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Lin C, Wang PP, Wang ZY, Lan GR, Xu KW, Yu CH, Wu B. Innovative integration of lung ultrasound and wearable monitoring for predicting pulmonary complications in colorectal surgery: A prospective study. World J Gastrointest Surg 2024; 16:2649-2661. [PMID: 39220059 PMCID: PMC11362956 DOI: 10.4240/wjgs.v16.i8.2649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/26/2024] [Accepted: 07/11/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Postoperative pulmonary complications (PPCs) are common in patients who undergo colorectal surgery. Studies have focused on how to accurately diagnose and reduce the incidence of PPCs. Lung ultrasound has been proven to be useful in preoperative monitoring and postoperative care after cardiopulmonary surgery. However, lung ultrasound has not been studied in abdominal surgeries and has not been used with wearable devices to evaluate the influence of postoperative ambulation on the incidence of PPCs. AIM To investigate the relationship between lung ultrasound scores, PPCs, and postoperative physical activity levels in patients who underwent colorectal surgery. METHODS In this prospective observational study conducted from November 1, 2019 to August 1, 2020, patients who underwent colorectal surgery underwent daily bedside ultrasonography from the day before surgery to postoperative day (POD) 5. Lung ultrasound scores and PPCs were recorded and analyzed to investigate their relationship. Pedometer bracelets measured the daily movement distance for 5 days post-surgery, and the correlation between postoperative activity levels and lung ultrasound scores was examined. RESULTS Thirteen cases of PPCs was observed in the cohort of 101 patients. The mean (standard deviation) peak lung ultrasound score was 5.32 (2.52). Patients with a lung ultrasound score of ≥ 6 constituted the high-risk group. High-risk lung ultrasound scores were associated with an increased incidence of PPCs after colorectal surgery (logistic regression coefficient, 1.715; odds ratio, 5.556). Postoperative movement distance was negatively associated with the lung ultrasound scores [Spearman's rank correlation coefficient (r), -0.356, P < 0.05]. CONCLUSION Lung ultrasound effectively evaluates pulmonary condition post-colorectal surgery. Early ambulation and respiratory exercises in the initial two PODs will reduce PPCs and optimize postoperative care in patients undergoing colorectal surgery.
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Affiliation(s)
- Chen Lin
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Pei-Pei Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zi-Yan Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Guo-Ru Lan
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Kai-Wen Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Chun-Hua Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Bin Wu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Su Y, Zhao L, Yu J, Chen X, Tan E, Liu H, Xie X, Liu F. Burnout among care workers in long-term care institutions: a systematic review and meta-analysis protocol. BMJ Open 2024; 14:e084900. [PMID: 39025823 PMCID: PMC11261695 DOI: 10.1136/bmjopen-2024-084900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/17/2024] [Indexed: 07/20/2024] Open
Abstract
INTRODUCTION Care workers play a fundamental role in delivering care services in long-term care institutions. Burnout has been found to have a negative impact on care recipients and organisations providing care. Little is known about the key factors associated with care workers' burnout. This systematic review aims to explore the prevalence, severity and correlates of burnout among care workers before and during COVID-19 pandemic. METHODS AND ANALYSIS A five-stage framework outlined by Whittemore and Knafl will be used. The following databases will be used to identify relevant literature, including Medline (PubMed), EMBASE, Cochrane library, PsycINFO, CINAHL, Scopus and Web of Science. RevMan will be used to assist the meta-analysis. Heterogeneity of the included studies will be tested using the I 2 test. ETHICS AND DISSEMINATION No ethics approval is required as this study only involves secondary data analysis. The findings will be published in peer-reviewed journals and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42024499178.
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Affiliation(s)
- Yinhua Su
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Ling Zhao
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Juping Yu
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Xia Chen
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - E Tan
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Hui Liu
- School of Nursing, University of South China, Hengyang, Hunan, People's Republic of China
| | - Xiaoping Xie
- First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
| | - Fen Liu
- First Affiliated Hospital of University of South China, Hengyang, Hunan, People's Republic of China
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Çalapkorur S, Bakır B, Toklu H, Akın S. The effect of the nutritional status and dietary inflammatory index on frailty and activities of daily living in geriatric outpatients. Ir J Med Sci 2024; 193:1671-1680. [PMID: 38127190 DOI: 10.1007/s11845-023-03595-0] [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: 11/02/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND It has been reported that the inflammatory process plays a role in the pathophysiology of frailty in elderly individuals and that diet is effective in regulating chronic inflammation. OBJECTIVE This study aims to evaluate the effects of nutritional status and dietary inflammatory index on frailty and activities of daily living in the elderly. METHOD A cross-sectional study in a hospital in Turkey has been carried out with 187 over the age of 65 who presented to the geriatric outpatient clinic participants. Anthropometric measurements of the patients were recorded, and the dietary inflammatory index (DII) was calculated using the 24-h dietary recall method. Mini Nutritional Assessment (MNA) was used to determine the malnutrition risk, the FRAIL scale was used for frailty assessment, and Katz and Lawton & Brody scales were used for daily living activities. RESULTS The mean age of the elderly is 70.83 ± 4.98 years. The frailty rate was determined to be 28.3%. The DII score was determined as 4.41 ± 5.16 in frail patients and 1.62 ± 4.39 in non-frail patients (p < 0.05). While DII showed a negative correlation with the Lawton & Brody scale score (r = - 0.353), MNA was positively correlated to the Katz score (r = 0.386, p = 0.000) and the Lawton & Brody score (r = 0.475). In addition, one-unit increase in the MNA score was associated with a 29% decrease in the risk of frailty. CONCLUSIONS The dietary inflammatory index was found to be high in frail and malnourished individuals. It was determined that the quality of life of individuals with malnutrition decreased.
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Affiliation(s)
- Sema Çalapkorur
- Nutrition and Dietetics Department, Erciyes University Health Science Faculty, Kayseri, Turkey.
| | - Buse Bakır
- Health Science Faculty, Nutrition and Dietetics Department, İzmir Katip Celebi University, İzmir, Turkey
| | - Hilal Toklu
- Nutrition and Dietetics Department, Erciyes University Health Science Faculty, Kayseri, Turkey
| | - Sibel Akın
- Faculty of Medicine, Department of Internal Medicine/Geriatrics, Erciyes University, Kayseri, Turkey
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Zhou WQ, Gao YT, Wang Y, Liu J, Wang QY, Zhou LS. Understanding Care Needs of Older Adults with Disabilities: A Scoping Review. J Multidiscip Healthc 2024; 17:2331-2350. [PMID: 38770173 PMCID: PMC11104368 DOI: 10.2147/jmdh.s454985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/28/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose To conducted a scoping review of care needs of older adults with disabilities at home and in the community and provide a comprehensive understanding of the essential needs of older adults with disabilities. Methods Eight databases were searched for relevant Chinese and English studies (supplemented by retrospective references of the included studies) from the establishment of the database to February 13, 2023. An thematic synthesis approach was used to qualitatively integrate the retrieved studies and identify need-related themes. Results A total of 6239 studies were retrieved, 2557 were de-weighted and excluded, and 56 were obtained after the double screening. Studies were from 11 countries. Thirty-three studies used a self-prepared survey instrument to investigate needs, and the other research tools commonly used were secondary databases and the Long-Term Care Needs of the Disabled Scale. A total of 78 specific need items were identified and summarized into three need themes based on the ICF framework: physical functioning needs, activity and participation needs, and environment needs. Conclusion The complex physical and mental health conditions faced by older adults with disabilities result in multifaceted, integrated needs that are difficult to identify and meet. Current research on older adults with disabilities is limited to common care. Future research should focus on the specificities of the older disabled population and understand the diverse care needs of people with disabilities in order to better target care services for this group. Policymakers should formulate more operational and strategic measures based on the actual needs of older adults with disabilities to expand the coverage of services and to pinpoint care services.
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Affiliation(s)
- Wan-Qiong Zhou
- School of Nursing, Naval Medical University, Shanghai, People’s Republic of China
| | - Yi-Tian Gao
- School of Nursing, Naval Medical University, Shanghai, People’s Republic of China
| | - Ying Wang
- Department of Nursing, The First Rehabilitation Hospital of Shanghai, Tongji University, Shanghai, People’s Republic of China
| | - Jing Liu
- School of Nursing, Naval Medical University, Shanghai, People’s Republic of China
| | - Qiu-Yi Wang
- School of Nursing, Naval Medical University, Shanghai, People’s Republic of China
| | - Lan-Shu Zhou
- School of Nursing, Naval Medical University, Shanghai, People’s Republic of China
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Goodarzi F, Barati M, Bashirian S, Ayubi E, Rahbar S, Cheraghi P. The experiences of the elderly regarding the use of rehabilitation assistive technologies: a directed qualitative content analysis. Disabil Rehabil Assist Technol 2024:1-12. [PMID: 38329221 DOI: 10.1080/17483107.2024.2313081] [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: 06/12/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE The elderly population faces reduced levels of health and performance, which necessitates the use of rehabilitation assistive technologies to maximize functional independence in daily activities. This study aimed to explain the experiences of the elderly regarding the use of rehabilitation assistive technologies based on the Unified Theory of Acceptance and Use of Technology. METHODS The present study was a qualitative study of the type of content analysis that was conducted in the city of Hamadan in 2022. Participants included 20 elderly aged 60 years or above who were selected as a purposive sample and subjected to individual semi-structured in-depth interviews. Data were analyzed using directed qualitative content analysis based on Hsieh and Shannon's approach. Data were coded using MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin). RESULTS According to the results, 260 primary codes were extracted, and they were classified into five predetermined categories of the Unified Theory of Acceptance and Use of Technology, including performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention, as well as two new categories of technology anxiety and perceived need for technology. After extracting 260 primary codes based on the Unified Theory of Acceptance and Use of Technology, 75 sub-categories were identified in 14 main categories. CONCLUSION The themes obtained from the study indicate the necessity of providing the required conditions to maintain the complete independence and health of the elderly and strengthen their morale. The results can be helpful in the development of support strategies for family members, healthcare providers, and policymakers.
