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Calvey B, McHugh Power J, Maguire R, Welmer AK, Calderón-Larrañaga A. How Do Discrepancies between Subjective and Objective Health Predict the Risk of Injurious Falls? A Study of Community-Dwelling Swedish Older Adults. J Am Med Dir Assoc 2024; 25:105072. [PMID: 38857684 DOI: 10.1016/j.jamda.2024.105072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES Previous studies demonstrated that discrepancies between subjective and objective health measures are associated with physical and mental health-related outcomes in older adults. We investigate whether such discrepancies are also associated with risk of injurious falls in community-dwelling Swedish older adults. DESIGN A prospective, observational cohort study. SETTING AND PARTICIPANTS Using data from the Swedish National Study on Aging and Care in Kungsholmen, we followed 2222 community-dwelling older adults aged ≥60 years at baseline, across a 10-year period of data collection (2001-2011). METHODS A "health asymmetry" metric classified older adults into 4 categories, based on the level of agreement between their subjective and objective health scores ("health pessimist", "health optimist", "poor health realist", and "good health realist"). Time-varying Cox proportional hazard and Laplace regressions were employed to investigate if these categories were associated with the risk of injurious falls. RESULTS Over a 10-year follow-up, 23.5% of the sample experienced an injurious fall. Health optimists had the greatest risk of experiencing an injurious fall [hazard ratio (HR) 2.16, 95% confidence interval (CI) 1.66, 2.80], compared with good health realists. Poor health realists (HR 1.77, 95% CI 1.50, 2.11) and health pessimists (HR 1.66, 95% CI 1.21, 2.29) also had an increased risk of experiencing injurious falls, compared with good health realists. Being a health pessimist was only associated with the risk of injurious falls within the younger-old (HR 2.43, 95% CI 1.63, 3.64) and among males (HR 1.95, 95% CI 1.14, 3.33). CONCLUSIONS AND IMPLICATIONS Older adults with similar objective health levels may differ in terms of their injurious fall risk, depending on their subjective health. Interpreting subjective health alongside objective health is clinically pertinent when assessing injurious fall risk.
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Affiliation(s)
- Bill Calvey
- Hamilton Institute, Maynooth University, Maynooth, Co. Kildare, Ireland.
| | - Joanna McHugh Power
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Centre, Stockholm, Sweden
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Jhon M, Shin MH, Yoon KC, Kim JS, Lee J, Park K, Park SC. The relationship between depressive mood and subjective health in centenarians and near-centenarians: a cross-sectional study from Korean centenarian cohort. Aging Male 2023; 26:2257302. [PMID: 37812685 DOI: 10.1080/13685538.2023.2257302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/06/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND With the rapid increase in population longevity, more clinical attention is being paid to the overall health of long-lived people, especially centenarians. Subjective health, which is the perception of one's health status, predicts both mortality and declining physical function in older adults. The purpose of this study was to investigate the factors related to subjective health among centenarians and near-centenarians (ages ≥95) living in a rural area of South Korea. METHODS A total of 101 participants were enrolled from four different regions (Gurye, Gokseong, Sunchang, and Damyang), known as the Longevity Belt in Korea. Variables assessing physical and mental health, including the results of blood tests, were examined. Factors associated with good subjective health were identified with logistic regression analysis. RESULTS Fifty-six participants (59.6%) were subjectively healthy among the centenarians and near-centenarians. Logistic regression analysis revealed that depressive mood was the only factor associated with subjective health and was negatively correlated. The regression model explained 39% of the variance in subjective health. CONCLUSIONS These findings emphasize the importance of mental health at very advanced ages. Because depressive mood negatively correlates with subjective health, more attention is needed to prevent and manage mood symptoms of people of advanced ages, including centenarians.
