scholarly journals Health and Social Determinants Associated With Delay of Health Care Among Rural Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 212-212
Author(s):  
Autumn Decker ◽  
Raven Weaver
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Insurance Coverage ◽  
Healthcare Providers ◽  
Perceived Quality ◽  
Health Conditions ◽  
White Female ◽  
Future Research ◽  
Financial Barriers

Abstract Delaying healthcare has the capacity to increase morbidity and mortality, especially among individuals with chronic and acute health conditions. Older adults in rural areas are more likely to have chronic health conditions and are more likely to delay care due to financial barriers than their urban counterparts. To further investigate these associations, we conducted descriptive, bivariate, and regression analyses using data from a needs assessment designed to identify health needs and service delivery gaps among an economically diverse eight-county region. A random sample of adults responded to the survey, with 1,226 respondents aged 60+ (mean age = 71). The majority of respondents were White, female, and had insurance coverage. Overall, 35% of respondents experienced a delay in healthcare. We used logistic regression to determine the associations of age, gender, number of health conditions, household income, distance from medical facility, and perceived quality of neighborhood with delay of healthcare. Individuals with younger age (p = .017), more chronic conditions (p < .001), lower income (p < .001), and lower perceived quality of neighborhood (p = .008) were more likely to experience a delay in healthcare. These findings highlight risk factors that were salient prior to the onset of the COVID-19 pandemic. However, the pandemic has contributed to an increasing trend of delaying healthcare and may have amplified existing challenges. Findings may inform efforts led by healthcare providers and policy makers to facilitate timely and preventive healthcare use. Future research is needed to investigate the compounding long-term health implications of delaying healthcare.

scholarly journals Healthcare Experiences of LGBTQ+ Elders: Two Focus Groups

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 78-79
Author(s):  
Kierra Foley ◽  
Nancy Hodgson ◽  
José Bauermeister
Keyword(s):  
Older Adults ◽  
Focus Groups ◽  
Healthcare Providers ◽  
Qualitative Studies ◽  
Medical Attention ◽  
Future Research ◽  
Psychosocial Needs ◽  
Financial Barriers ◽  
Poor General Health ◽  
Community Engaged Research

Abstract LGBTQ+ elders experience significantly higher rates of disability, poor general health, and behavioral health problems than heterosexual and cisgender older adults; additionally, LGBTQ+ elders are less likely to seek medical attention or have a primary care provider than other older adults. In previous qualitative studies, LGBTQ+ elders have reported difficulties navigating healthcare systems due to provider incompetence in treating this population, financial barriers, systemic homophobia/transphobia, and high disease burdens. However, few qualitative studies have been conducted with this population from a nursing perspective, and little is known about the role of nurses in the health and wellness of LGBTQ+ elders. Nurses are uniquely positioned to help address both the physiological and psychosocial needs of older LGBTQ+ adults, and garnering an understanding of these needs directly from this community can help better direct future research. Accordingly, two focus groups were conducted with LGBTQ+ elders at different queer community centers in Philadelphia by a nurse scientist. This community engaged research aims to learn more about how nurses can serve this population through identifying their priorities. Through thematic analysis, it was found that LGBTQ+ elders reported being concerned about housing access, discrimination from healthcare providers, and challenges in accessing mental health care. Additionally, the researchers’ hypotheses were triangulated with the participants’ responses to demonstrate the utility of continued community engagement in addressing specific population needs.

Whose Quality of Life is it Anyway? Why Not Ask Seniors to Tell US about IT?

2000 ◽  
Vol 50 (4) ◽  
pp. 361-383 ◽  
Author(s):  
Prem S. Fry
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Well Being ◽  
Qualitative Approach ◽  
External Factors ◽  
Future Research ◽  
Elderly Persons ◽  
Qualitative And Quantitative ◽  
Depth Interviews

Three hundred and thirty-one older adults participated in a study designed to examine their perceptions of what constitutes a reasonable quality of life. Participants responded to an open-ended questionnaire in which they were asked to state their priorities, preferences, aspirations, and concerns about their present and future quality of life. Responses were subjected to a principal components factor analysis which yielded four factors: 1) respondents' demands for specific guarantees; 2) respondents' aspirations and expectations for future quality of life; 3) fears and anxieties; and 4) external factors presenting a threat to quality of life. These factors accounted for 15 percent, 12 percent, 9.2 percent, and 7.1 percent, respectively, of the total variance. Additionally, data obtained from in-depth interviews with thirty-seven older adults were analyzed using a qualitative approach. Contrary to stereotypic notions that elderly persons are frail, vulnerable, and resigned to deteriorating conditions of well-being in late life, the results of both the qualitative and quantitative components of the study showed the majority of respondents as having clear demands for autonomy, control, and independence in making decisions, including the decision to terminate life. Implications are discussed in terms of future research on quality of life of older adults.

scholarly journals Cut-off point for WHOQOL-bref as a measure of quality of life of older adults

2014 ◽  
Vol 48 (3) ◽  
pp. 390-397 ◽  
Author(s):  
Patrícia Aparecida Barbosa Silva ◽  
Sônia Maria Soares ◽  
Joseph Fabiano Guimarães Santos ◽  
Líliam Barbosa Silva
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Roc Curve ◽  
Characteristic Curve ◽  
Perceived Quality ◽  
World Health ◽  
Southeastern Brazil ◽  
World Health Organization Quality ◽  
Perceived Quality Of Life

OBJECTIVE To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults. METHODS Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults’ quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory – good or very good self-reported quality of life and being satisfied or very satisfied with health – G5; and poor/very poor quality of life – poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health – G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref. RESULTS ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6). CONCLUSIONS Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health.

