scholarly journals Low back pain prevalence, beliefs, and treatment seeking behaviour in multi-ethnic Suriname

Author(s):  
Nancy Ho-A-Tham ◽  
Beverly Ting A Kee ◽  
Niels Struyf ◽  
Yves Vanlandewijck ◽  
Wim Dankaerts

Abstract Objectives To determine LBP prevalence in urban and rural communities and to assess back beliefs and treatment seeking behaviour for the first time in Suriname, a multi-ethnic country in the Caribbean community. Methods A cross-sectional community-based survey using the Community Oriented Program for the Control of Rheumatic Diseases methodology was performed between April 2016 and July 2017. Information on LBP prevalence and LBP-related treatment seeking, beliefs about LBP (Back Beliefs Questionnaire (BBQ)), level of disability (Oswestry Disability Index), and the risk of developing persistent disabling pain (Start Back Screening Tool) was collected. Results A total of 541 out of 2902 individuals reported current acute or chronic LBP. It was more prevalent in urban (20.2%) than in rural (13.7%) communities, especially in females and older adults (>55 years). Individuals from rural areas (median BBQ = 18.00 (14.00–22.00)) had significantly more negative beliefs than the urban population (median BBQ = 25.00 (19.00–31.00)) (p < 0.001). Maroons displayed more negative beliefs than Creole (p = 0.040), Hindustani (p < 0.001), Javanese (p < 0.001) and Mixed ethnicity (p < 0.001). At least 75% of the LBP population sought care, especially from a western healthcare practitioner. Seeking treatment and having a higher risk to develop persistent disabling pain was significantly associated with more disability (p < 0.001). Age ≥45 years (p < 0.001), Indigenous ethnicity (p < 0.05), and functional disability (p < 0.001) were factors influencing treatment seeking. Conclusions LBP is a prevalent health problem in the Surinamese urban community, especially in older adults and among females. Most individuals experiencing LBP visited a western healthcare practitioner and had more negative beliefs compared with other communities.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 412-413
Author(s):  
Hee Yun Lee ◽  
Eun Young Choi ◽  
Youngsun Kim ◽  
Jessica Neese ◽  
Yan Luo

Abstract Despite the overall increase in Internet use among older adults, the digital divide within older Americans remains substantial. This trend is particularly true for older adults living in rural areas. Informed by the Social Determinants of Health Framework, our study aims to examine how one’s residential area relates to (1) Internet Access, (2) subtypes of usage patterns, and (3) perceptions on technology use. Cross-sectional data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of 18,196 older adults aged 50 and above (47.6% rural residents). A series of linear and logistic regression analyses were performed. Our models controlled for demographic characteristics, socioeconomic status, and health conditions. Compared to older adults living in urban areas, those residing in rural areas had 29% lower odds of internet access. Living in rural areas predicted lower levels of all sub-types of technology use (communication, financial, health, and media technology). In addition, non-users in rural areas showed more unfavorable perceptions of technology than urban residents. They were more likely to conceive technology as “too complicated”, “too hard to learn”, and “too difficult to keep up with all changes.” Our findings suggest that substantial segments of older adults in rural areas are still behind in accessing and adopting digital technology. Targeted intervention efforts are urgently needed to reduce technology inequality including comprehensive plans to expand broadband access and building mobile technology infrastructure for rural communities.


Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.


Author(s):  
Sabuj Kanti Mistry ◽  
Armm Mehrab Ali ◽  
Md. Ashfikur Rahman ◽  
Uday Narayan Yadav ◽  
Bhawna Gupta ◽  
...  

The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI: 0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.


2020 ◽  
Author(s):  
Jian Rong ◽  
Yanhong Ge ◽  
Xueqin Wang ◽  
Guimei Chen ◽  
Hong Ding

Abstract Background: The association between functional disability and depressive symptoms among elderly people in rural China is not clear. This study explored the relationship between functional disability and depressive symptoms, focusing on whether an interactive association between functional disability, demographic characteristics and depressive symptoms exists among older adults in rural Anhui, China.Methods: A cross-sectional survey study was conducted with multi-stage stratified random sampling. The 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. The data were analyzed using SPSS statistics 25.0 program with chi-square test, Mann-Whitney U test, binary logistic regression analysis, and classification and regression tree model.Results: The prevalence of depressive symptoms in 3336 older people was 52.94%. After adjustment, subjects who had problems in participation (adjusted odds ratio [AOR]=3.499, 95% confidence interval [CI]: 2.385-4.987), life activities (AOR=1.683, 95% CI: 1.370-2.066), getting along (AOR=1.616, 95% CI: 1.299-2.010), and mobility (AOR=1.842, 95% CI: 1.503-2.258) had an increased depressive symptoms risk. However, cognition (AOR=0.785, 95% CI: 0.647-0.953) negatively correlated with depressive symptoms. Additionally, the interactive association between functional disability dimensions, various variables and depressive symptoms were identified for the first time. Those who had problems in mobility, getting along and were unemployed, the possibility of having depressive symptoms was the highest.Conclusions: Special attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along, and mobility and no problems in cognition to maintain a good psychological state. Our findings may be greatly significant for developing more targeted and effective mental health prevention and intervention measures for older adults in rural areas.


Author(s):  
Darlene Mara dos Santos Tavares ◽  
Nayara Gomes Nunes Oliveira ◽  
Flavia Aparecida Dias Marmo ◽  
Joilson Meneguci

Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.


Author(s):  
J.J. Aziz ◽  
K.F. Reid ◽  
J.A. Batsis ◽  
R.A. Fielding

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.


2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.


2022 ◽  
pp. 1-46
Author(s):  
Prosper Bazaanah

This chapter examined the link between ecological governance and water conservation as sustainable pathways for enhancing rural livelihoods in the Savannah Region. Designs adopted were post-positivist and cross-sectional. Probability sampling techniques were used to sample 450 household and official respondents. Questionnaires were administered, while descriptive statistics and chi-square test were utilised to analyse the data. Findings showed significant relationship between conservation initiatives, finance, rehabilitation/maintenance, and gender inclusion and domestic water conservation. Therefore, with commitment to maintenance, funding, and gender inclusion in water decisions, there is the likely for water to be locally sustainable in rural communities of the region. Democratic, decentralised, and participatory approaches to ecological governance and empowerment of the local communities are recommended as essential preconditions for achieving ecologically self-governing communities and sustaining domestic water systems in the rural areas of the region.


2019 ◽  
pp. 67-76
Author(s):  
Carlos A Reyes Ortiz ◽  
Claudia Payan ◽  
Geraldine Altamar ◽  
Jose F Gomez Montes ◽  
Harold G Koenig

Objective: To identify the relationship between religiosity and self-rated health among older adults in Colombia. Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity (how religious are you: not at all, somewhat or very). Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable(1-5) using weighted logistic regression, adjusting for confounders. Results: Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health (OR 0.92 95% CI 0.86- 0.99, p= 0.038); however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men (OR 0.86, 95% CI: 0.79-0.94, p= 0.001) but not significant in women. Conclusion: Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious.


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