Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan

Aims. We examined sexual activity and predictive factors among older people in Taipei, Taiwan. We aimed to characterize the older population engaged in sexual activity and determine influencing factors, exploring aspects of sexuality that may influence elders’ health and quality of life (QOL). Background. Studies of sexual attitudes and behaviour have found that sexual difficulties are common among mature adults worldwide, influenced in men and women by physical health, ageing, psychosocial and cultural factors. Design and methods. We conducted a community‐based retrospective study involving a random sample of 412 men and 204 women over age 65. A questionnaire on demographics and social situations was administered, along with a Sexuality Knowledge and Attitudes Scale; 34 questions evaluated sexual knowledge and 18 evaluated sexual attitudes. Results. Two‐hundred and twenty participants were sexually active (35·7%), 185 mainly with spouses (84·1%); frequency was 21·4 (SD 16·9) times per year (range: 1–120). Multiple logistic regressions identified five significant predictors of sexual activity: gender, age, being with spouse, sexual knowledge and sexual attitudes. Sexual activity was significantly associated with higher education levels, lower stress and more self‐reported daily activities. Conclusions. Our results agreed with Western studies linking sexual activity with better health and higher QOL in older adults. Older peoples’ stress and daily activity levels are recognized quality‐of‐life measures; lower stress and more daily activities among sexually active older people suggests a connection between sexual activity and higher QOL. Increasing knowledge and improving attitudes about sexuality may help older people build healthier relationships and enhance health and QOL. Relevance to clinical practice. If healthcare professionals possess greater understanding of older peoples’ sexuality, healthcare systems may find ways to increase sexual knowledge and foster healthier attitudes and relationships to improve older peoples’ overall health and QOL.     

Spirituality in later life: effect on quality of life

The purpose of this study was to explore the effects of spirituality on quality of life (QOL) in older adults when age, gender, social support, and health status are controlled. A secondary analysis of data was conducted using results from a cross-sectional survey of older adults. Data were available from a convenience sample of 426 people living in British Columbia, Canada, who volunteered to complete the questionnaire. Instruments included the WHOQOL-100 and a demographic data sheet. The results show spirituality was not a significant factor contributing to QOL in this sample, and that the strongest predictors of overall QOL were social support and health satisfaction. Given difficulties in measuring spirituality and homogeneity of the sample, further research is warranted.     

Quality of life of older adults in Canada and Brazil

In this study, we examined the factors contributing to quality of life (QOL) of older adults in regions of Canada and Brazil. The WHOQOL-BREF and a demographic data sheet were administered to random samples of 202 older adults from Canada and 288 from Brazil. Ratings on overall QOL and on the physical, psychological, and environmental domains were higher in the Canadian sample. Social domain scores were not significantly different. The authors found the same pattern of factors (health satisfaction, enough money, meaning in life, and opportunities for leisure activities) contributed to the variance of QOL in both countries, except for physical environment, which was significant in Brazil and not in Canada. Health satisfaction was the strongest contributor to QOL in both samples, and satisfaction with personal relationships was not significant in either country.     

Investigating the Domains of Life Satisfaction in Middle-Aged,Late Middle-Aged,and Older Adults with a Physical Disability

Little research exists that explores which domains of life satisfaction contributed to life satisfaction among Korean older adults with a physical disability. The purpose of this study was to investigate which domains of life satisfaction predicted life satisfaction by the identified different age groups among Korean older adults with a physical disability. This study analyzed the Panel Survey of Employment for the Disabled (PSED) collected in 2015 in Korea. A total of 2331 participants were used and examined their socio-demographic status, the satisfaction of life domains (social, health, finance, leisure, work and marital), and the overall life satisfaction. The results show that marital and employment statuses play an important role in promoting the overall life satisfaction for adults and older adults with a physical disability. In addition, this study suggests that the social and leisure satisfaction of an individual are the major contribution to life satisfaction among older adults (aged 55 and over) who have a physical disability.     

Relationship of health status and social support to the life satisfaction of older adults

We examined the relationship of health factors and social support to life satisfaction in older adults dwelling in a rural town. The gender difference in variables related to life satisfaction was also discussed in this study. One hundred and forty-two older adults (86 females and 56 males) who completed a self-administered questionnaire and participated in a health examination in 1998 or 1999 comprised the study participants. The t-test and chi-square test were used to assess the differences between the two genders. Correlation measure and multiple regression analysis were used to assess the relationship between life satisfaction and other health related or socially related factors for each gender. Significant gender differences were observed in living status and several health related factors. According to the results of the multiple regression analyses, life satisfaction was related to mental health and age in females, while it was related to mental health status and social support from others in males. Gender differences in the variables associated with life satisfaction were observed among the community-dwelling older adults. These data suggest the importance of mental health for older adults. When preparing health promotion strategies for older adults, results of gender differences as they related to social support and life satisfaction should be applied in practice.     