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Affiliation(s)
- Fataneh Goodarzi
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soulmaz Rahbar
- Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan university of medical sciences, Hamadan, Iran
| | - Parvin Cheraghi
- Department of Health Education and Promotion, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kim H, Jung YH, Park S, Shin J, Jang SI. Effects of disability-related limitations in daily living on unmet needs: a longitudinal-study 1. BMC Public Health 2024; 24:351. [PMID: 38308206 PMCID: PMC10835996 DOI: 10.1186/s12889-024-17674-z] [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: 08/02/2023] [Accepted: 01/04/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Unmet health needs are particularly important to people with disabilities; however, these unmet needs owing to limitations in daily life have been under-researched thus far. This study examined the effects of disability-related limitations in daily life on unmet needs. METHODS This study included 5,074 adults with disabilities from the 2018-2020 Korea Disability and Life Dynamics Panel. We analyzed the effects of disability-related limitations in daily life on unmet needs using logistic regression with a generalized estimating equation model. RESULTS Overall, 4.8% men and 4.6% women with disabilities had unmet needs. For men, unmet needs were 1.46 times (95% confidence interval [CI] 1.09-1.96) higher for those with moderate limitations in daily life. For women, unmet needs were 1.79 times (95% CI 1.22-2.39) higher when there were moderate limitations in daily life. The prominent factors causing this effect were physical or brain lesion disability for men and internal or facial disability and burden of medical expenses for women. CONCLUSIONS Limitations in daily life due to disability increase the risk of having unmet needs, an effect that is significantly more pronounced in men. These unmet needs differ depending on an individual's sex, disability type, limited body parts, and other specific causes. Efforts are required to reduce the unmet needs of people with disabilities by considering the type of disability, impaired body parts, and causes of unmet needs in daily life.
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Affiliation(s)
- Hanseul Kim
- Southern Seoul Regional Headquarters, National Pension Service, Seoul, Republic of Korea
| | - Yun Hwa Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Sohee Park
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.
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Lee S, Park HN, Nam HJ, Kim B, Yoon JY. A comparison of factors associated with unmet healthcare needs in people with disabilities before and after COVID-19: a nationally representative population-based study. BMC Health Serv Res 2024; 24:134. [PMID: 38267917 PMCID: PMC10809632 DOI: 10.1186/s12913-024-10579-y] [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: 02/06/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND People with disabilities, who require numerous healthcare services, are vulnerable to unmet healthcare needs. This study aimed to investigate and identify the factors that influence unmet healthcare needs among people with disabilities and to compare these factors before and after the COVID-19 pandemic in South Korea. METHODS A propensity score matching analysis was conducted using two datasets from the National Survey of Disabled Persons collected in 2017 and 2020. The participants were matched based on variables known to influence healthcare utilization. Based on the Andersen model, logistic regression was performed to analyze the key characteristics of the factors associated with unmet healthcare needs, including predisposing, enabling, and need factors. RESULTS Propensity score matching resulted in the inclusion of 1,884 participants in each group: an experimental group and control group. Before COVID-19, factors associated with unmet healthcare needs included sex, age, marital status, and education level (predisposing factors), instrumental activities of daily living dependency, satisfaction with medical staff's understanding of disability, satisfaction with medical institutional facilities and equipment (enabling factors), subjective health status, and depressive symptoms (need factors). After COVID-19, factors included physical disability, instrumental activities of daily living dependency, and discrimination (enabling factors), and subjective health status, chronic diseases, depressive symptoms, and regular medical care (need factors). No significant predisposing factors affecting unmet healthcare needs were identified after COVID-19. CONCLUSIONS This study compared the factors affecting unmet healthcare needs among people with disabilities before and after COVID-19. Recognizing the different factors associated with unmet healthcare needs before and after COVID-19, (e.g., sex, type of disability, satisfaction with medical staff's understanding of disabilities, medical institutional facilities and equipment considering the disabled, discrimination, chronic diseases, and regular medical care) may help governments and policymakers establish strategies to reduce and prevent unmet healthcare needs during and a future crisis.
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Affiliation(s)
- Sujin Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Han Nah Park
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Hye Jin Nam
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Bohye Kim
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, Republic of Korea.
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.
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Wang Y, Xu X, Liu J, Lv Q, Chang H, He Y, Zhao Y, Zhang X, Zang X. Latent transition analysis of instrumental activities of daily living in Chinese elderly: based on the 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey. BMC Geriatr 2024; 24:83. [PMID: 38254009 PMCID: PMC10804623 DOI: 10.1186/s12877-023-04631-5] [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: 11/07/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The instrumental activities of daily living (IADL) among the elderly have been found to be heterogeneous, with different trajectories. However, the transition of the IADL over time remains unclear. We aimed to explore the transition probabilities and the predictors of IADL among the elderly. METHODS Longitudinal data from the 2014 (T1) and 2018 (T2) waves of the Chinese Longitudinal Healthy Longevity Survey were extracted. A sample of 2,944 participants aged 65 years or older, with complete responses to the IADL scale, was included. Latent profile analysis (LPA) and latent transition analysis (LTA) were employed to identify latent profiles of IADL and investigate the transition probabilities between profiles from T1 to T2. The predictors of latent profiles and transition probabilities were examined using multinomial regression analysis. RESULTS The results of LPA at both T1 and T2 supported a 4-profile model solution. They were labeled as the "Normal function profile," "Mildly impaired profile," "Moderately impaired profile," and "Highly impaired profile". The Normal function profile and Highly impaired profile were characterized by maintaining stability rather than transitioning over time, with transition probabilities of 0.71 and 0.68, respectively, for maintaining stability. The Mildly impaired profile and Moderately impaired profile were characterized by a stronger tendency towards transition rather than stability, with transition probabilities of 0.29 and 0.45, respectively, of transitioning to the Highly impaired profile. The transition probabilities from the three impaired function profiles to the Normal function profile ranged from 0.05 to 0.19. Age, gender, place of residence, and social participation were significant predictors of profile attribution at T1 and transition probabilities over time. CONCLUSIONS This study employed the LTA to examine the transition probability of IADL among the Chinese elderly. By recognizing the different profiles of IADL and understanding the factors associated with transitions among the elderly, interventions can be tailored to improve their functional independence and successful reintegration into families and society.
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Affiliation(s)
- Yaqi Wang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Xueying Xu
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Jingwen Liu
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Qingyun Lv
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Hairong Chang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Yuan He
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
| | - Xiaonan Zhang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
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Phi PM, Giang LT, Pham TTH. Unmet needs for care for activities of daily living among older adults with functional disabilities in Vietnam. Front Public Health 2023; 11:1216785. [PMID: 37849716 PMCID: PMC10578490 DOI: 10.3389/fpubh.2023.1216785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/31/2023] [Indexed: 10/19/2023] Open
Abstract
Background Given its low-middle-income status, Vietnam is experiencing a rapidly aging population. Along with this demographic trend, the care needs of older adults, particularly those with functional disabilities, have become an emerging policy issue. Purpose This study examined the prevalence of unmet needs for care in activities of daily living (ADLs) among Vietnamese older adults with functional disabilities. Methods We used data from the Population Change and Family Planning Survey (PCS) in 2021, which was a nationally representative survey. Cross-tabulations and logistic regressions were applied to identify older adults' individual and household factors associated with their unmet care needs. Results Overall, 4.80% of older adults with at least one functional disability needing care to perform one or more ADLs suffered from unmet needs, of whom 2.32% did not receive any care and 3.05% received insufficient assistance. Logistic regression results revealed that age, sex, place of residence, ethnicity, marital status, education levels, and self-rated health were significantly associated with unmet needs. The higher risk of having unmet needs is associated with those in middle age (70-79), men, rural residents, ethnic minorities, currently unmarried people, those with less than a primary educational level, and those with normal or poor self-rated health. Conclusion Attention should be paid to vulnerable older adults, such as those living in rural areas with poor health status, in order to reduce their unmet needs for ADL assistance.
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Affiliation(s)
- Phong Manh Phi
- Faculty of Political Studies, Hanoi University of Mining and Geology, Hanoi, Vietnam
| | - Long Thanh Giang
- Faculty of Economics, National Economics University, Hanoi, Vietnam
| | - Tham Thi Hong Pham
- Faculty of Mathematical Economics, National Economics University, Hanoi, Vietnam
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Chen X, Xiao X, Huang X, Wang R, Yang J, Yang L, Wang Y, Zhou C. Empowerment and quality of life: the mediating role of self-efficacy and health literacy among spousal caregivers in China. Health Promot Int 2023; 38:daad133. [PMID: 37874985 DOI: 10.1093/heapro/daad133] [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] [Indexed: 10/26/2023] Open
Abstract
The aim of this study was to explore the chain mediation model of self-efficacy and health literacy between empowerment and quality of life among spousal caregivers of disabled elderly based on 'Marriage Binding'. From December 2020 to June 2022, the cross-sectional study was conducted in hospitals and communities, in Guangdong, Fujian, Sichuan, Hunan, Jiangxi, Guangxi and Yunnan provinces, China. Descriptive statistics were used to describe the demographic data and four main variables, including empowerment, self-efficacy, health literacy and quality of life. Spearman correlation analysis was used to analyze the correlation between the four main research variables. Multiple Linear Regression and bootstrap analysis were used to analyze the direct and indirect effects among them. Any two variables of spousal caregivers were correlated among empowerment, self-efficacy, health literacy and quality of life. Self-efficacy and health literacy can separately and sequentially mediate the relationship between empowerment and quality of life. To improve the quality of life of spousal caregivers of disabled elderly, the mediating role of self-efficacy, the mediating role of health literacy and the chain mediating role of self-efficacy and health literacy should take effect. In the future, some intervention studies should be taken to enhance the effects of those variables that may be beneficial for improving quality of life of spousal caregivers of disabled elderly.
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Affiliation(s)
- Xuan Chen
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Xiuying Xiao
- Department of Nursing, Zhuhai Fifth People's Hospital, Zhuhai, Guangdong, 519090, PR China
| | - Xiu'e Huang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Run Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Jing Yang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Lingli Yang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Yiling Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
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Wang P, Niu M, Chen Y, Wang S, Wu C, Zhao D, Wang P, Yang H, Guo P. Developing Family-Community Interactive program for the disabled older adults at home: a study protocol. BMC Geriatr 2023; 23:609. [PMID: 37773100 PMCID: PMC10540501 DOI: 10.1186/s12877-023-04273-7] [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: 03/12/2022] [Accepted: 09/01/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND With an aging population and the influence of traditional culture, the number of disabled older adults at home is increasing. Meanwhile, their care needs are also increasing. The cooperation between family and community can effectively improve the quality of home care for the disabled older adults. At present, there is a lack of research on the interaction between family and community in home care for disabled older adults. METHODS The aim of this study is to determine the experience and demands of the interaction for disabled older adults, family and community, construct an interaction program among disabled older adults, family and community, and improve the quality of life. From may 2022 to July 2022, This study will select disabled older adults families from seven communities in Henan provinces. The researchers, after training, will conduct semi-structured interview to collect research data. According to the integration results of qualitative research, the interactive program is constructed and revised using the Delphi expert consultation method. Then the participants will be selected to accept the intervention of the interactive program and evaluated through questionnaires. DISCUSSION Both family and community play an important role in the care of the disabled older adults at home. There is some evidence indicating the benefits of cooperation between family and community on disabled older adults. This study will take a step further and constructs a interaction program about how to create a positive and interactive home-based older adults care environment. TRIAL REGISTRATION Registered in the Chinese Clinical Trial Registry on April 19, 2021, number ChiCTR2100045584.
