Factors associated with home environmental problems among community-living older people

Purpose : This paper describes the types of difficulties older people have with their home environments and the factors associated with having such difficulties. Method : Data were used from 296 study participants of the University at Buffalo's Consumer Assessments Study that examines the home modification needs and environmental difficulties of older people. A combination of socio-demographic variables, health and functional status indicators and measures of psychosocial well-being were used to predict environmental problems. Results : An average of 13 problems with the environment that posed as a barrier to safe and independent performance was observed in homes. It was found that most difficulties occurred in bathrooms, kitchens, bedrooms and access to entryways and rooms. Hierarchical multiple regression analysis showed that having home environmental problems was most strongly associated with younger age, being female, being of minority status, having pain, and greater physical disability. Conclusion : The findings show that a combination of conditions that include demographic and functional conditions place older people at risk for problems with the home environment that impede performance of daily living activities.     

Factors associated with life space among community-living rural elders in Japan

ABSTRACT Objectives: The study objective was to identify factors associated with life space to examine the service needs of the elderly.
Design: Cross-sectional study.
Sample: 2,409 community-living elderly in a rural town in Japan.
Measurement: Daily activity level was used as a proxy for life space. Respondents were asked about their daily activity, health status, and psychosocial factors in a self-administered questionnaire. Factors associated with life space were identified using general linear models. Relative associations of each factor with life space were tested using stepwise multiple regression procedure.
Results: Elderly in a smaller life space were significantly older, had more illnesses, worse activities of daily living (ADL), and poor self-rated health. Poor psychological well-being and fewer social relations were also associated with a smaller life space. Age and ADL difficulty accounted for 51.7% of life space variations. In addition, more elderly with ADL difficulty expressed unmet needs for transportation and socializing opportunities.
Conclusions: Life space was related not only to age or health status but also to environmental or psychosocial factors. Appropriate services for a vulnerable population may have a positive effect on elderly health. Moreover, elderly life space may be used as an indicator to identify people at risk in order to provide more effective community-based programs for the elderly.     

Factors associated with nursing home entry for older people in Taiwan,Republic of China

Taiwan is facing a rapid change in the composition of its population. As the population ages, a greater demand for long-term care services and, in particular, nursing homes is expected. Before deciding who really needs nursing home care, it is important for policy makers to understand the current pattern of utilisation and what factors are associated with entry. This research assesses the relative importance of predisposing, enabling and need factors that lie behind this. It is based on a survey of elderly people in registered nursing homes, a comparison with a national sample of elderly people in their own homes and interviews with the lucid elderly patients (i.e. could communicate with no problems) and their carers. It was found that nursing home entry was associated with advanced age, gender, educational level and dependency levels of elderly people. After controlling for age, need factors have the greatest impact on admission. Specific medical problems such as cardiovascular, neurological and skeletal muscular diseases were also major contributors. Although most elderly people in Taiwan are cared for in their own homes by their families, under certain circumstances entry to a nursing home seemed inevitable. Decisions about nursing home entry were mainly taken within a family context with adult children being the main players while professionals played a relatively minimal role.     

Factors associated with nurses' willingness to handle abuse of older people

AimThe aim of this study was to explore predictors of nurses' willingness to handle abuse of older people.BackgroundAbuse of older people is a long-discussed healthcare issue worldwide. Although nurses are considered capable of identifying and reporting cases of abuse of older people, no study has been conducted in Taiwan on nurses' willingness to handle abuse of older people.DesignA cross-sectional design was used.MethodsThe study was conducted from May to June 2019. A convenience sampling was adopted to survey 555 nurses from a medical center in Taiwan. Data were collected using the Knowledge of Abuse of Older People Scale, Attitudes Towards Older People Scale, Attitudes Towards Handling Abuse of Older People Scale, Willingness to Handle Abuse of Older People Scale, and personal characteristics. Pearson correlation coefficient analysis, independent sample t-test, one-way analysis of variance, and multiple linear regression were performed.ResultsParticipants scored an average of 2.98 out of 4 on the Willingness to Handle Abuse of Older People Scale, indicating that they were inclined to do so. Attitudes towards older people, knowledge, attitudes towards handling abuse of older people, awareness of the hospital's reporting procedure and dissemination of information related to abuse of older people, sex, age, and clinical work experience explained 41.4% of the variance of willingness. Participants' attitudes toward handling abuse of older people was the most important predictor of their willingness to do so.ConclusionsTo improve nurses’ willingness to handle cases of abuse of older people, particularly that of male nurses, hospital authorities should provide in-service training and education and disseminate information on the subject matter. Nursing schools should prioritize offering gerontological nursing courses to foster nursing students’ positive attitudes toward older adults and handling abuse of older people.Tweetable abstractNurses' attitudes toward handling abuse of older people were the most important predictor of their willingness to handle abuse of older people.     

