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1.
ABSTRACT

Complementary and alternative medicine (CAM) includes a wide variety of treatments including modalities that are ingestible (e.g., vitamins/minerals), mind/body (e.g., yoga), and physical (e.g., acupuncture). Disclosure of CAM to medical care providers is important for avoiding potential health risks. The aim of the study was to elucidate reasons for CAM nondisclosure to physicians among a population of older adults. A sequential exploratory mixed-methods design utilizing quantitative questionnaires and qualitative interviews was employed. Linear regression was performed to evaluate variables that may contribute to disclosure. Ninety older patients from two primary care clinics – including 12 who completed qualitative interviews were included in this study. Participants were significantly less likely to disclose ingestible types of CAM compared to physical (p < .01) and mind/body modalities (p < .03). Linear regression resulted in a model that explained 25% of the variance in disclosure of ingestible forms of CAM; age, doctor’s opinion of CAM, and participants’ with less concern of their health were significantly related to disclosing CAM use. Qualitative interviews suggested that individuals over 70 years of age with longer lasting chronic conditions were less likely to disclose CAM as compared with those aged 65–69 who tended to use CAM for episodic and preventative care. Rates of CAM disclosure among older adults may be dependent on the participant’s age, their experience with health, and expectations surrounding communication with their physician. Understanding patterns of CAM use can help guide age-appropriate conversations and limit possible adverse outcomes from non-disclosure.  相似文献   

2.
Adults aged 60 or older are more likely than younger adults to experience severe complications or even death as a result of foodborne infections. This study investigated which specific groups of healthcare providers or other caregivers are most receptive to providing food safety information to older adults. Telephone-based focus groups were conducted with health care providers and caregivers to determine their knowledge, attitudes, and behaviors regarding foodborne illness prevention for older adults. Focus groups identified a gap between older adults’ trust in healthcare providers as a credible source of food safety information and healthcare providers’ lack of training, knowledge, and willingness to provide food safety information to older adults.  相似文献   

3.
ABSTRACT

The purpose of this study was to assess the HEARTS (Health, Experience of Abuse, Resilience, Technology use, and Safety) of older adults (OAs). More particularly, we aimed to assess three components of the HEARTS (health, experience of abuse, and resilience) of OAs and explore the relationships among health, resilience, the experience of abuse, and other demographic variables. Forty-two male and female OAs in Pittsburgh, Pennsylvania, USA participated in the study. A correlational design was used in this study. The variables correlated were health, the experience of abuse, and the resilience of OAs. We used a community-engaged research approach in that participants were more than research volunteers but stakeholders in the research project. Findings showed that the means for more positive health features (physical function, and social roles) increased with increases in education, while more negative health features (anxiety, depression, fatigue, sleep disturbance, pain interference, and pain intensity) decreased with higher levels of education. Regression models indicated that above and beyond demographic features, resilience had a significant prediction of anxiety and depression. None of the other health outcomes were significantly predicted by either resilience or older adults’ abuse suspicion.

Adding health to years in older adults is a collaborative effort with healthcare providers, healthcare systems, families, and communities. This study has identified three components of HEARTS (Health, Experience of Abuse, and Resilience) that blend with successful aging and provide data and possible prevention and intervention strategies, and family and community education programs that could add health to years in older adults.  相似文献   

4.
The primary purpose of the present study was to investigate age differences in goal concordance, time use, and Well-Being. Past research has found that despite age-related decline in life circumstances (e.g., health), the Well-Being of older adults is as high as young adults. The present study used a novel approach to explore the Paradox of Well-Being. One hundred and seventy-seven adults participated in the study. They first generated their three most important personal strivings and rated levels of goal concordance for external, introjected, identified, and intrinsic reasons. Then, they reported their actual and ideal time use in 10 categories of activities in the past 24 hours. Finally, Well-Being was assessed by the Flourishing Scale and the Scale of Positive and Negative Experience (Diener, Wirtz, et al., 2010). Older adults did not differ from young adults in overall Well-Being. However, they held higher levels of goal concordance and were more likely to spend time in spirituality and religion-related activities than young adults. The relationships between goal concordance, time use, and Well-Being were examined separately for young and older adults. Implications were discussed to improve Well-Being for young and older adults.  相似文献   