Daily life consequences of hearing loss in the elderly

Purpose.?To assess the daily life consequences of hearing loss in older adults and to explore the influences of hearing loss, subjective assessment of health and general life satisfaction, gender, age and marital status.

Method.?Eighty-four participants, each older than 65 years, were consecutively recruited from a hospital waiting list for outpatient hearing aid fitting. All participants were assessed by pure-tone audiometry. Daily life consequences of hearing loss were measured using the Hearing Disability and Handicap Scale, which assesses perceived activity limitation and participation restriction. Another questionnaire was used to measure self-assessed health and life satisfaction.

Results.?Adjusted linear regression analysis showed that activity limitation was significantly associated with increased hearing loss (p == 0.028) and decreased health (p == 0.009), and participation restriction with lower estimated life satisfaction (p ≤ 0.001). Gender, age and marital status were not determinant factors for perceived activity limitation or participation restriction.

Conclusions.?Daily life consequences of hearing loss, health conditions and general life satisfaction are closely related. These findings indicate that health factors and psychosocial aspects should be emphasised as a natural part of audiological rehabilitation.     

Characteristics of psychosexual functioning in adults with cerebral palsy

OBJECTIVE: To investigate the characteristics of psychosexual functioning in adults with cerebral palsy, as compared with able-bodied control subjects, matched by gender and marital status, and to identify the factors affecting psychosexual functioning. DESIGN: Interview and survey using the Derogatis Sexual Functioning Inventory (DSFI). SETTING: Inpatient and outpatient units in a rehabilitation hospital and welfare facilities. SUBJECTS: Sixty-two adults with cerebral palsy and 142 age-matched able-bodied controls participated in this study. The participants were grouped into four subgroups according to gender and marital status. MAIN MEASURES: General characteristics of the subjects, 10 domain scores of the DSFI and Sexual Functioning Index (SFI) as a global score were assessed. The scores for each cerebral palsy group according to gender and marital status were compared with those of their corresponding able-bodied control group. RESULTS: Unmarried men with cerebral palsy demonstrated lower SFI and weakness in sexual information, experience, drive, attitude, psychological symptoms, affect and satisfaction, compared with unmarried able-bodied men (p < 0.05). In contrast to unmarried men, unmarried women did not reveal any significant differences in all but body image domain score (p < 0.05) between the groups. Married adults with cerebral palsy showed higher levels of psychological distress in both men and women and lower sexual satisfaction in women (p < 0.05). Nonambulatory people with cerebral palsy had significantly a lower sexual information, experience and satisfaction, and a lower SFI than ambulatory (p < 0.05). Barthel Index was significantly related to body image (p < 0.05). Psychosexual functioning was not significantly different according to cerebral palsy type. CONCLUSION: This study revealed the characteristics on psychosexual functioning in adults with cerebral palsy, depending on gender and marital status. The results suggested that nonambulatory unmarried men with cerebral palsy were at high risk in terms of psychosexual dysfunction.     

Coronary artery bypass grafting: quality of life of patients in Karachi

In the Third World, cardiac patients often suffer not only from the nature of their illnesses, but also the insufficiency of the facilities available. Although the effectiveness of coronary artery bypass grafting (CABG) is being evaluated in terms of mortality, complications or recurrence of symptoms, empirical studies assessing the change in patients' quality of life (QOL) after CABG within the Pakistani cultural context are lacking. Aims: The aims of the present study are to assess and compare the change in health-related quality of life before and 1 month after CABG and to assess the differences in QOL with respect to age, gender and cardiac rehabilitation programme attendance. Method: A prospective single group pre- and post-study design was used, whereby patients completed a questionnaire before and 1 month after surgery. Questions considered the person's physical capacity, psychological wellbeing, social relationships and satisfaction from their health condition. Results: The results indicated a significant improvement in patients' physical and psychological health, satisfaction with social relationships and overall health status. Younger patients showed significantly lower scores on the social domain (reflecting greater dissatisfaction with their sex life and personal relationships). Female participants showed significantly lower scores in psychological health post surgery. Lastly, participants of the cardiac rehabilitation programme scored significantly higher in psychological health compared with non-participants. Conclusion: QOL improved from prior to and 1 month after CABG while differing (in specific domains) with respect to age, gender and cardiac rehabilitation programme attendance. The findings can be used to develop interventions to improve health and QOL in specific domains with respect to specific groups.     

