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Chi Z, Lun H, Ma J, Zhou Y. Income inequality and healthcare utilization of the older adults-based on a study in three provinces and six cities in China. Front Public Health 2024; 12:1435162. [PMID: 39114522 PMCID: PMC11303323 DOI: 10.3389/fpubh.2024.1435162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Purpose The objective of this study is to gain a more nuanced understanding of the specific impact of income inequality on the utilization of healthcare services for older adults. Additionally, the study aims to elucidate the moderating and mediating roles of public transfer income and psychological health in this context. Methods A systematic examination of the impact of income inequality on healthcare utilization among older adults was conducted through field questionnaire surveys in six cities across three major geographical regions (West, Central, and East). The analysis employed baseline regression, as well as mediating and moderating effect tests. Results First, there is a negative relationship between income inequality and the use of therapeutic healthcare services (β1 = -0.484, P < 0.01) and preventive healthcare services (β2 = -0.576, P < 0.01) by older adults. This relationship is more pronounced in the low- and medium-income groups as well as in the western region. The mediating effect of psychological state is significant (β3 = -0.331, P < 0.05, β4 = -0.331, P < 0.05). Public transfer income plays a significant role in regulation. The moderating effect of public transfer income on therapeutic services was more significant in low-income groups (β5 = 0.821, P < 0.01). The moderating effect of public transfer income on preventive services was more significant in middle-income groups (β6 = 0.833, P < 0.01). Conclusion The study clearly demonstrates a significant negative correlation between income inequality and the utilization of healthcare services by older adults. Furthermore, the study reveals that this relationship is particularly pronounced among older adults in low- and medium-income and Western regions. This detailed analysis of regional and income level heterogeneity is of particular value in this field of research. Secondly, this study attempts to integrate the two pivotal dimensions of public transfer income and psychological state for the first time, elucidating their moderating and mediating roles in this relationship. The findings indicate that public transfer income serves as a moderating factor, exerting a notable "reordering effect" on income inequality and resulting in a "deprivation effect." Such factors may impede the utilization of medical services, potentially influencing the psychological state of older adults.
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Affiliation(s)
- Zhang Chi
- School of Philosophy and Sociology, Lanzhou University, Lanzhou, China
| | - Hai Lun
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jiaxin Ma
- School of Philosophy and Sociology, Lanzhou University, Lanzhou, China
| | - Yaping Zhou
- School of Philosophy and Sociology, Lanzhou University, Lanzhou, China
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Greeley B, Chung SS, Graves L, Song X. Combating Barriers to the Development of a Patient-Oriented Frailty Website. JMIR Aging 2024; 7:e53098. [PMID: 38807317 DOI: 10.2196/53098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/02/2024] [Accepted: 03/07/2024] [Indexed: 05/30/2024] Open
Abstract
Unlabelled This viewpoint article, which represents the opinions of the authors, discusses the barriers to developing a patient-oriented frailty website and potential solutions. A patient-oriented frailty website is a health resource where community-dwelling older adults can navigate to and answer a series of health-related questions to receive a frailty score and health summary. This information could then be shared with health care professionals to help with the understanding of health status prior to acute illness, as well as to screen and identify older adult individuals for frailty. Our viewpoints were drawn from 2 discussion sessions that included caregivers and care providers, as well as community-dwelling older adults. We found that barriers to a patient-oriented frailty website include, but are not limited to, its inherent restrictiveness to frail persons, concerns over data privacy, time commitment worries, and the need for health and lifestyle resources in addition to an assessment summary. For each barrier, we discuss potential solutions and caveats to those solutions, including assistance from caregivers, hosting the website on a trusted source, reducing the number of health questions that need to be answered, and providing resources tailored to each users' responses, respectively. In addition to screening and identifying frail older adults, a patient-oriented frailty website will help promote healthy aging in nonfrail adults, encourage aging in place, support real-time monitoring, and enable personalized and preventative care.