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Affiliation(s)
- Min Jhon
- Department of Psychiatry, Chonnam National University Hospital, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
| | - Jeong-Sun Kim
- College of Nursing, Chonnam National University, Gwangju, Korea
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
| | - Jeonghwa Lee
- Department of Family Environment and Welfare, Chonnam National University, Gwangju, Korea
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
| | - Sang Chul Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Korea
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Fang B, Li D, Chen B, Huang J, Hou Y, Liu H. Perceived Support Protects Against Negative Affective Experiences of Momentary Solitude: An Ecological Momentary Assessment Study. J Gerontol B Psychol Sci Soc Sci 2022; 77:2170-2181. [PMID: 35678188 DOI: 10.1093/geronb/gbac081] [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: 07/25/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Momentary solitude (the objective state of being alone) has a strong association with negative affective experiences in older people, but little is known about how the role of social relationship characteristics on relationship between momentary solitude and affect. We examined the momentary association between momentary solitude and negative affect (NA), and whether such association was moderated by the structural and functional aspects of social relationships. METHODS A sample of 153 late-middle-aged and older adults were recruited and provided a total of 6,742 ecological momentary assessment surveys, of which momentary solitudes were reported for 1,885 (28%) surveys. Hierarchical linear model was used to examine how social networks and social support moderated the association of momentary solitude with NA experiences. RESULTS The association of momentary solitude with NA experiences was significant among middle-aged and older adults (b = 0.025, SE = 0.008, p < .01). Family networks had the main effect on NA. Perceived social support buffered against increased NA in momentary solitude: Individuals with a higher level of perceived support reported fewer increases in NA during momentary solitude than those perceiving a lower level of support. DISCUSSION Momentary solitude was experienced less negatively for middle-aged and older persons embedded in a context of higher levels of perceived social support. Practitioners need to pay more attention to the promotion of social resources when delivering programs to improve the subjective well-being of late-middle-aged and older adults.
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Affiliation(s)
- Boye Fang
- Department of Sociology and Social Work, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Danyu Li
- Department of Sociology and Social Work, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Beizhuo Chen
- Department of Sociology, Central South University, Changsha, Hunan, China
| | - Jiaojiao Huang
- Department of Sociology, Central South University, Changsha, Hunan, China
| | - Yanyan Hou
- Department of Sociology, Central South University, Changsha, Hunan, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, Hunan, China
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Chai L, Xue J. Weight, Weight Perceptions, and Health and Well-Being Among Canadian Adolescents: Evidence From the 2017-2018 Canadian Community Health Survey. Am J Health Promot 2022; 36:55-63. [PMID: 34282629 PMCID: PMC8669201 DOI: 10.1177/08901171211031064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/10/2021] [Accepted: 06/21/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The present study examines the extent to which (mis)matched weight and weight perceptions predict adolescents' self-rated health, mental health, and life satisfaction. DESIGN Quantitative, cross-sectional study. SETTING Data from the 2017-2018 Canadian Community Health Survey (CCHS)-a nationally representative sample collected by Statistics Canada. PARTICIPANTS Canadian adolescents aged between 12 and 17 (n = 8,081). MEASURES The dependent variables are self-rated health, mental health, and life satisfaction. The independent variable is (mis)matched weight and weight perceptions. ANALYSIS We perform a series of ordinary least squares (OLS) regression models. RESULTS Overweight adolescents with overweight perceptions are associated with poorer self-rated health (b = -.546, p < .001 for boys; b = -.476, p < .001 for girls), mental health (b = -.278, p < .001 for boys; b = -.433, p < .001 for girls), and life satisfaction (b = -.544, p < .001 for boys; b = -.617, p < .001 for girls) compared to their counterparts with normal weight and normal weight perceptions. Similar patterns have also been observed among normal weight adolescents with overweight perceptions (e.g., normal weight adolescents with overweight perceptions are associated with poorer self-rated health (b = -.541, p < .01 for boys; b = -.447, p < .001 for girls)). CONCLUSION Normal weight adolescents are not immune to adverse self-rated health, mental health, and life satisfaction because their weight perceptions are also a contributing factor to health and well-being consequences.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | - Jia Xue
- Factor-Inwentash Faculty of Social Work & Faculty of Information, University of Toronto, Toronto, Ontario, Canada
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What Is Frailty? Perspectives from Chinese Clinicians and Older Immigrants in New Zealand. J Cross Cult Gerontol 2021; 36:201-213. [PMID: 33830425 PMCID: PMC8203539 DOI: 10.1007/s10823-021-09424-0] [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] [Accepted: 01/21/2021] [Indexed: 11/03/2022]
Abstract
This qualitative study explores the meanings of frailty held by Chinese New Zealanders and Chinese health care professionals with the aim of identifying commonalities as well as potential differences. Two guided focus groups with Mandarin and Cantonese speaking older adults (n = 10), one individual interview with a English speaking older Chinese, and one focus group with Chinese New Zealand health care professionals (n = 7) were held to obtain views on frailty in older adults, followed by transcribing and a thematic qualitative analysis. Three main themes emerged: (1) Frailty is marked by ill-health, multiple chronic and unstable medical comorbidities, and is a linked with polypharmacy; (2) Frailty can involve physical weakness, decline in physical function such as reduced mobility or poor balance, and declining cognitive function; and (3) Frailty is associated with psychological and social health including depression, reduced motivation, social isolation, and loss of confidence. The perspectives of frailty that emerged are congruent with a multi-dimensional concept of frailty that has been described in both Chinese and non-Chinese medical research literature.
