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Osho OA, Harbidge C, Hogan DB, Manns PJ, Jones CA. Evaluation of a balance and mobility program for older adults at risk of falling: a mixed methods study. J Eval Clin Pract 2021; 27:307-315. [PMID: 32452089 DOI: 10.1111/jep.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022]
Abstract
RATIONAL, AIMS, AND OBJECTIVES The FallProof Balance and Mobility Program is a multifactorial fall prevention intervention that targets intrinsic risk factors such as muscle strength, balance, gait, and posture. Using mixed methods, we evaluated the implementation of the program for older adults at high risk of falling in the community. METHODS A pre-post program evaluation and semi-structured interviews were used to evaluate FallProof Balance and Mobility Program offered to older adults who were recurrent fallers. Over a 1-year period, the 12-week program was offered five times. Feasibility, acceptability, and outcome evaluation along with semi-structured interviews were done. Over the course of the evaluation, participants were evaluated three times (baseline, 12, and 16 weeks). RESULTS Of the 19 participants, who enrolled in the program, 16 completed the program and 12 attended at least 80% of the classes. Fourteen participants had mildly impaired cognition (Montreal Cognitive Assessment <26). Large gains (effect size 0.90) were seen with self-management (Partner-in-Health Scale). Participants were very satisfied with the program. Three themes emerged from the semi-structured interviews: (a) fall-related benefits, (b) variety of activities and motivating instructors, and (c) deterrents to participation. CONCLUSION Findings provided insights into pragmatic issues of implementing a balance and mobility program for older adults at risk of falling. The FallProof program was found to be feasible and acceptable in a small cohort of older adults from the community.
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Affiliation(s)
- Oluwaseyi A Osho
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Cathy Harbidge
- Calgary Fall Prevention Clinic, Alberta Health Services, Calgary, Alberta, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Patricia J Manns
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - C Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Kim HP, Lieber SR, Rogers ME, Moon AM, Loiselle M, Walker J, Assis DN, Safer R, Gomel R, Evon DM. A Systematic Review of Patient-Reported Outcomes in Primary Biliary Cholangitis and Primary Sclerosing Cholangitis. Hepatol Commun 2020; 4:1502-1515. [PMID: 33024919 PMCID: PMC7527768 DOI: 10.1002/hep4.1567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/03/2020] [Accepted: 06/14/2020] [Indexed: 12/17/2022] Open
Abstract
Primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC) are associated with decreased health-related quality of life and debilitating symptoms. These experiences can be defined as patient-reported outcome (PRO) concepts and measured using PRO instruments. We identified all PRO concepts and instruments used in the PBC and PSC literature. This systematic review identified PBC and/or PSC studies from January 1, 1990, to May 6, 2019, that measured at least one PRO concept. Study population, design, PRO concept, PRO instrument, and validation data for PRO instruments were investigated. We provided descriptive statistics of PRO concepts and instruments used, stratified by population type. Use of PRO concepts and instruments were assessed over time. The search yielded 318 articles (69% in PBC, 18% in PSC, 13% in both, and 24% in drug trials). Forty-nine unique PRO concepts were identified. The five most common PRO concepts included pruritus (25%), fatigue (19%), broad health-related quality of life (16%), gastrointestinal adverse events (6%), and physical adverse events (6%). Only 60% of PRO concepts were measured with a PRO instrument, most of which were nonvalidated visual analogue or numeric rating scales. Only three of 83 PRO instruments were developed with feedback from the target populations (one for PBC, one for PSC, and one for both), and only six documented any psychometric testing in the target populations. Use of PRO instruments increased over time from 30% in the 1990s to 67% by 2019. Conclusion: The overwhelming majority of PRO instruments used in PBC/PSC were nonspecific and lacked patient validation or empirical justification. Significant opportunities exist to use qualitative methods to better understand patient experiences, and translate this knowledge into meaningful, patient-driven study outcomes.