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Prats F, Choukou MA, Wittich W, Beaulieu-Bonneau S, Piquer O, Cherrier S, Poncet F. Digital tools to support technology-enabled budget management in people with acquired brain injury: a rapid review. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 38449447 DOI: 10.1080/17483107.2024.2323146] [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: 05/19/2023] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
People with acquired brain injuries (ABI) face financial challenges that affect their daily lives. Managing finances is a crucial activity that can help avoid social isolation. However, this task becomes difficult for people with ABI because of their cognitive impairments. Recent advances in digital technology can help people with ABI manage their finances more effectively. This study aims to identify and describe available digital tools that can help ABI in budget management, and identify their effectiveness, barriers and facilitators to implementation. To address this issue, we conducted a rapid review of academic databases followed by a modified Google/Google Scholar search to identify the digital tools to support budgeting tasks (DBT) used and tested by people with ABI. Our rapid review included only two articles on the use of DBT. The first study showed that common portable electronic devices were acceptable and desirable as memory and organisational aids for people with ABI. The second study documented the development of a DBT and the perception of users (research participants) who found it appealing and user-friendly. However, for both articles, the technologies used are outdated and lack information on barriers and facilitators to using DBT. In conclusion, this literature review revealed that digital technologies have the potential to support budget management in people with ABI, but technology needs to be made available on the market to benefit the users. Further research and development are needed to create new ways to help people with brain injuries manage their budgets.
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Affiliation(s)
- François Prats
- Assistance Publique des Hôpitaux de Paris (APHP), Hôpital San Salvadour, Hyères, France
- Université Paris-Creteil Est, Créteil, France
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Mohamed-Amine Choukou
- College of Rehabilitation Sciences, University of Manitoba - Winnipeg, Manitoba, Canada
| | - Walter Wittich
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Optometry, Université de Montréal, Montréal, Canada
| | - Simon Beaulieu-Bonneau
- École de psychologie, Université Laval, Québec, Canada
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada
| | - Olivier Piquer
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada
- École des sciences de la réadaptation, Université Laval, Québec, Canada
- Centre et Est du Québec de Fusion Jeunesse, Montréal, Canada
| | - Sarah Cherrier
- Marguerite-d'Youville Library, Université de Montréal, Montréal, Canada
| | - Frédérique Poncet
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Optometry, Université de Montréal, Montréal, Canada
- Lethbridge-Layton-Mackay Rehabilitation Centre, Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre Ouest-de-l'Ile-de-Montréal, Montréal, Canada
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Baptist AP, Freigeh GE, Nelson B, Carpenter L, Arora NS, Wettenstein RP, Craig T, Riedl MA. Hereditary angioedema in older adults: Understanding the patient perspective. Ann Allergy Asthma Immunol 2024; 132:76-81.e2. [PMID: 37852604 DOI: 10.1016/j.anai.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Hereditary angioedema (HAE) is a rare condition characterized by potentially fatal, recurrent episodes of painful swelling. Whereas there are limited studies evaluating the quality of life of individuals with HAE, none have evaluated the impact of HAE on older adults. OBJECTIVE To evaluate the effect of HAE on older adults through qualitative methodology. METHODS A group of 3 physicians with extensive research and clinical experience in HAE developed a focus group guidebook highlighting issues of importance to older adults. A total of 17 patients with HAE (type I or II) aged 60 years and older participated in focus groups. Three independent reviewers coded each focus group transcript using a thematic saturation approach. RESULTS Reviewers identified 7 core themes from the focus groups. The themes identified encompassed the following: (1) challenges with securing medications and insurance concerns; (2) the experience of living with HAE before the advent of newer and more effective therapeutic options; (3) a worsening of HAE attack frequency and severity with aging; (4) the effects of comorbid conditions such as arthritis, memory loss, and irritable bowel syndrome; (5) changes in HAE with menopause; and (6) changing perspective on HAE with age, the effect of HAE on interpersonal relationships including the decision to have children, and goals for future care and research including support groups and a desire to be included in clinical trials. CONCLUSION Older adults with HAE have specific challenges and concerns that may be unique compared with younger populations. Health care providers should address these to provide optimal care.
