The social network among the elderly and its relationship with quality of life

The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users

Hypothesis

As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic.

Background

The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users' real-world functioning is not well understood. This study investigated the impact of the COVID-19 pandemic on real-world communication abilities, social isolation, and CI-related QOL in adult CI users.

Methods

Fourteen adult CI users completed self-report questionnaires assessing communication abilities, social isolation, and CI-related QOL at time points before and after the onset of the COVID-19 pandemic. Responses at the 2 time points were compared to evaluate changes in CI users' real-world functioning.

Results

Adult CI users showed a significant decrease in self-reported communication ability and a nonsignificant decline in CI-related QOL from before to during COVID-19. However, a nonsignificant trend of a decline in social isolation was also observed in adult CI users.

Conclusion

Findings showed a decrease in self-reported communication abilities and, to a lesser extent, CI-related QOL, suggesting that changes to the auditory-social environment brought on by the COVID-19 pandemic may have negatively impacted communication abilities in real-world, challenging environments. Yet, the potential decrease in social isolation suggests that these changes may have had an overall positive effect on social interaction, potentially with close family and friends in well-controlled environments. Assessing changes in real-world functioning in the same CI users from both before and during the COVID-19 pandemic provided a unique glimpse into how changes in the auditory-social environment may impact outcomes in adult CI users.

Healthy Aging and its Determinants Among Community-dwelling Older Persons in East Coast, Malaysia: A Multidimensional Assessment

Objectives

Exploring the possibility of healthy aging among older persons is crucial for achieving optimal health in the growing older population. This study aimed to determine the prevalence, pattern, and determinants of healthy aging among older persons in Terengganu, Malaysia.

Methods

We conducted a community-based cross-sectional study involving older persons aged % 60 years. An interviewer-guided questionnaire, anthropometric measurements, and physical assessments were administered to operationalize healthy aging based on a multidimensional concept.

Results

Among the 765 older persons surveyed, only 14.1% (95% CI: 11.64?"16.59) were classified as healthy agers. Multiple logistic regression analysis revealed that superior intrinsic religiosity (odds ratio (OR) = 3.42; 95% CI: 1.34?"8.73), higher social interaction (OR = 2.82; 95% CI: 1.32?"6.04), larger calf circumference (OR = 2.05; 95% CI: 1.24?"3.38), taking water intake % 5 cups per day (OR = 2.01; 95% CI: 1.23?"3.30), better gait speed (OR = 1.71; 95% CI: 1.04?"2.80), having savings (OR = 1.71; 95% CI: 1.10?"2.66), and normal waist circumference (OR = 1.63; 95% CI: 1.04?"2.55) were found positively associated with healthy aging.

Conclusions

Only one in 10 older persons in the state met all the criteria for healthy aging. Specific aspects of religious status, social interaction, socioeconomic, behavioral, physical, and nutritional factors were found to predict healthy ageing in this population. These important determinants should be considered in developing a well-defined and comprehensive public health policy to promote healthy aging in the nation.

Prevention of the social isolation of older persons: the impact of community environmental satisfaction on social isolation

Background

To explore how to prevent the social isolation of the older adult, this study constructed a model of the influence of community environmental satisfaction on the social isolation of the older adult from the three dimensions of environmental facilities, transportation, and supporting facilities around the community. Methods: The social network scale and environmental satisfaction scale were used to collect the sample data of nine communities in Xi'an, and the maximum likelihood estimation method was used to analyze the data and test the model.

Results

(1) Environmental facilities, transportation, and community surrounding facilities promoted community environment satisfaction (R² = 0.904). Among them, environmental facilities (β = 0.869) had the greatest impact on community environmental satisfaction, followed by transportation (β = 0.118), and surrounding facilities (β = 0.084) had the least impact on community environmental satisfaction. (2) Environmental satisfaction had a direct positive impact on social isolation. Among them, the impact of environmental satisfaction on friend isolation (R² = 0.895, β = 0.829) was greater than that on family isolation (R² = 0.718, β = 0.747).

Conclusion

Environmental satisfaction can directly affect the social isolation of the older adult in the community and can be used as an intermediate variable of environmental facilities, transportation, and surrounding facilities in the community so that it can indirectly affect the social isolation of the older adult. The results of this study provide a scientific basis for the design of aging environments in the future.