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Affiliation(s)
- Peng Wang
- Medical School of Huanghe Science and Technology University, Zhengzhou, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Meilan Niu
- Medical School of Huanghe Science and Technology University, Zhengzhou, China
| | - Ying Chen
- Huanghuai University School of Medicine, Zhumadian, China
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chuqiao Wu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Di Zhao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Huashan Yang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China.
| | - Panpan Guo
- Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
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12
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Wang K, Zhao J, Hu J, Liang D, Luo Y. Predicting unmet activities of daily living needs among the oldest old with disabilities in China: a machine learning approach. Front Public Health 2023; 11:1257818. [PMID: 37771828 PMCID: PMC10523409 DOI: 10.3389/fpubh.2023.1257818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Background The ageing population in China has led to a significant increase in the number of older persons with disabilities. These individuals face substantial challenges in accessing adequate activities of daily living (ADL) assistance. Unmet ADL needs among this population can result in severe health consequences and strain an already burdened care system. This study aims to identify the factors influencing unmet ADL needs of the oldest old (those aged 80 and above) with disabilities using six machine learning methods. Methods Drawing from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2017-2018 data, we employed six machine learning methods to predict unmet ADL needs among the oldest old with disabilities. The predictive effects of various factors on unmet ADL needs were explored using Shapley Additive exPlanations (SHAP). Results The Random Forest model showed the highest prediction accuracy among the six machine learning methods tested. SHAP analysis based on the Random Forest model revealed that factors such as household registration, disability class, economic rank, self-rated health, caregiver willingness, perceived control, economic satisfaction, pension, educational attainment, financial support given to children, living arrangement, number of children, and primary caregiver played significant roles in the unmet ADL needs of the oldest old with disabilities. Conclusion Our study highlights the importance of socioeconomic factors (e.g., household registration and economic rank), health status (e.g., disability class and self-rated health), and caregiving relationship factors (e.g., caregiver willingness and perceived control) in reducing unmet ADL needs among the oldest old with disabilities in China. Government interventions aimed at bridging the urban-rural divide, targeting groups with deteriorating health status, and enhancing caregiver skills are essential for ensuring the well-being of this vulnerable population. These findings can inform policy decisions and interventions to better address the unmet ADL needs among the oldest old with disabilities.
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Affiliation(s)
- Kun Wang
- Zhongnan University of Economics and Law (School of Philosophy), Wuhan, Hubei, China
- Nankai University (Zhou Enlai School of Government), Tianjin, China
| | - Jinxu Zhao
- Zhongnan University of Economics and Law (School of Philosophy), Wuhan, Hubei, China
| | - Jie Hu
- Wuhan University (School of Physics and Technology), Wuhan, Hubei, China
| | - Dan Liang
- Tongji Medical College of Huazhong University of Science and Technology (School of Medicine and Health Management), Wuhan, Hubei, China
| | - Yansong Luo
- Zhongnan University of Economics and Law (School of Philosophy), Wuhan, Hubei, China
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Jaehn P, Fügemann H, Gödde K, Holmberg C. Using decision tree analysis to identify population groups at risk of subjective unmet need for assistance with activities of daily living. BMC Geriatr 2023; 23:543. [PMID: 37674137 PMCID: PMC10483760 DOI: 10.1186/s12877-023-04238-w] [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: 01/27/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Identifying predictors of subjective unmet need for assistance with activities of daily living (ADL) is necessary to allocate resources in social care effectively to the most vulnerable populations. In this study, we aimed at identifying population groups at risk of subjective unmet need for assistance with ADL and instrumental ADL (IADL) taking complex interaction patterns between multiple predictors into account. METHODS We included participants aged 55 or older from the cross-sectional German Health Update Study (GEDA 2019/2020-EHIS). Subjective unmet need for assistance was defined as needing any help or more help with ADL (analysis 1) and IADL (analysis 2). Analysis 1 was restricted to participants indicating at least one limitation in ADL (N = 1,957). Similarly, analysis 2 was restricted to participants indicating at least one limitation in IADL (N = 3,801). Conditional inference trees with a Bonferroni-corrected type 1 error rate were used to build classification models of subjective unmet need for assistance with ADL and IADL, respectively. A total of 36 variables representing sociodemographics and impairments of body function were used as covariates for both analyses. In addition, the area under the receiver operating characteristics curve (AUC) was calculated for each decision tree. RESULTS Depressive symptoms according to the PHQ-8 was the most important predictor of subjective unmet need for assistance with ADL. Further classifiers that were selected from the 36 independent variables were gender identity, employment status, severity of pain, marital status, and educational level according to ISCED-11. The AUC of this decision tree was 0.66. Similarly, depressive symptoms was the most important predictor of subjective unmet need for assistance with IADL. In this analysis, further classifiers were severity of pain, social support according to the Oslo-3 scale, self-reported prevalent asthma, and gender identity (AUC = 0.63). CONCLUSIONS Reporting depressive symptoms was the most important predictor of subjective unmet need for assistance among participants with limitations in ADL or IADL. Our findings do not allow conclusions on causal relationships. Predictive performance of the decision trees should be further investigated before conclusions for practice can be drawn.
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Affiliation(s)
- Philipp Jaehn
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School, Brandenburg an der Havel, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Potsdam, Germany
| | - Hella Fügemann
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School, Brandenburg an der Havel, Germany
- Institute of Public Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Kathrin Gödde
- Institute of Public Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School, Brandenburg an der Havel, Germany.
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Potsdam, Germany.
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Gao M, Zhang Y, Tian Y, Gao Y, Li X, Lu Y. A qualitative exploration of Chinese rural older adults' adaption experience to disability in Henan Province. BMC Public Health 2023; 23:512. [PMID: 36927448 PMCID: PMC10021979 DOI: 10.1186/s12889-023-15425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/11/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The global population is ageing in a serious way and the number of disabled elderly people is increasing. Disability is a combination of physical and functional impairments, activity limitations, and social participation restrictions that significantly affect the quality of life of older adults. This study used the Roy adaptation model to examine the adaptive strategies of rural disabled elderly. METHODS An interview outline was prepared based on the Roy Adaptation Model, in-depth interviews were conducted with eligible rural elderly with disabilities using purposive sampling. Interview data were analyzed using the colaizzi method to obtain relevant themes and sub-themes of the adaptation experience. RESULTS Fifteen eligible disabled elderly participated in the interview, with an average age of 73.7 years old, showing different adaptation experiences in different aspects, a total of 5 themes and 18 sub-themes were extracted: (a)physiological function adaptation: learning to monitor physiological indicators, active medical compliance behavior, active rehabilitation exercise, adjusting lifestyle and coping with failure, (b) self-concept adaptation: adjustment of gratitude mentality, self-consolation, transferring the attention, seeking emotional comfort, and negative emotional response, (c) role function adaptation: positive self-care role, negative family role and escape of social role, (d) interdependence adaptation: actively seeking support and complex social coping, and (e) adaptation influencing factors: personal factors, caregiver factors and the policy factors. CONCLUSIONS The disabled elderly show different adaptation strategies in four ways, and are affected by personal factors, caregiver factors and policy factors. A multi-faceted support system for the disabled elderly is recommended, and the caregivers should be trained in all-round care knowledge and skills.
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Affiliation(s)
- Mengke Gao
- School of Nursing and Health, Zhengzhou University, 101 Science Avenue, High-Tech Zone, Zhengzhou City, Henan Province, China
| | - Yan Zhang
- School of Nursing and Health, Zhengzhou University, 101 Science Avenue, High-Tech Zone, Zhengzhou City, Henan Province, China.
| | - Yutong Tian
- School of Nursing and Health, Zhengzhou University, 101 Science Avenue, High-Tech Zone, Zhengzhou City, Henan Province, China
| | - Yue Gao
- School of Nursing and Health, Zhengzhou University, 101 Science Avenue, High-Tech Zone, Zhengzhou City, Henan Province, China
| | - Xiaohua Li
- School of Nursing and Health, Zhengzhou University, 101 Science Avenue, High-Tech Zone, Zhengzhou City, Henan Province, China
| | - Yixin Lu
- School of Nursing and Health, Zhengzhou University, 101 Science Avenue, High-Tech Zone, Zhengzhou City, Henan Province, China
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15
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Liang H, Wang B, Wu Y, Zhang Q, Xiang N, Yue Z, Liu E. The association between financial support of adult children to their parents and informal care provision in China and its differences in household registration, residence arrangement and community-based care services: 2008 ~ 2018. Int J Equity Health 2023; 22:46. [PMID: 36918878 PMCID: PMC10012597 DOI: 10.1186/s12939-023-01856-z] [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: 07/19/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The changes in demographic and family structures have weakened the traditional norms of filial piety and intergenerational relationships dramatically. This study aims to examine the dynamic association between financial support of adult children to their parents and informal care provision in China and its differences in household registration, residence arrangement and community-based care services. METHODS Data was derived from the 2008-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), which is a longitudinal survey of a nationally representative sample of individuals aged 60 and over. Random effects model was used to assess the association between financial support and informal care provision of adult children to their parents. RESULTS It was found that financial support showed an upward trend while informal care provision showed a download trend from 2008 to 2018. The result indicated a significant and negative association between financial support and informal care provision of adult children to their parents (B = -0.500, 95% confidence interval (CI) = -0.761 to -0.239). And the association was significant among elderly people who were from urban areas (B = -0.628, 95% CI = -0.970 to -0.287), co-resided with adult children (B = -0.596, 95% CI = -0.939 to -0.253), and had community-based services (B = -0.659, 95% CI = -1.004 to -0.315). CONCLUSION Financial support was negatively associated with informal care provision of adult children to their parents in China, and the association has differences in household registration, residence arrangement and community-based care services. It is suggested that policymakers should prioritize planning interventions for elderly care services and establish a family caregiver support system.