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Affiliation(s)
- Alan P Baptist
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - George E Freigeh
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
| | - Belinda Nelson
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Laurie Carpenter
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Nonie S Arora
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Rachel P Wettenstein
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Timothy Craig
- Departments of Medicine and Pediatrics, Penn State University, Hershey, Pennsylvania
| | - Marc A Riedl
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of California San Diego, La Jolla, California
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Leung AYM, Parial LLB, Szeto SS, Koduah AO. Understanding the role of financial health literacy in midlife and old age: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3921-e3933. [PMID: 36350147 PMCID: PMC10100128 DOI: 10.1111/hsc.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 08/03/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
As global population ageing persists, understanding older adults' capacity to navigate the financial and healthcare system is essential. This scoping review examines how the concept of financial health literacy (FHL) is described and measured in the existing literature, the factors that may affect it, and its potential outcomes in middle-aged and older adults. The review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) extension guidelines to synthesise the available evidence on this topic. We utilised electronic databases and hand searching to identify relevant literature published between 2010 and 2022. A total of 29 articles were included in this review. The results showed that FHL involved accessing, understanding and utilising financial information for planning/management of healthcare expenses and selecting appropriate health services. However, FHL is not particularly depicted as a concept in the current literature, as most studies investigated health literacy, financial literacy and health insurance literacy as separate domains that were interrelated to one another. No validated measurement tool was developed for FHL. We propose five domains to indicate the concept and measurement of FHL in middle-aged/older adults: money management, management of medical bills, understanding health insurance, deciding on appropriate health services, and planning for long-term care needs. Demographic variables, such as sex (females), advanced age, cognitive impairment, low education and income and racial and ethnic minorities, were found to be related to low FHL. The reviewed studies also showed that FHL was related to several outcomes, including healthcare decision-making, physical health and psychological well-being. Hence, future studies to develop and validate assessment tools of FHL, together with the involvement of vulnerable groups, are imperative to understanding the concept of FHL. This could also facilitate the development of appropriate interventions that could enhance this capacity in the ageing population.
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Affiliation(s)
- Angela Y. M. Leung
- School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
- World Health Organization Collaborating Centre (WHOCC) for Community Health Services, School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
- Research Institute of Smart AgingThe Hong Kong Polytechnic UniversityHong Kong SARChina
| | - Laurence Lloyd B. Parial
- School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
- College of NursingUniversity of the Philippines ManilaManilaPhilippines
| | | | - Adwoa O. Koduah
- School of NursingThe Hong Kong Polytechnic UniversityHong Kong SARChina
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Guttman ZR, Ghahremani DG, Pochon JB, Dean AC, London ED. Age Influences Loss Aversion Through Effects on Posterior Cingulate Cortical Thickness. Front Neurosci 2021; 15:673106. [PMID: 34321994 PMCID: PMC8311492 DOI: 10.3389/fnins.2021.673106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/15/2021] [Indexed: 12/05/2022] Open
Abstract
Decision-making strategies shift during normal aging and can profoundly affect wellbeing. Although overweighing losses compared to gains, termed "loss aversion," plays an important role in choice selection, the age trajectory of this effect and how it may be influenced by associated changes in brain structure remain unclear. We therefore investigated the relationship between age and loss aversion, and tested for its mediation by cortical thinning in brain regions that are susceptible to age-related declines and are implicated in loss aversion - the insular, orbitofrontal, and anterior and posterior cingulate cortices. Healthy participants (n = 106, 17-54 years) performed the Loss Aversion Task. A subgroup (n = 78) provided structural magnetic resonance imaging scans. Loss aversion followed a curvilinear trajectory, declining in young adulthood and increasing in middle-age, and thinning of the posterior cingulate cortex mediated this trajectory. The findings suggest that beyond a threshold in middle adulthood, atrophy of the posterior cingulate cortex influences loss aversion.