Factors associated with exercise self-efficacy among people with chronic diseases

AimThe aim of this study is to assess the level of exercise self-efficacy in a population with chronic diseases and identify the factors that could influence exercise self-efficacy.BackgroundPerforming physical exercise is an important part of self-care in chronic diseases. It is highly influenced by individual's self- efficacy. However, little attention has been given to the identification of the factors that could affect the exercise self-efficacy among people with chronic diseases.MethodsThis cross-sectional study was conducted to assess the exercise self-efficacy among people with chronic diseases using the Exercise Self-Efficacy Scale (ESE). Demographic and exercise profiles were also collected.ResultsA total of eighty-five people with chronic diseases from outpatients' clinics participated in this study. The mean age of the participants was 52 ± 13.92 and more than half of them were females (58.8%). The mean score of exercise self-efficacy was 39 ± 21.55. Education level was the main factor that correlated with lower levels of exercise self-efficacy.ConclusionsThis study is first to provide preliminary evidence about levels of exercise self-efficacy and its associated factors among people with chronic diseases in Saudi Arabia. The level of exercise self-efficacy is low in people with chronic diseases and this mainly associated with educational factor. Nurses have an important role to promoting exercise self-efficacy through implementing a comprehensive plan that is patient's centered approach. However, further research is needed to assess perception, detect barriers and conduct intervention that aims to improve exercise Self-efficacy.     

Factors contributing to low weight in community-living older adults

PURPOSE: To investigate the factors that influence the dietary practices and eating patterns of low-weight, community-living older adults (aged 65 and older) and to examine the nutritional advice given to them by healthcare providers (HCPs) (e.g., nurse practitioner, medical doctor). DATA SOURCES: A qualitative approach was used to study a convenience sample of older women. Semistructured interviews were conducted. Thematic analysis and open coding were used to analyze data. CONCLUSIONS: Eating alone, social isolation, and stressors are the main reasons reported by participants for low weight. Data gathered in this study provide important insights into possible reasons for low weight in community-living older adults. IMPLICATION FOR PRACTICE: As HCPs, it is important to bring low weight to the attention of older adults and educate them regarding appropriate weight for their age (body mass index [BMI] range >21 to <27 kg/m2 for age 65 and older), to understand that older adults with a BMI of <24 may be at increased risk for poor nutritional status, and to weigh older adults at each office visit to assess change in BMI. Small changes in eating patterns and food intake can potentially play an important role in stabilizing weight. Strategies that address eating alone, social isolation, and stressors need to be pursued.     

Quality of life and symptoms among older people living at home

AIM: This paper reports a study comparing the socio-demographic data, quality of life (QoL) and symptoms of older people living at home with and without help. BACKGROUND: Despite growing numbers of older people worldwide, little is know about the differences between older people receiving help to live at home and those not receiving this, especially as regards QoL and symptoms. Not only symptoms but also dependency on others per se may reduce older people's QoL. From a nursing perspective, knowledge about such issues is important because the impact of symptoms may be reducible, even when diseases cannot be cured. METHOD: A postal questionnaire was sent to an age-stratified random sample of 1866 people aged 75 years or over. Of the respondents (n = 1248) 448 received help and 793 did not. RESULTS: The group receiving help had a significantly higher age, more women, more people widowed and living alone, more children, a higher number of self-reported diseases and symptoms, greater inability to remain alone at home and lower QoL. Loneliness, depressed mood and abdominal pain were significantly related to low QoL in both groups. Living alone, not being able to remain alone at home without help, and fatigue were also predictive of low QoL among those receiving help, and number of diseases and sleep problems in those without. CONCLUSION: Receiving help with daily living seems to be significantly related to low QoL and goes along with a high number of symptoms that need to be considered in nursing care. Through regular visits, systematic assessment and intervention, especially focusing on older people's symptoms, nurses may contribute to improved QoL for this section of the population.     

Cross-cultural validation of the Falls Efficacy Scale-International to assess concerns about falls among Hungarian community-living older people

Abstract

Purpose: The Falls Efficacy Scale-International (FES-I) is a reliable and valid tool for assessing concerns about falling. Our aims were to translate, culturally adapt, and evaluate the main psychometric characteristics (internal consistency, reproducibility, and convergent construct validity) of the Hungarian version of the FES-I on a sample of community-living older adults.

Methods: After translating and culturally adapting the original scale, 165 community-living older adults (aged 60?years or over) participated in the measurements and filled in the questionnaire. After two weeks, a subsample of 64 persons filled in the FES-I again to determine the test–retest reliability.

Results: The test–retest analysis showed excellent reliability: Intraclass Correlation Coefficient was 0.831. The FES-I Hungarian consisted of two factors that showed good internal consistency: Cronbach’s alpha 0.95 (Factor 1), 0.89 (Factor 2), and 0.93 (whole scale). The FES-I was able to discriminate the participants based on gender and fall history. It showed a significant correlation with the Timed Up and Go test (r?=?0.740) and the general health perception (r?=??0.713).

Conclusions: Translation and cultural adaptation of the original scale were successful. The Hungarian version proved to be a reliable, valid tool confirming that it can be used in future clinical and scientific work with Hungarian older people.