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Affiliation(s)
- Hang Liang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China
| | - Boyu Wang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China
| | - Yanli Wu
- Center for Social Security, Wuhan University, Wuhan, 430072, China
| | - Qilin Zhang
- Center for Social Security, Wuhan University, Wuhan, 430072, China
| | - Nan Xiang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China
| | - Zhang Yue
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China
| | - Erpeng Liu
- Institute of Income Distribution and Public Finance, Zhongnan University of Economics and Law, No. 182 Nanhu Rd, Wuhan, 430073, China.
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Niu S, Ding S, Wu S, Ma J, Shi Y. Correlations between caregiver competence, burden and health-related quality of life among Chinese family caregivers of elderly adults with disabilities: a cross-sectional study using structural equations analysis. BMJ Open 2023; 13:e067296. [PMID: 36806142 PMCID: PMC9944642 DOI: 10.1136/bmjopen-2022-067296] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To examine the relationship between caregiver competence and health-related quality of life (HRQoL) among family caregivers of disabled elderly adults, and to evaluate the role of caregiver burden as a potential mediator of that relationship. DESIGN Cross-sectional study. SETTING Two general hospitals in Shanghai, China. PARTICIPANTS Study participants were 135 family caregivers of disabled elderly adults listed on a roster for outpatient and emergency services utilisation from January to March 2022. DATA ANALYSIS AND OUTCOME MEASURES We used stratified linear regression and structural equation model analysis. HRQoL was the main outcome, measured using the Medical Outcomes Study 36-Item Short form Health Survey. Caregiver competence was assessed using the Family Caregiver Task Inventory, and caregiver burden was assessed with the Zarit Burden Interview. RESULTS Caregivers of moderately and severely disabled elderly adults showed poorer scores in Physical Component Summary (F=20.463, p<0.05) and Mental Component Summary (F=17.062, p<0.05) compared with caregivers of older adults with mild disabilities. At the same time, those caregivers showed higher scores on the caregiving burden (F=19.533, p<0.05) and caregiving difficulties (F=16.079, p<0.05). A structural equation model was performed and successfully adjusted (χ2/df=1.175, p=0.261, NFI=0.970, RFI=0.949, IFI=0.995, CFI=0.995, GFI=0.963, TLI=0.992, AGFI=0.920, RMSEA=0.036). The total effect of Family Caregiver Task Inventory scores on HRQoL scores was -0.980, with a direct effect of -0.645. The mediating effect on HRQoL scores through the intermediate variable of caregiver burden scores was -0.335. CONCLUSIONS Family caregivers' HRQoL is closely related to caregiver difficulties and burdens. Early identification and targeted measures are needed to reduce the burden and problems in caregiving.
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Affiliation(s)
- Shuzhen Niu
- Department of Nursing, Tenth People's hospital, School of Medicine, Tongji University, Shanghai, China
| | - Silian Ding
- Department of Neurology, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Songqi Wu
- Department of Nursing, Tenth People's hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiajia Ma
- Department of Nursing, Tenth People's hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yan Shi
- Department of Nursing, Tenth People's hospital, School of Medicine, Tongji University, Shanghai, China
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17
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Ma H, Jia E, Ma H, Pan Y, Jiang S, Xiong J. Preferences for public long-term care insurance among middle-aged and elderly residents: A discrete choice experiment in Hubei Province, China. Front Public Health 2023; 11:1050407. [PMID: 36778541 PMCID: PMC9909219 DOI: 10.3389/fpubh.2023.1050407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Objective It is critical to incorporate residents' preferences into the design of long-term care insurance (LTCI). However, little is known about middle-aged and elderly residents' preferences for personalized need-related attributes of LTCI in China. Through a discrete choice experiment (DCE), we aimed to focus on the direct beneficiaries of LTCI and then elicit their preferences for LTCI under a hypothetical scenario of dysfunction. Methods Attributes and levels were defined through a literature review and two rounds of expert consultations (n = 8). A D-optimal fractional factorial design was used to generate the DCE questionnaire. Face-to-face interviews with middle-aged and elderly residents were conducted in two cities in Hubei Province, China, between November and December 2020. A mixed logit model was utilized for estimation. Results Five attributes were identified and incorporated into the DCE questionnaire. A total of 390 participants completed DCE questionnaires. Care facilities, care content, reimbursement rate, caregivers, and annual premium per person all had a significant impact on residents' preferences. Residents had significantly higher preferences for the LTCI scheme with home and community-based care centers (β = 1.40, p < 0.01), multi-level services (β = 0.44, p < 0.01), 90% reimbursement rate (β = 0.37, p < 0.01), and sufficiently trained caregivers (β = 0.26, p < 0.01). Individual characteristics, such as gender, employment, and education level were the factors that drove heterogeneity in preferences for LTCI. Conclusion This study provides new evidence on the preferences of middle-aged and elderly residents for personalized need-related public LTCI features. The design of the LTCI scheme in China needs to take these findings into account to maximize the utility for direct beneficiaries of LTCI and enhance their enrollment.
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Affiliation(s)
- He Ma
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Erping Jia
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huimin Ma
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanzhi Pan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shan Jiang
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Juyang Xiong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China,*Correspondence: Juyang Xiong ✉
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Gao Y, Du L, Cai J, Hu T. Effects of functional limitations and activities of daily living on the mortality of the older people: A cohort study in China. Front Public Health 2023; 10:1098794. [PMID: 36743188 PMCID: PMC9895937 DOI: 10.3389/fpubh.2022.1098794] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Prevalence of functional limitations (FLs) and disabled activities of daily living (ADL) cause heavy burdens to the health of the older people. Stratified by gender, this study aimed to explore the effects of FL and ADL on the mortality of the older people in China, and the mechanism was then discussed. Methods We used survey data of a prospective 10-year cohort (2008-2018), from the China Longitudinal Healthy Longevity Survey (CLHLS). The primary outcome was all-cause mortality, and Independent variables included FL, basic ADL (BADL), and instrumental ADL (IADL). Covariates involved socio-demographic characteristics, health-related behaviors, and health status of the participants in the CLHLS project. Results There were 967 (19.20%) male and 2,235 (32.36%) female older people performed functional limitations, and their survival time was 60.98 (SE = 0.66) and 55.19 (SE = 0.55) months, respectively. Old adults with FL had significantly poorer survival than the ones without (Log-rank test, P < 0.001). Weibull regression suggested that FL (P < 0.001), abnormal BADL (P < 0.001) and IADL (P < 0.001) were negatively associated with the survival of the older people. Further analysis showed that BADL and IADL performed significantly mediating roles in the relation of FL and survival time in old adults; additionally, for female older people, BADL also exhibited a significant moderating role in the effect of FL on survival. Conclusions Prevalence of FL was serious among the older people in China, especially for the women. Disabilities of BADL and IADL and FL were negatively associated with the survival time of the older people in China. Regarding the effect of FL on survival, BADL and IADL performed significantly mediating roles, and the moderating role of BADL existed only for the female. These suggested evidence to implement strategies to maintain health in the older people.
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Affiliation(s)
- Yumeng Gao
- Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China,*Correspondence: Yumeng Gao ✉
| | - Liang Du
- School of Public Health, Fudan University, Shanghai, China
| | - Jianping Cai
- Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China
| | - Tingfa Hu
- Department of Medical Insurance, Jinshan Hospital of Fudan University, Shanghai, China
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Yang G, Wan L, Dong H, Liang X, He Y. Utilisation willingness for institutional care by the disabled elderly and its influencing factors based on Andersen's model: a cross-sectional survey of Henan, China. BMJ Open 2022; 12:e064949. [PMID: 36600340 PMCID: PMC9743373 DOI: 10.1136/bmjopen-2022-064949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To explore the factors that influence institutional care for the disabled elderly in China and the key factors that influence individuals based on the Andersen model. DESIGN Cross-sectional survey. SETTING The research was conducted in 18 cities in Henan Province, China. MAIN OUTCOME MEASURES A multistage, stratified sampling design was employed. The χ2 test was used to compare the differences in basic information of the disabled elderly. A binary Logit model was used to examine the factors influencing the willingness to institutionalise elderly people with disabilities. The determinants of willingness to care in an institution were also explored in a stratified study by gender, age and region to identify the key differences affecting institutionalisation. The Andersen model was used as the theoretical framework to infer the impact strength of each model. RESULTS Of the 2810 disabled elderly people in Henan, China, 7.4% of the elderly had a willingness for institutional care. In the binary logistic regression analysis, whether living alone (OR (95% CI)=0.596 (0.388 to 0.916)), medical payment method (basic medical insurance for urban employees: OR (95% CI)=2.185 (1.091 to 4.377)), having mental illness (OR (95% CI)=2.078 (1.044 to 4.137)) had a statistically significant difference (p<0.05) on the impact on the willingness of the disabled elderly to receive institutional care. Validation of the fitted coefficients of the model revealed that the needs factor had the most significant effect on the enabling variable, while the predisposing factor had more minerally effect. CONCLUSIONS Several factors influence the willingness of the disabled elderly to institutionalise. Therefore, it is recommended that relevant authorities take targeted measures to focus on the disabled elderly to identify more precise elderly care services to deal with the ageing crisis.
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Affiliation(s)
- Guangmei Yang
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Leping Wan
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haiying Dong
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoxiao Liang
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yan He
- Department of Social Medicine and Health Care Management, School of Public Health, Zhengzhou University, Zhengzhou, China
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Soll-Morka A, Kurpas D. The Degree of Meeting the Needs of Older People with Frailty Syndrome in the Residential Environment in Relation to Interventions-Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11682. [PMID: 36141956 PMCID: PMC9517563 DOI: 10.3390/ijerph191811682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
The study aimed to determine the degree of satisfaction with health, psychological, environmental, and social needs and to determine the effects of a nutritional intervention, physical activity, and comprehensive activity (nutritional intervention plus physical activity) on the degree of satisfaction of the needs of older people with frailty syndrome (FS). The study included 188 residents (140 women and 48 men) and was conducted using the Fried scale and Camberwell's modified brief needs assessment. In addition, data were collected on age, sex, educational level, type of the previous occupation, marital status, remaining in a relationship, co-residents, place of residence, work status, financial situation, and help with housework. Intervention groups were formed: G1-diet, G2-physical activity, G3-comprehensive therapy, and G4-control. Stage 1 (T1)-3 months after the first examination, stage 2 (T2)-after another three months, the measurements from stage 0. In all groups, the majority were women, respondents with a low or medium level of education in relationships. The degree of need satisfaction in groups G2, G3, and G4 depended on the measurement time (p = 0.019, p = 0.007, p = 0.016). The introduction of physical activity and physical activity in combination with dietary changes most effectively influenced the increase in the level of need satisfaction in elderly patients with frailty.