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Abma LC, Timmermans RA, Yonker JE. Health congruence paradox in older adults: Contribution of cognition and relational visits. Geriatr Nurs 2021; 42:708-713. [PMID: 33831718 DOI: 10.1016/j.gerinurse.2021.02.015] [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: 01/04/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 11/26/2022]
Abstract
The health congruence paradox can have important implications for those working with older adults as older adults' health understanding may be vague or directed toward health concerns other than those medically identified. Objective health was measured as diagnosed conditions from medical records. Two measures of subjective health were obtained through relational visits of university students, 1) health concerns older adults reported on a visit survey, 2) health concerns students reported during casual conversation. The results showed that community dwelling older adults with lower cognitive functioning ability were more susceptible to the health congruence paradox on the subjective measure of the survey report. Qualitative analysis of health concerns from subjective measures found older adults most concerned about health conditions impacting daily functioning, such as mobility and cognition, but not diagnosed hypertension. This mixed methods study confirmed the importance of understanding older adults' subjective health with measures easily obtained through relational visits with university students.
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Chiavarino C, Poggio C, Rusconi F, Beretta AAR, Aglieri S. Psychological factors and self-rated health: An observative study on cardiological patients. J Health Psychol 2019; 24:1993-2002. [DOI: 10.1177/1359105317712591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study investigated the association of illness representations, awareness of bodily states and health complaints to self-rated health in N = 150 consecutive patients with heart disease (ischaemic disease, heart failure and heart valve disease) and explored differences between ‘health optimist’ and ‘health pessimist’ patients. After controlling for medical variables, health complaints accounted for 14.2 per cent of patients’ self-rated health, and illness representations contributed for another 16.2 per cent; body awareness was not associated with self-rated health. Also, ‘optimists’ tended to see less negative consequences from their illness and perceived greater control over illness treatment compared to ‘pessimists’. Targeting symptoms and illness representations may optimize rehabilitation outcomes.
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Rai R, Jongenelis M, Pettigrew S, Jackson B, Newton RU. Identifying modifiable factors associated with health optimism in older adults. Aging Ment Health 2019; 23:376-384. [PMID: 29271666 DOI: 10.1080/13607863.2017.1416589] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Despite the documented importance of health optimism for enhancing health outcomes, very little work has been done to examine who experiences health optimism and under what conditions. The present study sought to identify modifiable factors associated with health optimism that could constitute the focus of future intervention efforts designed to promote health optimism among older people. DESIGN Participants were 453 (44% males) community-based Western Australians aged 60+ years (M = 70.39 years, SD = 6.06). Participants completed questionnaires to assess sociodemographic characteristics and provided information relating to physical and psychological health status. RESULTS Almost a quarter of participants (24%; n = 108) were classified as health optimists. Results from a multivariate regression analysis found quality of life, psychological well-being, and age to be directly and positively associated with health optimism. A subsequent path analytic model found depression (negatively) and self-efficacy (positively) to be indirectly associated with health optimism via both psychological well-being and quality of life. CONCLUSION These findings extend the limited evidence on health optimism in older adults by identifying various modifiable factors that may constitute potential areas of focus for future interventions designed to enhance health outcomes via the fostering of health optimism.
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Affiliation(s)
- Rajni Rai
- a School of Psychology , Curtin University , Bentley , Australia
| | | | - Simone Pettigrew
- a School of Psychology , Curtin University , Bentley , Australia
| | - Ben Jackson
- b School of Human Sciences , The University of Western Australia , Perth , Australia
| | - Robert U Newton
- c School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia
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Araújo L, Teixeira L, Ribeiro O, Paúl C. Objective vs. Subjective Health in Very Advanced Ages: Looking for Discordance in Centenarians. Front Med (Lausanne) 2018; 5:189. [PMID: 29998108 PMCID: PMC6028557 DOI: 10.3389/fmed.2018.00189] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/08/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Living beyond 100 years of age is associated with several functional and health constraints but their impact depends on one's perception of the situation. Associations between self-rated health (SRH) with sociodemographic and psychosocial variables have been explored in several studies, revealing that one's health appraisal depends of factors beyond the objective health condition. There is a large body of literature concerning SRH in later life but lack of evidence about centenarians' perception of health and its associated factors, which could increase the available knowledge on the strengths and resources individuals in very advanced ages have for facing daily life limitations. Objective and Methods: This study aims to analyse the relationship between subjective and objective health status in a sample of centenarians (n = 127). Subjective health was assessed by a single-item health measure, and objective health by considering the number of reported diseases and a functional capacity scale (BADL and IADL). Main health characteristics are described as well as examined the association between objective and subjective health. Results: 46.5% of the sample has a good, very good, or excellent appraisal of their own health. SRH was associated (p < 0.05) with BADL and IADL scores and with the total number of diagnosis; when analyzing SRH according to the level of functional capacity, results revealed that most individuals with severe and moderate dependence have a reasonable to excellent SRH (p > 0.05). Conclusion: Having diseases and functional dependence at 100 years old may not mean to have a bad SRH. The high variability in SRH and the discordance between objective and subjective measures are a proof of centenarian's capacity of adaptation and the existence of individual resources, which may be decisive for one' perception and handling of health situation at such an advanced age.
