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Vijayan B, Govil D, Sahoo H. Effect of Autonomy and Physical Activity on Self-Rated Health of Older Adults in India: Gendered Analysis Using Structural Equation Models. Exp Aging Res 2023:1-18. [PMID: 37953538 DOI: 10.1080/0361073x.2023.2278982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023]
Abstract
The gendered expectations and responsibilities placed upon women can impede their ability to participate in social activities and engage in physical leisure pursuits, ultimately having a negative impact on their health. Our study investigates the mechanisms through which gender influences individuals' engagement with physical activity during free time and how this relates to self-rated health outcomes among adults aged 45 years or older living in India. Using cross-sectional analysis and Structural Equation Modelling, we analyzed data stratified by gender and age from the Longitudinal Ageing Study of India to examine these conceptual pathways. We found that compared to men, women face greater limitations related to decision-making autonomy, experience more functional impairments, have weaker social networks that provide less support for engaging in leisure-time physical activity, leading them to report lower levels of overall wellbeing than men. Further analyses demonstrated distinct pathways through which each gender's level of social network connectivity shapes behavior - strong connections increase opportunities for women specifically to engage positively with both peers and physically active pursuits supporting overall wellness goals.
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Affiliation(s)
- Bevin Vijayan
- School of Development, Azim Premji University, Bhopal, India
| | - Dipti Govil
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, India
| | - Harihar Sahoo
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, India
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Fonseca C, Ramos A, Morgado B, Quaresma P, Garcia-Alonso J, Coelho A, Lopes M. Long-term care units: a Portuguese study about the functional profile. FRONTIERS IN AGING 2023; 4:1192718. [PMID: 37214776 PMCID: PMC10192701 DOI: 10.3389/fragi.2023.1192718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023]
Abstract
Aim: In this study, we analyze the relationship between the functional profile of older people admitted to long-term care units in Portugal and some demographic variables such as education level, sex, and age as well as the emotional state of mind. Methods: A sample of 59,516 older people from the National Network of Integrated Continuous Care of Portugal were analyzed in this longitudinal study. All the retrospective data of the older people were collected during the period of hospitalization at the long-term care units. The database records of these units were analyzed, and a functional profile spanning the period of hospitalization was calculated. Results: Activities of daily living and cognitive states improved, in the first 90 days of hospitalization, while mobility and instrumental activities of daily living worsened for the same period of 90 days. Generally, there was a decline in all domains after 450 days of hospitalization. The older women that did not attend school, those over 85 years old, and those who suffered from anxiety were pre-dominantly placed in the group of those with greater dependence (severe/complete dependence). Conclusion: The participants hospitalized between 90 and 360 days presented the best results in the long-term care units of the National Network of Integrated Continuous Care of Portugal. With this study, we highlight the importance of evaluating the functional status of persons in long-term hospitalizations and the influence exerted by the level of education on the recovery and rehabilitation of dependence.
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Affiliation(s)
- César Fonseca
- São João de Deus Higher School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
| | - Ana Ramos
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisbon, Portugal
| | | | - Paulo Quaresma
- Department of Computer Science, University of Évora, Évora, Portugal
- Centro de Investigação e Desenvolvimento em Ciências Humanas e Sociais (CIDEHUS), University of Évora, Évora, Portugal
| | - José Garcia-Alonso
- Department of Computer and Telematics Systems, University of Extremadura, Badajoz, Spain
| | - Anabela Coelho
- São João de Deus Higher School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Manuel Lopes
- São João de Deus Higher School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, Évora, Portugal
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Ramos A, Fonseca C, Pinho L, Lopes M, Oliveira H, Henriques A. Functional Profile of Older Adults Hospitalized in Convalescence Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study. J Pers Med 2021; 11:jpm11121350. [PMID: 34945822 PMCID: PMC8704872 DOI: 10.3390/jpm11121350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree of dependence as a function of age and sex. Methods: longitudinal, retrospective study with a sample of 59,013 older adults admitted to convalescence units of the National Network of Integrated Continuous Care of Portugal. Results: In the first 75 days of hospitalization, activities of daily living, mobility and cognitive state improved, but there was a decline after 75 days of hospitalization. The ability to perform instrumental activities of daily living improved in the first 15 days of hospitalization, stabilized until 45 days and then began to worsen. Women had a higher probability of having a severe/complete dependence three years earlier than men (88 years to 91 years). A higher education level and stable emotional state were protective factors against functional decline. Conclusions: The functional profile of older adults improved during the length of stay recommended for hospitalization in convalescence units (30 days). It is critical for health systems to adopt strategies to prevent declines in the emotional state of frail individuals.
