Active Coping,Personal Satisfaction,and Attachment to Land in Older African-American Farmers

Elevated suicide mortality rates have been reported for farmers and for the elderly. Very little literature exists that looks at the health of older minority farmers. This mixed-method study describes older African-American farmers (N = 156) in the contexts of active coping, personal satisfaction from farm work, and attachment to their farmland to provide insight into the psychosocial dimensions of their mental health. Findings show that the farmers have positive perspectives on work and farm future, and strong attachment to the land. Differences were noted by gender. Nurses can use these findings to frame culturally appropriate strategies for aging farmers to maximize positive outcomes.     

Workplace satisfaction in a mental health service for older adults: an analysis of the effects of setting and professional status

Research in mental health services for working-age adults has repeatedly shown that work is found more satisfying, if more stressful, by community practitioners than by hospital-based staff. This study examined whether similar differences exist in services for older adults and how this might be influenced by the high proportion of nonprofessionally qualified workers in inpatient settings for mentally infirm older people. The Work Environment Scale was given to all practitioners in a mental health service for older adults in a single London borough. Adjusting for the effect of professional status, community practitioners rated involvement, task orientation, and supervision more positively than institutional staff, but gave less favorable ratings for work pressure and physical comfort. Nurses rated peer cohesion, supervision, autonomy, and innovation more positively than nursing assistants, after controlling for type of setting. Multivariate modeling confirmed that type of setting and professional group were both associated with workplace satisfaction, accounting for 24% and 13% of the variance, respectively. The study highlights aspects of the work environment of mental health staff working with older adults that might benefit from attention.     

Outcome moderators of a fatigue management program for people with multiple sclerosis

OBJECTIVE. We determined whether age, gender, work status, or impairment moderated fatigue management program outcomes for people with multiple sclerosis (MS). METHOD. We conducted a secondary analysis of longitudinal data from a randomized controlled trial using mixed-effects models (N = 181) and examined outcomes of fatigue impact, mental health, physical health, and self-efficacy. Measures were collected before and immediately after intervention and at 6 wk, 3 mo, and 6 mo postintervention. RESULTS. Younger participants experienced greater reductions in fatigue impact and greater improvements in self-efficacy over time than did older participants, but we found no age differences in physical or mental health. Participants with less impairment experienced greater mental health gains and were more likely to retain these gains over time than were participants with greater impairment. Although women experienced greater fatigue impact benefits, men experienced greater mental health benefits. Work status did not moderate outcomes. CONCLUSION. Fatigue management program outcomes for people with MS are moderated by age, gender, and impairment.     

Employment status and perceived health status in younger and older people with multiple sclerosis

This study explores how employment is associated with perceived physical and mental health status in people with multiple sclerosis (MS) adjusted for sociodemographic and clinical variables stratified by age. The sample consisted of 184 MS patients divided into a younger (<45 years) and an older (≥45 years) age group. Respondents underwent an interview, a neurological examination on disability [Expanded Disability Status Scale (EDSS)], and completed the Short Form-36 Health Survey. Of the respondents (mean age 40.5±6.2 years), 43.5% were employed. Significant differences between younger and older patients were found in employment, EDSS, disease duration, and five Short Form-36 Health Survey dimensions. Block-step multiple regression explained 32.4% of the variance in physical health and 14.5% in mental health in the younger group. Being employed was significantly related to good physical health, whereas EDSS diminished the effect of being employed on physical health. The most important variable for mental health was employment status in the younger group. For the older age group, 19.1% of the variance in physical health and 14.0% of the variance in mental health was explained by the studied variables. Male gender and a lower EDSS were significant explanatory variables of better physical health. Male gender significantly explained mental health in the older age group. In conclusion, employment status was an explanatory variable for physical health and mental health in the younger patients. EDSS played a significant role in physical health for all patients. A vocational rehabilitation program could prevent eventual nonemployment and improve health outcomes in older MS people.     

Health and safety needs of older farmers: part II. Agricultural injuries.

A random sample (N = 87) of older Illinois farmers was surveyed to assess their experiences with traumatic injuries and the relationship between injury rate and age, type of farm activities, amount of stress, and hours of work per week. Farmers' knowledge of safety was assessed. Findings revealed that the number of hours worked, age, and type of farm activities were not significantly related to the number of injuries reported. However, self-reported stress, when stratified by age, was found to be related to injury among farmers aged 55 to 59 years. Also, scores on a farm safety quiz were found to be higher (less knowledge) among farmers who reported more injuries. Items in the safety quiz frequently missed by farmers included falls as a source of injury (29.2%), children being commonly injured on farms (19%), the cause of farmers' lung disease (46.9%), and animals as a cause of injury on farms (12.9%).     

