scholarly journals Supportive Homes as Mediator between Rural Status and Disability of Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 632-632
Author(s):  
Bernard Steinman ◽  
Bremen Whitlock ◽  
Casandra Mittlieder ◽  
Julie Overton ◽  
Jon Pynoos

Abstract By definition, older adults living in rural communities have fewer formal resources available to address aging-related functional needs. Supportive environments are frequently relied on in rural settings to help address this discrepancy. The purpose of this study was to assess the role of supportive housing features and home modifications in mediating the association between rurality and disability. We hypothesized that environmental supports would be more crucial in rural settings than non-rural settings. We analyzed data from the National Health and Aging Trends Study (NHATS). Variable selection was guided by the International Classification of Functioning, Disability and Health (ICF), including covariates for sociodemographics, chronic conditions, mobility functioning, and participation. A series of regression models tested mediation by environmental variables of the association between rurality (as determined by the metro/nonmetro file indicator) and ADL/IADL disability. Supportive home environments were operationalized using indicators of whether participants had access to homes from the outside without having to use stairs; presence of a bedroom, kitchen, and full bathroom with a shower or tub on the same floor; and whether bathroom fixtures had been modified with features such as grab bars. Results suggest a statistical relationship between rurality and disability that is explained in part by the presence or lack of supportive home features, and these effects were greater in rural settings. Implications are that older adults who live in rural settings can benefit greatly by supportive environments and modifications in areas of the home that are known to cause difficulty.

2018 ◽  
Vol 71 (3) ◽  
pp. 942-950
Author(s):  
Vania Dias Cruz ◽  
Silvana Sidney Costa Santos ◽  
Jamila Geri Tomaschewski-Barlem ◽  
Bárbara Tarouco da Silva ◽  
Celmira Lange ◽  
...  

ABSTRACT Objective: To assess the health/functioning of the older adult who consumes psychoactive substances through the International Classification of Functioning, Disability and Health, considering the theory of complexity. Method: Qualitative case study, with 11 older adults, held between December 2015 and February 2016 in the state of Rio Grande do Sul, using interviews, documents and non-systematic observation. It was approved by the ethics committee. The analysis followed the propositions of the case study, using the complexity of Morin as theoretical basis. Results: We identified older adults who consider themselves healthy and show alterations - the alterations can be exacerbated by the use of psychoactive substances - of health/functioning expected according to the natural course of aging such as: systemic arterial hypertension; depressive symptoms; dizziness; tinnitus; harmed sleep/rest; and inadequate food and water consumption. Final consideration: The assessment of health/functioning of older adults who use psychoactive substances, guided by complex thinking, exceeds the accuracy limits to risk the understanding of the phenomena in its complexity.


2021 ◽  
Vol 2 ◽  
Author(s):  
Maarit Karhula ◽  
Sari Saukkonen ◽  
Essi Xiong ◽  
Anu Kinnunen ◽  
Tuija Heiskanen ◽  
...  

Background: The International Classification of Functioning, Disability and Health (ICF) classification is a biopsychosocial frame of reference that contributes to a holistic understanding of the functioning of a client and the factors involved. Personal factors (PFs) are not currently classified in the ICF due to large societal and cultural diversity and lack of clarity in the scope of such factors.Aims: To ascertain which factors in the ICF classification have been defined as PFs in different studies and what conclusions have been drawn on their role in the ICF classification.Methods: The study was a scoping review. A systematic search for articles published in 2010–2020 was performed on the Cinahl, Pubmed, ScienceDirect, and Sport Discus databases. The PFs specified in the articles were classified according to the seven categories proposed by Geyh et al. socio-demographic factors; position in the immediate social and physical context; personal history and biography; feelings; thoughts and beliefs; motives; and general patterns of experience and behavior.Results: The search yielded 1,988 studies, of which 226 met the inclusion criteria. The studies had addressed a wide variety of PFs that were linked to all seven categories defined by Geyh et al. Some studies had also defined PFs that were linkable to other components of the ICF or that did not describe functioning. Approximately 22% (51) of the studies discussed the role of PFs in rehabilitation.Conclusions: The range of PFs in the ICF classification addressed in the reviewed studies is wide. PFs play an important role in rehabilitation. However, according to the reviewed studies, a more precise coding of PFs is not yet warranted.


BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e024274
Author(s):  
Johanna Tomandl ◽  
Stephanie Book ◽  
Susann Gotthardt ◽  
Stefan Heinmueller ◽  
Elmar Graessel ◽  
...  