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Affiliation(s)
- Lia Araújo
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
- School of Education, Polytechnic Institute of Viseu, Viseu, Portugal
| | - Laetitia Teixeira
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Constança Paúl
- Center for Health Technology and Services Research, Institute of Biomedical Sciences Abel Salazar (CINTESIS-ICBAS), University of Porto, Porto, Portugal
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Lau BHP, Kwan JSK, Cheung KSL, Martin P. Depression Moderates the Frailty-Subjective Health Link among Chinese Near Centenarians and Centenarians. Am J Geriatr Psychiatry 2016; 24:753-61. [PMID: 27423304 DOI: 10.1016/j.jagp.2016.05.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 04/19/2016] [Accepted: 05/20/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Very old adults may be physically frail, but they do not necessarily experience poor subjective health. The authors hypothesized that the relationship between frailty and subjective health is moderated by depression for very old people. METHODS In a cross-sectional study, a survey administered was by a face-to-face interview to 129 community-dwelling older adults aged 95-108. Measurements included the five-item FRAIL scale, the Geriatric Depression Scale Short-Form (GDS), and a subjective health rating. Hierarchical multiple regressions were conducted to test the moderation effects, adjusting for age, gender, living arrangement, perceived socioeconomic status, and cognition. RESULTS The interaction effect between frailty and depression was significant. Inspection of the simple slopes revealed that those who were more depressed had a more negative frailty-subjective health relationship. There was no significant moderation effect for a withdrawal-apathy-vigor dimension of the GDS. CONCLUSION Our findings suggest a protective psychological mechanism may enable very old adults to maintain an optimistic view of their health despite their increasing physical and functional limitations.
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Affiliation(s)
- Bobo Hi-Po Lau
- Faculty of Social Sciences, University of Hong Kong, Hong Kong
| | | | - Karen Siu-Lan Cheung
- Department of Social Work and Social Administration & Sau Po Centre on Ageing, University of Hong Kong, Hong Kong
| | - Peter Martin
- Human Development and Family Studies, College of Human Sciences, Iowa State University, Ames, IA
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Mitchell JA, Manning M, Shires D, Chapman RA, Burnett J. Fatalistic Beliefs About Cancer Prevention Among Older African American Men. Res Aging 2015; 37:606-22. [PMID: 25651585 PMCID: PMC4334730 DOI: 10.1177/0164027514546697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Evidence suggests that minority groups are more likely to exhibit fatalistic beliefs about cancer prevention (FBCP), which are defined as confusion, pessimism, and helplessness about one's ability to prevent cancer. This study examines the socioeconomic and psychosocial predictors of FBCP among older African American men (AAM). METHODS AAM (N = 1,666) enrolled in Medicare and participating in a longitudinal study on patient navigation were surveyed. Measures included three FBCP constructs, namely demographic items and physical and mental health variables. Binary logistic regression was performed. RESULTS The average participant was 73.6 years old; 76.5% felt helpless, 44.2% were confused, and 40.7% were pessimistic about the ability to prevent cancer. As education increased, so did all three FBCP. Being downhearted was predictive of confused and helpless beliefs. DISCUSSION It is critical for health practitioners to understand how psychosocial and economic challenges influence beliefs that may impede cancer prevention efforts for older AAM.