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Affiliation(s)
- Zoe R. Guttman
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Dara G. Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Andy C. Dean
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Research Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Brain Research Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, United States
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Balasubramaniam A, Diwakar MKP, Vaitheswaran S, Santhosh Kumar MP, Sushanthi S, Pandiyan I. Determining Association Between Cognitive Function and Oral Health Status among Rural Community Dwelling Geriatrics. J Int Soc Prev Community Dent 2021; 11:281-286. [PMID: 34268190 PMCID: PMC8257007 DOI: 10.4103/jispcd.jispcd_394_20] [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: 10/13/2020] [Revised: 01/08/2021] [Accepted: 03/27/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Numerous prospective studies worldwide investigated the association between oral health status and dementia or cognitive decline. No clear agreement has emerged on the association. This study aimed to determine the association of cognitive function and oral health status among community dwelling geriatrics in rural South India. MATERIALS AND METHODS A cross-sectional study was conducted among community dwelling geriatrics in rural South India by recruiting 211 individuals aged above 60 years. Their cognitive function was assessed using pre-validated community screening instrument for dementia (CSI-D) which has informant and cognitive scale. The data on cognitive function was collected by community health workers in electronic version (Web app). Their oral health status was assessed by World Health Organization (WHO) oral health assessment form in electronic version (Web app). RESULTS From the logistic regression analysis, it was observed that cognitive impairment showed an association with 1.6- and 1.9-times risk for root caries and a greater number of missing teeth (P ≤ 0.05). No association of other oral health parameters such as gingivitis, periodontitis, dental erosion, and dental trauma with cognitive impairment exhibited. CONCLUSION From the results, it can be concluded that cognitive impairment has an association with root caries and number of missing teeth which increases the risk for the same and vice versa.
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Affiliation(s)
- Arthi Balasubramaniam
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Chennai, India
| | | | - Sridhar Vaitheswaran
- Consultant Psychiatrist, Schizophrenia Research Foundation (SCARF), Chennai, India
| | - M P Santhosh Kumar
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College & Hospital, Chennai, Tamil Nadu, India
| | - S Sushanthi
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Chennai, India
| | - Indumathy Pandiyan
- Department of Public Health Dentistry, Saveetha Dental College & Hospital, Chennai, India
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Srivastava S, Chauhan S, Muhammad T, Simon DJ, Kumar P, Patel R, Singh S. Older adults’ psychological and subjective well-being as a function of household decision making role: Evidence from cross-sectional survey in India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.100676] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Appraising sufficiency of financial support for older adults in Anambra State, Nigeria. AGEING INTERNATIONAL 2020. [DOI: 10.1007/s12126-020-09379-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Fischer KA, Walling A, Wenger N, Glaspy J. Cost health literacy as a physician skill-set: the relationship between oncologist reported knowledge and engagement with patients on financial toxicity. Support Care Cancer 2020; 28:5709-5715. [PMID: 32193693 DOI: 10.1007/s00520-020-05406-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/06/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Oncologists are increasingly encouraged to communicate with patients about cost; however, they may lack the cost health literacy required to effectively perform this task. METHODS We conducted a pilot survey of oncologists in an academic medical center to assess potential factors that may influence provider attitudes and practices related to financial toxicity. We assessed perceived provider knowledge of treatment costs, insurance coverage and co-pays, and financially focused resources. We then evaluated the relationship between perceived knowledge and reported engagement with issues of financial toxicity. RESULTS Of 45 respondents (85% response rate), 58% had changed treatment within the past year as a result of patient financial burden. On self-report, 36% discussed out-of-pocket costs with patients, 42% assessed patient financial distress, but only 20% felt they could intervene upon financial toxicity. Self-perceived awareness of cost health literacy concepts were low; only 16% reporting high out-of-pocket cost knowledge, 31-33% high insurance knowledge, and 8% high awareness of financial resources. Report of cost discussion was associated with greater perceived awareness of both out-of-pocket costs and insurance design. However, reported financial distress assessment was only associated with perceived insurance awareness, not perceived cost knowledge. Cost health literacy was not associated with an increased sense of being able to impact on financial toxicity. CONCLUSION Oncologists acknowledge deficits in knowledge and skills that may play a role in the discussion and management of financial toxicity. Some cost health literacy competencies appear to correlate with physician involvement with financial toxicity, suggesting that education on this topic may facilitate physician engagement.
