‘I've never given it a thought’: older men's experiences with and perceptions of ageism during interactions with physicians

2020 ◽  
pp. 1-22
Author(s):  
Hazel MacRae

Abstract The subjective experience of ageism among older men has received little research attention. This study examines older Canadian men's experiences with and perceptions of ageism during interactions with physicians. In-depth, face-to-face interviews were conducted with 21 men aged 55 years and over. The findings indicate a seeming lack of awareness of ageism among many, and many did not believe ageism was likely to occur during patient–physician interaction. Negative stereotyping of older patients was common. A large majority of the participants reported that they had not personally experienced ageism during a medical encounter, nor were they concerned about it. Numerous rationales were proffered as explanations of why a particular participant had not experienced ageism and who was more likely to be a target.

Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.


2019 ◽  
Author(s):  
Linda Wilhelmsen

Purpose For centuries, men have dominated football organizations in all levels, and the imbalance in status between male and female football is unparalleled in the world of sports. This may affect female football by means of career opportunities, resource allocation and organizational performance. This study will explore managerial, organizational and cultural parameters that have an impact on women’s career possibilities in football organizations as players, coaches and leaders. The following research questions will be explored: In what way do governing mechanisms such as culture, attitudes and values have an impact on female positions in football organizations? How do organizational structures and cultures in football organizations affect women's career opportunities? How do power mechanisms, gender roles and stereotypes, unbalanced resource access, commercial investment impact female versus male football? Methodology Data will be collected among female football organizations in the two top football leagues in Norway. Qualitative data will be collected by interviews, field notes from facilitated face-to-face meetings with World Café dialogue technique and participant evaluations, whereas quantitative data will be collected by surveys and registry data. Implications Female football has received very little research attention, and as such, findings from the present project will give provide novel insight regarding the impact of organizational performance for women’s opportunity for a career in football. Directing attention towards female participation in football organizations may increase participation and positions of trust within the organizations.    


1995 ◽  
Vol 20 (1) ◽  
pp. 5-7 ◽  
Author(s):  
D. A. CAMPBELL ◽  
P. A. MILLNER ◽  
C. R. DREGHORN

Primary bone tumours are rare in the hand and wrist. This 34-year survey of the Leeds Regional Bone Tumour Registry reveals 80 such tumours, representing 3.9% of the total number of bone turnouts in the registry. The large majority of these tumours were benign (86%), and were found predominantly in younger patients. Malignant lesions were found more frequently in older patients. 61% of tumours were found in the metacarpals and proximal phalanges. Two-thirds of patients (67.5%) presented with features of swelling, either with or without pain. We conclude that the information gathered from Bone Tumour Registries is of value in describing tumour characteristics, where such information could not be gathered by personal experience alone.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16510-e16510
Author(s):  
Elizabeth Riley Kessler ◽  
Thomas W. Flaig ◽  
Elaine Tat Lam ◽  
Kathryn M. Breaker ◽  
Michael Wacker ◽  
...  

e16510 Background: Alteration of the androgen axis through androgen deprivation therapy (ADT) is the mainstay of prostate cancer (PCa) treatment. Unfortunately, the resultant hypogonadal state has detrimental effects on muscle and bone and may impair physical function (PF). Older patients may be more vulnerable to PF changes while on ADT. We conducted a pilot study to evaluate the changes in PF and geriatric health in older men initiating ADT using tests easily employed in routine clinical practice. Methods: Men with PCa initiating ADT were enrolled and were assessed every 3 months (mos) for up to 12 mos. PF was measured using the short physical performance battery (SPPB) and geriatric health was screened using the Vulnerable Elders Survey (VES13) which predicts potential death or decline over 2 years. The primary endpoint was change in SPPB and VES13 at 3 mos. Results: We enrolled 17 patients with a median age of 75 years (range 67-85) beginning ADT therapy. Fourteen patients had metastasis, 2 had locally advanced disease, and 1 had biochemical recurrence. The majority had Gleason score (GS) 7 cancer (9/17), 7/17 GS 8-10, and 1/17 with GS 6. Eight patients had normal SPPB baseline scores and 9 had moderate impairment (moderate frailty risk) (Mean 10, SD 1.71). Seven had a clinically significant decline in the SPPB at 3 mos, with 1 patient testing as severely impaired. The VES13 screening tool identified 6/17 patients as vulnerable at baseline (Mean 3, SD 3.92). At 3 months, 3/17 patients had a decline in VES13 and 6/17 with an improvement. Of the 10 patients who were followed for at least 6 months, 5 had worsening of the VES13 and 2 had a worsening in SPPB. Conclusions: Older patients initiating ADT have baseline vulnerabilities in geriatric health with little immediate detriment after treatment initiation, perhaps due to overall health improvement with treatment initiation. Changes in PF, however, are seen within the first 3 months of ADT in nearly half of our patients, warranting further investigation into early rehabilitation of men even on short-term ADT. The SPPB is easily employed in clinic and important as reliance on VES13 alone is likely to miss patients with PF impairments.


