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Rozani V. Ethnic Differences in Socioeconomic and Health Determinants Related to Self-Rated Health Status: A Study on Community-Dwelling Israeli Jews and Arabs in Old Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13660. [PMID: 36294239 PMCID: PMC9603467 DOI: 10.3390/ijerph192013660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Self-rated health (SRH) is widely used as a proxy for general health status. In old age, SRH has been found to be a strong predictor of morbidity, physical functioning, recovery from illness, use of health services, and mortality. This study was designed to examine differences in socioeconomic and health determinants related to self-rated health status among community-dwelling Jews and Arabs aged 65+ years. Cross-sectional data from 2011 on such Jews and Arabs were extracted from reprehensive National Surveys. The association between socioeconomic and health factors with poor SRH was estimated using three hierarchical logistic regression models. The majority of the respondents were Jews (86%), with a mean age of 73.1 (±6.3) years. The study revealed that older Arabs are disadvantaged according to almost every socioeconomic and health indicator compared to Jews. Poor SRH was significantly associated with age (OR = 1.03, p = 0.002), ethnicity (Jews OR = 2.62, p < 0.001), unemployment/retirement (OR = 2.03, p < 0.001), low income (OR = 3.03, p < 0.001), low education (OR = 1.37, p = 0.013), absence of physical activity (OR = 2.17, p < 0.001), dentures (OR = 1.40, p = 0.002), and prevalence of one or more chronic diseases (OR = 4.06, p < 0.001). The findings therefore indicated that these factors need to be detected and focused on by health professionals in order to improve the population's general health status.
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Affiliation(s)
- Violetta Rozani
- Department of Nursing, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Viana RT, de Freitas Araújo É, Lima LAO, Teixeira-Salmela LF, de Morais Faria CDC. General and comparative self-rated health in chronic stroke: an important outcome measure for health professionals. BMC Neurol 2022; 22:78. [PMID: 35255837 PMCID: PMC8900340 DOI: 10.1186/s12883-022-02592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND After a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors. METHODS Sixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%). RESULTS General SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function. CONCLUSION SRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains.
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Affiliation(s)
- Ramon Távora Viana
- Department of Physical Therapy, Faculty of Medicine, Universidade Federal Do Ceará, Fortaleza, Brazil
| | - Érika de Freitas Araújo
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 1270-901, MG, Belo Horizonte, Brazil
| | | | - Luci Fuscaldi Teixeira-Salmela
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 1270-901, MG, Belo Horizonte, Brazil
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Wettstein M, Schilling OK, Wahl HW. Trajectories of Pain in Very Old Age: The Role of Eudaimonic Wellbeing and Personality. FRONTIERS IN PAIN RESEARCH 2022; 3:807179. [PMID: 35295803 PMCID: PMC8915612 DOI: 10.3389/fpain.2022.807179] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/26/2022] [Indexed: 11/27/2022] Open
Abstract
Pain is common in very old age and in the last years prior to death. However, little is known regarding longitudinal trajectories of pain in very old age and at the end of life. Moreover, whereas medical and morbidity-related factors contributing to pain are established, the role of psychosocial factors, such as eudaimonic wellbeing or personality as potential determinants of late-life pain trajectories has so far not been sufficiently investigated. We used data from the LateLine project. The sample consisted of n = 118 very old adults (M = 90.5 years, SD = 2.8 years) who were living alone at baseline and who had died between 2009 and 2021. They took part in up to 16 measurement occasions (M = 5.2, SD = 4.7, range 1–16) within an observational interval of 7 years. Assessment of pain was based on the SF-36 bodily pain subscale. Key indicators of eudaimonic wellbeing (autonomy, environmental mastery, and purpose in life) as well two of the Big Five personality traits (neuroticism and extraversion) were included as predictors. We controlled in all analyses for gender, education, subjective health, and depressive symptoms. Contrasting pain trajectories over chronological age (time since birth) vs. time to death, a time-to-death-related model resulted in a better model fit and accounted for a larger amount of pain variability than the age-related model. Mean-level change in pain, both over age and time to death, was not significant, but there was substantial interindividual variability in intraindividual trajectories. Age-related change in pain was significantly predicted by autonomy and neuroticism, with increasing pain among those who had lower initial autonomy scores and higher initial neuroticism scores. With regard to time-to-death-related trajectories of pain, higher purpose in life as well as lower extraversion at baseline predicted less increase or even steeper decrease in pain with approaching death. Our findings suggest that, despite overall mean-level stability in pain both over age and time to death, there is a substantial proportion of individuals who reveal deterioration in pain over time. Regarding the role of psychosocial predictors, personality traits and eudaimonic wellbeing are related with late-life pain trajectories both over age and time-to-death.
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Affiliation(s)
- Markus Wettstein
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- *Correspondence: Markus Wettstein
| | - Oliver Karl Schilling
- Department of Psychological Aging Research, Psychological Institute, Heidelberg University, Heidelberg, Germany
| | - Hans-Werner Wahl
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Department of Psychological Aging Research, Psychological Institute, Heidelberg University, Heidelberg, Germany
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Borim FSA, de Assumpção D, Neri AL, Batistoni SST, Francisco PMSB, Yassuda MS. Impact of functional capacity on change in self-rated health among older adults in a nine-year longitudinal study. BMC Geriatr 2021; 21:627. [PMID: 34736401 PMCID: PMC8567595 DOI: 10.1186/s12877-021-02571-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
The aims of the present study were to estimate the frequency of change in self-rated health (SRH) among community-dwelling older adults, between two measures taken at a 9-year interval; and determine factors associated with a decline and an improvement in SRH, in relation to aspects of physical/emotional health and subjective wellbeing. Data were derived from a community-based study on frailty among Brazilian elderly. Associations were investigated using Pearson’s chi-square test and relative risk ratios were estimated using multinomial logistic regression analysis. 39.3% of participants did not change their SRH at both assessment times, 21.7% rated it as worse and 39.0% rated it as better. The relative risk ratio of an improvement in SRH for individuals with disability in basic activities of daily living (ADLs) was lower than for individuals with independence in basic ADLs (IRR=0.22; IC95%: 0.08-0.63). Understanding the complex interactions between self-rated health and the dimensions that influence the improvement of health perception may shed light on key determinants of the wellbeing among older adults.