Demographic characteristics and perceived health status of users of folk therapies in Taiwan

OBJECTIVES: This study examined the prevalence of folk therapy use among Taiwanese adults and factors associated with such use. SUBJECTS AND METHODS: The data used in this study were from the 2001 National Health Interview Survey in Taiwan, which utilized a multistaged stratified systematic sampling scheme. Included in the current analysis were 11,290 individuals from 20 to 65 years. RESULTS: Only 1.3% of those surveyed were classified as users of folk therapy. Users of folk therapies were older (p = 0.002), had higher annual incomes (p < 0.001), and experienced more health problems (p = 0.006) than nonusers. The two groups were comparable in the areas of marital status, employment status, gender, and educational level. Users had lower scores in the physical functioning (p < 0.001), role physical (p = 0.041), general health perception (p = 0.002), and bodily pain (p < 0.001) domains of the Medical Outcome Studies 36-Item Short-Form Health Survey. The two groups were not significantly different regarding the utilization and satisfaction with conventional medical resources and the domain scores of the brief version of the World Health Organization Quality of Life (QOL) questionnaire. CONCLUSIONS: Less than 2% of adult Taiwanese population reported relying primarily on folk therapies for their common physical discomfort. Users of folk therapies are older, have higher incomes, and have more health problems and poorer health-related QOL, but they neither make more frequent use of conventional medical services nor are they dissatisfied with the available services.     

Sexual issues in special populations: geriatric oncology - sexuality and older adults

OBJECTIVE: To provide an overview of sexuality and sexual expression in older adult cancer survivors and to outline implications for nursing and interdisciplinary practice. DATA SOURCES: Research articles, abstracts, reviews, and clinical expertise. CONCLUSION: Unique features of sexuality in late life provide evidence to support clinical exploration of sexuality for older adult cancer survivors. Approaches to intervention with older adult cancer survivors are predicated on adaptation of best practices in sexuality and sexual health to create care that is sensitive to age and generation. Targeted research in sexuality for older adult cancer survivors includes intimacy, relationship, sexual experience, and imbedded sexual behavior. IMPLICATIONS FOR NURSING PRACTICE: Nurses can improve the care of older adults with cancer by careful consideration of intimacy and sexuality using standards of practice with younger adults integrated with understanding of issues unique to later life.     

Humor and its relationship to perceived health, life satisfaction, and morale in older adults

The purpose of this investigation was to examine the relationship between the use of humor as a coping strategy and health indicators as measured by perceived health, life satisfaction, and morale in older adults. A packet of questionnaires was administered to a nonrandom sample of 73 noninstitutionalized adults over age 55. Of the independent variables of situational humor, coping humor, residence, gender, age, living arrangements, and socioeconomic status (SES), none are significant predictors of perceived health at the .017 alpha level, whereas the variable of living arrangements is predictive of life satisfaction. Furthermore, coping humor and socioeconomic status are predictive of morale in older adults. This study adds to the knowledge of humor as a coping strategy as well as a developmental concept in older adults. Implications for nursing practice and research are discussed.     

Health literacy and functional health status in Korean older adults

Aims and objectives. The aim of the study was to investigate the relationships of health literacy to chronic medical conditions and the functional health status among community‐dwelling Korean older adults. Background. In the literature, limited health literacy has been reported to have adverse effect on health outcomes. However, the link between health literacy to health status among Korean older adults needs to be clarified. Design. A cross‐sectional survey. Methods. A cross‐sectional survey of 103 community‐dwelling Korean older adults was conducted from June 2007–September 2007. Health literacy was measured using the Korean Functional Health Literacy test and functional health status was measured using the subscales of the Medical Outcomes Study 12‐item Short‐Form Health Survey. Results. Individuals with a low health literacy had significantly higher rates of arthritis and hypertension. After adjusting for age, education and income, older individuals with low health literacy had higher limitations in activity and lower subjective health. In a model adjusting for age and income only, older individuals with low health literacy were more likely to report lower levels of physical function and subjective health and higher levels of limitations in activity and pain. Conclusions. Among community‐dwelling Korean older adults, limited health literacy is associated independently with higher rates of chronic medical conditions and lower subjective health status. Relevance to clinical practice. Nurses are key to providing health education to older adults. The understanding of the relationship of health literacy to health status is essential to develop communication and health education efforts for older adults in nursing practice.     