2009 ◽  
Vol 27 (10) ◽  
pp. 1557-1563 ◽  
Author(s):  
William Dale ◽  
Joshua Hemmerich ◽  
Kathryn Bylow ◽  
Supriya Mohile ◽  
Mary Mullaney ◽  
...  

Purpose Androgen deprivation therapy (ADT) is first-line therapy for patients with prostate cancer (PCA) who experience biochemical recurrence (BCR). However, the optimal timing of ADT initiation is uncertain, and earlier ADT initiation can cause toxicities that lower quality of life (QOL). We tested the hypothesis that elevated cancer anxiety leads to earlier ADT initiation for BCR in older men. Patients and Methods We conducted a prospective cohort study of older patients with BCR of PCA (n = 67). Patients completed questionnaires at presentation and each follow-up visit until initiation of ADT. PCA-specific anxiety was measured with the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). Other collected data included demographics, clinical information, and general anxiety information. Treating oncologists were surveyed about their recommendations for ADT initiation. The primary outcome was the time to ADT initiation. Univariate, multivariate logistic regression, and time-to-event analyses were conducted to evaluate whether cancer anxiety was a predictor of earlier initiation of ADT. Results Thirty-three percent of patients initiated ADT at the first or second clinic visit. Elevated PCA anxiety (MAX-PC > 16) was the most robust predictor in multivariate analyses of early initiation (odds ratio [OR], 9.19; P = .01). PSA also independently correlated with early initiation (OR, 1.31; P = .01). PSA did not correlate with MAX-PC. Conclusion Cancer anxiety independently and robustly predicts earlier ADT initiation in older men with BCR. For older patients with PCA, earlier ADT initiation may not change life expectancy and can negatively impact QOL. PCA-specific anxiety is a potential target for a decision-making intervention in this setting.


2021 ◽  
Author(s):  
◽  
Rebekah Smith

<p>Loneliness is widespread – 31 percent of New Zealanders reported being lonely a little, some, most, or all of the time in 2012, which equates to approximately 1.3 million New Zealanders. Loneliness is firstly an individual problem associated with corrosive health outcomes such as depression, and suicide. It is also a social problem because of the way social exclusion inhibits community wellbeing.  Loneliness is a reflection of both an objective condition and a subjective condition. The former reflects measures of the number and depth of social contact, and the later captures how people feel and judge their own level of loneliness. Typically, loneliness as a condition is ‘being alone and not liking it’.  The majority of research attention, both internationally, as well as in New Zealand, has been paid to loneliness among the old. What my thesis shows is that loneliness is not confined to a particular age group but widespread across all ages, and is in fact highest among the young and declines with age. Therefore, studies of loneliness are most appropriately based on population-wide surveys so that its prevalence across all age and socio-economic groups can be addressed. At the same time, particular attention now needs to be paid to the young. For this reason I apply statistical models of loneliness to two separate data sets: the 2012 New Zealand General Social Survey, and a sample of youth in Wellington, Taranaki and Auckland as provided by the 2006 Youth Connectedness Project.  My analysis of these two samples focuses on the relationship between objective measures of social connection and the subjective expression of loneliness itself. I show that while loneliness decreases with the level of social connection, it is also subject to considerable variation across a range of covariates. These include, most importantly, age, gender, socioeconomic status and health.  Connectivity also has a number of geographical properties which render this topic of interest to the human geographer. Among these are proximity – the readily availability of family and friends for regular face-to-face contact, as well as the ability to easily access and contribute to the local community. These are matters of geographic context which is addressed in several ways, including through a GIS analysis.  My primary finding has to do with the cumulative nature of connectedness. Over and above the separate effect of having a partner, local family, and friends, is the importance of their combined and cumulative effect in reducing loneliness, a feature which reinforces the importance of the concept of community.  I find that the young, females, migrants, the poor, and people in poor health are more likely to be lonely, particularly when these attributes combine. In terms of geographical context, residents of main urban areas, and in lower socioeconomic areas show a higher likelihood of being lonely in both datasets. However GIS results for the City of Wellington show that lonely youth show no evidence of spatially clustering in ways that would imply social exclusion in a geographic sense.  My analysis takes place against a backdrop of widespread concern about social connection in general, about the growing role of non-face-to-face communication among the young, about the dislocating effects of marital instability, and the supporting role of families both for the young and the old. None of my results dispel these concerns. What my results suggest is the need for a focused attention on the nature of social connections in particular contexts, and the way they evolve over time.</p>