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Affiliation(s)
- Flávia Silva Arbex Borim
- Postgraduate Program in Gerontology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.,Department of Collective Health, School of Health Sciences, University of Brasilia, Brasília, DF, Brazil
| | - Daniela de Assumpção
- Postgraduate Program in Gerontology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Anita Liberalesso Neri
- Postgraduate Program in Gerontology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Samila Sathler Tavares Batistoni
- Postgraduate Program in Gerontology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.,School of Arts, Sciences and Humanities, Universidade de São Paulo, Arlindo Bettio, 1000, Ermelino Matarazzo, São Paulo, SP, CEP 03828-000, Brazil
| | | | - Monica Sanches Yassuda
- Postgraduate Program in Gerontology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil. .,School of Arts, Sciences and Humanities, Universidade de São Paulo, Arlindo Bettio, 1000, Ermelino Matarazzo, São Paulo, SP, CEP 03828-000, Brazil.
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Henning-Smith C, Lahr M, Tanem J. " They're not leaving their home; this is where they were born, this is where they will die.": Key Informant Perspectives From the U.S. Counties With the Greatest Concentration of the Oldest Old. Res Aging 2021; 44:312-322. [PMID: 34259090 DOI: 10.1177/01640275211032387] [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: 11/16/2022]
Abstract
The "oldest old," age 85 and older, constitute one of the fastest growing segments of the U.S. population. Yet, surprisingly little is known about the characteristics of U.S. counties with the highest percentage of the oldest old, nearly all of which are rural. We used qualitative analysis of key informant interviews (n = 50) with county commissioners and other county-level representatives from rural counties with the highest prevalence of the oldest old, targeting the 54 rural counties with ≥5% of the population age 85+. We found that the rural counties with the highest proportion of residents age 85+ face unique challenges to supporting successful aging among the oldest old, including resource constraints, limited services, isolated locations, and widespread service areas. Still, interviewees identified particular reasons why the oldest old remain in their counties, with many highlighting positive aspects of rural environments and community.
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Affiliation(s)
- Carrie Henning-Smith
- Division of Health Policy and Management, 43353University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Megan Lahr
- Division of Health Policy and Management, 43353University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Jill Tanem
- Division of Health Policy and Management, 43353University of Minnesota School of Public Health, Minneapolis, MN, USA
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Araújo ÉDF, Viana RT, Teixeira-Salmela LF, Lima LAO, Faria CDCDM. Self-rated health after stroke: a systematic review of the literature. BMC Neurol 2019; 19:221. [PMID: 31493791 PMCID: PMC6731602 DOI: 10.1186/s12883-019-1448-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/26/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Self-rated health (SRH) allows for comparison and identification of the health status of various populations. The aim of this study was to conduct a systematic review of the literature to expand the understanding of SRH after stroke. METHODS This systematic review was registered with PROSPERO (CRD42017056194) and conducted according to PRISMA guidelines. Studies published until December 2018 that evaluated the SRH of adults with stroke were included. RESULTS Of the 2132 identified studies, 51 were included. Only four studies had experimental designs (7.8%). In 60.7% of the studies, SRH was assessed by variations on direct questions (i.e., general and comparative SRH). Analog visual scales and quality of life instruments were also used to evaluate SRH, but there is no consensus regarding whether they are appropriate for this purpose. The results of cross-sectional and longitudinal studies revealed significant associations between poor SRH and stroke as well as between SRH, function, and disability. The power of SRH to predict stroke mortality is still uncertain. Two interventions (a home-based psychoeducational program concerning stroke health care and family involvement in functional rehabilitation) effectively improved SRH. CONCLUSIONS Direct questions are the most common method of evaluating SRH after stroke. Studies reported significant associations between the SRH of individuals with stroke and several relevant health outcomes. However, few experimental studies have evaluated SRH after stroke. Interventions involving health education and family involvement had a significant impact on SRH.
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Affiliation(s)
- Érika de Freitas Araújo
- Graduate Program in Rehabilitation Sciences of the Universidade Federal de Minas Gerais, (UFMG), Belo Horizonte, MG Brazil
| | - Ramon Távora Viana
- Graduate Program in Rehabilitation Sciences of the Universidade Federal de Minas Gerais, (UFMG), Belo Horizonte, MG Brazil
- Department of Physical Therapy, Universidade Federal do Ceará (UFC), Fortaleza, Ceará Brazil
| | - Luci Fuscaldi Teixeira-Salmela
- Department of Physical Therapy, Universidade Federal de Minas Gerais, (UFMG), Av. Antonio Carlos, 6627, Campus Pampulha, Belo Horizonte, MG ZIP code 31270-901 Brazil
| | | | - Christina Danielli Coelho de Morais Faria
- Department of Physical Therapy, Universidade Federal de Minas Gerais, (UFMG), Av. Antonio Carlos, 6627, Campus Pampulha, Belo Horizonte, MG ZIP code 31270-901 Brazil
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