Mental health issues in Japanese workers. An update.

In this cross sectional study conducted in one city in Japan, psychiatrists were asked to answer self administered questionnaires related to their patients' vital status, constituent family members, employment status, financial support from family, emotional support from family, present state of mental condition, and steps used to help them return to society. The focus of the study was to identify and understand the needs of Japanese workers with mental health problems, and to relate the findings to implications for the workplace. Of the 1,283 male patients reported on in the survey, the greatest proportion (45.1%) suffered from schizophrenia, with the prevalence of this serious illness decreasing with age. One half of the total group worked full or part time, with highest rates of employment among those in their 40s and 50s. The most common jobs were simple physical work or assembly. Workers older than 40 years also were more likely to be responsible for financial support of their families. It is suggested that the occupational health nurse has an important role in providing interventions to help these workers remain productive in the workplace, and thus in society.     

被征地农民的心理健康研究

目的探讨被征地农民的心理健康问题以便促进其心理健康。方法采用问卷法调查我国东、西部 3 2 2户被征地农民的心理健康状况 ,分析人口统计因素和社会心理因素对被征地农民心理症状的影响。结果我国被征地农民总的心理健康状况较好 ,其心理问题的症状较轻微 ;但西部地区被征地农民的心理健康状况明显不如东部地区的被征地农民 ,其心理症状得分都显著地高于东部地区 ;人口统计因素和社会心理因素 (如征地前的职业、征地后的经济来源等 )对被征地农民不同的心理症状具有不同的影响。结论征地部门应重视被征地农民的就业安置或职业培训 ,以改善被征地农民的心理健康水平 ,尤其是西部地区被征地农民的心理健康水平。     

A Review of: “Losing a Parent to Death in the Early Years: Guidelines for the Treatment of Traumatic Bereavement in Infancy and Early Childhood by Alicia F. Lieberman,Nancy C. Compton,Patricia Van Horn,and Chandra Ghosh Ippen”

Abstract

This article addresses the need for improved clergy-mental health professional collaboration in the assessment and treatment of elderly suicide. Millions of older adults with personal problems seek the counsel of clergy. A recent Gallup survey found that elders are more willing to turn to their clergy than their medical doctor or a mental health specialist for help when a friend is contemplating suicide (Gallup Organization, 1992). Elder suicide prevention presents the mental health and religious communities with unique opportunities to work together in the best interests of those they serve.     

Mental health nurses' and allied health professionals' perceptions of the role of the Occupational Health Service in the management of work‐related stress: how do they self‐care?

Higher rates of stress-related sickness are found in health care professionals when compared with other sectors. The annual direct cost of absence to the National Health Service is ￡1.7 billion. Increased clinical demand, long hours, low staffing and a lack of support from colleagues and management are contributing to absenteeism, somatic complaints and mental health problems. Mental health work is inherently stressful and levels of work stress experienced by mental health nurses are especially high. The study investigated mental health nurses' and allied health professionals' (AHPs) awareness and knowledge of the service provided by the Occupational Health Service (OHS) and identified work-related stress and self-care strategies within these two groups. Nurses and AHP staff employed in mental health services in a Scottish healthboard area were invited to complete an anonymous questionnaire. Results demonstrated that staff found their contact with the OHS to be a positive experience. They considered direct patient care to be less stressful than the organizational constraints they work under, and they reported a lack of support from both their peer groups and management. There should be recognition of the increased stress that hospital-based nurses and AHPs experience. These areas should be scrutinized and reviewed further to support staff within these environments in accordance with organizational objectives.     

The relationship between psychosocial state and exercise behavior of older women 2 months after hip fracture.

Despite the potential benefits associated with exercise after hip fracture, those who have sustained hip fractures are among the least likely to engage in regular exercise (resistive or aerobic). This article describes the psychosocial state, specifically the self-efficacy expectations and outcome expectations related to exercise, mood, fear of falling, pain, and health status of older women who enrolled in either of two Baltimore Hip Studies (BHS), BHS-4 and BHS-5, and to test a self-efficacy-based model to explain exercise behavior after hip fracture. A total of 389 older women with hip fractures participated in these studies. The participants reported moderate confidence in their ability to exercise and a general belief in the benefits of exercise, high perceived health status, limited depressive symptoms, and some pain and fear of falling. Consistently across these two samples, age and mental status or depressive symptoms influenced outcome expectations, such that older women with more depressive symptoms or lower mental health status had weaker outcome expectations for exercise. Self-efficacy expectations consistently influenced exercise behavior across both samples. It was also consistent across both models that age, cognitive status, physical and mental health status, pain, fear, outcome expectations, and depressive symptoms did not directly influence exercise behavior.     

