scholarly journals A Longitudinal Study of Retirement Transition and Advance Directive Completion

2020 ◽  
Vol 60 (6) ◽  
pp. 1005-1010
Author(s):  
Catheryn S Koss
Keyword(s):  
Advance Directives ◽  
Advance Directive ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Optimal Time ◽  
Role Change ◽  
Retirement Transition ◽  
Study Participants ◽  
Design And Methods ◽  
Retirement Study

Abstract Background and Objectives Advance directives (AD) help to ensure patients’ wishes are honored and contribute to improved end-of-life care. According to normative life course theory, retirement is a significant role change that signals a transition into the third age and its socially prescribed activities. This study tested whether transitioning from work to retirement prompted AD completion. Research Design and Methods The sample included Health and Retirement Study participants who, in 2012, had no ADs and were not completely retired (N = 919). Three waves of data were analyzed using multinomial logistic regression to test associations between retirement transition and advance directive completion. Results By 2014, 21% had completed ADs and another 17% completed them by 2016. Those who completely retired between 2012 and 2014 were almost twice as likely to complete ADs between 2014 and 2016. Graduated increase in level of retirement between 2012 and 2014 was associated with higher odds of new AD possession in 2016, but did not reach statistical significance at p < .05. Discussion and Implications The period following retirement may be an optimal time to encourage patients and clients who have not already done so to complete advance directives.

scholarly journals A Longitudinal Study of Retirement Transition and Advance Directive Completion

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 441-441
Author(s):  
Catheryn Koss
Keyword(s):  
End Of Life ◽  
Advance Directives ◽  
Advance Directive ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Optimal Time ◽  
Retirement Transition ◽  
Multistep Process ◽  
Study Participants ◽  
Retirement Study

Abstract Advance directives (AD) help to ensure patients’ wishes are honored and contribute to improved end-of-life care. According to normative life course theory, retirement is a significant role change that signals a transition into the third age and its socially prescribed activities. To the extent that ACP is viewed as something to do when one reaches a more advanced stage in life, retirement may spark recognition that planning for incapacity and the end of life is now personally relevant and appropriate. This study tested whether transitioning from work to retirement prompted AD completion. The sample included Health and Retirement Study participants 65 and older who, in 2012, had no ADs and were not completely retired (N = 919). Retirement was operationalized as both a categorical status and as a multistep process. Three waves of data were analyzed using multinomial logistic regression to test associations between retirement transition and advance directive completion. By 2014, 21% had completed ADs and another 17% completed them by 2016. Those who completely retired between 2012 and 2014 were almost twice as likely to complete ADs between 2014 and 2016. Graduated increase in level of retirement between 2012 and 2014 was associated with higher odds of new AD possession in 2016, but did not reach statistical significance at p < .05. These results suggest the period following retirement may be an optimal time to encourage patients and clients who have not already done so to complete advance directives.

Making Your Wishes Known: Who Completes an Advance Directive and Shares It With Their Health Care Team or Loved Ones?

2017 ◽  
Vol 38 (12) ◽  
pp. 1746-1762 ◽  
Author(s):  
Megumi Inoue ◽  
Emily Ihara ◽  
Albert Terrillion
Keyword(s):  
Health Care ◽  
Advance Directives ◽  
Health Care Providers ◽  
Advance Directive ◽  
Multinomial Logistic Regression ◽  
Public Awareness ◽  
Behavioral Model ◽  
Health Care Team ◽  
Care Providers ◽  
Educational Training

Using Andersen’s health behavioral model as a framework, this study examined factors associated with the completion of advance directives and the behavior of sharing them with one’s family and health care providers. Data were from the 2014 United States of Aging Survey ( N = 1,153; aged 60 or older), and multinomial logistic regression was used for analysis. We found that 73% of respondents had advance directives. However, 28% have not shared their advance directives with anyone. The sense of having completed a great deal of preparation for the future and the number of illnesses were found to be relevant to the behavior of sharing advance directives. Existing educational training and interventions can be expanded to increase public awareness and encourage people to share their completed advance directives with others. Policies mandating physicians to engage in advance directive conversations with patients during annual checkups might improve completion and sharing of advance directives.

