Physician Service Use by Older Adults in New Zealand

1999 ◽  
Vol 5 (2) ◽  
pp. 126-135
Author(s):  
Michelle A. Millar ◽  
Ross A. Flett ◽  
Nikolaos Kazantzis ◽  
Nigel R. Long ◽  
Carol MacDonald
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Service Use ◽  
Behavioral Model ◽  
Structured Interview ◽  
Hierarchical Regression ◽  
Physician Service ◽  
Physician Services ◽  
Cross Sectional ◽  
Use Of Services

The paper presents data on the use of physician services by 354 older adults in New Zealand. Utilization of physician services and predisposing factors were ascertained by structured interview in a cross-sectional sample of men (n = 155) and women (n = 199) aged 60 years or over. Interview responses were used to test the hypothesis that a combination of predisposing, enabling, and need characteristics are better predictors of physician service use, than need characteristics alone. Hierarchical regression results predicting the use of medical services support our hypothesis, underscoring the importance of need and enabling characteristics for service use. Research applying the behavioral model to the use of services among older adults could be enriched by the inclusion of enabling and predisposing characteristics.

Sense of clubhouse community belonging and empowerment

2018 ◽  
Vol 64 (3) ◽  
pp. 276-285 ◽  
Author(s):  
Kimiko Tanaka ◽  
Larry Davidson ◽  
Thomas J Craig
Keyword(s):  
Mental Health ◽  
Sense Of Community ◽  
Secondary Analysis ◽  
The United States ◽  
Structured Interview ◽  
Self Report ◽  
Hierarchical Regression ◽  
Future Research ◽  
Cross Sectional ◽  
Community Belonging

Background: While the neighborhood community literature well documents a link between participation in supportive and effective community groups or activities and empowerment, there is as yet little empirical evidence of this relationship in the context of community mental health programs. Aim: The primary purpose of the study was to examine the relationship between sense of community belonging and empowerment among members of mental health clubhouses. Methods: A secondary analysis using a hierarchical regression model was conducted on cross-sectional structured interview data collected through a self-report questionnaire from 102 clubhouse members from six clubhouses in the United States and Finland. Results: The results indicated that members’ sense of clubhouse community belonging positively contributes to their empowerment. Conclusion: Fostering sense of community belonging appears to be a valid approach to catalyze empowerment. Study limitations and future research agendas were discussed.

Bridging community and prison for older adults: invoking human rights and elder and intergenerational family justice

2014 ◽  
Vol 10 (1) ◽  
pp. 55-73 ◽  
Author(s):  
Tina Maschi ◽  
Deborah Viola ◽  
Mary T. Harrison ◽  
William Harrison ◽  
Lindsay Koskinen ◽  
...  
Keyword(s):  
Older Adults ◽  
Human Rights ◽  
Service Use ◽  
Family System ◽  
Prison Population ◽  
Interdisciplinary Approach ◽  
Well Being ◽  
Care Needs ◽  
Cross Sectional ◽  
Content Type

Purpose – Older adults in prison present a significant health and human rights challenge for the criminal justice system. To date, there is no known study that provides a comprehensive examination or portrait of older persons in prison. The purpose of this paper is to understand individual, family, system, and community vulnerabilities that can complicate successful community reintegration for these individuals. Design/methodology/approach – This study provides a cross-sectional, descriptive analysis of biopsychosocial, spiritual, and prison use characteristics associated with a sample of 677 older prisoners, aged 50+, in a state-wide prison system. Findings – Results indicate the extent of diversity within this population based on demographic, clinical, social, legal profiles, prison service use patterns, and professional and personal contacts. Research limitations/implications – Due to the diversity within this population, an interdisciplinary approach is needed to address the complex social and health care needs of an aging prison population and to plan for their reentry. Practical implications – These findings suggest the need for holistic prevention, assessment, and interventions to interrupt the social-structural disparities that foster and support pathways to incarceration and recidivism. Originality/value – The human rights implications for the current treatment of older adults in prison include providing in-prison treatment that promotes safety, well-being, reconciliation, and seamless bridges between prison and community for older adults and their families. The True Grit Program is presented as an example of a humanistic and holistic approach of such an approach.