Comparison of rural versus urban residence for symptoms and quality of life in recurrent ovarian cancer: Baseline analysis of GOG-0259, an NRG Oncology/GOG study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18083-e18083 ◽  
Author(s):  
Sarah M. Belcher ◽  
Susan M. Sereika ◽  
Zan M. Dodson ◽  
Meghan K. Mattos ◽  
Teresa Hagan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Marital Status ◽  
Recurrent Ovarian Cancer ◽  
Future Research ◽  
Protective Effects ◽  
Financial Barriers ◽  
Wide Range ◽  
The Impact

e18083 Background: Women with recurrent ovarian cancer (OC) experience a wide range of cancer- and treatment-related symptoms that negatively impact quality of life (QOL). Studies have reported healthcare disparities by geographic residence related to distance, time, and financial barriers to accessing high quality care. However, no studies have evaluated the impact of residence on symptoms and QOL in women with OC. Therefore, our objectives were to evaluate whether geographic residence (urban versus rural) is associated with symptoms and QOL in a sample of women with recurrent OC. Methods: The Center for Health Equity Research and Promotion conceptual framework guided analyses of baseline GOG-0259 data. We mapped zip codes to RUCA commuter codes and compared sociodemographic and clinical variables between rural and urban groups using two-sample t and chi-square tests. We used MANCOVA, adjusted for age and marital status, to test for associations between residence and symptoms (Symptom Representation Questionnaire) and QOL (Functional Assessment of Cancer Therapy-Ovarian). Results: Rural (n = 122, 25%) and urban (n = 374, 75%) women were similar in all sociodemographic and clinical comparisons except for marital status (83% vs. 70% married, p = .003). Women reported moderate symptom severity (M = 5.5, SD = 2.3) and QOL scores similar to other OC studies (M = 108.4, SD = 19.5). In multi-variate analyses, age and marital status were both associated with symptoms; marital status was associated with QOL. Geographical residence was not associated with either symptoms or QOL. Conclusions: Counter to previous research, there were no symptom or QOL disparities based on geographic residence in this sample. Possible explanations to be explored in future research include a) cooperative group selection bias for women with good access to care regardless of geographic residence and b) protective effects of marital status on symptoms and QOL.

End-of-Life Preferences in Afro-Caribbean Older Adults: A Systematic Literature Review

2014 ◽  
Vol 69 (3) ◽  
pp. 271-282 ◽  
Author(s):  
Karen O. Moss ◽  
Ishan C. Williams
Keyword(s):  
Older Adults ◽  
Cultural Identity ◽  
End Of Life ◽  
Healthcare Providers ◽  
Black Population ◽  
The United States ◽  
Future Research ◽  
End Of Life Decisions ◽  
Caribbean Immigrants ◽  
The Cost

Research suggests that older Blacks tend to prefer more aggressive treatment as they transition toward the end of life. African and Afro-Caribbean immigrants and their offspring are the fastest growing segments of the Black population in the United States. With the increasing population of Black older adults, the cost of end-of-life care is rising. This article presents a review of the literature on the end-of-life preferences of Afro-Caribbean older adults. Findings suggest that Afro-Caribbean older adults make end-of-life decisions with a significant emphasis on family structure, religion/spirituality, cultural identity, migration, and communication. Concerns regarding the meaning of end-of-life preparation and hospice are often viewed in ways that differ from that of healthcare providers. Future research is needed to investigate this process in the Afro-Caribbean older adult subset.

scholarly journals Integrated Care for Older Adults Improves Perceived Quality of Care: Results of a Randomized Controlled Trial of Embrace

2016 ◽  
Vol 32 (5) ◽  
pp. 516-523 ◽  
Author(s):  
Ronald J. Uittenbroek ◽  
Hubertus P. H. Kremer ◽  
Sophie L. W. Spoorenberg ◽  
Sijmen A. Reijneveld ◽  
Klaske Wynia
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Quality Of Care ◽  
Integrated Care ◽  
Controlled Trial ◽  
Perceived Quality ◽  
Randomized Controlled ◽  
Perceived Quality Of Care

scholarly journals Impact of an Interprofessional Education Quality of Life Forum on Students’ Perceptions and Commitment to Addressing Local Health Disparities and the Social Determinants of Health

2020 ◽  
Author(s):  
Jamie Bayliss ◽  
Erin Hofmeyer ◽  
BC Charles-Liscombe ◽  
Kristin Clephane ◽  
Sandra Matthias ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Interprofessional Education ◽  
Healthcare Providers ◽  
Health Science ◽  
Qualitative Assessment ◽  
Future Research ◽  
Local Health ◽  
Longitudinal Assessment ◽  
The Impact

Purpose: Healthcare providers and educational programs share a challenge where limited resources make interprofessional education (IPE) and collaboration difficult. The purpose of this research was to investigate the impact of IPE, specifically The Greater Cincinnati Quality of Life Forum within the School of Health Science at Mount St. Joseph University, on students’ perceptions of communication skills, collaboration, and values of interprofessional practice as they relate to emergent topics within the community and healthcare. Methods: Consenting participants completed an electronic survey with five reflection questions. Qualitative assessment included analysis of text for emergent themes. Results: Four themes evolved impacting future practice: consciousness, roles and responsibilities, professional values and ethics, and skepticism of the IPE activity benefit. Analysis of data also revealed three learner-readiness categories: desire to know, desire to act, and questioning value and validity. Conclusion & Recommendations: This IPE activity aimed to integrate holistic patient care approaches within a supportive interprofessional team. Educators ought to consider alignment of IPE activities to the learner audience for better integration of the process. Future research should also include longitudinal assessment of students’ development through IPE activities.

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