1
|
Zhang J, Shen Z, Tong X, Sun X, Yao N. Availability of family care resources, bathing assistance and toileting assistance among older adults with functional limitations: an evidence-based study from China. BMC Geriatr 2024; 24:419. [PMID: 38730380 PMCID: PMC11088109 DOI: 10.1186/s12877-024-05047-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND An aging population has contributed to an increasing prevalence of functional limitations among older adults. Family support plays a crucial role in toileting and bathing assistance. Yet, the relationship between availability of family care resources and such actual assistance remains insufficiently explored. Our study aims to describe availability of family care resources and identify the association between availability of family care resources and toileting assistance or bathing assistance. METHODS This study employed a cross-sectional analysis of data from the 2018 National Survey of the China Health and Retirement Longitudinal Study (CHARLS). The availability of family care resources was assessed using measurements of spouse availability, adult child availability, and living arrangement. Bathing assistance and toileting assistance were measured based on self-reported receipt of such assistance. Descriptive statistics were used to depict the overall and subgroup situation of availability of family care resources. Multivariable logistic models were employed to investigate the relationship between availability of family care resources and the receipt of toileting assistance or bathing assistance. RESULTS Among the sample of older adults with functional limitations, 69% had a spouse, 63% had at least one adult child, and 80% resided with family members. Among those with bathing disability, 13% reported lacking bathing assistance, and among those with toileting disability, 54% reported lacking toileting assistance. Participants with 1-2 adult children had lower odds of receiving toileting assistance (OR: 0.28, 95% CI: 0.09, 0.91, p= 0.034) compared to those with three or more adult children. Spouse availability and living arrangement did not exhibit statistically significant associations with toileting assistance. Participants without a spouse had lower odds of receiving bathing assistance (OR: 0.27, 95% CI: 0.09-0.78, p= 0.016) in comparison to those with a spouse; however, adult child availability and living arrangement did not display statistically significant associations with bathing assistance. CONCLUSION The present findings suggest a gap in family commitment when it comes to assisting older adults with functional limitations in bathing/toileting. To address this, policymakers are encouraged to prioritize the implementation of proactive mechanisms for identifying family caregivers, alongside incentives to enhance their engagement in practical caregiving activities. Furthermore, it is crucial to emphasize the prioritization of affordable and easily accessible formal toileting/bathing assistance options for older adults who lack sufficient family care resources.
Collapse
Affiliation(s)
- Jinxin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Rd, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Zi Shen
- Zibo First Hospital, Zibo, Shandong, 255200, China
| | - Xiyang Tong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Rd, Jinan, Shandong, 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Rd, Jinan, Shandong, 250012, China.
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Nengliang Yao
- Home Centered Care Institute, Schaumburg, IL, USA
- University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
2
|
Venkatapuram P, Angulo-Lozano JC, Spinzi S, Brown-Johnson C, Phord-Toy A, Kan KM. Parental Knowledge, Beliefs, Practices, and Barriers Related to Children's Bladder Health in the School Environment. THE JOURNAL OF SCHOOL HEALTH 2024. [PMID: 38711264 DOI: 10.1111/josh.13456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/18/2024] [Accepted: 03/28/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Pediatric lower urinary tract symptoms (LUTS) are a set of common childhood problems. Community-level interventions that target behavioral change among children with LUTS can improve symptoms outside of the clinic environment. Parents, navigating the home and school environments, are key in supporting healthy bladder behaviors. Thus, we asked parents about their perceptions and barriers related to pediatric bladder health. METHODS English-speaking parents (n = 30) of children ages 5-10 years with and without LUTS were interviewed. Transcripts were coded iteratively by two independent coders using deductive and inductive approaches that emphasized consensus coding and peer debriefing. RESULTS Ninety-three percent of participants were women, 50% were 30-39 years old, and 60% held a graduate degree. Parents identified school-, classroom-, and child-based barriers to bladder health. These included the bathroom environment, restrictive policies for bathroom use, and anxiety on how and when to use the bathroom. CONCLUSIONS Addressing school-, classroom-, and child-based barriers is necessary to promote healthy bladder habits among children in the school environment and beyond. Recommended school-based interventions include bathroom use and sanitation policies that support students' voiding needs, teachers' professional development, and school readiness initiatives. Limitations include participation of English-speaking parents only.