5.
This study explored Korean older adults’ concerns and preferences regarding end-of-life care and the expected role of physicians in the decision making process. The purpose was to assist health care professionals, in particular, physicians, to better understand how to interact with Korean older adults. A qualitative method using in-person interviews was conducted with Korean older adults (N = 54). The seven main themes generated in this study included the following: (a) life-sustaining treatments and hope for quality of life; (b) physician expert status; (c) truth telling and ethics; (d) preferred way to disclose bad news; (e) physician's role to treat, (f) potential misuse of life-sustaining treatments; and (g) priority of patients’ preferences. Overall, study participants generally anticipated a larger role for physicians in their own end-of-life decision making, though some expressed concerns about the outcome of giving such power to physicians, especially in agreeing to life-sustaining treatments. Although culture provides one important clue about expectations, it is always crucial for health care providers to ask about individual preferences and to develop an open communication style to decrease distress. Our findings highlight the importance of understanding concerns and preferences regarding end-of-life care among Korean older adults and the importance of assisting them in planning end-of-life care within a cultural framework.  相似文献   

6.
This paper provides insight into the reasons underlying medical students' interest in geriatrics. Semi-structured interviews, informed by attitude theory, were conducted with first-year medical students who indicated that they were not interested in geriatric medicine (n = 10) and those who indicated that they were moderately to very interested in geriatrics (n = 10). The interviews were analyzed qualitatively. While most students in both groups did not plan on pursuing geriatric medicine, differences were found between the two groups. Students who expressed an interest in geriatrics had more positive and negative experiences with older adults, were more comfortable with palliative care, did not view their patients as responsible for their illnesses, and held more fears about aging and death than did those students who were not interested in geriatrics. The discussion of the results focuses on the role of experience in students' interest in geriatrics, and their beliefs about personal gain and loss and the field of medicine in general. Implications for educators, including the need to increase exposure to older patients and geriatric medicine for all students, are discussed.  相似文献   

7.
The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather than buffering the negative effect of low health literacy, social support has a more positive impact on physical health in older adults with high health literacy. Implications for improving the health status of older adults through health literacy and social support are discussed.  相似文献   

8.
ABSTRACT

Health literacy skills are known to be a key mediator of the relationship between education and health in the general population. However, one aspect of health literacy skills—individuals’ actual literacy activities—remains understudied, especially among older adults. Health disparities that are driven by inequalities in education and level of health literacy skills are particularly problematic for older adults since they are exacerbated in old age by disadvantages that accumulate over the life course. This study examined a nationally representative sample of US adults age 50 years and older (n = 2,573) using data from the 2014 Program for International Assessment of Adult Competencies (PIAAC). Parallel mediation analysis was conducted to examine the partial mediation effects of health literacy skills and literacy activity (i.e., reading at home) on the relationship between education and health. Results showed that both health literacy skills and literacy activity mediated the education–health relationship. On average, literacy skills mediated 31.89% and literacy activities mediated 9.59% of the effect of education of self-rated health. Literacy activity, such as reading, is an easily accessible, autonomous, and sustainable option for promoting health in later life. Policies that support the intersection of public health and education may promote lifelong learning and well-being among US adults.  相似文献   

9.
ABSTRACT

Effective strategies that bring health promotion messages to older adults in a developing country are needed. To evaluate the impact of various education media upon changes in knowledge and health behavior, a double-blind, randomized controlled trial was conducted involving 1,268 older adults in a southwest Bangkok suburb. Group teaching supplemented by a video program was provided in the communities. A simplified booklet and an audiotape containing the same health education information as in the videotape were given to the older adults for self-study. Health knowledge was assessed before the health education program. Identical assessment was performed again 3 months after the intervention. The quadriceps exercise and Cawthorne-Cooksey head-and-neck-balance exercise—representing changes in health promotion behavior—were also evaluated. Those who attended the group-teaching program had higher test scores than the control group. Only those who both read the booklet and listened to the audiotape in the intervention group gained more knowledge than the control group. The combination of group teaching supplemented by the video program and self-study using the booklet and audiotape was effective in improving health knowledge and behavior.  相似文献   