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Affiliation(s)
- Aneta Soll-Morka
- Institute of Health Sciences, University of Opole, 45-040 Opole, Poland
| | - Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland
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Cui M, Miao W, Chen J, Yang W, Geng Z, Qian X, Geng G. Effects of an emotional support programme on older adults living in nursing homes: A quasi-experimental study. Geriatr Nurs 2022; 45:180-187. [PMID: 35512507 DOI: 10.1016/j.gerinurse.2022.04.005] [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: 01/25/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to examine the feasibility and validity of an emotional support programme developed for older adults living in nursing homes, using a quasi-experimental design. Older adults in the intervention group attended a 12-week emotional support programme while those in the control group received usual care. Outcome variables, assessed at baseline and at 1-month and 3-month follow ups, included nursing home adjustment, perceived social support, and quality of life. Group-by-time interaction effects were found concerning nursing home adjustment and perceived social support. Significant improvements in the two variables were observed in the intervention group, but no significant difference was found in quality of life. The emotional support programme based on social learning theory resulted in significant improvements in nursing home adjustment and perceived social support. To respond to the demands of an ageing society, further studies are needed on this topic.
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Affiliation(s)
- Min Cui
- MSN, Nantong University Medical School, No19, Qixiu Road, Chong Chuan District, Nantong, Jiangsu, China
| | - Weiwei Miao
- MSN, Nantong University Medical School, No19, Qixiu Road, Chong Chuan District, Nantong, Jiangsu, China
| | - Jianqun Chen
- MSN, North Nantong Nursing Home, No18, Fuda Road, Chong Chuan District, Nantong, Jiangsu, China
| | - Wenwen Yang
- MSN, Nantong University Medical School, No19, Qixiu Road, Chong Chuan District, Nantong, Jiangsu, China
| | - Zihan Geng
- BM, Nantong University Medical School, No19, Qixiu Road, Chong Chuan District, Nantong, Jiangsu, China
| | - Xiangyun Qian
- MSN, Nantong Third People's Hospital, No. 60 Qingnian Zhong road, Chongchuan District, Nantong, Jiangsu 226001, China.
| | - Guiling Geng
- MSN, Nantong University Medical School, No19, Qixiu Road, Chong Chuan District, Nantong, Jiangsu, China.
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22
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Fuchs J, Gaertner B, Prütz F. Limitations in activities of daily living and support needs - Analysis of GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2022; 7:6-25. [PMID: 35434501 PMCID: PMC9009067 DOI: 10.25646/9570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time.
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Affiliation(s)
- Judith Fuchs
- Corresponding author Dr Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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Abstract
In 2020, China's population aged 60 or older exceeded 264 million, representing 25% of the global population in that age-group. Older adults in China experienced periods of dramatic political and social unrest in early life, as well as economic transformations leading to drastic improvements in living standards during adulthood and older age. However, the implications of life course socioeconomic status (SES) trajectories for healthy longevity in later life have not been systematically studied in China. We utilize data from the China Health and Retirement Longitudinal Study (CHARLS) to comprehensively investigate how early-life conditions and adult SES combine to influence healthy longevity in later life. We find that both childhood and adulthood SES are associated with late-life health. The largest disparities in life expectancy (LE) and disability-free LE are found between those with persistently low SES throughout life and those with consistently high SES. At age 45, the gap in total LE between the most advantaged and least advantaged groups is six years for men and five years for women. Despite China's major policy changes prioritizing equity in income and health care in recent decades, our findings suggest that dramatic health inequalities among older adults remain. Our findings extend the literature on the effect of socioeconomic patterns across the life course on gradients in later-life health and highlight continuing disparities in healthy longevity among older adults in China.
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Affiliation(s)
- Collin F Payne
- School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australia
| | - Kim Qinzi Xu
- School of Demography, Research School of Social Sciences, The Australian National University, Canberra, Australia
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24
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The role of care-giver and mental health for older adults with disabilities: a mixed-method study. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x21001409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Because of the exacerbation of population ageing, more family members are involved in the informal care-giving for older adults with disabilities to cater to their long-term care needs. As informal care-givers are associated with the mental health of the care recipient, this study, based on the theoretical framework of the Actor–Partner Effect, utilises a mixed method composed of quantitative and qualitative strategies to identify the relationship among gender and type of both care-giver and care recipient, and mental health of the recipient and explain its internal mechanism. In the quantitative research, ordinary least squares (OLS) regression results based on the basis of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data corroborate the existence of actor and partner effects within the care-giving dyad. The qualitative analysis further explains the socially constructed differences in gender role, trust relationship and perception towards filial piety of adult care-givers playing their role in the emergence of the Actor–Partner Effect. Finally, this study proposes a developed Actor–Partner Effect analysis framework, advocating to destigmatise disability and construct social support networks for the older adults with disabilities who receive informal care to promote their mental health based on the reflection of socially constructed gender difference.
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Wang J, Cui J, Tu S, Yang R, Zhao L. Resilience and caregiving ability among caregivers of people with stroke: The mediating role of uncertainty in illness. Front Psychiatry 2022; 13:788737. [PMID: 36483138 PMCID: PMC9723154 DOI: 10.3389/fpsyt.2022.788737] [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: 10/03/2021] [Accepted: 11/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In China, stroke survivors are usually cared for by their family members. However, the caregiving ability of these informal caregivers remain inadequate during the hospitalization of their family members following a sudden onset of a stroke, and this sudden need for care overwhelms caregivers even after the hospital discharge. Therefore, research is required to identify predictors of caregiving ability that could be targeted in future interventions aimed at improving caregiving skills and reducing the burden on caregivers who care for stroke survivors. MATERIALS AND METHODS From August 2019 to February 2020, stroke survivors were hospitalized for the first time, and their family caregivers were registered via convenience sampling. Caregiver demographic information, resilience status, uncertainty in illness, caregiving ability, and patients' severity of stroke were measured using standardized questionnaires. Structural equation modeling was used to test the proposed model, where caregiver resilience and stroke severity predicted caregiving ability directly, and uncertainty in illness mediated the association between caregiver resilience and caregiving ability. RESULTS A total of 306 dyads were included in the study. The tested model fit the data well (χ2 = 118.2, df = 64, RMSEA = 0.053, CFI = 0.946, TLI = 0.923). Statistically significant pathways linked caregivers' resilience status to uncertainty in illness (β = -0.558, S.E. = 0.022, P < 0.01), caregivers' resilience to the status of caregiving ability (β = -0.269, S.E. = 0.013, P < 0.01) and caregivers' uncertainty about the illness to caregiving ability (β = 0.687, S.E. = 0.051, P < 0.01). We also found that caregivers' uncertainty in illness mediated the association between caregivers' resilience and caregiving ability (β = -0.384, S.E. = 0.061, P < 0.01). CONCLUSIONS Our structural equation modeling result identified resilience and uncertainty about the illness as predictors of the caregiving ability of informal family caregivers who suffered from care burdens. Supporting family caregivers to build their resilience and reduce illness uncertainty may improve caregiving for stroke survivors.
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Affiliation(s)
- Jinyao Wang
- West China School of Nursing, Sichuan University, Chengdu, China.,Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Cui
- West China Hospital, Sichuan University, Chengdu, China
| | - Shuangyan Tu
- West China School of Nursing, Sichuan University, Chengdu, China.,Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Yang
- West China Hospital, Sichuan University, Chengdu, China
| | - Lihong Zhao
- West China School of Nursing, Sichuan University, Chengdu, China.,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Wang X, Yin Y, Wang H, Chen H. Ability to Cope by Family Caregivers of People Living With HIV in the Yi Population in Liangshan Prefecture: A Cross-sectional Study. J Assoc Nurses AIDS Care 2021; 32:569-577. [PMID: 32809986 DOI: 10.1097/jnc.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
ABSTRACT Informal caregivers' abilities to provide care for people living with HIV plays an essential role in improving health outcomes. Little is known about caregivers in the Yi population. A cross-sectional study was conducted, and 216 participants completed the Chinese version of the Caregiver Task Inventory (CTI-C). The total mean CTI-C score was 17.46 (SD = 7.70), which showed a low level of caring ability. Regression analysis indicated that caregiving willingness and caring time were significantly positively associated with CTI-C scores. Knowledge regarding HIV was negatively associated with CTI-C scores. There is an urgent need to increase the level of HIV-related knowledge in the rural regions of Liangshan Prefecture. Education contributes to improved knowledge. Therefore, educational campaigns should be implemented to improve this situation. The local government should plan policies to improve educational levels and develop targeted knowledge-improving programs based on cultural background.
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Affiliation(s)
- Xia Wang
- Xia Wang, BN, RN, Yao Yin, BN, RN, and Huan Wang, BN, RN, are graduate students, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China. Hong Chen, PhD, RN, is a Professor, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
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Yoshioka-Maeda K, Kono A. Factors related to complex care needs of older adults in community-based integrated care centers in Japan: A cross-sectional study. Jpn J Nurs Sci 2021; 18:e12440. [PMID: 34196480 DOI: 10.1111/jjns.12440] [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: 11/27/2020] [Revised: 05/03/2021] [Accepted: 05/24/2021] [Indexed: 11/26/2022]
Abstract
AIM This study aimed to identify the factors related to complex care needs of older adults in community-based integrated care centers. METHODS We sent 936 self-reported questionnaires to community-based integrated care center directors in the Kinki region of Japan. These questionnaires included questions not only about the directors' demographic data, but also regarding the sociodemographic, psychosocial, and family-related dimensions of the older adults in the community centers. The directors divided their cases into two categories: "Complex cases" and "Straightforward cases." We compared the intergroup differences and examined the factors related to complex care needs in older adults. RESULTS A total of 232 directors responded. Complex cases were significantly associated with younger age, poor health conditions, and having a family member who needs care, as compared to straightforward cases where these associations were not present. Logistic regression showed that in older adults, factors of refusing support or social services, social isolation, and trouble with neighbors were associated with their complexities. Additionally, family members with a high likelihood of refusing social services, older adults without a key family member, and difficulties in forming their consensus regarding care were associated with older adults' complexities. CONCLUSION Older adults with complex care needs could have the risk of self-neglect, and their families faced difficulties in supporting them as family members. Healthcare professions should carefully assess these factors and develop needs-oriented services for them without their family support as an upstream intervention.