The experience of loneliness among the Chinese bereaved parents-a qualitative study from the life course perspective

BACKGROUND

With the implementation of the 37 years one-child policy, many couples only have one child in China. Chinese parents whose only child died and did not give birth to or adopt another child are known as "Shidu" parents or "Shiduer". Characterised by elements of childlessness, bereavement, and ageing, Shiduer are at a higher risk of experiencing loneliness. However, little is known about their loneliness experience. Adopting a life course perspective, this research aims to investigate how loneliness was experienced and coped by older Chinese Shidu parents and identify the most vulnerable groups for policy intervention.

METHODS

Qualitative method was adopted for this study. Semi-structured interviews were conducted with 27 participants from urban and rural Wuhan, the capital city of Hubei province in central China, to collect data on participants' life course related resources and loneliness experience after bereavement. An abductive approach was used to analyse the data.

RESULTS

The results demonstrate that the social environment (urban/rural), timing of bereavement (midlife/older age), social network (strong/weak), and coping strategies (escape-avoidance/problem-solving) differentiate the experience of loneliness among the Shiduer. Those who lived in rural communities, those bereaved in older age, those who had a weak social network, and those who adopted the escape-avoidance strategy were found vulnerable and suffered from more chronic and intensive loneliness than their counterparts without these characteristics.

CONCLUSION

This study is among the first attempts to examine loneliness experience and coping among older Chinese bereaved parents from a qualitative, life course perspective. It provides insights into how loneliness has been perceived and experienced differently among the bereaved one-child parents in China. The results of the current study provide important implications for policymakers and practitioners/social workers for the intervention of loneliness.

Relationship between social network and individual performance of core members from aged care services social organizations: cross-sectional study

BACKGROUND

The social network of core members can affect the performance of the organization, while there is a lack of research on the relationship between the social network of core members of social organizations and individual performance in the field of aged care services. This study aimed to explore the relationship between social network and individual performance of core members from social organizations engaged in aged care services and explore measures to promote the development of aged care services.

METHODS

We used a multi-stage stratified sampling method to conduct a cross-sectional study and collected the required data in six cities in Anhui Province, China. Univariate analysis and binary logistic regression were used to estimate the relationship between social network and individual performance.

RESULTS

Our results indicated that core members with higher social network scores were more likely to yield better individual performance, including receiving awards or recognitions related to aged care services (AOR=2.534; 95% CI: 1.397-4.596). Moreover, teams led by the core members were more likely to receive awards or recognitions related to aged care services (AOR=2.930; 95% CI: 1.740-4.933). The core members or the teams led by them were more likely to be reported by the media (AOR=1.748; 95% CI: 1.030-2.966) and participate in the drafting or discussion of local aged care service standards or service specifications (AOR=2.088; 95% CI: 1.093-3.911). In addition, demographic variables such as gender, marital status, and education of core members were significantly related to their performance (P<0.05).

CONCLUSIONS

The social network of core members of aged care service social organizations has an impact on their individual performance. To improve the performance of the core members of senior citizens services and organizations, relevant measures should be taken from the government, social organizations and core members to strengthen the social network construction of core members.

Social Capital Mediates the Association between the ICT Usage and Well-Being of Older People in Japan: Implication for a New Design Paradigm

As the population ages, the question of how to prevent isolation among older people and increase their well-being becomes a social issue. It has often been argued that Information and Communication Technology (ICT) usage can be a solution to these challenges, but empirical studies have not shown consistent results. Moreover, there are even fewer studies targeting older people in Japan, which is the most aging country in the world. Therefore, using the psychological comprehensive data of Japanese people aged 60 and over recorded in World Values Survey Wave 7, we conducted a study to clarify the relationship between the ICT usage, social capital, and well-being of older people to make a meaningful contribution to policymakers and the scientific community. As a result of the analysis, it was shown that ICT usage indirectly enhances well-being by increasing social capital. This indicates that for older people, ICT usage does not have a large effect on enhancing well-being, but becomes sufficiently large only through the improvement of social capital. The pros and cons of such modern communication means should be utilized as a reference when considering the development of future communication means and a human coach—a person who supports the use of communication means by older people. In other words, to think about the spread of communication means to community-dwelling older people in the future, it is always necessary to think about technology usage emphasizing the relationship between older people and society.

Health-Related Quality of Life and Social Support of Elderly Lung and Gastrointestinal Cancer Patients Undergoing Chemotherapy

Introduction

Increasing life expectancy has led to a higher incidence of cancer in the elderly, thus making them vulnerable and worsening their health-related quality of life (HRQoL) and their need for support.

Objective

The aim of this study was to examine the HRQoL and social support in elderly Greek lung and gastrointestinal cancer patients undergoing chemotherapy.