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Affiliation(s)
- Hannah P. Kim
- Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of North CarolinaChapel HillNC
| | - Sarah R. Lieber
- Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of North CarolinaChapel HillNC
| | - Michael E. Rogers
- Division of Pediatric GastroenterologyDepartment of PediatricsUniversity of North CarolinaChapel HillNC
| | - Andrew M. Moon
- Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of North CarolinaChapel HillNC
| | - Marci Loiselle
- Department of Psychiatry and Behavioral SciencesDivision of Behavioral MedicineDuke University Medical CenterDurhamNC
| | - Jennifer Walker
- University of North CarolinaHealth Sciences LibraryChapel HillNC
| | - David N. Assis
- Digestive DiseasesDepartment of MedicineYale School of MedicineNew HavenCT
| | - Ricky Safer
- PSC Partners Seeking a CureGreenwood VillageCO
| | | | - Donna M. Evon
- Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of North CarolinaChapel HillNC
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Edwards JD, Philllips CB, O'Connor ML, O'Brien JL, Hudak EM, Nicholson JS. Applying the Health Belief Model to Quantify and Investigate Expectations for Computerized Cognitive Training. JOURNAL OF COGNITIVE ENHANCEMENT 2020; 5:51-61. [PMID: 33817548 DOI: 10.1007/s41465-020-00183-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite the demonstrated benefits of computerized cognitive training for older adults, little is known about the determinants of training behavior. We developed and tested scales to quantify expectations about such training, examine whether expectations predicted training adherence, and explore if training expectations changed from pre- to post-training. Participants (N=219) were healthy older adults aged 55-96 years (M=75.36, SD=9.39), enrolled in four studies investigating Dakim, Insight, or Posit Science Brain Fitness computerized cognitive training programs. Instruments were adapted from existing health behavior scales: Self Efficacy for Cognitive Training, Outcome Expectations for Cognitive Training, Perceived Susceptibility to Cognitive Decline, Dementia or Alzheimer's Disease, and Perceived Severity of Cognitive Decline, Dementia or Alzheimer's Disease. Participants completed scales at baseline (N=219) and post-training (n=173). Eight composites were derived from factor analyses. Adherence rates were high (M=81%), but none of the composites predicted training adherence. There was an overall significant effect of time, Wilks' λ=.843, F(8, 114)=2.65, p=.010, partial η 2 =.157, a significant overall effect of training group, Wilks' λ=.770, F(16, 228)=1.99, p=.015, partial η 2 =.123, and an overall significant group x time interaction, Wilks' λ=.728, F(16, 226)=2.44, p=.002, partial η 2 =.147. Significant effects of time were found for expected psychological outcomes and self-efficacy. Post-training, participants more strongly agreed that training was enjoyable and increased their sense of accomplishment. Changes in self-efficacy for cognitive training varied by program, improvingfor Dakim- and declining for the more challenging Brain Fitness- and InSight participants. These newly devised scales may be useful for examining cognitive training behaviors. However, more work is needed to understand factors that influence older adults' enrollment in and adherence to cognitive training.
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Affiliation(s)
- Jerri D Edwards
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, USA
- Department of Communication Sciences and Disorders, University of South Florida, USA
| | | | | | - Jennifer L O'Brien
- Department of Communication Sciences and Disorders, University of South Florida, USA
- Department of Psychology, University of South Florida, USA
| | - Elizabeth M Hudak
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, USA
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Swain MG, Jones DEJ. Fatigue in chronic liver disease: New insights and therapeutic approaches. Liver Int 2019; 39:6-19. [PMID: 29935104 DOI: 10.1111/liv.13919] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/20/2018] [Indexed: 02/07/2023]
Abstract
The management of fatigue associated with chronic liver disease is a complex and major clinical challenge. Although fatigue can complicate many chronic diseases, it is particularly common in diseases with an inflammatory component. Fatigue can have both peripheral (i.e., neuromuscular) and central (i.e., resulting from changes in neurotransmission within the brain) causes. However, fatigue in chronic liver disease has strong social/contextual components and is often associated with behavioural alterations including depression and anxiety. Given the increasing awareness of patient-reported outcomes as important components of treatment outcomes and clinical research, there is a growing need to better understand and manage this poorly understood yet debilitating symptom. Although several pathophysiological mechanisms for explaining the development of fatigue have been generated, our understanding of fatigue in patients with chronic liver disease remains incomplete. A better understanding of the pathways and neurotransmitter systems involved may provide specific directed therapies. Currently, the management of fatigue in chronic liver disease can involve a combined use of methods to beneficially alter behavioural components and pharmacological interventions, of which several treatments have potential for the improved management of fatigue in chronic liver disease. However, evidence and consensus are lacking on the best approach and the most appropriate biochemical target(s) whilst clinical trials to address this issue have been few and limited by small sample size. In this review, we outline current understanding of the impact of fatigue and related symptoms in chronic liver disease, discuss theories of pathogenesis, and examine current and emerging approaches to its treatment.
