varimax rotation resulted in a final 36-item scale consisting of seven factors of active aging: 1) being self-reliant, 2) being actively engaged with society, 3) developing spiritual wisdom, 4) building up financial security, 5) maintaining a healthy lifestyle, 6) engaging in active learning, and 7) strengthening family ties to ensure care in later life. These factors explained 69% of the total variance. Cronbach’s alpha coefficient for the overall AAS-Thai was 0.95 and varied between 0.81 and 0.91 for the seven subscales. Concurrent validity and test–retest reliability were confirmed. Conclusion The AAS-Thai demonstrated acceptable overall validity and reliability for measuring the multidimensional attributes of active aging in a Thai context. This newly developed instrument is ready for use as a screening tool to assess active aging levels among older Thai adults in both community and clinical practice settings.
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Affiliation(s)
- Kattika Thanakwang
- Institute of Nursing, Suranaree University of Technology, Nakhon Ratchasima, Thailand ; Research Center for Caring System of Thai Elderly, Prince of Songkla University, Songkla, Thailand
| | - Sang-Arun Isaramalai
- Research Center for Caring System of Thai Elderly, Prince of Songkla University, Songkla, Thailand ; Faculty of Nursing, Prince of Songkla University, Songkla, Thailand
| | - Urai Hatthakit
- Faculty of Nursing, Prince of Songkla University, Songkla, Thailand
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Foster L, Walker A. Active and successful aging: a European policy perspective. THE GERONTOLOGIST 2014; 55:83-90. [PMID: 24846882 DOI: 10.1093/geront/gnu028] [Citation(s) in RCA: 205] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 03/10/2014] [Indexed: 11/12/2022] Open
Abstract
Over the past two decades, "active aging" has emerged in Europe as the foremost policy response to the challenges of population aging. This article examines the concept of active aging and how it differs from that of "successful aging." In particular, it shows how active aging presents a more holistic, life course-oriented approach than successful aging. We provide a critical perspective on active aging too by, first, tracing its emergence in Europe and then showing how, in practice, it has been dominated by a narrow economic or productivist perspective that prioritizes the extension of working life. It has also been gender blind. Nonetheless, it is argued that an active aging approach has the potential to enable countries to respond successfully to the challenges of population aging because of its comprehensive focus and emphasis on societal as well as individual responsibility. Finally, we set out the basic principles that need to be followed if the full potential of active aging is to be achieved.
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Affiliation(s)
- Liam Foster
- Department of Sociological Studies, University of Sheffield, UK.
| | - Alan Walker
- Department of Sociological Studies, University of Sheffield, UK
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Holmberg C, Rappenecker J, Karner JJ, Witt CM. The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: a qualitative interview study. Clin Interv Aging 2014; 9:403-10. [PMID: 24627629 PMCID: PMC3948360 DOI: 10.2147/cia.s54249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Chronic pain is prevalent in elderly populations. The goals of this study were 1) to understand the results of a randomized clinical trial – Qigong and Exercise Therapy for Elderly Patients with Chronic Neck Pain (QIBANE) – that showed no difference between qigong, exercise therapy, and no-treatment on quality of life, and 2) to understand how elderly individuals with chronic pain experience interventions of qigong and exercise therapy. A qualitative interview study was conducted with 20 QIBANE participants. Interviews asked about motivation for and expectations of trial participation, experiences with the exercise classes (qigong or exercise therapy), and changes in pain experience. Interviews were transcribed, entered into the software program ATLAS.ti, and coded thematically by two coders. Content analysis was performed. All interviewees reflected positively on their QIBANE experience and described their participation in QIBANE as helpful. However, what was discussed in both groups when they talked about “positive experiences” in the study differed between the two groups. For example, themes that emerged in the exercise-therapy group related to difficulties associated with aging and staying physically active. In the interviews with qigong group members, emergent themes related to qigong as a method that improved bodily experiences and influenced daily activities. The effects that exercise therapy and qigong have on an elderly population cannot be captured by health-related quality-of-life measurements, such as the Short Form (36) Health Survey. Broader concepts of quality of life that include the concepts of self-efficacy and positive affect may be more appropriate. The results presented in this study suggest that for this population group, the approach of patient-centered outcomes is especially pertinent in order to design meaningful intervention studies in the elderly. This means that research questions, interventions, and outcome measurements need to take into account the special situation of elderly people.