Methods

This was a descriptive, cross-sectional study of 104 elderly cancer patients, who were receiving chemotherapy in the outpatient department and inpatient ward of a General Hospital in Athens. The data were collected using purposive sampling between December 2019 and May 2020, and included demographic and clinical characteristics, the HRQoL questionnaire, Short Form 36 (SF36), and the Personal Resource Questionnaire (PRQ-2000).

Results

The participants' median age was 72 years; the majority were male (62.5%) and had lung cancer (57.7%). The SF36 data revealed a relatively moderate (42.7-62.61) HRQoL in most subscales. The "Pain" subscale recorded the highest score (75.0), and the "social function" subscale the lowest (42.79). The PQR-2000 indicated a satisfactory level of social support (81.65), with values ranging between 48 and 105; married patients with higher education scored more highly (p < .05). Patients aged 65-75 years reported better HRQoL and greater social support than older patients. In addition, patients with their own family and a relatively high income reported better HRQoL and social support compared to single individuals, with low income, who were cared for by their children. Positive and statistically significant (p < .05) correlations were found between the SF36 subscales of role functioning/physical, vitality, general health, emotional well-being and the PRQ-2000.

Conclusion

The HRQoL and social support of elderly cancer patients positively affect the course of their health. Healthcare systems and social services should address the multiplying needs of these patients with targeted interventions to support their well-being.

Validation of expanded form of lubben social network scale among community-dwelling geriatric population in India

Background:

For assessing social networks in the elderly and the social support they receive and to predict social isolation, a proper valid and reliable short-scale screening tool is necessary. The present study aims to estimate the internal consistency and structural validity of the Lubben Social Network Scale (LSNS-18) among community-dwelling Indian older adults.

Materials and Methods:

We have administered the LSNS-18 scale to 500 older adults (>60 years) and performed confirmatory factor analysis (CFA) and structural equation modeling for the validation. Cronbach's alpha was done for estimating the internal consistency.

Results:

The LSNS-18 was easily answerable and the only minimum time is required for administration. CFA identified three domains with six items for each domain that demonstrated a good fit for the older adults with the internal consistency of 0.91.

Conclusion:

These findings suggest that LSNS-18 may be a valid tool for assessing the social network of the elderly and help to predict the risk for isolation in this vulnerable group.

Relationship of Loneliness and Social Isolation With Self-Care Ability Among Older Adults

The current study aimed to assess the relationship of loneliness and social isolation with self-care ability (SCA) among older adults. Participants were 170 older adults randomly recruited from seven urban health care centers in Gonbad Kavus, Iran. Data were collected using a personal characteristics questionnaire, the UCLA Loneliness Scale, Lubben Social Network Scale, and Self-Care Ability Questionnaire for the Elderly. Findings showed that 72.9% of participants reported mild loneliness and 2.4% reported severe loneliness. Mean scores of participants' loneliness, social isolation, and SCA were 29.91 (SD = 11.22), 18.57 (SD = 4.97), and 146.39 (SD = 7.62), respectively. Mean SCA score had a significant inverse relationship with mean loneliness score (β = -0.368; p < 0.0001) and a significant direct relationship with mean social isolation score (β = 0.726; p < 0.0001). Current findings can be used to develop interventions for reducing loneliness and social isolation and improving SCA among older adults. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 15-20.].

The effects of elective aortic repair, colorectal cancer surgery and subsequent postoperative delirium on long-term quality of life, cognitive functioning and depressive symptoms in older patients

Objectives: This study aimed to demonstrate the impact of elective major abdominal surgery and subsequent postoperative delirium on quality of life (QOL; primary outcome), cognitive functioning and depressive symptoms (secondary outcomes) in older surgical patients.Method: A single-centre, longitudinal prospective cohort study was conducted between November 2015 and June 2018, including patients ≥70 years old who underwent surgery for colorectal cancer or an abdominal aortic aneurysm. They were followed-up at discharge and at 6 and 12 months postoperatively until June 2019. QOL was assessed with the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Cognitive functioning was measured with the Mini-Mental State Examination and depressive symptoms with the CES-D 16.Results: In all patients (n = 265), physical and psychological health were significantly lower at discharge compared to baseline (p < 0.001 for both domains). Physical health restored after 6 months, but psychological health remained decreased for the complete study period. Psychological, social and environmental QOL were significantly worse in patients with delirium compared to patients without (p = 0.001, p = 0.006 and p = 0.001 respectively). The cognitive functioning score was significantly lower at baseline in patients with delirium compared to those without (p = 0.006). Patients with delirium had a significantly higher CES-D 16 score compared to those without after 12 months (p = 0.027).Conclusion: Physical and psychological QOL were decreased in the early postoperative period. While physical health was restored after 6 and 12 months, psychological health remained decreased. After 12 months, postoperative delirium resulted in worse psychological, social and environmental QOL and more depressive symptoms. Decreased cognitive functioning may be a risk factor for delirium.