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Affiliation(s)
- Mark G Swain
- Calgary Liver Unit, Division of Gastroenterology and Hepatology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - David E J Jones
- Institute of Cellular Medicine, University of Newcastle, Newcastle upon Tyne, UK
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Pericleous M, Kelly C, Ala A, De Lusignan S. The role of the chronic care model in promoting the management of the patient with rare liver disease. Expert Rev Gastroenterol Hepatol 2018; 12:829-841. [PMID: 29976101 DOI: 10.1080/17474124.2018.1497483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The chronic care model (CCM) provides a holistic approach for managing chronic illnesses. Patients with rare liver diseases (RLD) have complex needs, impaired quality of life and often life-threatening complications. Most RLD meet the criteria for a long-term chronic condition and should be viewed through the prism of CCM. We aimed to ascertain whether the CCM has been considered for the frequently-encountered RLD. METHODS MEDLINE®/PubMed®/Cochrane/EMBASE were searched to identify publications relating to the use of the CCM for the management of six RLD. We identified 33 articles eligible for inclusion. RESULTS Six, eleven, one, thirteen, two and zero studies, discussed individual components of the CCM for autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cirrhosis (PSC), Wilsons disease (WD), alpha-1 antitrypsin deficiency (A1AD) and lysosomal acid lipase deficiency (LALd) respectively. We have not identified studies using the full CCM for any of the aforementioned RLD. DISCUSSION Unlike in common chronic conditions e.g. diabetes, there has been limited consideration of the use of CCM (or its components) for the management of RLD. This may reflect a reluctance of the clinical community to view these diseases as chronic or lack of healthcare policy investment in rare diseases in general.
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Affiliation(s)
- Marinos Pericleous
- a Department of Gastroenterology and Hepatology , Royal Surrey County Hospital NHS Foundation Trust , Guildford , UK.,b Department of Clinical and experimental medicine , University of Surrey , Guildford , UK
| | - Claire Kelly
- a Department of Gastroenterology and Hepatology , Royal Surrey County Hospital NHS Foundation Trust , Guildford , UK.,b Department of Clinical and experimental medicine , University of Surrey , Guildford , UK
| | - Aftab Ala
- a Department of Gastroenterology and Hepatology , Royal Surrey County Hospital NHS Foundation Trust , Guildford , UK.,b Department of Clinical and experimental medicine , University of Surrey , Guildford , UK
| | - Simon De Lusignan
- b Department of Clinical and experimental medicine , University of Surrey , Guildford , UK
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Arkkukangas M, Sundler AJ, Söderlund A, Eriksson S, Johansson AC. Older persons' experiences of a home-based exercise program with behavioral change support. Physiother Theory Pract 2017; 33:905-913. [PMID: 28812402 DOI: 10.1080/09593985.2017.1359869] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. PURPOSE This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. METHODS Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. RESULTS Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. CONCLUSION With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.