scholarly journals Race and Educational Disparities in Advance Directive Completion: Encouraging Trends in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 331-331
Author(s):  
Catheryn Koss ◽  
Rebecca Hensley
Keyword(s):  
Advance Directives ◽  
Advance Directive ◽  
The United States ◽  
Educational Disparities ◽  
The Past ◽  
Exit Survey ◽  
Time Period ◽  
Race Disparities ◽  
Race And Education ◽  
Retirement Study

Abstract Advance directives (AD) help to ensure patients’ wishes are honored and contribute to improved end-of- life care. Race and education disparities in advance directive completion have been extensively documented. This study examined five waves of U.S. Health and Retirement Study exit survey data (N = 7,067) to examine to what extent these disparities have expanded or diminished over the past decade. Overall, advance directive completion increased from about 63% among participants who died in 2005-06 to about 73% among those whose deaths occurred between 2015 and 2016. Non-Hispanic whites were almost four times as likely to have advance directives compared to Hispanics or African Americans across this time period (OR=3.90. p<.0001). However, the growth rate in advance directive completion among non-Hispanic whites was significantly slower than for non-whites (OR=.90, p<.01). Compared to those with a high school education or less, those with some college (OR=1.67, p<.0001) and those with at least a college degree (OR=2.02, p<.0001) were significantly more likely to have advance directives across the time period. There were no significant differences in growth rates of advance directive completion for the different educational categories. These results suggest that educational disparities in advance directive completion are fairly stable, but that race disparities may be diminishing.

scholarly journals Advance Directives as Support of Autonomy for Persons with Dementia A Pilot Study among Persons with Dementia and Their Informal Caregivers

2017 ◽  
Vol 7 (3) ◽  
pp. 328-338 ◽  
Author(s):  
Martina Schmidhuber ◽  
Sandra Haeupler ◽  
Velislava Marinova-Schmidt ◽  
Andreas Frewer ◽  
Peter L. Kolominsky-Rabas
Keyword(s):  
Pilot Study ◽  
Advance Directives ◽  
Advance Directive ◽  
Informal Caregivers ◽  
Public Information ◽  
Face To Face ◽  
Level Of Knowledge ◽  
Study Participants ◽  
Lack Of Knowledge

Background: Advance directives could be an important instrument to support a person’s will once he/she is not able to consent anymore – if composed competently. A survey was conducted to identify the level of knowledge concerning possibilities and limits of advance directives. Methods: The study was conducted as part of the Bavarian Dementia Survey (BayDem). Data were collected from January 2014 to December 2015 by structured face-to-face interviews. Study participants were persons with dementia and their informal caregivers (n = 74). Results: In total, 66% reported having written an advance directive. Concerning the participants’ knowledge about possibilities and limitations of advance directives, a lack of knowledge was noted about the possibility to revoke an advance directive. Furthermore, 70% of informal caregivers and 56% of persons with dementia were not aware of the possibility to include dementia-specific terms in the advance directive. Conclusion: It is necessary to optimize structures for public information and education concerning the topic of advance directives for persons with dementia.

Narcissism and Political Left-Right Orientation in view of Basic Human Values

2020 ◽  
Author(s):  
Fatma Ülkü Selçuk ◽  
Nil Demet Güngör
Keyword(s):  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Political Orientation ◽  
The Self ◽  
Human Values ◽  
Hierarchical Regression ◽  
Openness To Change ◽  
Self Sufficiency ◽  
Political Left ◽  
Self Transcendence

<p>The study explores the relation of narcissism to political orientation and their association with basic human values, using an undergraduate sample from Turkey. Leftwing orientation is weakly and negatively correlated with narcissism, and specifically with its self-sufficiency dimension. Leftwing is correlated positively with universalism and negatively with tradition. Narcissism is positively correlated with the self-enhancement and openness to change dimensions and negatively correlated with the self-transcendence and conservatism dimensions of the basic values. Hierarchical regression results indicate that the value tradition is a stronger predictor of political orientation than narcissism. In multinomial logistic regression, for narcissism, statistical significance appears for only extreme right compared to moderate left political positions. We did not find power-hunger to be related to political orientation. We did not find pro-sociality to be related to familial-religious customs. We did not find any sex difference for mean narcissism scores. However, females are more leftwing oriented than males and they report more eagerness to strive for justice for others. Striving for justice for others is negatively correlated with the value power; positively correlated with leftwing orientation and striving for justice for self; and uncorrelated with narcissism. Males have higher mean scores for the value tradition and females have higher mean scores for the value security.</p>

