Validation of the Brief Ageing Perceptions Questionnaire (B-APQ) in Malaysia

Objectives: The Brief Ageing Perceptions Questionnaire (B-APQ) has five domains that explore views about own ageing. The aim of this study was to validate the B-APQ for use among older adults in Malaysia and to explore socio-demographic variations in ageing self-perceptions.Method: Older adults aged 50 years and above were randomly selected to complete a set of questionnaires. Cronbach's α was used to measure internal consistency, while corrected item-total correlations and correlation with DASS-21 and the CASP-19 scores were employed to assess convergent and discriminant validity. Confirmatory Factor Analysis (CFA) was conducted to confirm the factorial structure of the B-APQ. Difference in self-perceptions of ageing across socio-demographic variables was assessed.Results: Internal consistency for each of the domains was good. Item-total correlations within each domain were strong (>0.6) or very strong (>0.8). Convergent and discriminant validity were supported by significant correlations with DASS-21 depression and CASP-19 scores. CFA results indicated good model fit with the original B-APQ model. Presence of chronic illness also has a significant impact on B-APQ domain scores.Conclusion: The B-APQ is a valid and reliable instrument which can be used to assess self-perceptions of ageing among older Malaysian adults.

Ecological perspectives on youth alcohol consumption in the Kuala Lumpur conurbation: a place-based study in Malaysia

Objective The objectives of this study were to investigate the patterns of alcohol consumption and ecological factors influencing those patterns in the Klang Valley. The study focuses on youth from the Chinese, Indian and Malay ethnic groups in Malaysia, resident in urban and semi-urban areas of the Klang Valley. Methods Data were collected with a combination of interviews and self-administered questionnaires available in Bahasa Malaysia and English were adapted from the Centers for Disease Control (CDC) Youth Risk Behavior Survey. The study sample consisted of 326 respondents: 103 Malays, 111 Chinese and 112 Indians. There were 171 males and 155 females, with mean age of 20.56 and 20.59 years, respectively, were identified by convenience sampling in six sites. Results A combination of at least one family member and one friend who consumed alcohol was a significant driver of alcohol use: 80% in this category had tried alcohol; 55% were current drinkers; and 35% were binge drinkers. With at least one family member, the respective figures were 72%, 48%, and 30%; and with at least one friend, but no family pattern of consumption, the figures dropped to 64%, 42% and 26%, respectively. With respect to ethnicity, 72% of Chinese youth had tried alcohol or were current drinkers (49%). The figure was lower for Indian youth (47% and 37%, respectively) and Malay youth (15% and 9%, respectively). In the binge drinking category, however, the highest figures were from the Indian youth (31%) followed by Chinese youth (23%) and significantly less in Malay youth (5%). Alcohol consumption was consistently higher among males: 54% had tried alcohol, 44% were current drinkers, and 30% were binge drinkers, compared to 36%, 18% and 9% of female youth, respectively. Conclusion Family alcohol consumption patterns were most strongly associated with consumption patterns which varied across the three ethnic groups. Family education regarding family influence on youth's alcohol consumption patterns is warranted.

Development and Validation of a Cross-Country Hospital Patient Quality of Care Assessment Tool in Europe

BACKGROUND

Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework.

DESIGN

We conducted a multi-country cross-sectional study.

METHODS

Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed.

RESULTS

Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities.

CONCLUSIONS

The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.

The relationship of tobacco and alcohol use with ageing self-perceptions in older people in Ireland

Background

Health behaviour patterns in older groups, including tobacco and alcohol use, are key factors in chronic disease prevention. We explore ageing self-perceptions as motivating factors behind smoking and drinking alcohol in older adults, and the complex reasons why individuals engage harmfully in these behaviours.

Methods

Cigarette and alcohol use was assessed in a large cross-sectional national sample aged 50 years and above from the Irish Longitudinal Study on Ageing (TILDA) (n = 6,576). The Brief Ageing Perceptions Questionnaire (BAPQ) assessed individual’s views of their own ageing across five domains. Study hypothesis that stronger beliefs on each of the BAPQ domains would be related to drinking and smoking was examined using multinomial logit models (MNLM). Regression parameter estimates for all variables were estimated relative risk ratios (RRR).

Results

More women were non-drinkers (30 % vs. 20 %) and men displayed significantly higher alcohol use patterns. One in five older Irish adults was a current smoker (16.8 % of women, 17 % of men), and smoking and harmful drinking were strongly associated (P < .001). Some domains of ageing perceptions were significantly associated with harmful drinking and smoking. While the risk of being be harmful drinker decreased with stronger beliefs about the positive consequences of ageing (RRR 0.89), it increased with higher scores on both emotional representation and control positive domains.

Greater awareness of ageing and stronger emotional reaction to ageing increased likelihood of smoking. A greater sense of control over the outcomes of ageing was associated with increased risk of both harmful drinking (RRR control positive 1.16) and smoking (RRR control and consequences negative 1.25). This suggests optimistic bias in relation to perceived health risk from smoking and harmful drinking as a potential adverse effect of perceptions of control.

Risks of concurrent smoking and harmful drinking increased with chronic awareness of ageing (RRR 1.24), and negative emotional responses to it (RRR 1.21), and decreased with stronger perceptions of the positive consequences of ageing (RRR 0.85).

Conclusions

The relationship between ageing perceptions, smoking and drinking is complex. Altering perceptions of ageing may be a useful intervention target aimed at facilitating engagement in preventative health behaviours in older people.

The contribution of illness perception to psychological distress in heart failure patients

BACKGROUND

The influences on the psychological well-being of heart failure (HF) patients have received limited attention. Illness perceptions are a specific set of cognitive representations that have been shown to predict health-related outcomes in other patient groups. This study sought to explore the role of illness perceptions in the psychological well-being of HF patients by creating a profile of illness perceptions in HF and examining their relations with anxiety and depression.

METHODS

Participants were 95 consecutive outpatients. Indices of psychological well-being were depression and anxiety, measured using the Hospital Anxiety and Depression Scale (HADS). Illness perceptions were measured using the Illness Perception Questionnaire - Revised (IPQ-R). Functional status was also determined using the New York Heart Association (NYHA) classification.

RESULTS

Illness perceptions were associated with indices of psychological well-being. Regression analyses showed that illness perceptions accounted for a significant proportion of the variance in both depression and anxiety. The contribution of illness perceptions was greater than that made by traditional covariates (socio-demographic variables and functional status).

CONCLUSIONS

Results highlight dynamic interrelations between perceptions of illness and mental health indices. They also suggest that in considering the role of illness perceptions in psychological well-being, the primary focus should be on the overall dynamic of an individual's illness experience rather than on specific illness dimensions. Findings highlight the potential role of illness perceptions in depression and anxiety in HF. This has implications for interventions to maximise psychological well-being in this patient group.