Elderly suicide, mental health professionals, and the clergy: a need for clinical collaboration, training, and research

This article addresses the need for improved clergy-mental health professional collaboration in the assessment and treatment of elderly suicide. Millions of older adults with personal problems seek the counsel of clergy. A recent Gallup survey found that elders are more willing to turn to their clergy than their medical doctor or a mental health specialist for help when a friend is contemplating suicide (Gallup Organization, 1992). Elder suicide prevention presents the mental health and religious communities with unique opportunities to work together in the best interests of those they serve.     

Gender,exercise, and health: A life‐course cross‐sectional study

The purpose of this study is to explore relationships between the practice of exercise, gender, and health, from adolescence to old age, testing the magnitude of gender differences throughout the life cycle in the practice of exercise of Spanish people. A cross‐sectional study with 4,575 women and 4,334 men, aged 13–85 years, was conducted. The participants were assessed on the weekly hours they dedicated to the practice of exercise, masculine/instrumental and feminine/expressive traits, mental health symptomatology, and self‐rated health). Univariate and multivariate analyses were performed in the age groups of adolescence, late adolescence, young adulthood, middle adulthood, and older age. Results showed that men dedicated significantly more hours to the practice of exercise than women within all age groups, except in older age (men´s average = 4.07; women´s average = 2.55). The masculine/instrumental trait played a mediating role between gender and practice of exercise hours. Furthermore, a decline in the amount of time dedicated to exercise from adolescence to older age was found, with higher drops in men. Finally, the practice of exercise was associated with better self‐rated health and less mental symptoms. These results underline the important role that gender and masculine‐instrumental trait play on the practice of exercise .     

Work status and chronic low back pain: exploring the International Classification of Functioning, Disability and Health

PURPOSE: Exploring which variables are related to work status in patients with chronic low back pain (CLBP), classified according to the International Classification of Functioning, Disability and Health (ICF). METHOD: Ninety-two patients with CLBP filled out questionnaires inquiring after health status, impairments in body functions/structures, limitations in activities of daily living (ADL), participation in work, environmental and personal factors. Additionally, patients performed tests to measure physical fitness and performance of work-related activities. Univariate analyses were performed to investigate whether differences exist between working and non-working patients. Logistic linear regression analysis was performed to explain work status from the variables of functioning. RESULTS: Non-working patients had a lower self-reported physical and mental health, lower physical fitness, more self-reported limitations in ADL, lower education, more depressive symptoms and higher psycho neuroticism than working patients. Self-reported physical and mental health and educational level correctly classified 84.5% of the patients as working or non-working. Performance of work-related activities was not significantly related with work-status. CONCLUSIONS: The relation between work status and CLBP is multidimensional, as was illustrated by using the bio-psychosocial model of the ICF. Patients with a low educational level, a low self-reported physical or mental health were more likely to be non-working. Self-reported limitations and physical and mental health are more important in explaining work status than objective measurements of performance.     

The physical and mental health of acute psychiatric ward staff,and its relationship to experience of physical violence

To evaluate and describe the physical and mental health of staff on acute psychiatric wards and examine whether violence exposure is linked with health status. We undertook a cross‐sectional survey with 564 nursing staff and healthcare assistants from 31 psychiatric wards in nine NHS Trusts using the SF‐36, a reliable and valid measure of health status and compared summary scores with national normative data. Additional violence exposure data were collated simultaneously and also compared with health status. The physical health of staff was worse, and their mental health was better than the general population. Physical health data were skewed and showed a small number of staff in relatively poor health while the majority were above average. Better physical health was associated with less time in the current post, a higher pay grade, and less exposure to mild physical violence in the past year. Better mental health was associated with being older and from an ethnic minority background. Violence exposure influenced physical health but not mental health when possible confounders were considered. Mental health was strongly influenced by ethnicity, and further research might highlight the impact on own‐group ethnic density on the quality of care. The impact of staff whom are physically unwell or impaired in the workplace needs to be considered as the quality of care may be compromised despite this being an example of inclusiveness, equal opportunities employment, and positive staff motivation.     