2021 ◽  
Author(s):  
◽  
Rebekah Smith

<p>Loneliness is widespread – 31 percent of New Zealanders reported being lonely a little, some, most, or all of the time in 2012, which equates to approximately 1.3 million New Zealanders. Loneliness is firstly an individual problem associated with corrosive health outcomes such as depression, and suicide. It is also a social problem because of the way social exclusion inhibits community wellbeing.  Loneliness is a reflection of both an objective condition and a subjective condition. The former reflects measures of the number and depth of social contact, and the later captures how people feel and judge their own level of loneliness. Typically, loneliness as a condition is ‘being alone and not liking it’.  The majority of research attention, both internationally, as well as in New Zealand, has been paid to loneliness among the old. What my thesis shows is that loneliness is not confined to a particular age group but widespread across all ages, and is in fact highest among the young and declines with age. Therefore, studies of loneliness are most appropriately based on population-wide surveys so that its prevalence across all age and socio-economic groups can be addressed. At the same time, particular attention now needs to be paid to the young. For this reason I apply statistical models of loneliness to two separate data sets: the 2012 New Zealand General Social Survey, and a sample of youth in Wellington, Taranaki and Auckland as provided by the 2006 Youth Connectedness Project.  My analysis of these two samples focuses on the relationship between objective measures of social connection and the subjective expression of loneliness itself. I show that while loneliness decreases with the level of social connection, it is also subject to considerable variation across a range of covariates. These include, most importantly, age, gender, socioeconomic status and health.  Connectivity also has a number of geographical properties which render this topic of interest to the human geographer. Among these are proximity – the readily availability of family and friends for regular face-to-face contact, as well as the ability to easily access and contribute to the local community. These are matters of geographic context which is addressed in several ways, including through a GIS analysis.  My primary finding has to do with the cumulative nature of connectedness. Over and above the separate effect of having a partner, local family, and friends, is the importance of their combined and cumulative effect in reducing loneliness, a feature which reinforces the importance of the concept of community.  I find that the young, females, migrants, the poor, and people in poor health are more likely to be lonely, particularly when these attributes combine. In terms of geographical context, residents of main urban areas, and in lower socioeconomic areas show a higher likelihood of being lonely in both datasets. However GIS results for the City of Wellington show that lonely youth show no evidence of spatially clustering in ways that would imply social exclusion in a geographic sense.  My analysis takes place against a backdrop of widespread concern about social connection in general, about the growing role of non-face-to-face communication among the young, about the dislocating effects of marital instability, and the supporting role of families both for the young and the old. None of my results dispel these concerns. What my results suggest is the need for a focused attention on the nature of social connections in particular contexts, and the way they evolve over time.</p>


Rheumatology ◽  
2020 ◽  
Vol 60 (1) ◽  
pp. 366-370 ◽  
Author(s):  
Lorenzo Cavagna ◽  
Giovanni Zanframundo ◽  
Veronica Codullo ◽  
Maria Grazia Pisu ◽  
Roberto Caporali ◽  
...  