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Affiliation(s)
- Marina Arkkukangas
- a School of Health, Care and Social Welfare, Mälardalen University , Västerås , Sweden
| | - Annelie J Sundler
- b Faculty of Caring Science, Work Life and Social Welfare , University of Borås , Sweden
| | - Anne Söderlund
- c School of Health, Care and Social Welfare , Mälardalen University , Västerås , SE , Sweden
| | - Staffan Eriksson
- d Centre for Clinical Research Sörmland , Uppsala University , Eskilstuna , Sweden.,e Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.,f Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
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Guo L, Söderhamn U, McCallum J, Ding X, Gao H, Guo Q, Liu K, Liu Y. Testing and comparing two self-care-related instruments among older Chinese adults. PLoS One 2017; 12:e0182792. [PMID: 28792975 PMCID: PMC5549914 DOI: 10.1371/journal.pone.0182792] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 07/25/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The study aimed to test and compare the reliability and validity, including sensitivity and specificity of the two self-care-related instruments, the Self-care Ability Scale for the Elderly (SASE), and the Appraisal of Self-care Agency Scale-Revised (ASAS-R), among older adults in the Chinese context. METHODS A cross-sectional design was used to conduct this study. The sample consisted of 1152 older adults. Data were collected by a questionnaire including the Chinese version of SASE (SASE-CHI), the Chinese version of ASAS-R (ASAS-R-CHI) and the Exercise of Self-Care Agency scale (ESCA). Homogeneity and stability, content, construct and concurrent validity, and sensitivity and specificity were assessed. RESULTS The Cronbach's alpha (α) of SASE-CHI was 0.89, the item-to-total correlations ranged from r = 0.15 to r = 0.81, and the test-retest correlation coefficient (intra-class correlation coefficient, ICC) was 0.99 (95% CI, 0.99-1.00; P<0.001). The Cronbach's α of ASAS-R-CHI was 0.78, the item-to-total correlations ranged from r = 0.20 to r = 0.65, and the test-retest ICC was 0.95 (95% CI, 0.92-0.96; P<0.001). The content validity index (CVI) of SASE-CHI and ASAS-R-CHI was 0.96 and 0.97, respectively. The findings of exploratory and confirmatory factor analyses (EFA and CFA) confirmed a good construct validity of SASE-CHI and ASAS-R-CHI. The Pearson's rank correlation coefficients, as a measure of concurrent validity, between total score of SASE-CHI and ESCA and ASAS-R-CHI and ESCA were assessed to 0.65 (P<0.001) and 0.62 (P<0.001), respectively. Regarding ESCA as the criterion, the area under the receiver operator characteristic (ROC) curve for the cut-point of SASE-CHI and ASAS-R-CHI were 0.93 (95% CI, 0.91-0.94) and 0.83 (95% CI, 0.80-0.86), respectively. CONCLUSION There is no significant difference between the two instruments. Each has its own characteristics, but SASE-CHI is more suitable for older adults. The key point is that the users can choose the most appropriate scale according to the specific situation.
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Affiliation(s)
- Lina Guo
- Department of Neurology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ulrika Söderhamn
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Grimstad, Aust-Agder, Southern Norway
| | - Jacqueline McCallum
- School of Health and Life Sciences, Department of Nursing & Community Health, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Xianfei Ding
- Department of Integrated ICU, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Han Gao
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, People's Republic of China
| | - Qiyun Guo
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, People's Republic of China
| | - Kun Liu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, People's Republic of China
| | - Yanjin Liu
- Department of Nursing, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
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Busetto L, Kiselev J, Luijkx KG, Steinhagen-Thiessen E, Vrijhoef HJM. Implementation of integrated geriatric care at a German hospital: a case study to understand when and why beneficial outcomes can be achieved. BMC Health Serv Res 2017; 17:180. [PMID: 28270122 PMCID: PMC5341181 DOI: 10.1186/s12913-017-2105-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 02/21/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Many health systems have implemented integrated care as an alternative approach to health care delivery that is more appropriate for patients with complex, long-term needs. The objective of this article was to analyse the implementation of integrated care at a German geriatric hospital and explore whether the use of a "context-mechanisms-outcomes"-based model provides insights into when and why beneficial outcomes can be achieved. METHODS We conducted 15 semi-structured interviews with health professionals employed at the hospital. The data were qualitatively analysed using a "context-mechanisms-outcomes"-based model. Specifically, mechanisms were defined as the different components of the integrated care intervention and categorised according to Wagner's Chronic Care Model (CCM). Context was understood as the setting in which the mechanisms are brought into practice and described by the barriers and facilitators encountered in the implementation process. These were categorised according to the six levels of Grol and Wensing's Implementation Model (IM): innovation, individual professional, patient, social context, organisational context and economic and political context. Outcomes were defined as the effects triggered by mechanisms and context, and categorised according to the six dimensions of quality of care as defined by the World Health Organization, namely effectiveness, efficiency, accessibility, patient-centeredness, equity and safety. RESULTS The integrated care intervention consisted of three main components: a specific reimbursement system ("early complex geriatric rehabilitation"), multidisciplinary cooperation, and comprehensive geriatric assessments. The inflexibility of the reimbursement system regarding the obligatory number of treatment sessions contributed to over-, under- and misuse of services. Multidisciplinary cooperation was impeded by a high workload, which contributed to waste in workflows. The comprehensive geriatric assessments were complemented with information provided by family members, which contributed to decreased likelihood of adverse events. CONCLUSIONS We recommend an increased focus on trying to understand how intervention components interact with context factors and, combined, lead to positive and/or negative outcomes.