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Affiliation(s)
- Christine Holmberg
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Rappenecker
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julia J Karner
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia M Witt
- Institute for Social Medicine, Epidemiology, and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Center for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
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Bowling A, Rowe G, McKee M. Patients' experiences of their healthcare in relation to their expectations and satisfaction: a population survey. J R Soc Med 2013; 106:143-9. [PMID: 23564898 DOI: 10.1258/jrsm.2012.120147] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate patients' experiences of health services, and how these related to what they had expected to receive, and satisfaction with their care. DESIGN Surveys of patients before and after their consultations in general practice and hospital outpatients departments. SETTING Greater London and Essex PARTICIPANTS In total, 833 patients attending 21 hospitals (434 patients; 52%) and 22 general practices (399 patients; 49%) across Greater London and Essex sampled in clinics and a population survey. MAIN OUTCOME MEASURES Patient expectations of care, patient satisfaction. RESULTS Compared with younger people, and those in black and ethnic minority groups, older people (aged 65+) and White British people had significantly higher overall realistic expectations of their care (pre-visit realistic expectations score: age 60+: mean 53.26 [standard deviation 13.73]; age <60: 56.20 [15.17]; White British: 54.41 [13.50]; Black and other ethnic groups: 56.90 [16.15]) and greater satisfaction post-consultation (satisfaction score age 60+: 1.71 [0.80]; age <60: 1.97 [0.97]; White British: 1.79 [0.89]; Black and other ethnic groups: 2.01 [0.95]). Pre-visit ideal and realistic expectations of care was not significantly associated with patient satisfaction, although met expectations (post-visit experiences) were. Elements of these which was predictive of satisfaction were communication with the doctor, information conveyed and clinical outcomes. Factors associated with satisfaction included having a sense of control over one's life, being older, female, White British and attending general practice, compared with hospital outpatient clinics. CONCLUSIONS It is the ability of the system to meet patients' expectations in respect of the emotional and human features of the consultation, and the clinical outcomes, that matter most to people. This research also questions prevailing stereotypes of older age: it is not the case that older patients are more satisfied with their care because their expectations are lower. In fact, they are higher, but they believe that they are being met.
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Affiliation(s)
- Ann Bowling
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UK.
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Choo J, Kim EK. Health-related Quality of Life of Fallers vs. Non-fallers in Community-dwelling Elderly People. ACTA ACUST UNITED AC 2012. [DOI: 10.5953/jmjh.2012.19.3.373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Van Malderen L, Mets T, De Vriendt P, Gorus E. The Active Ageing-concept translated to the residential long-term care. Qual Life Res 2012; 22:929-37. [PMID: 22678352 DOI: 10.1007/s11136-012-0216-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2012] [Indexed: 11/24/2022]
Abstract
PURPOSE Active Ageing (AA), as described by the WHO (Active Ageing: a policy framework. World Health Organisation, Geneva 5), is an important concept in gerontology. Since the AA-concept has not been examined in the context of residential long-term care facilities, our study addresses this gap by describing the determinants of AA within this setting. METHODS A qualitative study with semi-structured focus groups, followed by a thematic analysis, was conducted. Through purposive sampling, four focus groups of either residents of long-term care facilities (n = 8), children of residents (n = 8), community-dwelling older people (n = 8) and gerontologists (n = 6) were formed. RESULTS The thematic analysis yielded nine determinants of AA. Seven correspond to those identified by the WHO: Culture, Behaviour, Psychological Factors, Physical Environment, Social Environment, Economic Characteristics and Health and Social Care. Two new determinants were identified: Meaningful Leisure and Participation. The determinant Participation is seen as crucial to AA in residential care. CONCLUSION This study points to a more extensive set of determinants of AA than those identified by the WHO (Active Ageing: a policy framework. World Health Organisation, Geneva 5). Staff of long-term care facilities can make use of these determinants to promote AA in their residents.