Narcissism and Political Left-Right Orientation in view of Basic Human Values

2020 ◽  
Author(s):  
Fatma Ülkü Selçuk ◽  
Nil Demet Güngör
Keyword(s):  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Political Orientation ◽  
The Self ◽  
Human Values ◽  
Hierarchical Regression ◽  
Openness To Change ◽  
Self Sufficiency ◽  
Political Left ◽  
Self Transcendence

<p>The study explores the relation of narcissism to political orientation and their association with basic human values, using an undergraduate sample from Turkey. Leftwing orientation is weakly and negatively correlated with narcissism, and specifically with its self-sufficiency dimension. Leftwing is correlated positively with universalism and negatively with tradition. Narcissism is positively correlated with the self-enhancement and openness to change dimensions and negatively correlated with the self-transcendence and conservatism dimensions of the basic values. Hierarchical regression results indicate that the value tradition is a stronger predictor of political orientation than narcissism. In multinomial logistic regression, for narcissism, statistical significance appears for only extreme right compared to moderate left political positions. We did not find power-hunger to be related to political orientation. We did not find pro-sociality to be related to familial-religious customs. We did not find any sex difference for mean narcissism scores. However, females are more leftwing oriented than males and they report more eagerness to strive for justice for others. Striving for justice for others is negatively correlated with the value power; positively correlated with leftwing orientation and striving for justice for self; and uncorrelated with narcissism. Males have higher mean scores for the value tradition and females have higher mean scores for the value security.</p>

scholarly journals Life Quality and Participation of Disabled Children and Young People: Design and Methods of a Transformative Study

2021 ◽  
Vol 20 ◽  
pp. 160940692110167
Author(s):  
Snæfrídur Thóra Egilson ◽  
Linda B. Ólafsdóttir ◽  
Anna Sigrún Ingimarsdóttir ◽  
Freyja Haraldsdóttir ◽  
Ásta Jóhannsdóttir ◽  
...  
Keyword(s):  
Life Quality ◽  
Social Contexts ◽  
Lessons Learned ◽  
Control Group ◽  
Childhood Disability ◽  
Disabled Children ◽  
Sequential Mixed Methods ◽  
Study Participants ◽  
Design And Methods

The LIFE-DCY research project has two aims. First, to evaluate disabled children’s quality of life (QoL) as reported by themselves and their parents, and second, to locate commonalities, differences, and conflicting issues in the processes that may influence disabled children’s life quality and participation. This paper describes the study design, methodology, and methods along with lessons learned. In addition various methodological and ethical concerns are raised. A sequential mixed-methods design was applied. In Phase one (mapping) we used KIDSCREEN-27 to study how disabled children evaluate their QoL compared with the perspectives of their parents and those of non-disabled children and their parents. Using the Participation and environment measure we also studied parents’ perspectives of their children’s participation in different social contexts. Altogether 209 disabled children and their parents, and 335 children in a control group and their parents (paired reports) participated in phase one. Phase two (unpacking) consisted of 14 case studies with disabled children aged 8–18 years and focus groups with 21 disabled people aged 19–35 years. The initial analysis was inductive and data-oriented. We then used critical and transformative lenses to shed light on how meaning was made of life quality and participation in relation to the context in which study participants found themselves. The LIFE-DCY research promotes an understanding of how important aspects of life quality and participation may intersect within different contexts and at different times. The theoretical understandings from this study may also help unpack various aspects of childhood disability in terms of knowledge and power and enhance understandings of how ideas about normality and childhood disability are constructed.

scholarly journals Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults

SLEEP ◽  
2021 ◽  
Author(s):  
G L Dunietz ◽  
R D Chervin ◽  
J F Burke ◽  
A S Conceicao ◽  
T J Braley
Keyword(s):  
Older Adults ◽  
Statistical Significance ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Not Otherwise Specified ◽  
Dementia Risk ◽  
Obstructive Sleep ◽  
Study Participants