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Affiliation(s)
- Loraine Busetto
- Tranzo Scientific Center for Care and Welfare, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | - Jörn Kiselev
- Geriatrics Research Group, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Katrien Ger Luijkx
- Tranzo Scientific Center for Care and Welfare, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
| | | | - Hubertus Johannes Maria Vrijhoef
- Tranzo Scientific Center for Care and Welfare, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
- Panaxea B.V., Amsterdam, The Netherlands
- Department of Patient & Care, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
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Sandlund M, Skelton DA, Pohl P, Ahlgren C, Melander-Wikman A, Lundin-Olsson L. Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review. BMC Geriatr 2017; 17:58. [PMID: 28212622 PMCID: PMC5316178 DOI: 10.1186/s12877-017-0451-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 02/14/2017] [Indexed: 11/10/2022] Open
Abstract
Background To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both women’s and men’s views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older people’s views or preferences regarding uptake and adherence to exercise to prevent falls. Methods A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of men’s and women’s views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older women’s and men’s views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise. Electronic supplementary material The online version of this article (doi:10.1186/s12877-017-0451-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Petra Pohl
- Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Christina Ahlgren
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Anita Melander-Wikman
- Department of Health Sciences, Division of Health and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Lillemor Lundin-Olsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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Guo L, Zauszniewski JA, Ding X, Zhang L, Gao H, Guo Q, Liu K. The Appraisal of Self-Care Agency Scale-Revised (ASAS-R): Reliability and Validity Among Older Chinese People. West J Nurs Res 2016; 39:1459-1476. [PMID: 27703077 DOI: 10.1177/0193945916672821] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study aimed to test the reliability and validity of the Chinese version of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R-CHI). A cross-sectional design was used to conduct this study, and the sample consisted of 1,219 older people, collected by a demographic questionnaire, ASAS-R-CHI and the Exercise of Self-Care Agency (ESCA) scale. The Cronbach's alpha (α) of ASAS-R-CHI was .79, the test-retest correlation was 0.95, and the item-to-total correlations ranged from r = .41 to r = .74. Exploratory factor analysis (EFA) resulted in three factors that explained 65.31% of the total variance; all 15 items had strong factor loadings ranging from 0.54 to 0.91. Confirmatory factor analysis (CFA) indicated the three-factor solution of ASAS-R-CHI had a good fit (x2,chi-square/degree of freedom [CMIN/DF] = 2.61, goodness of fitness index [GFI] = 0.93, adjusted goodness of fit index [AGFI] = 0.92,, comparative fit index [CFI = 0.92], Tucker Lewis index [TLI] = 0.91, root mean square error of approximation [RMSEA] = 0.04, root mean residual [RMR] = 0.02, P-value for test of close fit [PCLOSE] = 0.68). ASAS-R-CHI is a short, reliable, and valid instrument for measuring self-care agency among Chinese older adults.
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Affiliation(s)
- Lina Guo
- 1 Jinzhou Medical University, Liaoning, China
| | | | - Xianfei Ding
- 3 The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lin Zhang
- 1 Jinzhou Medical University, Liaoning, China
| | - Han Gao
- 1 Jinzhou Medical University, Liaoning, China
| | - Qiyun Guo
- 1 Jinzhou Medical University, Liaoning, China
| | - Kun Liu
- 1 Jinzhou Medical University, Liaoning, China
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Snyder H, Engström J. The antecedents, forms and consequences of patient involvement: A narrative review of the literature. Int J Nurs Stud 2016; 53:351-78. [DOI: 10.1016/j.ijnurstu.2015.09.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
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