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Affiliation(s)
- Lien Van Malderen
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
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Victor CR, Bowling A. A Longitudinal Analysis of Loneliness Among Older People in Great Britain. THE JOURNAL OF PSYCHOLOGY 2012; 146:313-31. [DOI: 10.1080/00223980.2011.609572] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Victor CR, Burholt V, Martin W. Loneliness and Ethnic Minority Elders in Great Britain: An Exploratory Study. J Cross Cult Gerontol 2012; 27:65-78. [DOI: 10.1007/s10823-012-9161-6] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Grant RL, Bowling A. Challenges in comparing the quality of life of older people between ethnic groups, and the implications for national well-being indicators: a secondary analysis of two cross-sectional surveys. Health Qual Life Outcomes 2011; 9:109. [PMID: 22142447 PMCID: PMC3256105 DOI: 10.1186/1477-7525-9-109] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 12/05/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current international interest in well-being indicators among governmental agencies means that many quality of life scales are potential components of such national indicator sets. Measuring well-being in minority groups is complex and challenging. Scales are available that have been validated in specific parts of the population, such as older people. However, validation among combinations of minority groups, such as older adults of ethnic minority backgrounds, is lacking. FINDINGS We pooled data from two surveys of older adults in Great Britain: one conducted among White British people, and one among four ethnic minority groups. Quality of life was measured by the Older People's Quality of Life (OPQOL); Control, Autonomy, Self-realisation, Pleasure (CASP-19); and World Health Organization Quality of Life scale for older people (WHOQOL-OLD). We found differences, some significant, between groups in terms of self-reported importance of various aspects of quality of life. A regression model of each total quality of life scale revealed greater unexplained variability in the White British group than the others. Principal components analysis within each ethnic group's data showed considerable differences in the correlation structures. CONCLUSIONS There are differences between ethnic groups that are consistent across the three scales and are not explained by a battery of predictor variables. If scales such as these are used to compare quality of life between ethnic groups, or equivalently between geographical regions, the different results in each group are liable to bias any comparison which could lead to inequitable policy decisions.
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Affiliation(s)
- Robert L Grant
- Faculty of Health and Social Care Sciences, Kingston University and St George's, University of London, UK.
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Avelar NCP, Simão AP, Tossige-Gomes R, Neves CDC, Rocha-Vieira E, Coimbra CC, Lacerda ACR. The effect of adding whole-body vibration to squat training on the functional performance and self-report of disease status in elderly patients with knee osteoarthritis: a randomized, controlled clinical study. J Altern Complement Med 2011; 17:1149-55. [PMID: 22087576 DOI: 10.1089/acm.2010.0782] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The study objectives were to evaluate the effects of adding whole-body vibration to squat training on functional performance and self-report of disease in elderly individuals with knee osteoarthritis (OA). DESIGN This was a prospective, randomized trial in which selected variables were evaluated at three periods: 3 weeks prior to the training, immediately prior, and after the end of the training. SUBJECTS Twenty-three (23) elderly subjects were evaluated using four functional performance tests: Berg Balance Scale (BBS), Timed Get Up and Go Test (TGUG), Chair Stand Test (CST), and 6-Minute Walk Test (6MWT), and a self-report of the status of disease (WOMAC). INTERVENTIONS The intervention lasted for 12 weeks, 3 times per week. The participants were randomized into two groups: (1) squat training with whole-body vibration, and (2) squat training without vibration. RESULTS Although there was no statistical difference in functional performance and self-report of disease status between the groups, performance in all the functional tests and in all the domains of WOMAC improved in the vibration group compared to their initial status. In the exercise group, performance improved only two tests (BBS and 6MWT), and there was a reduction in self-reported pain (WOMAC) compared to their initial status. CONCLUSIONS Although the addition of whole-body vibration to squat training failed to result in a significant improvement in functional performance and self-reported status of knee osteoarthritis in the elderly, the intragroup results suggest that whole-body vibration may represent a feasible and effective way of improving the functionality and self-perception of disease status in older adults with knee OA.
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Affiliation(s)
- Núbia Carelli Pereira Avelar
- Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), School of Health and Biological Sciences, Exercise Physiology Laboratory, Diamantina, Minas Gerais, Brazil
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Abstract
AIM To document population perceptions of well-being and predictors of self-assessed well-being. METHODS National face-to-face interview survey of adults aged ≥16 years, conducted by the Office for National Statistics for their Omnibus Survey in Britain (response 58%; 1049 of 1823 eligible). RESULTS People aged 65+ years were more likely than younger people to define well-being as being able to continue to do the things they had always done. Most men and women, in all age groups, rated their well-being and mental well-being positively. Self-rated health, mental health symptoms, long-standing illness and social support were the main drivers of overall well-being in all age groups. Mental health symptoms, long-standing illness and social support were the main drivers of mental well-being. For example, in reduced multivariable models, those who reported no long-standing illness had almost twice the odds of others, of good, rather than not good, overall well-being, and over three times the odds of good, rather than not good, mental well-being. The odds of good versus not good overall well-being were also multiplied by 1.002 for each additional available person for comfort and support and similarly by 1.073 in relation to mental well-being. CONCLUSIONS Understanding the drivers of well-being among adults, including older adults, is of high policy importance. Attention should be focused on improvements in population health and functioning and on encouraging younger and older people to develop and maintain social support networks and engagement in social activities.