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Affiliation(s)
- Ana Ramos
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal; (A.R.); (A.H.)
| | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Evora, Portugal; (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Evora, Portugal
| | - Lara Pinho
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Evora, Portugal; (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Evora, Portugal
- Correspondence:
| | - Manuel Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Evora, Portugal; (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Evora, Portugal
| | | | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), 1600-096 Lisbon, Portugal; (A.R.); (A.H.)
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
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Lopes MJ, de Pinho LG, Fonseca C, Goes M, Oliveira H, Garcia-Alonso J, Afonso A. Functioning and Cognition of Portuguese Older Adults Attending in Residential Homes and Day Centers: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137030. [PMID: 34209339 PMCID: PMC8297339 DOI: 10.3390/ijerph18137030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022]
Abstract
The functioning and cognition of older adults can be influenced by different care contexts. We aimed to compare the functioning profiles and cognition of institutionalized and noninstitutionalized older adults and to evaluate the effect of sociodemographic factors on the functioning and cognition. This is a cross-sectional study that included 593 older adults. The data were collected using the Elderly Nursing Core Set and Mini Mental State Examination. Women, older adults who did not attend school and those live in Residential Homes are more likely to have a higher degree of cognitive impairment than men, those who attended school and those frequent Day Centre. The chances of an older adult with moderate or severe cognitive impairment increases with age. Older women, older adults who did not attend school, and older adults who live in Residential Homes had a higher degree of functional problem than men, those who attended school and those who frequent a Day Centre, independently to age. It is necessary to promote the health literacy of older adults throughout life. The implementation of social and health responses should allow older adults to remain in their homes, given the influence of functioning and cognition on self-care and quality of life.
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Affiliation(s)
- Manuel José Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Correspondence: (M.J.L.); (L.G.d.P.); Tel.: +351-266-730-300
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Correspondence: (M.J.L.); (L.G.d.P.); Tel.: +351-266-730-300
| | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
| | - Margarida Goes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Escola Superior de Saúde, Instituto Politécnico de Beja, 7800-111 Beja, Portugal
| | - Henrique Oliveira
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Escola Superior de Saúde, Instituto Politécnico de Beja, 7800-111 Beja, Portugal
- Instituto de Telecomunicações, 1049-001 Lisboa, Portugal
| | - José Garcia-Alonso
- Department of Computer Systems and Telematics Engineering, University of Extremadura, 10003 Cáceres, Spain;
| | - Anabela Afonso
- Departamento de Matemática, Escola de Ciências e Tecnologia, Universidade de Évora, 7000-671 Évora, Portugal;
- Centro de Investigação em Matemática e Aplicações, Universidade de Évora, 7000-671 Évora, Portugal
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Fonseca C, de Pinho LG, Lopes MJ, Marques MDC, Garcia-Alonso J. The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study. BMC Nurs 2021; 20:108. [PMID: 34162387 PMCID: PMC8220736 DOI: 10.1186/s12912-021-00623-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The aging population and its associated health needs require specific nursing care. The aim of this study was to draw an epidemiological profile of Portuguese elderly adults attending in residential homes and day centers and to evaluate the association between the functioning and cognition of these older adults and their sociodemographic characteristics and presence of multimorbidity. METHODS This was a cross-sectional study of 613 older adults. Functioning was assessed using the Elderly Nursing Core Set, and cognition was assessed using the Mini Mental State Examination. Descriptive and inferential analyses were performed. RESULTS The mean age was 85.73 years; the majority of the participants were female (69.3 %), widowed (67.0 %) and over 85 years old (60.4 %). A total of 68.2 % of the sample presented multimorbidity. A total of 54.5 % had cognitive impairment, and the average functional profile was classified as "moderate difficulty". Institutionalized older adults had more diseases than those who attended the day center. Women, those who were illiterate, those who were institutionalized and older adults who had diseases of the nervous system had a worse functional profile and greater cognitive impairment. Those with multimorbidity had a worse functional profile, and those without a spouse had greater cognitive impairment. CONCLUSIONS Given the functional and cognitive profile of older adults, it is necessary to adopt care practices focused on the rehabilitation/maintenance of self-care and affective relationships. This care must be provided by highly qualified professionals. Therefore, it is necessary to increase the ratio of nurses per older adult in these institutions.