scholarly journals Associations between dietary patterns and metabolic syndrome in older adults in New Zealand: the REACH study

2021 ◽  
pp. 1-30
Author(s):  
Karen D. Mumme ◽  
Cathryn A. Conlon ◽  
Pamela R. von Hurst ◽  
Beatrix Jones ◽  
Jamie V. de Seymour ◽  
...  
Keyword(s):  
Older Adults ◽  
Metabolic Syndrome ◽  
New Zealand ◽  
Dietary Patterns ◽  
Principal Component ◽  
Cross Sectional Study ◽  
Processed Meat ◽  
Cross Sectional ◽  
Multiple Deprivation ◽  
Index Of Multiple Deprivation

Abstract Metabolic syndrome is common in older adults and may be modified by the diet. The aim of this study was to examine associations between a posteriori dietary patterns and metabolic syndrome in an older New Zealand population. The REACH study (Researching Eating, Activity, and Cognitive Health) included 366 participants (65-74 years, 36% male) living independently in Auckland, New Zealand. Dietary data were collected using a 109-item food frequency questionnaire with demonstrated validity and reproducibility for assessing dietary patterns using principal component analysis. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III. Associations between dietary patterns and metabolic syndrome, adjusted for age, sex, index of multiple deprivation, physical activity, and energy intake were analysed using logistic regression analysis. Three dietary patterns explained 18% of dietary intake variation – ‘Mediterranean style’ (salad/leafy cruciferous/other vegetables, avocados/olives, alliums, nuts/seeds, shellfish and white/oily fish, berries), ‘prudent’ (dried/fresh/frozen legumes, soy-based foods, whole grains, carrots), and ‘Western’ (processed meat/fish, sauces/condiments, cakes/biscuits/puddings, meat pies/hot chips). No associations were seen between ‘Mediterranean style’ [OR=0.75 (95% CI 0.53, 1.06), P=0.11] or ‘prudent’ [OR=1.17 (95% CI 0.83, 1.59), P=0.35] patterns and metabolic syndrome after co-variate adjustment. The ‘Western’ pattern was positively associated with metabolic syndrome [OR=1.67 (95% CI 1.08, 2.63), P=0.02]. There was also a small association between an index of multiple deprivation [OR=1.04 (95% CI 1.02, 1.06), P<0.001] and metabolic syndrome. This cross-sectional study provides further support for a Western dietary pattern being a risk factor for metabolic syndrome in an older population.

scholarly journals Nutritional Care for older adults in Primary Health Care, from the perspective of health professionals

2020 ◽  
Vol 23 (6) ◽  
Author(s):  
Carolina Lou de Melo ◽  
Maria Angélica Tavares de Medeiros
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Healthy Aging ◽  
Structured Interview ◽  
Cross Sectional ◽  
Nutritional Care ◽  
Primary Health ◽  
Theoretical Saturation

Abstract Objective: to characterize and analyze Nutritional Care (NC) for older adults in Primary Health Care (PHC), identifying how food and nutrition actions (F&N) were performed and the conceptions that guided them. Methods: a cross-sectional, quantitative and qualitative study was performed in PHC in Santos, São Paulo, Brazil, in two phases: i) a census study was carried out of health units, N=28 (100%), with managers who answered a structured interview to assess NC; followed by descriptive analysis. ii) a deeper investigation of this diagnosis was performed, using semi-structured interviews with key informants (interviewees) of care for older adults; being a nutritionist was not a criteria, as there were only three such professionals throughout the entire PHC, and one of the health regions studied was not served by a nutrition professional. The concept of theoretical saturation was used for the sampling plan; content analysis was carried out and the inferences were supported by references of integrality and aging. Results: NC for older adults was highlighted by individual care, predominant in all the services studied (28) (100%); nutritionists participated in this activity in just nine units (32.1%). Theoretical saturation was achieved with nine interviews. According to the discourse analysis, F&N actions were generic, focused on the treatment of diseases, influenced by negative aspects attributed to aging, there was no planning based on the needs of the territory, and health professionals identified themselves as information transmitters, leaving the responsibility of acting on such information to the older adults themselves. Conclusion: F&N actions were guided by the biomedical paradigm, fragmented, restricted to disease management, imputing the responsibility for health to the individual themselves. Thus, NC distanced itself from the promotion of healthy aging, weakening its strategic role in the quest for integrated care.