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Affiliation(s)
- Ann Bowling
- Faculty of Health and Social Care, St George's, University of London and Kingston University, London, UK.
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Bowling A, Iliffe S. Psychological approach to successful ageing predicts future quality of life in older adults. Health Qual Life Outcomes 2011; 9:13. [PMID: 21388546 PMCID: PMC3063186 DOI: 10.1186/1477-7525-9-13] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Accepted: 03/09/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public policies aim to promote well-being, and ultimately the quality of later life. Positive perspectives of ageing are underpinned by a range of appraoches to successful ageing. This study aimed to investigate whether baseline biological, psychological and social aproaches to successful ageing predicted future QoL. METHODS Postal follow-up in 2007/8 of a national random sample of 999 people aged 65 and over in 1999/2000. Of 496 valid addresses of survivors at follow-up, the follow-up response rate was 58% (287). Measures of the different concepts of successful ageing were constructed using baseline indicators. They were assessed for their ability to independently predict quality of life at follow-up. RESULTS Few respondents achieved all good scores within each of the approaches to successful ageing. Each approach was associated with follow-up QoL when their scores were analysed continuously. The biomedical (health) approach failed to achieve significance when the traditional dichotomous cut-off point for successfully aged (full health), or not (less than full health), was used. In multiple regression analyses of the relative predictive ability of each approach, only the psychological approach (perceived self-efficacy and optimism) retained significance. CONCLUSION Only the psychological approach to successful ageing independently predicted QoL at follow-up. Successful ageing is not only about the maintenance of health, but about maximising one's psychological resources, namely self-efficacy and resilience. Increasing use of preventive care, better medical management of morbidity, and changing lifestyles in older people may have beneficial effects on health and longevity, but may not improve their QoL. Adding years to life and life to years may require two distinct and different approaches, one physical and the other psychological. Follow-up health status, number of supporters and social activities, and self-rated active ageing also significantly predicted QoL at follow-up. The longitudinal sample bias towards healthy survivors is likely to underestimate these results.
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Affiliation(s)
- Ann Bowling
- Faculty of Health and Social Care, St George's, University of London and Kingston University, St George's, University of London, Cranmer Terrace, London SW17ORE, UK.
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Bilotta C, Bowling A, Casè A, Nicolini P, Mauri S, Castelli M, Vergani C. Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health Qual Life Outcomes 2010; 8:56. [PMID: 20529325 PMCID: PMC2889875 DOI: 10.1186/1477-7525-8-56] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 06/08/2010] [Indexed: 11/10/2022] Open
Abstract
Background There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients. Methods We conducted a cross-sectional survey of 239 community-dwelling outpatients aged 65+ (mean age 81.5 years) consecutively referred to a geriatric medicine clinic in Italy between June and November 2009. Participants underwent a comprehensive geriatric assessment, including assessment of their frailty status according to the Study of Osteoporotic Fractures (SOF) criteria, and QOL, which was evaluated by using the Older People's QOL (OPQOL) questionnaire. One-way ANOVA and chi-squared tests were used to find correlates of frailty, including QOL dimensions, after stratification of participants in the "robust" (n = 72), "pre-frail" (n = 89) and "frail" (n = 78) groups. Multiple linear regression analyses were performed to find correlates of QOL in the overall sample and among "frail" and "robust" participants. Results A negative trend of QOL with frailty status was found for almost all dimensions of QOL (health, independence, home and neighbourhood, psychological and emotional well-being, and leisure, activities and religion) except for social relationships and participation and financial circumstances. Independent correlates of a poor QOL in the total sample were "reduced energy level" (SOF criterion for frailty), depressive status, dependence in transferring and bathing abilities and money management (adjusted R squared 0.39); among "frail" participants the associations were with depressive status and younger age, and among "robust" participants the association was with lower body mass index. Conclusions Five out of seven dimensions of QOL were negatively affected by frailty, but only one SOF criterion for frailty was independently related to QOL, after correction for age, functional status and depression. A more advanced age as well as a better affective status were correlates of a better QOL among frail elders. Interventions targeting the QOL in frail community-dwelling older outpatients should consider as outcomes, not only health-related QOL, but also other domains of the QOL.
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Affiliation(s)
- Claudio Bilotta
- Department of Internal Medicine, Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
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