Quality of life among frail older persons (65+ years) in nursing homes: A cross-sectional study

AIM

To assess the quality of life in frail older persons (65+ years) living in nursing homes and to examine differences between quality of life perceptions among different gender and age groups.

DESIGN

Cross-sectional.

METHODS

Data were collected during 2015-2017 based on two questionnaires (WHOQOL-OLD and WHOQOL-BREF). Seventy-eight older persons living in nursing homes in southern Sweden answered the questionnaires in structured interviews. Descriptive and comparative statistics were used to analyse the data. The study was guided by Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) guidelines.

RESULTS

The frail older persons reported low autonomy related to few opportunities to engage in everyday activities and were unable to do the things they liked to do and not feeling in control of their future. Another important result was that frail older persons seemed to have no or little fear of death and dying. No significant differences between gender or age on quality of life were revealed.

Efficacy of the self-mutual-group model targeting quality of life improvement among empty-nest older adults in Taiyuan, China: an intervention study

Background

In China, more and more older people have encountered a situation called “empty nest.” Meanwhile, the health status of empty-nest older adults is an increasing public health concern. This research aims to examine the effectiveness of Self-Mutual-Group (SMG) model in improving quality of life of the empty-nest older adults to provide a scientific evidence for improving their health.

Methods

A prospective intervention study was conducted among empty-nest older adults in Taiyuan, Shanxi. Multi-stage stratified random cluster sampling was employed to selected participants. A total of 396 empty nesters were enrolled as participants, of which 204 and 192 were in the intervention and control group, respectively. The intervention group received a seven-month SMG-based intervention. A participant’s quality of life was measured at the baseline and seven months after using the Short Form 36-Item Health Survey (SF-36).

Results

No significant difference was found between the intervention and control groups in terms of participant characteristics at baseline (P > 0.05). After the intervention, participants’ scores on Mental Component Summary (MCS), Physical Component Summary (PCS), role emotional (RE), vitality (VT), social function (SF), mental health (MH) and general health (GH) increased significantly in the intervention group. Additionally, these scores differed significantly from those in the control group (P < 0.05).

Conclusion

This study showed that the SMG-based health management is effective in improving quality of life among empty-nest older adults after seven months.

Trial registration

Study on the ‘SMG’ Health Management Model Based on Community Organization Theory among empty-nest older adults (ChiCTR1800015884). Registration date: 26-04-2018. Retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02155-4.

Methanol (80%) leaf extract of Otostegia integrifolia Benth (Lamiaceae) lowers blood pressure in rats through interference with calcium conductance

BACKGROUND

Otostegia integrifolia Benth. (Lamiaceae) leaves are used to treat hypertension in Ethiopian folk medicine. However, the claim has so far not been investigated scientifically. Thus, the objective of this study was to evaluate the antihypertensive activity of 80% methanol leaf extract of O. integrifolia in animal model of hypertension and possible underlying mechanisms in isolated rat aorta.

METHODS

Antihypertensive effect of various oral doses of the extract (250, 500 and 1000 mg/kg) was determined in fructose-induced hypertensive rats using the non-invasive tail-cuff method. Thoracic aortic strips of rats were isolated and suspended in organ bath, and the vasodepressor effect as well as the possible mechanism (s) of action were studied by means of isometric tension recording experiments ex vivo. Phytochemical analysis was also performed to suggest possible constituents related to the activity.

RESULTS

Blood pressure was significantly lowered in a dose-dependent manner following extract administration, suggesting that the extract possesses antihypertensive activity. The extract also caused a dose-dependent relaxation of aortic strip precontracted with KCl at a concentration of 6.25-125 μg/L, with a maximum relaxation (100%) achieved at a cumulative concentration of 318.75 μg/ml. The relaxation mechanism was found to be independent of muscarinic receptors, prostanoids, histamine receptors, ATP dependent K+ channels, sarcoplasmic reticulum stored Ca2+ and the endothelium system. The extract shifted the Ca2+ concentration-response curve to the right similar to that caused by nifedipine, suggesting that vasorelaxation could possibly be mediated via calcium channel blockade. The extract was found to contain phenolic compounds (164.3 mg/g, expressed as gallic acid equivalents) and flavonoids (125.7 mg/g, expressed as quercetin equivalents).