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Affiliation(s)
- Katrina A Fischer
- Department of Medicine, Division of Hematology & Oncology, UCLA School of Medicine, 200 UCLA Medical Plaza, Suite 120, Los Angeles, CA, 90095, USA.
| | - Anne Walling
- Department of Medicine, Division of General Internal Medicine & Health Services Research, UCLA School of Medicine, Los Angeles, CA, USA
| | - Neil Wenger
- Department of Medicine, Division of General Internal Medicine & Health Services Research, UCLA School of Medicine, Los Angeles, CA, USA
| | - John Glaspy
- Department of Medicine, Division of Hematology & Oncology, UCLA School of Medicine, 200 UCLA Medical Plaza, Suite 120, Los Angeles, CA, 90095, USA
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Aggarwal V, Sashindran VK, Dudeja P. Health-care needs and morbidity profile of the elderly veterans and their dependents staying in an urban area:A cross-sectional study. JOURNAL OF MARINE MEDICAL SOCIETY 2020. [DOI: 10.4103/jmms.jmms_4_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Aghakhani N, Park CSY. Spiritual well-being promotion for older adults: Implication for healthcare policy makers' decision making on cost savings. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:165. [PMID: 31867350 PMCID: PMC6796292 DOI: 10.4103/jehp.jehp_236_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/13/2019] [Indexed: 06/10/2023]
Abstract
A spiritual well-being-based nursing intervention may boost older adults' resilience-based recovery. Its potential contribution may have positive knock-on effects: controlling skyrocketing healthcare costs; reducing the productive population's social burden of supporting the older adults; and alleviating a generational conflict. However, healthcare policy-makers are still skeptical about investing in those healthcare resources which would develop and implement a spiritual well-being-based nursing intervention for older adults. It is time for nurse scientists, as front-line gatekeepers for patients' omnidirectional well-being, to escape from thinking within the box by actively addressing first the feasibility, then the direct and indirect effectiveness on actual patient outcomes, and finally the cost efficiency of a spiritual well-being-based nursing intervention for the added benefit of easing the decision-making of healthcare policy-makers.
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Affiliation(s)
- Nader Aghakhani
- Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Engel LL, Beaton DE, Green RE, Dawson DR. Financial Management Activity Process: Qualitative inquiry of adults with acquired brain injury. Can J Occup Ther 2019; 86:196-208. [DOI: 10.1177/0008417419833839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Little is known about the financial management occupations of people living with brain injury, despite the importance of these to adult autonomy. Purpose. This work aims to develop a conceptual framework for financial management after adulthood acquired brain injury. Method. This qualitative study used grounded theory methods. Data included semistructured interviews of 10 adults living with brain injury and two close others who assist with financial management occupations. Analysis included initial and focused coding, memo writing, constant comparison, theoretical sampling of questions, and member checking. Findings. The Financial Management Activity Process conceptual framework describes a complex action process. This includes accounting for factors influencing financial choices and actions, and identifying and using a trusted personalized process, including using financial management strategies aligned with the constraints of factors. Implications. This conceptual framework may be useful to assessment and intervention development. It highlights the between-person and between-activity variability in financial management processes and strategy use.
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Mittal R. Frail Elderly, Inconspicuous Finance System, Complex Healthcare: Are We Realists or Optimists? J Am Med Dir Assoc 2018; 19:721-722. [PMID: 29807747 DOI: 10.1016/j.jamda.2018.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 03/30/2018] [Accepted: 04/13/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Rakhi Mittal
- Faculty of Dentistry, National University of Singapore, National University Health System, Singapore
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