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Affiliation(s)
- Jamie A. Mitchell
- School of Social Work and Institute of Gerontology, Wayne State University, 4756 Cass Avenue, Detroit, MI 48202, , Phone: (313) 577-4408, Fax: (313) 577-8770
| | - Mark Manning
- Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, 4100 John R - MM03BF, Detroit, MI 48201, , Phone: 313-576-8703, Fax: 313-576-8270
| | - Deirdre Shires
- School of Social Work, Wayne State University, Thompson Home, 4756 Cass Avenue, , Detroit, MI, 48202, Phone: 313-577-4400
| | - Robert A. Chapman
- Division Head, Hematology/Oncology, Henry Ford Health System, 2799 W Grand Blvd # K9 Detroit, MI 48202, (313) 916-2719,
| | - Janice Burnett
- Josephine Ford Cancer Center, Senior Support, 3031 West Grand Blvd, suite 621, Detroit, MI 48202, 313-916-9228,
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Branco K, Crane J. Religiousness, Coping Styles, and Situational Optimism Among Nursing Home Residents. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2014. [DOI: 10.1080/15528030.2013.807485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shmotkin D, Shrira A, Eyal N, Blumstein T, Shorek A. The prediction of subjective wellness among the old-old: implications for the "fourth-age" conception. J Gerontol B Psychol Sci Soc Sci 2013; 69:719-29. [PMID: 23740093 DOI: 10.1093/geronb/gbt052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES As the "fourth-age" conception suggests that the adaptability of psychosocial capabilities is disrupted at old-old age due to failures in maintaining balanced functions, this study examines the predictability of subjective wellness outcomes by factual dysfunction markers of health among old-old people across 12 years. METHOD Participants were self-respondents in a 3-wave survey that sampled the older (age 75-94) Jewish population in Israel. Wave 1 (N = 1,369, mean age = 83.5) preceded Wave 2 (N = 687, mean age = 85.4) by 4 years and Wave 3 (N = 164, mean age = 91.6) by 12 years. RESULTS The dysfunction markers (comorbidity, medication consumption, doctor's visits, and difficulties in activities of daily living [ADL]) predicted subjective wellness by relating to an increase in depressive symptoms, as well as to a decrease in life evaluation and self-rated health, beyond adjustment for sociodemographics. However, in most cases, an interaction finding indicated that dysfunction markers were weaker predictors of age-related change in subjective wellness among older participants. DISCUSSION At old-old age, the results point to reduced predictability of subjective wellness by factual dysfunction. This finding supports the fourth-age model. Still, researchers should consider an alternative interpretation, by which increasing independence between factual and subjective indicators is protective, rather than debilitating, among old-old people.
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Affiliation(s)
- Dov Shmotkin
- School of Psychological Sciences and Herczeg Institute on Aging, Tel Aviv University, Israel.
| | - Amit Shrira
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Nitza Eyal
- Herczeg Institute on Aging, Tel Aviv University, Israel
| | - Tzvia Blumstein
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Aviva Shorek
- Herczeg Institute on Aging, Tel Aviv University, Israel
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Examining the role of positive and negative affect in recovery from spine surgery. Pain 2011; 153:518-525. [PMID: 22119337 DOI: 10.1016/j.pain.2011.10.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 09/21/2011] [Accepted: 10/06/2011] [Indexed: 11/24/2022]
Abstract
Consistent evidence supports a significant association between lower positive affect and higher negative affect and increased pain and disability in adults with chronic pain. However, examining this relation in surgical populations has received little empirical consideration. The primary purpose of this study was to determine whether preoperative and postoperative positive and negative affect predict pain, disability, and functional status after spine surgery. A secondary objective was to assess the relation of depression to postoperative outcomes compared with positive and negative affect. Participants were 141 patients treated by spine surgery for lumbar or cervical degeneration. Data collection occurred at baseline and 6 weeks and 3 months postoperatively. Affect was measured with the Positive and Negative Affect Schedule. Multivariable mixed-model linear regression analyses found that preoperative variables were not predictive of postoperative pain, disability and functional status. However, multivariable postoperative analysis found that 6-week positive affect predicted functional status, and 6-week negative affect predicted pain interference and pain-related disability at 3 months following surgery. Postoperative depression demonstrated statistically significant and stronger associations with pain intensity, pain interference, and pain-related disability at 3-month follow-up, as compared with negative affect. Results suggest that positive affect and depression are important variables to target when seeking to improve postoperative outcomes in a spine surgery population. Recommendations include postoperative screening for positive affect and depression, and treating depression as well as focusing on rehabilitation strategies to bolster positive affect so as to improve functional outcomes after spine surgery.