Abstract Study Objectives To examine associations between PAP therapy, adherence and incident diagnoses of Alzheimer’s disease (AD), mild cognitive impairment (MCI), and dementia not-otherwise-specified (DNOS) in older adults. Methods This retrospective study utilized Medicare 5% fee-for-service claims data of 53,321 beneficiaries, aged 65+, with an OSA diagnosis prior to 2011. Study participants were evaluated using ICD-9 codes for neurocognitive syndromes [AD(n=1,057), DNOS(n=378), and MCI(n=443)] that were newly-identified between 2011-2013. PAP treatment was defined as presence of ≥1 durable medical equipment (HCPCS) code for PAP supplies. PAP adherence was defined as ≥2 HCPCS codes for PAP equipment, separated by≥1 month. Logistic regression models, adjusted for demographic and health characteristics, were used to estimate associations between PAP treatment or adherence and new AD, DNOS, and MCI diagnoses. Results In this sample of Medicare beneficiaries with OSA, 59% were men, 90% were non-Hispanic whites and 62% were younger than 75y. The majority (78%) of beneficiaries with OSA were prescribed PAP (treated), and 74% showed evidence of adherent PAP use. In adjusted models, PAP treatment was associated with lower odds of incident diagnoses of AD and DNOS (OR=0.78, 95% CI:0.69-0.89; and OR=0.69, 95% CI:0.55-0.85). Lower odds of MCI, approaching statistical significance, were also observed among PAP users (OR=0.82, 95% CI:0.66-1.02). PAP adherence was associated with lower odds of incident diagnoses of AD (OR=0.65, 95% CI:0.56-0.76). Conclusions PAP treatment and adherence are independently associated with lower odds of incident AD diagnoses in older adults. Results suggest that treatment of OSA may reduce risk of subsequent dementia.

scholarly journals Enhancing Competency in Professionalism: Targeting Resident Advance Directive Education

2010 ◽  
Vol 2 (2) ◽  
pp. 278-282 ◽  
Author(s):  
Colleen Y. Colbert ◽  
Curtis Mirkes ◽  
Paul E. Ogden ◽  
Mary Elizabeth Herring ◽  
Christian Cable ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Medical School ◽  
Advance Directives ◽  
Advance Directive ◽  
Residency Program ◽  
Health Science ◽  
Science Center ◽  
Sufficient Knowledge ◽  
Significant Difference ◽  
School Curricula

Abstract Background Education about advance directives typically is incorporated into medical school curricula and is not commonly offered in residency. Residents' experiences with advance directives are generally random, nonstandardized, and difficult to assess. In 2008, an advance directive curriculum was developed by the Scott & White/Texas A&M University System Health Science Center College of Medicine (S&W/Texas A&M) internal medicine residency program and the hospital's legal department. A pilot study examining residents' attitudes and experiences regarding advance directives was carried out at 2 medical schools. Methods In 2009, 59 internal medicine and family medicine residents (postgraduate year 2–3 [PGY-2, 3]) completed questionnaires at S&W/Texas A&M (n  =  32) and The University of Texas Medical School at Houston (n  =  27) during a validation study of knowledge about advance directives. The questionnaire contained Likert-response items assessing attitudes and practices surrounding advance directives. Our analysis included descriptive statistics and analysis of variance (ANOVA) to compare responses across categories. Results While 53% of residents agreed/strongly agreed they had “sufficient knowledge of advance directives, given my years of training,” 47% disagreed/strongly disagreed with that statement. Most (93%) agreed/strongly agreed that “didactic sessions on advance directives should be offered by my hospital, residency program, or medical school.” A test of responses across residency years with ANOVA showed a significant difference between ratings by PGY-2 and PGY-3 residents on 3 items: “Advance directives should only be discussed with patients over 60,” “I have sufficient knowledge of advance directives, given my years of training,” and “I believe my experience with advance directives is adequate for the situations I routinely encounter.” Conclusion Our study highlighted the continuing need for advance directive resident curricula. Medical school curricula alone do not appear to be sufficient for residents' needs in this area.

Sign in / Sign up

Export Citation Format

Share Document