10.
Several studies have found that older women report lower self-rated health than men. However, it is not clear why older women are more likely to report poor self-rated health than older men. Data for this study came from a national cross-sectional survey, Mental Health and Quality of Life of Older Malaysians (MHQoLOM). Included in the survey were 2980 respondents consisting of Malaysians aged 60 years and over, with both men (n = 1428) and women (n = 1552) represented. Results of t-tests showed older men expressed significantly higher levels of self-rated health and self-esteem than women (p < .01). Separate multivariate regression by gender revealed that age, life-threatening problems, and self-esteem were highly significant predictors of self-rated health among older men and women and explained 18.4% of variance in self-rated health for men and 18.2% for women. In the last step we examined the main effects of gender on self-rated health using General Linear Models (GLM) Univariate by adjusting for age, life-threatening problems, and self-esteem. Results showed an insignificant difference in self-rated health between older men and women (F (1,2715) = 2.26, P = 0.13) only after adjusting for self-esteem. It can be concluded that self-esteem affects responses to self-rated health of older men and women.  相似文献   

11.
To effectively address medication adherence and improve cardiovascular health among older adults, a deeper understanding is needed of the barriers that this age group faces and of approaches that would be most effective and feasible for improving adherence. We conducted a focus group study (n = 25) in a diverse population of older adults with hypertension recruited from the Cohort Study of Medication Adherence in Older Adults (CoSMO). A structured guide was used to collect feedback on barriers to adherence and acceptability and the feasibility of intervention strategies. The final coding framework outlines factors at the individual, relationship, health care system, and environmental or policy level that affect adherence in older adults. These include memory, knowledge, attitudes and beliefs, side effects, social support, interaction with healthcare providers, and cost and convenience of medication filling. Patient responses highlighted the varied nature of barriers and the need for interventions that are both multifaceted and tailored.  相似文献   

12.
The primary purpose of the present study was to examine age differences in choice deferral when young and older adults make high vs. low conflict decisions in two domains (i.e., health and commodity). Sixty young and 60 older adults were presented with four different decision scenarios in which they could either choose an option or use choice deferral (i.e., not choose any of the options for the time being). The high conflict decisions had negative interattribute correlations, while the low conflict decisions had positive interattribute correlations. Older adults were more likely than young adults to choose the deferral option across domains. Participants were more likely to choose the deferral option when making high conflict decisions than when making low conflict decisions. For older adults, an increase in postdecision positive affect was greater for those who deferred choice than for those who did not defer choice in the commodity domain. Implications were discussed in terms of real-life decision making of older adults.  相似文献   

13.
This paper examines the preferred sexuality education sources of older Australian adults in later life. Drawing on findings from qualitative interviews with 30 men and 23 women aged 60 years and older, we consider the sources that participants currently use, or would like to use, in seeking information about sex. Where relevant, we examine participants’ experiences of learning about sex in later life using different sources, and the impact these had on their sexual expression, pleasure and well-being. Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices. As such, learning about sex should be viewed as a lifelong endeavour. Our findings carry important implications for the development and delivery of sexuality education for older adults.  相似文献   

14.
Many older adults do not use health information available on the Internet. Older adults residing in affordable housing were taught to use the NIHSeniorHealth.gov Web site. Participants were predominantly African American women with limited education and income (N = 42). Outcomes included changes in computer and health Web site navigation skills. Results showed significant improvements for all demographic groups in both computer and Web site navigation (p < .001). Older minority adults with no prior computer experience were willing and able to learn to use health Web sites. Success factors included an instructor familiar with the community, peer training assistants, and a focus on new learner needs.  相似文献   