CONCLUSION

The findings revealed that the plant is endowed with antihypertensive activity, providing evidence for its traditional use. The effect maybe, at least in part, due to dilation of blood vessels through blockade of Ca+ 2 channels mediated by phenolic and flavonoid constituents.

Acceptance and Influencing Factors of Social Virtual Reality in the Urban Elderly

In the stage of aging society and population aging, the social needs of the elderly are widely discussed by researchers. Especially driven by the demand of tele-medical treatment and tele-rehabilitation therapy, it is vital for the elderly to integrate into virtual communities by combining social virtual reality (VR) with different medical services and entertainment needs. In addition, affected by the COVID-19 epidemic, it is more difficult for people to have face-to-face contacts. With more remote consultation, entertainment and virtual social connectivity, the application of social VR is more urgent and valuable. However, there is little discussion on the acceptability and influencing factors of social VR among the elderly at present. Therefore, in order to get further data, we used (1) early stage semi-structured interviews and then (2) Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaires for investigation. One hundred fourteen elderly people aged 60–89 living in the metropolitan area of Taipei were taken as the subjects. To help them understand the situation and state of using social VR, these elderly people were asked to use a head-mounted display (HMD) to experience social VR games. The preliminary results showed that the elderly had obvious preference for entertainment (32.4%) and medical treatment (31.3%). The interview showed that this was related to the physiological condition or medical needs of the age range. In order to further understand how social VR would affect the social life of the elderly, we proposed the further demand structure of UTAUT Model based on the interview of both experts and the elderly. The model structures include (1) Performance Expectancy, (2) Perceived Enjoyment, (3) Social Influence, (4) User Attitude, (5) Behavioral Intention, and so on. These structures were applied to conduct interviews and questionnaires to find out the influence extent and relevance of the elderly on different structural needs, and suggestions were given accordingly. The results of the above interviews showed that (1) the elderly thought that the functions of entertaining and interacting of social VR could increase their social opportunities, and also meet medical needs (teleconference, cognitive decline, etc.), (2) the closeness of social relations (between family members, friends, doctors, and places), and also affect the relevance of Perceived Enjoyment (β = 0.77, p = 0.000 < 0.05). The results of these phenomena and interviews showed the interplay between the demand structures and their special relevance. They also indicated that as to social VR technologies, various demands and functional issues of the elderly need to be considered, and these demands would appear in the subtle usage, and different social VR interfaces and functions would emerge based on their special living ways and physical and psychological demands.

Age sequences of the elderly' social network and its efficacies on well-being: an urban-rural comparison in China

Background

Although social network is a known determinant of the elderly’s well-being, it is not clear, in urban-rural and age-comparison, what its structural characteristics are and how it works for well-being. The research aims to discuss the features of the elderly’s social network and the social network efficacies on the well-being of older adults in China’s urban and rural areas as well as revealing the urban-rural disparities among the elderly of different age groups.

Methods

In this study, descriptive statistical analysis and structural equation Modeling (SEM) were used to make a group comparison between the urban and rural elderly of different age groups. All data are quoted from 2014 China Longitudinal Aging Social Survey (CLASS). The survey adopted the multi-stage probability sampling method, targeting Chinese senior citizens aged 60 and above, the ultimate samples totaled 11,511.

Results

The social network of the elderly in China feature a “reverse structure” in age sequences: with ageing, family network of the elderly expand while their friend network shrink; also, the expansion scale of the rural elderly’s family network is significantly larger than that of the city’s while the shrinkage scale of their friend network is smaller compared with its urban counterpart. The effect of family network on the rural elderly’s well-being shows a remarkable increase with age. However, there is no noticeable change in urban elderly groups of different ages.

Conclusion

The social network characteristics of the Chinese elderly are different between different age stages. Namely, the family network and the friend network have the “reverse structure “ in age sequences. Meanwhile, the family network and the friend network have different efficacies on the well-being of the elderly in China, and the differences between urban and rural areas are even more obvious. For rural elderly, family network has very important effects on their well-being. Moreover, With the increase of age, family network’s efficacies increase gradually. For urban elderly, comparatively, family network is just as important as friend network.