Older people's expectations regarding ageing, health-promoting behaviour and health status

Title.  Older people's expectations regarding ageing, health-promoting behaviour and health status.
Aim.  This paper is a study to explore the influence of expectations regarding ageing on physical and mental health status, and to examine the mediating effects of health-promoting behaviour on the relationship between these expectations and physical and mental health.
Background.  To achieve healthy ageing, it is necessary for older people to play an active role in maintaining good health. Without any expectations for healthy ageing among older people themselves, encouraging them to participate in health-promoting behaviour and thereby to maintain good health would be unsuccessful.
Method.  A convenience sample of 99 community-residing Korean older people was surveyed in 2007 via questionnaire using a short version of the Expectations Regarding Aging questionnaire, Health Promoting Lifestyle Profile II, and Medical Outcomes Study 12-item short form.
Findings.  Having a higher expectation about ageing was associated with better physical and mental health, after adjusting for age, gender and education. Expectations about ageing were partially mediated through the health-promoting behaviour that influenced physical and mental health.
Conclusion.  It may be necessary for nurses to make an effort to improve older people's expectations about ageing to help them achieve good health. Nursing interventions to improve these expectations need to be used in conjunction with an emphasis on older people's active involvement in health-promoting behaviour.     

Residential transitions from nursing homes for adults with cerebral palsy.

PURPOSE: The impact of moving out of nursing homes into community-based settings for adults with cerebral palsy was assessed by comparing the health and community functioning of movers and non-movers at time 1 and 3 years later at time 2. SUBJECTS: The sample included 83 non-movers and 28 movers age 30 years and older who initially were living in nursing homes. The majority of residents had severe to profound mental retardation. The movers transferred to 15 community-based settings between 1 and 3 years (mean of 2 years) prior to the time 2 assessment. Assessments of residents at baseline and at follow-up included health measures (health status, health limits, mobility limits, days hospitalized and depression) and community functioning measures (adaptive functioning, maladaptive behaviour, community inclusion, day programme hours and monthly wages). RESULTS: Findings indicated that movers showed benefits in terms of improved health and community functioning. For movers, health status, mobility limitations, and community inclusion improved, while there were no significant changes for non-movers. This research corroborates previous research on the effects of deinstitutionalization and expands its implications to a group with severe disabilities.     

Barriers to depression care for black older adults. Practice and policy implication

Late-life depression is a public health problem in the United States. Untreated, depression contributes to poorer health outcomes and increased mortality among older adults. Specifically, Black older adults are at higher risk for misdiagnosis, undertreatment, and more severe depressive symptomatology than other groups. Barriers to identification and treatment of depression in Black older adults include lack of access to quality mental health care, the stigma of mental illness, mistrust of mental health providers, and poor provider-client communication. Recommendations for gerontological nursing practice, education, and research to improve the care of depressed Black older adults are discussed. Implications for policy development are presented.     

Association of employment and working conditions with physical and mental health symptoms for people with fibromyalgia

Purpose: This study examines physical and mental health symptoms among people with fibromyalgia (FM) by employment status and working conditions. Method: Secondary data analysis of the 2007 National Fibromyalgia Association Questionnaire study resulted in employment and symptom information for 1702 people of working age with FM. In this cross-sectional internet study, six factors of symptom clusters (physical, mental health, sleeping, concentration, musculoskeletal, support) were seen in the data. Linear regression models used employment, age, income, gender, and education to predict symptom clusters. Among those employed, working conditions were also associated with symptom severity. Results: In the predominately female sample, 51% were working. Of these, 70% worked over 30 hours/week and half had flexible hours. Employment, higher income, and education were strongly associated with fewer symptoms. Working conditions, including level of physical and mental exertion required on the job as well as coworkers’ understanding of FM, were related to symptoms, particularly physical and mental health symptoms. Many participants reported modifying their work environment (66%) or changing occupations (33%) due to FM. Conclusions: Work modifications could allow more people with FM to remain employed and alleviate symptoms. Persons with FM should be counseled to consider what elements of their work may lead to symptom exacerbation.

Implications for Rehabilitation

• People with fibromyalgia (FM) are at increased risk for unemployment.

• People with FM who remain working experience benefits, including fewer physical and mental health symptoms, higher income, and more social support.

• To remain working, people with FM may require an altered work situation, such as flexible or reduced hours.

• Persons with FM should be counselled upon diagnosis to consider which elements of their work may lead to symptom exacerbation or problems with work productivity.

     

老年干部病房护理人员睡眠质量及相关因素调查

目的 了解长期在老年干部病房工作的护理人员睡眠情况及其影响因素,从而为改善护理人员的睡眠质量,缓解疲劳,促进健康,合理利用人力资源提供临床依据.方法 采用匹兹堡睡眠质量指数量表（pittsburgh sleep quality index,PSQI）及自制的睡眠问卷对我院老年干部病房339名工作两年以上临床护理人员进行调查,分析影响其睡眠质量及相关影响因素.结果有睡眠障碍的调查对象占56.63%;年龄大于40岁组是睡眠障碍的高发年龄段;导致睡眠障碍的相关因素主要为：精神压力、工作压力、轮班制工作、个人作息习惯和睡眠环境.结论 采取综合措施有效改善老年干部病房护理人员睡眠状况,是提高其健康状况的有效途径.