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Affiliation(s)
- César Fonseca
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal. .,Comprehensive Health Research Centre (CHRC), Évora, Portugal.
| | - Manuel José Lopes
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Maria do Céu Marques
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Évora, Portugal
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Aheto JMK, Udofia EA, Kallson E, Mensah G, Nadia M, Nirmala N, Chatterji S, Kowal P, Biritwum R, Yawson AE. Prevalence, socio-demographic and environmental determinants of asthma in 4621 Ghanaian adults: Evidence from Wave 2 of the World Health Organization's study on global AGEing and adult health. PLoS One 2020; 15:e0243642. [PMID: 33296442 PMCID: PMC7725342 DOI: 10.1371/journal.pone.0243642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/24/2020] [Indexed: 12/25/2022] Open
Abstract
Background A previous multi-site study involving lower- and middle-income countries demonstrated that asthma in older adults is associated with long-term exposure to particulate matter, male gender and smoking. However, variations may occur within individual countries, which are relevant to inform health promoting policies as populations live longer. The present study estimates asthma prevalence and examines the sociodemographic characteristics and environmental determinants associated with asthma in older adults in Ghana. Methods This study utilised data from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2. A final sample of 4621 individuals residing in 3970 households was used in analytical modelling. Factors associated with asthma were investigated using single level and multilevel binary logistic regression models. Results Asthma was reported by 102 (2.2%) respondents. Factors associated with asthma in the univariate model were: those aged 60–69 (OR = 5.22, 95% CI: 1.24, 21.95) and 70 or more (OR = 5.56, 95% CI: 1.33, 23.26) years, Ga-Adangbe dialect group (OR = 1.65, 95% CI: 1.01, 2.71), no religion (OR = 3.59, 95% CI: 1.77, 7.28), having moderate (OR = 1.76, 95% CI: 1.13, 2.75) and bad/very bad (OR = 2.75, 95% CI: 1.58, 4.80) health state, and severe/extreme difficulty with self-care (OR = 3.49, 95% CI: 1.23, 9.88) and non-flush toilet facility (OR = 0.62, 95% CI: 0.39, 0.99). Factors independently associated with asthma in the adjusted models were: those aged 60–69 (OR = 4.49, 95% CI: 1.03, 19.55) years, father with primary education or less (OR = 0.40, 95% CI: 0.17, 0.94), no religion (OR = 2.52, 95% CI: 1.18, 5.41), and households with non-flush toilet facility (OR = 0.58, 95% CI: 0.35, 0.96). Significant residual household-level variation in asthma was observed. Over 40% of variance in asthma episodes could be attributable to residual household-level variations. Conclusion Individual as well as household factors were seen to influence the prevalence of asthma in this national survey. Clinical management of these patients in health facilities should consider household factors in addition to individual level factors.
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Affiliation(s)
- Justice Moses K. Aheto
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- * E-mail: ,
| | - Emilia A. Udofia
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Eugene Kallson
- Deloitte Consulting, West Africa Deloitte & Touche, Accra, Ghana
| | - George Mensah
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Minicuci Nadia
- National Research Council, Institute of Neuroscience, Padova, Italy
| | - Naidoo Nirmala
- World Health Organization HIS/HIS/MCS, Geneva, Switzerland
| | | | - Paul Kowal
- World Health Organization HIS/HIS/MCS, Geneva, Switzerland
- University of Newcastle Research Centre for Gender, Health and Ageing, Newcastle, Australia
| | - Richard Biritwum
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred E. Yawson
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Goes M, Lopes MJ, Oliveira H, Fonseca C, Marôco J. A Nursing Care Intervention Model for Elderly People to Ascertain General Profiles of Functionality and Self Care Needs. Sci Rep 2020; 10:1770. [PMID: 32019984 PMCID: PMC7000781 DOI: 10.1038/s41598-020-58596-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/15/2020] [Indexed: 11/09/2022] Open
Abstract
A core set of International Classification of Functioning, Disability and Health codes was used to ascertain general profiles of functionality as a function of biological and sociodemographic characteristics and to develop structured nursing interventions in accordance with self care deficits identified by studying self care behavior for elderly people living in both extensively and sparsely populated rural areas. Data were collected by health professionals in the participants' houses. An exploratory factor analysis enabled reduced data dimensions, and factorial validity was assessed by a confirmatory factor analysis. An ordinal regression model was built to identify general profiles of functionality as a function of age. A bar graph was used as a measurement tool for nursing care needs as a function of self care behavior and functional profile level. No functional problems were expected among people under the age of 74 years, while mild functionality problems were expected among people older than 74 years. Regarding nursing care needs, the results of the constructed model suggested that the functional concept "Support and Relationships" is associated with higher levels of functional problems and thus a greater need for self care interventions and that people aged 85 years and older always show therapeutic self care deficits.
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Affiliation(s)
- Margarida Goes
- Escola Superior de Saúde, Instituto Politécnico de Beja, Beja, Portugal
| | - Manuel José Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, Évora, Portugal
| | | | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, Évora, Portugal
| | - João Marôco
- ISPA - Instituto Universitário de Ciências Psicológicas Sociais e da Vida, Lisbon, Portugal
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