Prevalence, clustering and combined effects of lifestyle behaviours and their association with health after retirement age in a prospective cohort study, the Nord-Trøndelag Health Study, Norway

Background

Lifestyle behaviours are potential risk factors for disease and mortality, but less is known about the association with health in retirement age. The aim of this paper was to study the prevalence, clustering and combined effects of lifestyle behaviours and their association with health outcomes in the first decade after retirement in a Norwegian cohort.

Methods

Participants were 55–64-year-olds at baseline in the Nord-Trøndelag Health Survey 2 (HUNT2, 1995–97) who also participated in HUNT3 (2006–08). Logistic regression analyses were used to investigate the association of daily smoking, physical inactivity, risky alcohol consumption, disturbed sleep duration, excessive sitting time and low social participation before retirement with self-rated health (n = 4022), life satisfaction (n = 5134), anxiety (n = 4461) and depression (n = 5083) after retirement, 11 years later.

Results

Low social participation and physical inactivity were the most prevalent lifestyle behaviours (41.1 and 40.6%). Risky alcohol consumption and disturbed sleep were the lifestyle behaviours most strongly associated with poor self-rated health, poor life satisfaction and anxiety after retirement (OR’s = 1.39–1.92). Physical inactivity was additionally associated with depression (OR = 1.44 (1.12–1.85)). Physical inactivity had the largest population attributable fractions for reducing poor self-rated health and depression (14.9 and 8.8%). An increasing number of lifestyle risk behaviours incrementally increased the risk for the adverse health outcomes.

Conclusions

Risky alcohol consumption and disturbed sleep duration were most strongly associated with poor health outcomes after retirement age. On a population level, increased physical activity before retirement had the largest potential for reducing adverse health outcomes after retirement age.

The role of geriatric palliative care in hospitalized older adults

Take-Away Points:1. Geriatric palliative care requires integrating the disciplines of hospital medicine and palliative care in pursuit of delivering comprehensive, whole-person care to aging patients with serious illnesses.2. Older adults have unique palliative care needs compared to the general population, different prevalence and intensity of symptoms, more frequent neuropsychiatric challenges, increased social needs, distinct spiritual, religious, and cultural considerations, and complex medicolegal and ethical issues.3. Hospital-based palliative care interdisciplinary teams can take many forms and provide high-quality, goal-concordant care to older adults and their families.

Personal relationships during end-of-life care: Support staff views of issues for individuals with intellectual disability

BACKGROUND

Life expectancy for persons with intellectual disability has increased dramatically over the past decade, which has seen an associated rise in the need for end-of-life care. However, little is known regarding how end-of-life affects the individual's personal relationships with family, friends and staff.

METHODS

Focus group interviews were undertaken with 35 disability support workers from four rural and two metropolitan locations in NSW and Queensland, Australia. A semi-structured interview guide was used, with a focus on the gaining an understanding of the impact that end-of-life has on personal relationships for persons with intellectual disability.

RESULTS

The thematic analysis identified three key thematic areas: Relationships with Family, Relationships with Friends and Staff Roles. Relationships with Family had three sub-themes of 'Active and Ongoing', 'Active but Limited' and 'After Death'. Relationships with Friends had two sub-themes of 'Positive Experiences' and 'Negative Experiences', and Staff Roles had two sub-themes of 'Loss of Contact' and 'Default Decision Making'.

DISCUSSION

The frequency of family contact was not reported as increasing or decreasing following the diagnosis of a life-ending illness and during an individual's end-of-life. A lack of counselling support was noted as potentially impairing the individual's friends' ability to cope with death. Staff also reported a number of concerns regarding how their relationships with the individual changed, particularly when end-of-life entailed potential movement of the individual with intellectual disability to a new residential setting.

The effect of Tai Chi on quality of life in male older people: A randomized controlled clinical trial

BACKGROUND AND AIM

Physical activity can improve the mental and physical functioning of older people. This study investigated the impact of Tai Chi exercise on the quality of life of older men.

METHODS

This randomized controlled clinical trial was conducted on 132 older men in an urban area of Iran. The subjects were randomly assigned into two groups: a Tai Chi intervention group and a control group (n = 66 per group). Quality of life was evaluated using the Leiden-Padua quality of life questionnaire before and after the intervention. Data analysis was performed using analytical statistics via the SPSS software.

RESULTS

After eight weeks of Tai Chi exercise, the mean scores of quality of life in different areas demonstrated a statistically significant difference between the two groups (p < 0 0.05).

CONCLUSION

This study illustrated that the 8-week Tai Chi intervention had a positive effect on quality of life in older men.