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Affiliation(s)
- Kyoko Yoshioka-Maeda
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Ayumi Kono
- Department of Home Health Nursing, Osaka City University, Osaka, Japan
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Rao S, Shenoy R, Karat D, Poojary D, D'Souza V. Evaluation of Dental Program for Older Adults Living in Long-Term Care Facilities. Clin Cosmet Investig Dent 2021; 13:275-281. [PMID: 34234571 PMCID: PMC8255310 DOI: 10.2147/ccide.s311019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/20/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Compared to the general population, older adults living in long-term care facilities have poorer oral health. Also, they seldom have access to dental care services. Given that, a dental health program was initiated by Manipal College of Dental Sciences, Mangalore (MCODSM), to deliver dental care to the residents of St. Antony Home (SAH), a long-term care facility in Mangalore, India. This study aimed to evaluate the dental program by investigating the views and recommendations toward the program through its stakeholders. Methodology The stakeholders were divided into three groups: Group 1, transport personnel; Group 2, coordinator and administrators of the program from both the sites; and Group 3, the residents of SAH who received dental care at the MCODSM. Data were collected through a structured questionnaire to measure satisfaction levels of the participants. Data analyses included calculating the frequencies required to describe the evaluation outcomes narrative. Results A total of 19 stakeholders participated in the study, of them 12 were SAH residents (Group 3). These Group 3 participants received various kinds of dental care. Almost all stakeholders were satisfied with the program and reported that the program was beneficial to the SAH residents. The stakeholders of the program were satisfied with transportation, the time allotted for the treatment, and the attitude of the dentists who delivered the program. Conclusion The dental program was successful in delivering the most needed dental care to SAH residents. It provided an opportunity to provide treatment to SAH residents, and the stakeholders were highly satisfied with the program. That said, there are opportunities to improve the program, especially in relation to transporting the SAH residents to the program site, having a single window to deliver the dental treatment, and acquiring more supporting staff. Future evaluations are warranted using well-designed evaluation procedures and larger samples.
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Affiliation(s)
- Shushma Rao
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Mangalore, Karnataka, India.,Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ramya Shenoy
- Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.,Department of Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Karnataka, India
| | - Dolphin Karat
- Department of Medicine, Fr.Muller Homoeopathic Medical College, Mangalore, Karnataka, India
| | - Dharnappa Poojary
- Affiliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.,Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, Karnataka, India
| | - Violet D'Souza
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Zhao J, Liu X, Wan L, Gao Y, Huang M, Zha F, Long J, Li D, Nie G, Wang Y. A novel Longshi Scale measured activity of daily living disability in elderly patients affected by neurological diseases: a multi-center cross-sectional study in China. BMC Geriatr 2021; 21:348. [PMID: 34090363 PMCID: PMC8180129 DOI: 10.1186/s12877-021-02296-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
Background Ability in the activities of daily life is often impaired in the older adults with a neurological disease. The Barthel Index is an instrument used worldwide to assess such ability. The Longshi Scale is a picture-based alternative, but its effectiveness has not been evaluated with older adult subjects. This study was to determine whether the Longshi Scale can effectively quantify the ability of older adults in the activities of daily living by comparing its ratings with those using the Barthel Index. Methods A multi-center cross-sectional study was conducted among patients over 65 years. A total of 2438 patients were divided into three groups, including bedridden, domestic, or community group based on their ability to go out of bed, move outdoors, and return indoors. Their ability in the activities of daily living among three groups was evaluated using both the Longshi Scale and the Barthel Index, and the results were compared. Results There was a significant difference in the average Barthel Index scores of three groups classified using the Longshi Scale. The average Longshi Scale scores also showed significant differences between the four groups classified using the Barthel Index. Spearman correlation coefficients showed strong correlation(>0.83) between the Longshi Scale and Barthel Index scores. Conclusions The Longshi Scale can efficiently distinguish the ability in the activities of daily living of people with a neurological disease. Its rating correlate well with those using the Barthel Index.
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Affiliation(s)
- Jingpu Zhao
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xiangxiang Liu
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Li Wan
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yan Gao
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Meiling Huang
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Fubing Zha
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jianjun Long
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Dongxia Li
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Guohui Nie
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
| | - Yulong Wang
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
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Association between primary caregiver type and mortality among Chinese older adults with disability: a prospective cohort study. BMC Geriatr 2021; 21:268. [PMID: 33882871 PMCID: PMC8061058 DOI: 10.1186/s12877-021-02219-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Socio-demographic transitions have dramatically changed the traditional family care settings in China, caused unmet care needs among older adults. However, whether different primary caregiver types have different influences on disabled older adults’ health outcomes remain poorly understood. We aimed to examine the association between the type of primary caregiver (e.g., spouse and children) and death among community-dwelling Chinese older adults disabled in activities of daily living. Methods We used data from Chinese Longitudinal Healthy Longevity Survey. The analytic sample comprised 4278 eligible adults aged ≥ 80 years. We classified primary caregiver type into five categories: spouse, son/daughter-in-law, daughter/son-in-law, grandchildren, and domestic helper. We used Cox regression model to examine the association between primary caregiver type and all-cause mortality. Covariates included age, sex, residence, years of education, co-residence status, financial independence, whether living with children, number of ADL disability, number of chronic conditions, and self-reported health, cognitive impairment, and caregiving quality. Results Married older adults whose primary caregivers were son/daughter-in-law had a 38% higher hazard of death than those who had spouse as the primary caregiver. Married men who received care primarily from son/daughter-in-law or daughter/son-in-law had a 64 and 68% higher hazard of death, respectively, than those whose primary caregiver was spouse. The association between primary caregiver type and mortality among widowed older adults differed between urban and rural areas. Urban residents who had domestic helpers as the primary caregiver had an 16% lower hazard of death, while those living in rural areas had a 50% higher hazard of death, than those having son/daughter-in-law as the primary caregiver. Conclusions The quality of care of the primary caregiver may be a risk factor for mortality of disabled older adults in China. Interventions are necessary for reducing unmet needs and managing care burden.
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Ning H, Du Y, Ellis D, Deng HW, Hu H, Zhao Y, Chen H, Liao L, Li M, Peng L, Feng H. Malnutrition and its associated factors among elderly Chinese with physical functional dependency. Public Health Nutr 2021; 24:1404-1414. [PMID: 32389160 PMCID: PMC7864553 DOI: 10.1017/s1368980019005299] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/11/2019] [Accepted: 12/23/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To assess the prevalence and to identify the associated factors of malnutrition among elderly Chinese with physical functional dependency. DESIGN Face-to-face interviews using standardised questionnaires were conducted to collect demographic information, health-related issues and psychosocial status. Physical function was measured by the Barthel Index (BI), and nutrition status was assessed by the Mini Nutritional Assessment-Short Form. Multivariate binary logistic regression was used to assess associated factors of malnutrition. SETTING China. PARTICIPANTS A total of 2323 participants (aged ≥ 60 years) with physical functional dependency in five provinces in China were enrolled using a multistage cluster sampling scheme. RESULTS The prevalence of malnutrition was 17·9 % (95 % CI 16·3, 19·4). Multivariable binary logistic regression revealed the independent risk factors of poor nutrition status were being female, older age, lower educational status, poor hearing, poor physical functional status, lack of hobbies, low religious participation, poor social support, lack of social participation and changes in social participation. The study found that the most significant independent risk factor for malnutrition was complete physical functional dependence (OR 4·46, 95 % CI 2·92, 6·82). CONCLUSIONS The findings of the study confirm that malnutrition and the risk of malnutrition are prevalent in Chinese older adults with physical functional dependency. In addition to demographic and physical health-related factors, psychosocial factors, which are often overlooked, are independently associated with nutrition status in Chinese older adults with physical functional dependency. A holistic approach should be adopted to screen for malnutrition and develop health promotion interventions in this vulnerable population.
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
| | - Yan Du
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, USA
| | - Donna Ellis
- RN School of Nursing, Loyola University New Orleans, New Orleans, LA70118, USA
| | - Hong-Wen Deng
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA70112, USA
- School of Basic Medical Sciences, Central South University, Changsha, Hunan410013, China
| | - Hengyu Hu
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
| | - Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
| | - Huijing Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
| | - Lulu Liao
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
| | - Mengqi Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
| | - Linlin Peng
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan410008, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan410013, China
- Xiangya School of Nursing, Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, Hunan410013, China
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Liu Y, Guo H. Empowerment in Chinese primary caregivers of post-stroke patients with disability: A cross-sectional study. Medicine (Baltimore) 2021; 100:e23774. [PMID: 33592833 PMCID: PMC7870185 DOI: 10.1097/md.0000000000023774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/16/2020] [Indexed: 01/05/2023] Open
Abstract
To investigate the status quo of empowerment ability of primary caregivers in post-stroke patients with disability and its influencing factors.A cross-sectional design and a convenience sample were used. Participants (N = 189) from 3 hospital in Beijing were recruited from October 2018 to June 2019. The following measurement tools were used in this study: Barthel index, Main Caregiver Empowerment Measurement, General Self-Efficacy Scale, Simplified Coping Style Questionnaire and Social Support Rating Scale. Multiple linear stepwise regression analysis was used to statistically infer the influencing factors of empowerment ability of primary caregivers.The total score of main caregivers' empowerment measurement among the participants was 161.03 ± 14.678, the median (interquartile range) score was 162.00 (150.00-171.50). The average scores of each dimension ranged from high to low: relationship with the person being cared for, goodwill care, expectation for care outcomes, subjectivity of caregiver, faith in care, understanding of care role, knowledge and skills of care, scruples about the surroundings, personal resources. The single factor analysis showed that the patient's payment method for medical expenses, whether the patient accompanied by other chronic diseases and the gender of the caregiver had an effect on the empowerment ability of primary caregivers, and the positive coping style, negative coping style, self-efficacy and subjective support of primary caregivers were positively correlated with their empowerment ability (P < .05). Multiple linear stepwise regression analysis showed that the type of payment for treatment of patients (b = 7.449, P < .01), and gender of caregivers (b = 5.039, P < .05), subjective support of caregivers (b = 0.439, P < .05), positive coping style of caregivers (b = 0.585, P < .01), self-efficacy of caregivers (b = 6.456, P < .01) were the main influencing factors of empowerment ability of primary caregivers.The empowerment ability of the primary caregivers of post-stroke patients with disability in China is at the upper middle level. However, there are more scruples about the surrounding and less personal resources, which deserve attention. Furthermore, the identification of the factors related to empowerment lays a foundation for clinical nursing practitioners to further develop targeted interventions on empowerment of caregivers.