Healthy behaviors, self-efficacy, self-care, and basic conditioning factors in older adults

A secondary statistical analysis of data from a study investigating the relations among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an older adult population is reported (Callaghan, in press). Influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care in 235 older adults is presented. The research instruments used to collect data for this study include the following: Health-Promoting Lifestyle Profile II scale, Self-Rated Abilities for Health Practices scale, Exercise of Self-Care Agency scale, and a demographic questionnaire assessing basic conditioning factors. Statistically significant relations were found between the following basic conditioning factors and the study variables: education, income, health insurance, race, support system, routine practice of religion, medical problems, marital status, gender, age, and number of children. Community health nurses can use these results in directing interventions that promote the self-care and health of older adults.     

Personal characteristics that influence exercise behavior of older adults

Long-term exercise participation among older adults will result in healthier lifestyles and reduced need for health care. A better understanding, therefore, of what influences older individuals to start and maintain exercise plans would be beneficial. The twofold purpose of this study was (1) to create a knowledge base of determinants that influence exercise behavior in older adults and (2) to have health professionals prioritize determinants that affect exercise initiation and adherence in older adults. The expert panel examined nine determinants within the category of personal characteristics: age, gender, ethnicity, occupation, educational level, socioeconomic status, biomedical status, smoking status, and past exercise participation. The experts rated the determinants on importance for influencing exercise behavior of older adults. This expert panel concluded that older adults who are in good health and have a history of exercise activity might be more likely to participate in long-term exercise programs.     

Stress,workload, sexual well‐being and quality of life among physician residents in training

Objectives: To assess the impact of stress and workload on sexual health and quality of life (QOL) of the medical residents in training. Design and subjects: A total of 339 male and female medical residents from 11 specialties were surveyed. Level of stress, sexual health and QOL were measured using validated questionnaires. Results: Overall, 49% of the female and 11% of male residents had sexual dysfunction, and 47% and 34% respectively indicated being very to mostly dissatisfied with their sexual life. Both the frequency of sexual activity and quality of relationship with partner decreased during residency compared with the time immediately prior to residency. This decline was irrespective of gender, specialty or year of residency. A majority of residents (75% of women and 54% of men) were identified to be at high levels of stress using a validated questionnaire. In women, stress negatively influenced most domains of sexual health including desire, arousal and satisfaction; in men, satisfaction was significantly affected by high levels of stress. Long hours of work (> 70 h per week) impacted sexual health less profoundly than did stress. Among both male and female residents, QOL was significantly lower among residents who experienced sexual dysfunction and dissatisfaction compared with those with normal sexual functioning. Conclusions: Our results highlight the importance of stress‐management efforts in residency programmes and provide evidence that limiting work hours alone may not lead to significant improvement in sexual health and QOL during residency.     

Sexuality and intimacy in older adults

In most long-term care settings, staff members tend to view a resident's attempts at sexual expression as "problem" behavior. However, we are increasingly recognizing that interest in, and the right to, sexual expression exists throughout the life span and should be supported. Assisted living nurses need information and tools to adequately address residents' sexual health and to overcome the many barriers to intimacy in this population. This article briefly reviews age and illness-related changes in sexual function; describes the research regarding older adults' and their family's and caregivers' attitudes regarding sexuality and intimacy; discusses sexuality and residents with dementia; and reviews nursing assessment and educational interventions that support healthy sexuality among older adults.     

Sex-role attributes, gender, and postpartal perceptions of the marital relationship

The relationships of sex-role attributes and gender to perceptions of changes in intimacy and in the overall marital relationship were examined, as was the quality of that relationship following the birth of an infant. For a sample of 165 couples, positive changes in intimacy and in the overall relationship following delivery were positively related to marital quality at four months postpartum. Of gender and sex-role attributes, only femininity contributed significantly to the prediction of overall change and quality. None of the variables predicted perceived change in intimacy.     

Sleep and other correlates of high-level health in older adults

A large sample (N?=?1139) of adults ≥75 years from the 2011–2014 NHANES cohorts was used to examine predictors of high-level health. Analyses were done with SAS to control for sample weights and allow results to be reported as population parameters. The majority of participants described their health as high-level (73.6%). Logistic regression found a longer sleep duration, minority status, decreased income, multiple medications, low physical activity, and late stage memory impairment were significant predictors of low-level health (p?<?.05) while sex, education level, marital status, body mass index, and depression symptoms were not. The assessment of sleep should be expanded to cover dimensions such as sleep quality and sleep disorders to help maintain wellness in older adults. This study supports that the majority of older adults have high-level health and identifies several modifiable factors to maintain wellness.