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Ruthig JC, Chipperfield JG, Payne BJ. A five-year study of older adults’ health incongruence: Consistency, functional changes and subsequent survival. Psychol Health 2011; 26:1463-78. [DOI: 10.1080/08870446.2010.515307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Depressive symptoms in old age: relations among sociodemographic and self-reported health variables. Int Psychogeriatr 2011; 23:941-9. [PMID: 21486519 DOI: 10.1017/s1041610211000627] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Depression in old age is a complex multifactorial phenomenon that is influenced by several biopsychosocial variables. Depressive symptoms are associated with the presence of chronic diseases, with being female, with low education and low income levels, and with poor perceived health assessment. In impoverished areas, older adults may have more physical disability, as they may have less access to health services. Therefore, they may be more likely to report depressive symptoms. METHODS Population-based cross-sectional research was undertaken using data from the FIBRA study conducted in Ermelino Matarazzo, a poor subdistrict of the city of São Paulo, Brazil. The participants comprised 303 elderly people, aged 65 years and over, who attended a single-session data collection effort carried out at community centers. The protocol comprised sociodemographic and self-reported health variables, and the Geriatric Depression Scale. RESULTS The majority of the subjects reported five or fewer symptoms of depression (79.21%), reported one or two self-reported chronic diseases (56.86%), declared themselves to have one or two self-reported health problems (46.15%), and had good perceived health assessment (40.27%). The presence of depressive symptoms was associated with a higher number of self-reported health problems, poor perceived health assessment, and lower schooling levels, in the total sample and in analyses including men only. For women, depressive symptoms were associated with the number of self-reported health problems and family income. CONCLUSION The presence of health problems, such as falls and memory problems, lower perceived health, and low education (and low family income for women) were associated with a higher presence of depressive symptoms among elderly people in this poor area of São Paulo.
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Ruthig JC, Hanson BL, Pedersen H, Weber A, Chipperfield JG. Later life health optimism, pessimism and realism: psychosocial contributors and health correlates. Psychol Health 2011; 26:835-53. [PMID: 21432733 DOI: 10.1080/08870446.2010.506574] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.
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Affiliation(s)
- Joelle C Ruthig
- Department of Psychology, University of North Dakota, 319 Harvard Street, Stop 8380, Grand Forks, ND 58202, USA.
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Frisco ML, Houle JN, Martin MA. The image in the mirror and the number on the scale: weight, weight perceptions, and adolescent depressive symptoms. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2010; 51:215-228. [PMID: 20617760 PMCID: PMC3610322 DOI: 10.1177/0022146510372353] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Double jeopardy and health congruency theories suggest that adolescents' joint experience of their weight and weight perceptions are associated with depressive symptoms, but each theory offers a different prediction about which adolescents are at greatest risk. This study investigates the proposed associations and the applicability of both theoretical perspectives using data from 6,557 male and 6,126 female National Longitudinal Study ofAdolescent Health (Add Health) Wave II participants. Empirically, results indicate that focusing on the intersection of weight and weight perceptions better shows which adolescents are at risk of depressive symptoms than an approach that treats both predictors as independent, unrelated constructs. Weight pessimists are at greatest risk of depressive symptoms. Thus, results support the health congruency framework, its extension to subpopulations outside of older adults, and its extension to optimism and pessimism about specific health conditions.
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Affiliation(s)
- Michelle L Frisco
- Department of Sociology, Penn State University, 211 Oswald Tower, University Park, PA 16802, USA.
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Coping styles in heart failure patients with depressive symptoms. J Psychosom Res 2009; 67:339-46. [PMID: 19773027 PMCID: PMC2751656 DOI: 10.1016/j.jpsychores.2009.05.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 03/24/2009] [Accepted: 05/26/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Elevated depressive symptoms have been linked to poorer prognosis in heart failure (HF) patients. Our objective was to identify coping styles associated with depressive symptoms in HF patients. METHODS A total of 222 stable HF patients (32.75% female, 45.4% non-Hispanic black) completed multiple questionnaires. Beck Depression Inventory (BDI) assessed depressive symptoms, Life Orientation Test (LOT-R) assessed optimism, ENRICHD Social Support Inventory (ESSI) and Perceived Social Support Scale (PSSS) assessed social support, and COPE assessed coping styles. Linear regression analyses were employed to assess the association of coping styles with continuous BDI scores. Logistic regression analyses were performed using BDI scores dichotomized into BDI<10 vs. BDI> or =10, to identify coping styles accompanying clinically significant depressive symptoms. RESULTS In linear regression models, higher BDI scores were associated with lower scores on the acceptance (beta=-.14), humor (beta=-.15), planning (beta=-.15), and emotional support (beta=-.14) subscales of the COPE, and higher scores on the behavioral disengagement (beta=.41), denial (beta=.33), venting (beta=.25), and mental disengagement (beta=.22) subscales. Higher PSSS and ESSI scores were associated with lower BDI scores (beta=-.32 and -.25, respectively). Higher LOT-R scores were associated with higher BDI scores (beta=.39, P<.001). In logistical regression models, BDI> or =10 was associated with greater likelihood of behavioral disengagement (OR=1.3), denial (OR=1.2), mental disengagement (OR=1.3), venting (OR=1.2), and pessimism (OR=1.2), and lower perceived social support measured by PSSS (OR=.92) and ESSI (OR=.92). CONCLUSION Depressive symptoms in HF patients are associated with avoidant coping, lower perceived social support, and pessimism. Results raise the possibility that interventions designed to improve coping may reduce depressive symptoms.