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Affiliation(s)
- Youhua Liu
- School of Nursing, Beijing University of Traditional Chinese Medicine, Beijing
- Shantou Health School, Shantou, China
| | - Hong Guo
- School of Nursing, Beijing University of Traditional Chinese Medicine, Beijing
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Wu D, Gao X, Xie Z, Xu Z. Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020389. [PMID: 33419143 PMCID: PMC7825496 DOI: 10.3390/ijerph18020389] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022]
Abstract
One of the challenges in response to population aging is to meet needs for elderly care among older people especially for those who want to age in their homes or communities. However, disabled older people have more challenges due to their restricted mobility to access care resources than non-disabled ones. We propose a new framework based on the changing relationship between older people and their environment, in which resource linkage in elderly care utilization is emphasized. We conducted a survey with 139 participants (i.e., older people age 60 years or over with different level of disabilities) in three types of neighborhoods in Beijing, China. By conducting a decision tree analysis under the Person-Environment Link (P-E Link) model, we (1) characterized unmet needs for elderly care (activities of daily living (ADL) and instrumental activities of daily living (IADL) assistance) among community-dwelling disabled older people; (2) found disabled older people had more unmet needs for both ADL and IADL assistance because of a lack in linkages to care resources than non-disabled ones; and (3) characterized the linkages to care resources for better supporting disabled older people to age in place, including family support, social connection, and spatial environment. Our findings help improve the Anderson behavioral model by characterizing enabling environments, which highlights that not only the availability of enabling resources but also linkages to these enabling resources play an important role in meeting needs for care among disabled older people. Our findings can also inform improvements in policy design that are targeted to reduce elderly care inequalities.
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Affiliation(s)
- Danxian Wu
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100190, China;
- Correspondence: (D.W.); (X.G.); Tel.: +86-188-1098-1198 (D.W.); +86-136-1124-4369 (X.G.)
| | - Xiaolu Gao
- Key Laboratory of Regional Sustainable Development Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- University of Chinese Academy of Sciences, Beijing 100190, China;
- Correspondence: (D.W.); (X.G.); Tel.: +86-188-1098-1198 (D.W.); +86-136-1124-4369 (X.G.)
| | - Zhifei Xie
- University of Chinese Academy of Sciences, Beijing 100190, China;
- Institute for the History of Nature Science, Chinese Academy of Sciences, Beijing 100101, China
| | - Zening Xu
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, China;
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Zhou J, Yang L. Who is taking care of the Chinese functionally impaired older people? The characteristics of family caregivers from China Health and Retirement Longitudinal Study. Australas J Ageing 2020; 40:e143-e154. [PMID: 33336539 DOI: 10.1111/ajag.12859] [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: 02/05/2020] [Revised: 08/24/2020] [Accepted: 08/31/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate caregiving in terms of personal, family and living arrangement among Chinese functionally impaired older people. METHODS A secondary cross-sectional analysis of data obtained from China Health and Retirement Longitudinal Study (CHARLS) was performed. Among 6,252 participants aged 65 years or older, people with at least one indicator of Activities of Daily Living Scales (ADLs) of disabilities were included in this research. Statistical analyses included chi-square tests and multiple logistic regression modelling. RESULTS Data of 973 functionally impaired people aged 65 and over, and 2772 adult offspring were extracted and analysed. The level of impairment, age, gender, marital status of the functionally impaired older people, adult offspring's income and living status were significantly associated with caregiving types. CONCLUSION This research describes the characteristics of functionally impaired older people and their caregivers, which may help improve the efficiency, quality and equity within the Chinese social care system.
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Affiliation(s)
- Jianfang Zhou
- Faculty of Sociology and Population Sciences, Nanjing University of Posts and Telecommunications, Qixia District, Nanjing, China
| | - Lu Yang
- Faculty of Sociology and Population Sciences, Nanjing University of Posts and Telecommunications, Qixia District, Nanjing, China
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Sun C, Yu Y, Li X, Cui Y, Ding Y, Zhu S, Li X, Chen S, Zhou R. The factors of adaptation to nursing homes in mainland China: a cross-sectional study. BMC Geriatr 2020; 20:517. [PMID: 33256628 PMCID: PMC7708906 DOI: 10.1186/s12877-020-01916-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China is one of the most rapidly ageing countries and has the largest ageing population in the world. The demand for long-term care is increasing. Nursing home placement is one of the most stressful events in a person's life. Although research on relocation adjustment has been conducted in many countries, few studies have been related to the predictors of nursing home adjustment in mainland China. This study aimed to identify the predictors of nursing home adjustment in the context of filial piety in mainland China. METHODS This was a descriptive study that employed a cross-sectional survey. A total of 303 residents from 22 nursing homes in Nanjing, China, were recruited. A structured questionnaire about residents' characteristics, activities of daily living, social support, resilience, and nursing home adjustment was administered. Multiple linear regression was used to identify the predictors of adaptation to nursing homes. RESULTS The predictors of nursing home adjustment were the satisfaction with services(β = .158, P < .01), number of diseases(β = -.091, P < .05), length of stay(β = .088, P < .05), knowledge of the purpose of admission (β = .092, P < .05), resilience(β = .483, P < .001) and social support(β = .186, P < .001). The total explained variance for this model was 61.6%. CONCLUSION Nursing staff members should assess the characteristics of residents to promote their better adjustment. Resilience had the most significant influence on the level of adaptation, which has been the primary focus of interventions to improve adjustment. The management of disease comorbidities in nursing homes should be standardized and supervised by the government. More volunteers from universities and communities should be encouraged to provide social support to residents. Moreover, a caring culture needs to be emphasized, and the value of filial piety should be advocated in nursing homes of East Asian countries.
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Affiliation(s)
- Changxian Sun
- Nanjing Medical University, Nanjing, China.,Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Yiting Yu
- Nanjing Medical University, Nanjing, China
| | - Xuxu Li
- Landsea Lvy Elder Care Service, Nanjing, China
| | - Yan Cui
- Nanjing Medical University, Nanjing, China.
| | | | - Shuqin Zhu
- Nanjing Medical University, Nanjing, China
| | - Xianwen Li
- Nanjing Medical University, Nanjing, China
| | - Shen Chen
- Nanjing Medical University, Nanjing, China
| | - Rong Zhou
- Nanjing Medical University, Nanjing, China
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Chen S, Cui Y, Ding Y, Sun C, Xing Y, Zhou R, Liu G. Prevalence and risk factors of dysphagia among nursing home residents in eastern China: a cross-sectional study. BMC Geriatr 2020; 20:352. [PMID: 32943011 PMCID: PMC7495827 DOI: 10.1186/s12877-020-01752-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/02/2020] [Indexed: 12/19/2022] Open
Abstract
Background Dysphagia is a common health care problem and poses significant risks including mortality and hospitalization. China has many unsolved long-term care problems, as it is a developing country with the largest ageing population in the world. The present study aimed to identify the prevalence and risk factors of dysphagia among nursing home residents in China to direct caregivers towards preventative and corrective actions. Methods Data were collected from 18 public or private nursing homes in 9 districts of Nanjing, China. A total of 775 older adults (aged 60 ~ 105 years old; 60.6% female) were recruited. Each participant underwent a standardized face-to-face interview by at least 2 investigators. The presence of risk of dysphagia was assessed using the Chinese version of the EAT-10 scale. The Barthel Index (BI) was used to evaluate functional status. Additionally, demographic and health-related characteristics were collected from the participants and their medical files. Univariate analyses were first used to find out candidate risk factors, followed by binary logistic regression analyses to determine reliable impact factors after adjusting for confounders. Results Out of 775 older adults, the prevalence of dysphagia risk was calculated to be 31.1%. A total of 85.0% of the older adults reported at least one chronic disease, and diseases with the highest prevalence were hypertension (49.5%), stroke (40.4%), diabetes (25.5%) and dementia (18.2%). Approximately 11.9% of participants received tube feeding. The mean BI score was 56.2 (SD = 38.3). Risk factors for dysphagia were texture of diet (OR = 2.978, p ≤ 0.01), BI level (OR = 1.418, p ≤ 0.01), history of aspiration, pneumonia and heart attack (OR = 22.962, 4.909, 3.804, respectively, p ≤ 0.01), types of oral medication (OR = 1.723, p ≤ 0.05) and Parkinson disease (OR = 2.566, p ≤ 0.05). Conclusions A serious risk of dysphagia was observed among Chinese nursing home residents. Overall, nursing home residents were moderately dependent, according to the BI level. The risk for dysphagia increased with thinner diet texture, worse functional status, history of aspiration, pneumonia and heart attack, more oral medications and Parkinson disease. The findings of our study may serve to urge nursing home staff to pay more attention to the swallowing function of all residents and to take more actions in advance to prevent or reduce dysphagia.
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Affiliation(s)
- Shen Chen
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China.
| | - Yaping Ding
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China.,Jiangsu Vocational Institute of Commerce, 180 Longmian Avenue, Nanjing, 211168, China
| | - Ying Xing
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Rong Zhou
- School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, 211166, Jiangsu Province, China
| | - Guohua Liu
- JORU QingHe Senior Care Center, 70 Youyi Street, Nanjing, 210041, China
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Weaver RH, Roberto KA. Location Matters: Disparities in the Likelihood of Receiving Services in Late Life. Int J Aging Hum Dev 2020; 93:653-672. [PMID: 32830543 DOI: 10.1177/0091415020948205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Moving beyond typical dichotomous rural-urban categorizations, this study examines older adults' likelihood of receiving home- and community-based services. Data from 1608 individuals aged 60+ who requested assistance from Area Agencies on Aging in Virginia in 2014-2015 were analyzed; 88% of individuals received at least one service. Receiving services was associated with geographic-based factors. Individuals living in completely rural areas were significantly less likely to receive any service compared to individuals in mostly rural (OR = 2.46, p = .003) and mostly urban (OR = 1.97, p = .024) areas. There were subtle but significant geographic-based differences in the likelihood of receiving specific services including food/meal, fresh food, information and referral, in-home care, utilities support, and transportation. Findings provide nuanced insights about geographic-based disparities in the receipt of services and suggest the need for new and modified service delivery strategies that maximize older adults' ability to live.