IntroductionWith the medical focus on disease, the problem of overdiagnosis inevitably increases with ageing. Considering the functional health of patients might help to discriminate between necessary and unnecessary medicine. The International Classification of Functioning, Disability and Health (ICF) is an internationally recognised tool for describing functional health. However, it is too detailed to be used in primary care practices. Consequently, the aim of this study is to identify relevant codes for an ICF core set for community-dwelling older adults (75 years and above) in primary care.Methods and analysisThe study will follow the methodology proposed by the ICF Research Branch to identify relevant concepts from different perspectives: (1) Research perspective: A systematic review of studies focusing on functional health in old age will be conducted in different databases. Relevant concepts will be extracted from the publications. (2) Patients’ perspective: Relevant areas of functioning and disability will be identified conducting qualitative interviews and focus groups with community-dwelling older persons. The interviews will be transcribed verbatim and analysed using the documentary method of interpretation. (3) Experts’ perspective: An online survey with open-ended questions will be conducted. Answers will be analysed using the qualitative content analysis of Mayring. (4) Clinical perspective: A cross-sectional empirical study will be performed to assess the health status of community-dwelling older adults using the extended ICF checklist and other measurement tools.Relevant concepts identified in each study will be linked to ICF categories resulting in four preliminary core sets.Ethics and disseminationEthical approval for the study was obtained (90_17B). All participants will provide written informed consent. Data will be pseudonymised for analysis. Results will be disseminated by conference presentations and journal publications.Trial registration numberProjektdatenbank Versorgungsforschung Deutschland: VfD_17_003833,Clinicaltrials.gov:NCT03384732and PROSPERO: CRD42017067784.


Author(s):  
Simone J.J.M. Verswijveren ◽  
Cormac Powell ◽  
Stephanie E. Chappel ◽  
Nicola D. Ridgers ◽  
Brian P. Carson ◽  
...  

Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study (N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.


Author(s):  
Chenchen Yang ◽  
Elias Mpofu ◽  
Xiaoli Li ◽  
Diana Dorstyn ◽  
Qiwei Li ◽  
...  

Abstract Objective: Physical activity (PA) is a known benefit to older adults with diabetes; however, the determinants of PA are less well studied in this population. Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), a well-established biopsychosocial framework, we explored PA participation among older adult with type 2 diabetes. Method: Using data from the Health and Retirement Study and the RAND Center for the Study of Aging (N = 2,016; mean age = 73.19; SD = 6.16), we conducted hierarchical stepwise regression analysis to evaluate the relative contribution of different biopsychosocial predictors to PA – namely, body functions and structure, activity and participation, personal, and environmental factors. Results: Altogether, biopsychosocial factors accounted for 20% of the variance in PA participation. Of the personal factors, high extraversion and low neuroticism explained approximately 54% of the variance in PA among the older adults – beyond sociodemographics. Low body mass index, reduced pain, reduced depression, and higher cognitive functioning also had good explanatory power (25% of explained variance), whereas activity participation and environment did not (10% each). Conclusion: Aligning care with components of the ICF will help to ensure a focus on person-centric practices and, in turn, optimize participation outcomes such as PA.


2016 ◽  
Vol 43 (3) ◽  
pp. 273-283 ◽  
Author(s):  
KIM E. REUTER ◽  
HALEY RANDELL ◽  
ABIGAIL R. WILLS ◽  
BRENT J. SEWALL

SUMMARYThe role of wild meat for subsistence or as a luxury good is debated. We investigated the role of wild meat in food security in Madagascar, where consumption is poorly understood in urban areas and at regional scales. Using semi-structured interviews (n = 1339 heads-of-households, 21 towns), we aimed to: (1) quantify the amount and purpose of, (2) understand the drivers of, and (3) examine changes in wild meat consumption. Few respondents preferred wild meat (8 ± 3%) but most had eaten it at least once in their lifetime (78 ± 7%). Consumption occurred across ethnic groups, in urban and rural settings. More food insecure areas reported higher rates of wild meat consumption in the 6–8 months prior to interviews. Consumption was best explained by individual preferences and taboos. Less than 1% of respondents had increased consumption during their lifetimes. Wild meat prices showed no change from 2005–2013. Most consumption involved wild pigs and smaller-sized animals, though they were consumed less in the years following the 2009 coup. These data illustrate the differences between urban and rural communities, the occasions in which wild meat is used a source of food security, and provide evidence that some taxa are not hunted sustainably in Madagascar.


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