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Hong SI, Chen LM. Contribution of residential relocation and lifestyle to the structure of health trajectories. J Aging Health 2008; 21:244-65. [PMID: 19114610 DOI: 10.1177/0898264308328960] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Underlining ecological theories of aging, we assessed the impact of relocation, residential type, and individual lifestyle factors on the structure of health status overtime. METHODS From the data of Longitudinal Study on Aging II, we included older adults aged 70 and older (N = 5,294). To analyze individual longitudinal trajectories of health outcomes, Latent Growth Curve Modeling (LGCM) was employed. RESULTS LGCMs supported that older adults' residential relocation and health-related lifestyles were important in preserving better health outcomes. Multiple structural equations corroborated the causal chains in the multidimensionality of health structure. DISCUSSION These findings suggest a necessity to design policies for older adults to create a synergy between housing and health care and to translate meaningful health-related lifestyles into diverse long-term care settings.
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Affiliation(s)
- Song-Iee Hong
- Department of Social Work, National University of Singapore, Block AS3, Level 4, 3 Arts Link, Singapore 117570.
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Abstract
Addressing the need to explore how Native American (NA) elders' subjective health (SH) compares to their objective health (OH; chronic disease conditions), we examined whether: congruence between 8191 NA elders' SH and OH parallels that of non-NA elders; health optimism (SH > OH) is protective and health pessimism (SH < OH), is detrimental; and whether gender moderates links between health congruence and health-related outcomes. Results comparing health optimists and pessimists to realists in functioning, hospitalizations, and social engagement showed optimists experienced better outcomes; pessimists had poorer outcomes; the role of health congruence differed by gender. Findings suggest implications for improving health-related outcomes among NA elders.
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Hu J, Gruber KJ. Positive and negative affect and health functioning indicators among older adults with chronic illnesses. Issues Ment Health Nurs 2008; 29:895-911. [PMID: 18649214 DOI: 10.1080/01612840802182938] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Emotional states have been linked with physical and mental health outcomes. In this study the role of positive and negative affect was investigated as determinants of health functioning for a community-dwelling sample of 153 older adults (age 60 or older) with chronic illnesses. High positive affect and low negative affect were found to be associated with lower levels of symptom distress, fewer depressive symptoms, higher daily activity scores, and higher perceived physical and mental health-related quality of life. These results have important clinical implications for the use of positive and negative affect as an indicator of life functioning among older adults. The relationship of positive and negative affect to reported health functioning found in this study suggests that measuring affect can provide a valuable means for understanding how individuals view their mental health as well as their symptoms of illness.
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Affiliation(s)
- Jie Hu
- The University of North Carolina at Greensboro, Greensboro, School of Nursing, North Carolina 27402-6170, USA. jie
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Abstract
OBJECTIVE Accumulating evidence indicates the beneficial effects of positive emotion on health and general well-being in older age. Less evidence is available on whether positive emotion supports improvement in functional status after an acute medical event such as stroke. This study examined the association between positive emotion at discharge from inpatient medical rehabilitation and functional status 3 months later in persons with stroke. METHODS A longitudinal study using information from the Stroke Recovery in Underserved Patients database. The study included 823 persons aged 55 years or older with stroke and admitted to an inpatient medical rehabilitation facility. Information was collected during inpatient medical rehabilitation stay and approximately 3 months after discharge. RESULTS The mean age of the sample was 72.8 years (SD = 9.5), 51.5% were women and 53.8% were married. The sample was mostly non-Hispanic white (79.2%), followed by non-Hispanic black (15.0%) and Hispanic (5.8%). The average length of stay was 20.1 day (SD = 10.1). In multivariate regression analyses, discharge positive emotion score was significantly associated with higher overall functional status (b = 0.70, SE = 0.21, p = .001) as well as with higher motor (b = 0.37, SE = 0.17, p = .003) and cognitive (b = 0.30, SE = 0.05, p = .0001) status at 3-month follow-up after adjustment for relevant risk factors. CONCLUSIONS Our results indicate positive emotion is associated with gains in functional status after stroke. Findings have implications for stroke recovery programs and suggest the need to include measures of positive emotion inpatient assessments.