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Affiliation(s)
- Raven H Weaver
- 6760 Department of Human Development, Washington State University, Pullman, WA, USA
| | - Karen A Roberto
- 1757 Institute for Society, Culture and Environment & Center for Gerontology, Virginia Tech, Blacksburg, VA, USA
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Nursing Care Ethical Implications Regarding Chronic Patients at Hospital Discharge. Healthcare (Basel) 2020; 8:healthcare8020167. [PMID: 32545173 PMCID: PMC7349255 DOI: 10.3390/healthcare8020167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022] Open
Abstract
Mortality rates among pluripathological patients are significantly higher in the hospital setting, with advanced age and dependence on certain vital functions the main clinical aspects. Other features involved in the care, such as the loss of autonomy and social problems, have important ethical implications. The aim of this article is to analyze the health problems and the functional and social situation of chronic patients after hospital admission in order to determine their care needs and the ethical implications these might have. For this, a cross-sectional descriptive study is being carried out with a sample of 111 chronic pluripathological patients admitted to the internal medicine service and discharged later. Overall, 96.6% of the patients in the sample were dependent, 91.7% had social problems or were at social risk and 36.9% had cognitive impairment. Among dependent patients, 59.4% had social problems (p = 0.029), 19.2% lived alone (p = 0.13), and in 73.3% of cases the housing was inadequate (p = 0.47). Among those with cognitive impairment, 79.5% of patients had social problems (p = 0.001), and 10.3% lived alone (p = 0.038). The results of the study confirm the presence of dependence and social problems at hospital discharge in a high proportion of chronic patients. Planning their care can lead to ethical conflicts related to the use of information technologies, which are destined to promote the patients' autonomy, and to the social problems associated with the illness.
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Rasheedy D, Abou-Hashem RM. Overestimated functional dependency in older patients: Can we blame gender difference, unneeded assistance or assessment tools? Arch Gerontol Geriatr 2020; 88:104018. [PMID: 32044523 DOI: 10.1016/j.archger.2020.104018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The population is aging in Egypt and hence functional limitation is increasing. Thus finding the best measures for its detection is mandated. OBJECTIVES The aim of this study was to assess whether Katz ADL (activities of daily living) and Lawton IADL (instrumental activities of daily living) were suitable measures to represent the functional abilities of older Egyptians of both genders during hospital admission and to determine the dimensionality of both tools. METHODS Functional status was assessed during hospital admission as a part of the comprehensive geriatric assessment for 786 older patients (aged 60 years and older). 150 of them were randomly interviewed to collect data regarding the difficulty during each task of Katz ADL and Lawton IADL performance, unnecessary and unmet needed assistance, barriers to get needed assistance and the type of care providers. RESULTS The prevalence of ADL and IADL dependency was 61.80 % and 85.87 %, respectively. Functional limitation in both scales was found to be significantly associated with increasing age, marital status other than married, cognitive impairment. Both scales showed a bi-dimensional factor structure, removing continence from Katz ADL resulted in a uni-dimensional scale. Females were more dependent than males in all tasks except household tasks of IADL. CONCLUSIONS Katz ADL and Lawton IADL did not capture the actual dependency level among older Egyptians. The household tasks in Lawton IADL and continence in Katz ADL mislabeled dependency in the studied sample.
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Affiliation(s)
- Doha Rasheedy
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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Ran L, Kong H, Du M, He J, Zhong Q, Ran Y, Si Y, Zhang J, Yao C, Luo H, Ye Q. Comparison of health-related quality of life between the Han and Yi ethnicity elderly in the Yi autonomous areas of Yunnan Province. BMC Geriatr 2019; 19:326. [PMID: 31766992 PMCID: PMC6878633 DOI: 10.1186/s12877-019-1257-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/25/2019] [Indexed: 11/28/2022] Open
Abstract
Background The purpose of this research was to assess the health-related quality of life (HRQOL) and functional abilities of Yi and Han elderly who resided in Yi Autonomous prefecture or Counties in Yunnan Province, as well as to compare their differences in HRQOL, functional abilities and other factors. Methods A total of 1636 older subjects, which included 863 Han and 773 Yi, were recruited from 10 Yi Autonomous regions. Their HRQOL and functional capabilities were assessed by the MOS 36-Item Short Form Health Survey (SF-36), activities of daily living (ADL), and instrumental activities of daily living (IADL) scales. Results The Han elderly performed better in every domain of SF-36 than the Yi elderly. Both of the two ethnic groups could perform their ADL independently but the Yi elderly showed greater dependency in IADL abilities. The HRQOL was positively associated with their ADL, IADL, and education levels. Moreover, age, health insurance status, and living arrangement were negatively correlated with HRQOL. Conclusion The HRQOL and IADL capabilities of the Han elderly were higher than that of the Yi counterparts in the Yi Autonomous regions. The HRQOL of both the two ethnic groups was positively connected with ADL, IADL abilities as well as education levels, whereas it was negatively correlated with age and health insurance. The elderly-care policy on the Yi autonomous areas should focus more on the HRQOL, ADL improvement, education background, age needs, and health insurance, etc.
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Affiliation(s)
- Lingyun Ran
- Nursing School of Kunming Medical University, Kunming, Yunnan, China.
| | - Hongqian Kong
- Qujing Center for Disease Control and Prevention, Kunming, Yunnan, China
| | - Mengqi Du
- Steinhardt School of New York University, New York, USA
| | - Jianhui He
- Public Health School of Kunming Medical University, Kunming, China.
| | - Qiong Zhong
- The Sixth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Yuanyuan Ran
- Hunan University of Finance and Economics, Changsha, China
| | - Yanping Si
- Nursing School of Kunming Medical University, Kunming, Yunnan, China
| | - Jiang Zhang
- The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Cheng Yao
- Nursing School of Kunming Medical University, Kunming, Yunnan, China
| | - Huineng Luo
- The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Qin Ye
- The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Maresova P, Javanmardi E, Barakovic S, Barakovic Husic J, Tomsone S, Krejcar O, Kuca K. Consequences of chronic diseases and other limitations associated with old age - a scoping review. BMC Public Health 2019; 19:1431. [PMID: 31675997 PMCID: PMC6823935 DOI: 10.1186/s12889-019-7762-5] [Citation(s) in RCA: 208] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 10/11/2019] [Indexed: 01/21/2023] Open
Abstract
Background The phenomenon of the increasing number of ageing people in the world is arguably the most significant economic, health and social challenge that we face today. Additionally, one of the major epidemiologic trends of current times is the increase in chronic and degenerative diseases. This paper tries to deliver a more up to date overview of chronic diseases and other limitations associated with old age and provide a more detailed outlook on the research that has gone into this field. Methods First, challenges for seniors, including chronic diseases and other limitations associated with old age, are specified. Second, a review of seniors’ needs and concerns is performed. Finally, solutions that can improve seniors’ quality of life are discussed. Publications obtained from the following databases are used in this scoping review: Web of Science, PubMed, and Science Direct. Four independent reviewers screened the identified records and selected relevant publications published from 2010 to 2017. A total of 1916 publications were selected. In all, 52 papers were selected based on abstract content. For further processing, 21 full papers were screened.” Results The results indicate disabilities as a major problem associated with seniors’ activities of daily living dependence. We founded seven categories of different conditions - psychological problems, difficulties in mobility, poor cognitive function, falls and incidents, wounds and injuries, undernutrition, and communication problems. In order to minimize ageing consequences, some areas require more attention, such as education and training; technological tools; government support and welfare systems; early diagnosis of undernutrition, cognitive impairment, and other diseases; communication solutions; mobility solutions; and social contributions. Conclusions This scoping review supports the view on chronic diseases in old age as a complex issue. To prevent the consequences of chronic diseases and other limitations associated with old age related problems demands multicomponent interventions. Early recognition of problems leading to disability and activities of daily living (ADL) dependence should be one of essential components of such interventions.
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Affiliation(s)
- Petra Maresova
- Department of Economics, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic
| | - Ehsan Javanmardi
- Department of Economics, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic
| | - Sabina Barakovic
- Faculty of Traffic and Communications, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Signe Tomsone
- Faculty of Rehabilitation, Riga Stradinš University, Riga, Latvia
| | - Ondrej Krejcar
- Center of Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Center of Basic and Applied Research, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 500 03, Hradec Kralove, Czech Republic. .,Malaysia Japan International Institute of Technology (MJIIT), Universiti Teknologi Malaysia Kuala Lumpur, Jalan Sultan Yahya Petra, 54100, Kuala Lumpur, Malaysia.
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Yoshida D, Ohara T, Hata J, Shibata M, Hirakawa Y, Honda T, Uchida K, Takasugi S, Kitazono T, Kiyohara Y, Ninomiya T. Dairy consumption and risk of functional disability in an elderly Japanese population: the Hisayama Study. Am J Clin Nutr 2019; 109:1664-1671. [PMID: 31075788 DOI: 10.1093/ajcn/nqz040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about the association between dairy intake and risk of functional disability in the elderly. OBJECTIVES We examined the influence of dairy intake on the development of declining functional capacity and activities of daily living (ADL) in a prospective cohort study of an elderly population. METHODS A total of 859 community-dwelling Japanese residents, aged ≥65 y without functional disability, were followed up for 7 y. Functional capacity impairment was defined as a Tokyo Metropolitan Institute of Gerontology Index of Competence score of ≤12, and ADL disability was defined as a Barthel Index score of ≤95. Dairy intake was evaluated using a 150-item semiquantitative food frequency questionnaire, grouped into quartiles. The RR of dairy intake on incident functional disability was computed using a Poisson regression model. RESULTS The multivariable-adjusted RR of impaired functional capacity decreased significantly with increasing dairy intake levels (RR [95% CI]: quartile 1, 1.00 [reference]; quartile 2, 0.85 [0.71, 1.02]; quartile 3, 0.81 [0.68, 0.98]; and quartile 4, 0.74 [0.61, 0.90]; P-trend = 0.001). Regarding the three subscales of functional capacity, the inverse association between dairy intake and risk for impairment of intellectual activity and social role remained significant (P-trend = 0.0009 and 0.02, respectively), but such an association was not observed for instrumental ADL. The multivariable-adjusted risk of ADL disability also decreased weakly but significantly with elevating dairy intake (P-trend = 0.04). A similar association was seen for severity of functional disability (P-trend = 0.002). However, the magnitude of these associations was attenuated after further adjustment for protein intake. CONCLUSION Our findings suggest that higher dairy intake is associated with a lower risk of functional disability and its progression in the elderly, probably via an increase in protein intake.
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Affiliation(s)
- Daigo Yoshida
- Department of Epidemiology and Public Health, Fukuoka, Japan
| | | | - Jun Hata
- Department of Epidemiology and Public Health, Fukuoka, Japan
| | | | - Yoichiro Hirakawa
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Fukuoka, Japan
| | - Kazuhiro Uchida
- Department of Health Promotion, School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan
| | | | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yutaka Kiyohara
- Hisayama Research Institute for Lifestyle Diseases, Fukuoka, Japan
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