Health anxiety among older people: an exploratory study of health anxiety and safety behaviors in a cohort of older adults in New Zealand

2010 ◽  
Vol 22 (4) ◽  
pp. 549-558 ◽  
Author(s):  
Ann F. Boston ◽  
Paul L. Merrick
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Older People ◽  
Exploratory Study ◽  
Health Anxiety ◽  
Behavioral Model ◽  
Medical Utilization ◽  
Cognitive Behavioral ◽  
Safety Behaviors ◽  
Cognitive Behavioral Model

ABSTRACTBackground: Despite a stereotype that characterizes older people as excessively anxious about their health, there is little research into this phenomenon. The present exploratory study examined: (a) whether a cohort of older adults was unduly health anxious, (b) which demographic and health factors predicted health anxiety (HA), and (c) whether an aspect of the cognitive behavioral model of HA was applicable to older adults by investigating the relationship between HA and safety behaviors.Method: Participants were a convenience sample of adults aged over 65 and living independently in Auckland, New Zealand. Participants (104 women and 41 men) completed an anonymous self-report questionnaire measuring demographic factors, physical health and function, health anxiety, safety behaviors, and medical utilization.Results: This cohort of adults over 65 were not unduly health anxious. Occurrence of severe HA was similar to that found in younger populations. Decreased physical function and lower education predicted scores on the HA measure. Consistent with the cognitive behavioral model, HA was a unique significant predictor of safety behaviors. HA and decreased physical function predicted medical utilization.Conclusions: Generally low levels of HA among this cohort of older individuals challenged the pervasive stereotype of the “hypochondriacal” older person. Factors contributing to HA were similar to those reported in studies with younger cohorts. Findings provided preliminary support for the applicability of the cognitive behavioral model of HA to adults over 65. Implications of the findings and directions for future research were discussed.

scholarly journals Fall risk among older adults residing in Bharatpur, Chitwan, Nepal

2020 ◽  
Vol 10 (3) ◽  
pp. 12-15
Author(s):  
Jogmaya Limbu ◽  
Sunita Poudyal
Keyword(s):  
Older Adults ◽  
Older People ◽  
Fall Risk ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Risk Of Falls

Background: Falls in older people is a common serious health problem that has profound im­pact on overall health and quality of life of older people. The aim of this study was to assess the fall risk among older adults. Methods: The descriptive cross-sectional study was carried out among older adults residing in Bharatpur, Chitwan. A total of 98 older adults were selected by using simple random sampling technique. The data were collected by using structured interview schedule and fall risk was as­sessed by Timed Up and Go (TUG) test. Data were collected from 23rd June, 2019 to 7th July, 2019. Obtained data were analyzed using descriptive and inferential statistics. Results: The study findings revealed that more than half (60.2%) of the older adults were from the age group of ≤79 years, male (63.3%) and almost half (50%) were illiterate. Nearly all (96.9%) older adults were living with their family however, 50% were undernourished (BMI- <22.9). Ma­jorities (66.3%) were suffering from chronic diseases and had been taking medicine. Majority of older adults reported vision problem (64.3%) and hearing problem (60.2%). However, only 8.2% reported history of fall within last 6-12 months. More than half (59.2%) of the older adults had high risk of fall and found significant association with age (p=0.039) and vision problem (p=0.043). Conclusions: More than half of the older adults are in risk of falls. Therefore, more emphasis should be given in screening the older people for fall risk factors as preventive measures.