15.
Sexually transmitted infections (STIs) have risen among older people in Australia and other countries. To guide future initiatives, we examined sources of information that older people use or are willing to use for knowledge about safer sex and STIs, including whether there are any gender differences. A total of 2137 Australian adults aged 60+ years completed a nationwide survey. Analyses focused on participants who were at risk of an STI (n = 686; 220 women and 466 men). Overall, information-seeking on STIs in the last year was low (18% men; 15% women). When sought, common sources included general media outlets (e.g., magazines, TV), healthcare providers (HCPs), and the Internet. HCPs were the most relied upon source among both women and men. Brochures, websites, and HCPs were rated highest as future sources; however, women indicated they were more willing than men to have information provided by brochures and websites. STI information-seeking was generally low, but there was willingness among both men and women to use a range of sources for gaining future information.  相似文献   

16.
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17.
This study examined the associations of educational level with functioning and life satisfaction among community-dwelling older adults in South Korea (n = 4,152). The sample was drawn from Wave I of the Korean Longitudinal Study on Aging. To examine educational disparities, separate analyses were run to note predictors in less educated (below the 6th grade) and better educated (above the 6th grade) respondents. Educational disparities were found in major predictors of health and well-being. Older age and lower cognition were strong predictors of functional limitations, while being married, receiving public assistance, and better psychological functioning were associated with greater life satisfaction. The health and well-being of less educated respondents were influenced by demographic factors, while social engagement and psychological functioning were more prominent predictors for better educated respondents. These findings highlight the importance of enhancing cognitive functioning and function among older adults in Korea to promote their health and well-being.  相似文献   

18.
Later life learning (LLL) has a profound beneficial effect on older adults; therefore, it is important to assess older adults' learning needs. A representative random sample of 1,867 soon-to-be older adults (between 45 and 59 years of age) were assessed for their interest in formal learning after their retirement or when they become 60 years old. We examined their preferences for courses and identified the socioeconomic and health-related characteristics related to their planned participation in formal LLL. About 38% of these respondents expressed an interest in formal learning after retirement; the most popular three content courses included computers, interest classes, and physical exercise. Those who did not plan to commit themselves to formal LLL indicated "no interest" and "lack of time" as the most frequently reported reasons for not wanting to participate in LLL. Moreover, we found that LLL was positively related to socioeconomic indicators including education, income, and retirement protection; whereas those who received financial support from adult children or from the government (in the form of welfare) were less likely to express interest in formal LLL.  相似文献   

19.
A national data base was employed for the first time to examine in detail the educational participation behavior of adults 60 years and older. Participation rates, subjects studied, reasons for participation, and locations utilized for learning were found to vary significantly in relation to relative age, educational attainment, sex, race, income, and other participant characteristics. The “old old” and the socioeconomically disadvantaged were much less likely than other older adults to continue their education. What they studied, why, and where contrasted markedly not only with the patterns for adults in general but also with the patterns for other older adults. It is concluded that conventional programming approaches are inadequate for reaching older adults generally, and are particularly inadequate for reaching the old‐old and the socioeconomically disadvantaged.  相似文献   

20.
As the private education sector grows across the globe, private providers by extension are becoming significant employers of teachers. In India, more than 3 million teachers are employed in the private sector, contributing to meeting the rapidly expanding educational demands and learning needs of children. Teacher working conditions are crucial to ensure teacher retention and success within the education system. We use the 2011–2012, nationally representative employment data from India, to investigate private teacher working conditions. We conduct a series of regression analysis to account for the differences in demographic attributes of public and private teachers, differences in rural and urban growth of private schools and cross-state variations. We find that, compared to public school teachers, private school teachers experience less favorable monetary and non-monetary working conditions including less access to paid leaves, pension and health care. They also experience lower job security in terms of the existence of a contract and the length of contract period. Private school teachers also have a lower access to teacher unions and thus weaker collective bargaining to negotiate their working conditions. Private teachers are more frequently likely to seek additional work and alternate work. Some noteworthy differences in teacher demographics in rural and urban areas (urban teachers are more likely to be female, somewhat older, and more educated) notwithstanding, these patterns of public-private teacher working conditions are consistent across rural and urban location. We conclude with reflections on potential explanations for these results and suggest steps for future research.  相似文献   

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