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Allaire JC, Tamez E, Whitfield KE. Examining the association between lung functioning and cognitive performance in African American adults. J Aging Health 2007; 19:106-22. [PMID: 17215204 DOI: 10.1177/0898264306297190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED The current study examined the extent to which pulmonary functioning, as measured by average peak expiratory flow, was related to performance on seven cognitive measures. Analyses were conducted on a sample of 396 African American adults ranging in age from 22 to 89 years. RESULTS Lung functioning was not uniquely associated with cognitive performance in the younger adults, though it emerged as a significant predictor of individual differences in performance on the Telephone Interview of Cognitive Status even after controlling for age, education, and smoking history. Biobehavioral assessments such as the one presented here appear to provide important new insights into the sources of individual differences in cognition observed in this understudied population.
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Kelley-Moore JA, Schumacher JG, Kahana E, Kahana B. When do older adults become "disabled"? Social and health antecedents of perceived disability in a panel study of the oldest old. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2006; 47:126-41. [PMID: 16821507 PMCID: PMC2134789 DOI: 10.1177/002214650604700203] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Disability carries negative social meaning, and little is known about when (or if), in the process of health decline, persons identify themselves as "disabled." We examine the social and health criteria that older adults use to subjectively rate their own disability status. Using a panel study of older adults (ages 72+), we estimate ordered probit and growth curve models of perceived disability over time. Total prevalent morbidity, functional limitations, and cognitive impairment are predictors of perceived disability. Cessation of driving and receipt of home health care also influence older adults 'perceptions of their own disability. A dense social network slowed the rate of labeling oneself disabled, while health anxiety accelerated the process over time, independent of health status. When considering perceived disability, the oldest old use multidimensional criteria capturing function, recent changes in health status and social networks, and anxiety about their health.
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Fors S, Thorslund M, Parker MG. Do actions speak louder than words? Self-assessed and performance-based measures of physical and visual function among old people. Eur J Ageing 2006; 3:15-21. [PMID: 28794746 DOI: 10.1007/s10433-006-0021-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Self-assessments and performance-based tests are methods commonly used to assess physical function in health surveys of older people. It has been suggested that the choice of method could affect the results, particularly in certain groups. This study compares results attained using self-assessed and performance-based measures of upper and lower body function and vision. The influence of sex, age, education and cognitive status is explored. This is done by studying the prevalence rates of self-reported and observed limitations in function, the prevalence rates of discrepancies between measures and the prevalence rates as well as the odds ratios of discrepancies depending on sex, age, education and cognitive status. Data are from a nationally representative sample of the Swedish population aged 77 or above (n=492). The results show that discrepancies occur among a minority of the sample and with no distinctive bias toward either under- or overestimations of functional ability at the cross-sectional level. Cognitive impairment seemed to increase the risk of discrepancies. Women showed an increased tendency toward discrepancies between measures of upper body function. Age and education showed associations with some discrepancies but were not significant in the multiple regression models. In conclusion, there is a risk of systematic biases in the association between self-assessed and performance-based measures of function. At the cross-sectional level, however, these differences are small.
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Affiliation(s)
- Stefan Fors
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Mats Thorslund
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
| | - Marti G Parker
- Aging Research Center, Karolinska Institute and Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden
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Hong TB, Oddone EZ, Dudley TK, Bosworth HB. Subjective and objective evaluations of health among middle-aged and older veterans with hypertension. J Aging Health 2005; 17:592-608. [PMID: 16177452 DOI: 10.1177/0898264305279780] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The congruence between self-rated health and objective health was examined for associations with health factors related to hypertension (health behaviors, medication barriers, and perceived blood-pressure control). METHODS The Charlson Comorbidity Index was cross classified with self-rated health, producing four health-congruence groups: good health realists, poor health realists, health optimists, and health pessimists. Data for this study were obtained from 588 hypertensive veterans (mean age = 63) at baseline of a clinical trial to improve blood-pressure control before randomization to an intervention. RESULTS Optimists had higher perceived control of their hypertension when compared to pessimists. Additionally, optimists had higher levels of exercise and fewer medication barriers when compared to poor health realists. DISCUSSION Health congruence classification could be a useful tool to alert practitioners of patients who may be having difficulties managing their hypertension.
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Affiliation(s)
- Tantina B Hong
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Duke University Medical Center, Building 16, Room 70, 508 Fulton St., Durham, NC 27705, USA.
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