Profile of ethnicity, living arrangements and loneliness amongst older adults in Aotearoa New Zealand: A national cross-sectional study

2017 ◽  
Vol 37 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Hamish A Jamieson ◽  
Helen M Gibson ◽  
Rebecca Abey-Nesbit ◽  
Annabel Ahuriri-Driscoll ◽  
Sally Keeling ◽  
...  
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Living Arrangements ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Aotearoa New Zealand

scholarly journals Abuse Experienced by Elderly Residing in a Community of Pokhara, Nepal

2020 ◽  
Vol 2 (2) ◽  
pp. 128-134
Author(s):  
Pramila Bhandari ◽  
Mira Baral
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Sampling Technique ◽  
The Elderly ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
And Migration

Background: Abuse of the elderly is a hidden problem in Nepalese community. Pokhara city is highly affected by urbanization, modernization and migration that predispose older adults to social isolation and financial difficulties increasing their risk to abuse. This study aims to fill the gap in the knowledge in the area of abuse of elderly in Pokhara city.Objectives: The major objective of this study was to determine the prevalence of caregiver abuse experienced by the older adults and find out the factors associated with the abuse. Method: A cross sectional study was used for the study. Convenience sampling technique was used and data was collected from 192 elderly above the age of 60 years residing a community of Pokhara-28, Kaski at their households using a structured interview schedule. Data was collected in June 2018, for a period of one month. Before data collection, informed written consent was taken from participants. The data was analyzed by using SPSS-16 and chi-square test was used as inferential statistics to determine the association between the elder abuse and selected variables.Result: We found out that 65.6% of the elderly experienced at least one abuse in the last 6 months. The most common forms of abuse were caregiver neglect (55.2%) and psychological abuse (38.5%). The elderly abuse was statistically significant with female sex (p=0.001), unmarried/widow/widower/separated/divorced (p=.021), illiterate (p=0.002), and among those having chronic illness (p=0.003). Conclusion: Almost 7 out of 10 elderly experienced abuse in the past 6 months. The most common form of abuse was caregiver neglect followed by psychological and financial abuse. Older adults who were females, unmarried/widowed/separated/divorced, illiterate and those having chronic disease were at higher risk for abuse.

scholarly journals Baseline Prevalence of Polypharmacy in Older Hypertensive Study Subjects with Elevated Dementia Risk: Findings from the Risk Reduction for Alzheimer’s Disease Study (rrAD)

2020 ◽  
Vol 77 (1) ◽  
pp. 175-182
Author(s):  
Eric D. Vidoni ◽  
Ashwini Kamat ◽  
William P. Gahan ◽  
Victoria Ourso ◽  
Kaylee Woodard ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Risk Reduction ◽  
Structured Interview ◽  
Median Number ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Dementia Risk

Background: Little is known about the prevalence of polypharmacy, the taking of five or more medications a day, in older adults with specific dementia risk factors. Objective: To examine the prevalence of polypharmacy in participants at baseline in a vascular risk reduction focused Alzheimer’s disease (rrAD) trial targeting older patients with hypertension and elevated dementia risk. Methods: We conducted a detailed review of medications in a cross-sectional study of community-dwelling older adults with hypertension and elevated dementia risk. Medications were identified in a structured interview process with an onsite pharmacist or qualified designee. Polypharmacy was defined as use of five or more medications on a regular basis. Descriptive analyses were conducted on the sample as well as direct comparisons of subgroups of individuals with hypertension, diabetes, and hyperlipidemia. Results: The 514 rrAD participants, mean age 68.8 (standard deviation [sd] 6), reported taking different combinations of 472 unique medications at their baseline visit. The median number of medications taken by participants was eight [Range 0–21], with 79.2% exhibiting polypharmacy (n = 407). Sites differed in their prevalence of polypharmacy, χ2(3) = 56.0, p < 0.001. A nearly identical percentage of the 2,077 prescribed (51.8%) and over the counter (48.2%) medications were present in the overall medication profile. The presence of diabetes (87.5%), hyperlipidemia (88.2%), or both (97.7%) was associated with a higher prevalence of polypharmacy than participants who exhibited hypertension in the absence of either of these conditions (63.2%), χ2(3) = 35.8, p < 0.001. Conclusion: Participants in a dementia risk study had high levels of polypharmacy, with the co-existence of diabetes or hyperlipidemia associated with a greater prevalence of polypharmacy as compared to having hypertension alone.

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