• Implications for rehabilitation

• Excessive concerns about falls may lead to avoidance of activities, decreasing functional abilities, increasing of risk of a future fall, ultimately premature nursing home admission.

• The Falls Efficacy Scale-International is a widespread tool for assessing concerns about falls.

• The Hungarian version of Falls Efficacy Scale-International has an excellent test–retest reliability, good internal consistency, and acceptable construct validity.

• The Hungarian version of Falls Efficacy Scale-International is a valid and reliable tool for measuring the concerns about falls among Hungarian-speaking community-living older people in everyday clinical practice and scientific studies.

     

Factors associated with fear of falling among frail older adults

Some factors increase the fear of falling in frail older adults. Our aim is to quantify the influence of these factors. This cross-sectional study involved 229 community-dwelling prefrail and frail older adults aged 70 years and older. Fear of falling was moderate in 38.9% of our sample and high in 12.2%. Higher values were observed in women, those living alone, and those meeting criteria for slowness and feelings of exhaustion. A linear regression showed that being a woman, a history of falls, and depressive symptoms were related to higher fear of falling, while high levels of independence in basic and instrumental activities of daily living, along with good gait and balance, were associated with lower fear of falling. Screening for depressive symptoms and fear of falling in the comprehensive geriatric assessment of frail community-dwelling older adults could help to support preventive strategies.     

Factors associated with cane use among community dwelling older adults

Guided by the Theory of Planned Behavior (TPB), this study examined factors associated with cane use among community dwelling older adults. Data were collected in a cross-sectional survey of a convenience sample of 106 community residing older adults in Ottawa, Canada. Using a stepwise discriminant analysis, subjective norms, attitudes, and age surfaced as the key variables associated with cane use in this sample. The discriminant function accounted for 67% of the variance in cane use and correctly classified 91% of cases (Wilks's lambda = 0.33, lambda2 = 110.12, df = 3, p < 0.0001). The findings provide evidence for the utility of the TPB in its application to understanding cane use behaviors of older persons and have important implications for the design of theory-based fall prevention interventions to enhance the acceptance and effective use of mobility aids.     

Factors associated with nutrition risk among community-dwelling older adults in Thailand

This study was to investigate socio-demographic, chronic conditions and health factors associated with nutrition risk among Thai community-dwelling older adults. This was a cross-sectional study, involving 330 participants aged ≥ 60 years living in low-income suburban Chiang Mai, Northern Thailand. Of the 330 participants, 54.8% were at nutritional risk based on the Mini Nutritional Assessment. Multivariate analysis indicated factors significantly associated with nutritional risk were: aged ≥80 years (OR:8.59, 95% CI = 2.94–25.11), low income (OR: 2.35, 95% CI = 1.15–4.78), living alone (OR: 2.02, 95% CI = 0.20–0.78), moderate to severe pain (OR: 5.88, 95% CI = 2.30–15.02), dyslipidemia (OR: 5.12, 95% CI = 2.23–11.77), osteoarthritis (OR: 2.49, 95% CI = 1.14–5.48), poor physical performance (OR: 1.49, 95% CI = 1.70–3.15), and ≥1 fall in the previous year (OR: 2.22, 95% CI = 1.21–4.07). Results point to the need for multifactorial interventions to reduce risk for geriatric nutrition problems. Further studies are needed to determine effective solutions to the problem of malnutrition among older adults.     

Suicide among older people

Overall, the number of people who kill themselves across all ages is falling but suicide rates among older people remain comparatively high. This article considers possible risk factors and suggests ways of reducing and containing potential harm. It also explores ways of responding when prevention of suicide fails.     

Factors associated with HIV testing among people who inject drugs Tehran

Background: Little published research have assessed factors predicting the uptake of HIV-testing services for people who inject drugs (PWID) in Iranian settings. The objectives of the present study were to determine factors associated with HIV testing uptake among PWID in Tehran.

Methods: We surveyed 500 PWID in Tehran concerning demographic characteristics, drug-related and sexual risk behaviors, and HIV testing. HIV-related stigma variables were assessed using a scale consisted of 22 agree/disagree statements in three subscales including shame/blame/isolation, perceived discrimination, and equity. We used multivariate logistic regression to identify factors associated with HIV testing.

Results: Participant ages ranged from 19 to 67 years. Multivariable model shows that factors independently associated with recent HIV testing included level of education (adjusted odds ratios [aOR] 1.12, 95% CI 1.44–4.42), living status (aOR 1.91, 95% confidence interval [CI] 1.35–2.71), income (aOR 1.64, 95% CI 1.18–2.29), length of injecting career (aOR 1.3, 95% CI 1.2–2.23), and perceived risk of HIV infection (aOR 0.51, 95% CI 1.18–0.88). There was a statistically significant relationship between lower level of HIV-related stigma and HIV testing among PWID (OR 2.78, 95% CI 1.15–5.2).

Conclusions: These findings suggested a need to strengthen current HIV testing programs by social support and reducing HIV-related stigma. It is also important to modify the attitude of the public toward people living with HIV/AIDS.