Collapse
Affiliation(s)
- Pranaya Venkatapuram
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, 94304, CA
| | - Juan C Angulo-Lozano
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, 94304, CA
| | - Stav Spinzi
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, 94304, CA
| | - Cati Brown-Johnson
- Department of Primary Care and Population Health, Stanford University School of Medicine, 1265 Welch Road, Stanford, 94305, CA
| | - Ashley Phord-Toy
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, 94304, CA
| | - Kathleen M Kan
- Department of Urology, Stanford University School of Medicine, 453 Quarry Road, Palo Alto, 94304, CA
| |
Collapse
|
3
|
Smoyer AB, Pittman A, Borzillo P. Humans peeing: Justice-involved women's access to toilets in public spaces. PLoS One 2023; 18:e0282917. [PMID: 36897925 PMCID: PMC10004595 DOI: 10.1371/journal.pone.0282917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
Justice-involved women face myriad challenges as they negotiate the terms of community supervision and manage the long-term implications and stigma of living with a criminal record. Major tasks that women juggle include securing safe, affordable housing, finding and retaining employment, accessing physical and mental health care (including substance use treatment), and handling relationships with family, friends, children, and intimate partners. In addition to these responsibilities, women must meet their basic physiological needs to eat, sleep, and use the toilet. Women's ability to safely meet their personal care needs may impact their capacity to manage their criminal-legal challenges. This study uses qualitative methods to understand justice-involved women's lived experiences related to urination. Specifically, the study reports on a thematic analysis of 8 focus groups conducted with justice-involved women (n = 58) and the results of a toilet audit conducted in the downtown areas of the small city in the United States where the focus group participants were living. Findings suggest that women had limited access to restrooms and reported urinating outside. Lack of restroom access impacted their engagement with social services support and employment and their ability to travel through public spaces. Women perceived their public toilet options as unsafe, increasing their sense of vulnerability and reinforcing the idea that they did not have full access to citizenship in the community because of their criminal-legal involvement. The exclusion and denial of women's humanity that is perpetuated by a lack of public toilet access impacts women's psychosocial outcomes. City governments, social service agencies, and employers are encouraged to consider how lack of toilet access may impact their public safety and criminal-legal objectives and expand opportunities for people to access safe restroom facilities.
Collapse
Affiliation(s)
- Amy B. Smoyer
- Department of Social Work, College of Health and Human Services, Southern Connecticut State University, New Haven, Connecticut, United States of America
- * E-mail:
| | - Adam Pittman
- Department of Sociology, College of Arts and Sciences, Southern Connecticut State University, New Haven, Connecticut, United States of America
| | - Peter Borzillo
- Department of Curriculum and Learning, College of Education, Southern Connecticut State University, New Haven, Connecticut, United States of America
| |
Collapse
|
4
|
Williams BR, Burgio KL, Hebert-Beirne J, James A, Kenton K, LaCoursiere DY, Rickey L, Brady SS, Kane Low L, Newman DK. A multisite focus group study of US adult women's beliefs and assumptions about bladder health and function. Neurourol Urodyn 2022; 41:1590-1600. [PMID: 35819129 PMCID: PMC9595129 DOI: 10.1002/nau.25006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 11/05/2022]
Abstract
AIMS This analysis explored and characterized the ideas adult women have about how the bladder works, the assumptions guiding their bladder-related behaviors, and the beliefs they hold about how their behaviors affect bladder health. METHODS This was a directed content analysis of qualitative data from the Study of Habits, Attitudes, Realities, and Experiences, a focus group study conducted at seven United States research centers (July 2017 to April 2018). Participants were 316 adult women organized by four age categories (age range: 18-93 years). Analysis and interpretation focused on the "bladder assumptions and beliefs" code using a transdisciplinary lens and inductive approach. RESULTS During their focus group discourse, participants exhibited a speculative mode of thinking about bladder health and function characterized by uncertainty about how the bladder works. They described the bladder as a mechanism for cleansing the body of impurities, viewing it as part of a larger interconnected bodily system to enable the body to stay healthy. They saw it as susceptible to anatomical changes, such as those related to pregnancy and aging. The women also postulated perceived relationships between bladder function and several health behaviors, including eating healthy foods, staying hydrated, engaging in physical activity and exercise, and adopting specific toileting and hygiene practices. CONCLUSIONS The findings underscore the importance of guidance from healthcare professionals and systematic community based educational programs for promoting women's understanding about bladder health and empowering them to exert agency to engage in healthy bladder behaviors.
Collapse
Affiliation(s)
- Beverly Rosa Williams
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Kathryn L Burgio
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Department of Veterans Affairs, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, Alabama, USA
| | - Jeni Hebert-Beirne
- School of Public Health, Division of Community Health Sciences, University of Illinois, Chicago, Illinois, USA
| | - Aimee James
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Kimberly Kenton
- Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daphne Yvette LaCoursiere
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, San Diego, California, USA
| | - Leslie Rickey
- Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Sonya S Brady
- School of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Diane K Newman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
5
|
Rickey LM, Camenga DR, Brady SS, Williams BR, Wyman JF, Brault MA, Smith AL, LaCoursiere DY, James AS, Lavender MD, Low LK. Women’s Knowledge of Bladder Health: What We Have Learned in the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. CURRENT BLADDER DYSFUNCTION REPORTS 2022; 17:188-195. [DOI: 10.1007/s11884-022-00655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|