Abstract Objectives The SARS-CoV-2 outbreak has imposed considerable restrictions on people’s mobility, which affects the referral of chronically ill patients to health care structures. The emerging need for alternative ways to follow these patients up is leading to a wide adoption of telemedicine. We aimed to evaluate the feasibility of this approach for our cohort of patients with CTDs, investigating their attitude to adopting telemedicine, even after the pandemic. Methods We conducted a telephonic survey among consecutive patients referred to our CTD outpatients’ clinic, evaluating their capability and propensity for adopting telemedicine and whether they would prefer it over face-to-face evaluation. Demographical and occupational factors were also collected, and their influence on the answers has been evaluated by a multivariate analysis. Results A total of 175 patients answered our survey (M/F = 28/147), with a median age of 62.5 years [interquartile range (IQR) 53–73]. About 80% of patients owned a device allowing video-calls, and 86% would be able to perform a tele-visit, either alone (50%) or with the help of a relative (36%). Telemedicine was considered acceptable by 78% of patients and 61% would prefer it. Distance from the hospital and patient’s educational level were the strongest predictive factors for the acceptance of telemedicine (P &lt; 0.05), whereas age only affected the mastering of required skills (P &lt; 0.001). Conclusion Telemedicine is a viable approach to be considered for routine follow-up of chronic patients, even beyond the pandemic. Our data showed that older patients would be willing to use this approach, although a proper guide for them would be required.


Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 74
Author(s):  
Mette Merete Pedersen ◽  
Rasmus Brødsgaard ◽  
Per Nilsen ◽  
Jeanette Wassar Kirk

The aim of this study was to identify the most common barriers and facilitators physicians perceive regarding their role in the promotion of mobility in older adults hospitalized for medical illness as part of on an intervention to promote mobility. Twelve physicians at two medical departments were interviewed face-to-face using semi-structed interviews based on the Theoretical Domains Framework. The physicians’ perceived barriers to promoting mobility were: the patients being too ill, the department’s interior does not fit with mobility, a culture of bedrest, mobility not being part their job, lack of time and resources and unwillingness to accept an extra workload. The facilitators for encouraging mobility were enhanced cross-professional cooperation focusing on mobility, physician encouragement of mobility and patient independence in e.g., picking up beverages and clothes. The identified barriers and facilitators reflected both individual and social influences on physicians’ behaviors to achieve increased mobility in hospitalized older medical patients and suggest that targeting multiple levels is necessary to influence physicians’ propensity to promote mobility.


2020 ◽  
Vol 22 (3) ◽  
pp. 153-163
Author(s):  
David N. Eades

Purpose This paper aims to explore the impact of stressors and the strategies staff use to cope with these at a detention facility. It documents through case studies some of the triggers of trauma, possible coping mechanisms that might assist in navigating the associated stressors in a workplace and recommendations as to what might assist staff. Design/methodology/approach A naturalist approach was used in this research, using an ethnographic qualitative methodology. Grounded theory assisted in the analysis of the data to capture naturalistically the subjective experience of the participants of the study. Conversations occurred with staff who had worked in a detention facility using face to face semi-structured interviews. The structure was open-ended to allow the staff to discuss and share their experiences freely. Findings Stressors that impacted staff working in a detention facility resulted from areas such as heightened reactions from detainees because of the length of their detainment, detainee self-harm, dealing with the effects of an increase of substance abuse through detainees obtaining contraband and the associated violent reactions that can occur as a result. Adverse symptoms noted within the lives of staff included acute anxiety, sleeplessness, depression and tension within impersonal relationships, including family. What compounded the issue was staffs’ reluctance to talk about work stressors. Research limitations/implications The research used nine participants for case studies of staff who had formerly experienced various adverse impacts of stressors. This is not a comprehensive study, however, of the broader experiences of staff at an Australian detention facility. It does provide, however, a snapshot of the experiences of a small group who had significantly been impacted by the stressors of the workplace. Practical implications This paper provides fresh perspectives or initiatives that are needed to assist staff to navigate the changing environment of working in a detention facility. In particular, some support mechanisms and protective factors that could be put in place to curb the negative impact of stressors in the workplace and to mitigate against long term stress disorders developing in the personal lives of staff. Social implications Many staff are not getting the help they need to cope with the emotional distress they experience in their workplace. However, there are practical interventions to support staff in managing the stressors they face. These will be outlined in this article. Originality/value This study was carried out with the goal of giving staff a voice and to capture their former experiences in their vocational responsibilities in a venue that has had very limited research attention. This study has presented the challenges staff faced in a unique venue of working in a detention facility. It has documented some of the common stressors staff faced, the impact of such and some coping mechanisms used to handle them.


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