scholarly journals Staging Activity Limitation and Participation Restriction in Elderly Community-Dwelling Persons According to Difficulties in Self-Care and Domestic Life Functioning

2012 ◽  
Vol 91 (2) ◽  
pp. 126-140 ◽  
Author(s):  
Margaret G. Stineman ◽  
John T. Henry-Sánchez ◽  
Jibby E. Kurichi ◽  
Qiang Pan ◽  
Dawei Xie ◽  
...  
Author(s):  
Varun Vijay Gaiki ◽  
Manasi Khardekar

Background: There are limited studies from India on use of ICF in finding out the Disability experienced by PLHIV. We undertook this study to understand the level of disability experienced by the PLHIV attending tertiary healthcare setting. This study mainly focuses on the self-care domain of ICF classification.Methods: Cross sectional, hospital based, conducted with permission from institutional ethics committee. Predesigned standardised ICF questionnaire, with only self care part of it was administered and participants assessed for activity limitation and participation restriction domains of self care.Results: Inactivity limitation block, with regards to washing oneself, caring for body parts and dressing none reported any problem. In regulating menstruation 15 (6.67%) had moderate, 15 (6.67%) had severe and 3 (1.33%) had complete problem while 67 (29.67%) had no problem. In participation restriction, it was observed that participants had difficulties in regulating defecation 47 (20.8%) moderate, 33 (14.66%) severe, 9 (4%) mild whereas 6 (2.67%) complete problem. Overall prevalence was 42.67%. in block of participation restriction, on performance qualifier, overall 149 (66.67%) had problem in eating, 77 (34.22%) had moderate, 36 (16%) severe, 34 (15.1%) had mild and 3 (1.33%) had complete problem. In drinking overall 29.78% participants experienced problems, out of which 31 (13.7%) had moderate, 23 (10.22%) mild 12 (5.33%) and 1 (0.44%) had complete problem.Conclusions: Significant amount of activity limitation in self care observed with reference to toileting, eating drinking. Hence, this parameters to be stressed on in planning National program on AIDS.


2020 ◽  
Vol 30 (6) ◽  
pp. 1225-1230 ◽  
Author(s):  
Julio Cabrero-García ◽  
Rocío Juliá-Sanchis ◽  
Miguel Richart-Martínez

Abstract Background Summary health measures as the global activity limitation indicator (GALI) or self-rated health (SRH) allow to quantify and monitor the health of the population. The GALI is widely used in the European Union; however, evidence of its construct validity is still limited. We examine whether the GALI reflects disability in specific living contexts such as self-care, domestic life and work activity, whether it does so consistently across gender and age and its added value concerning SRH. Methods We used the subsample of adults aged 16–64 years (N = 15 934) from the 2009 European Health Interview Survey in Spain and analyzed the data with logistic regression models using the GALI and SRH as response variables. Results The GALI was strongly and significantly associated with the three measures of disability: self-care (OR = 22.8, 95% CI: 15.9–32.7), domestic life (OR = 16.3, 95% CI: 13.6–19.5) and work activity (e.g. impossibility to work: OR = 41.9, 95% CI: 30.3–57.8; prolonged sick leave: OR = 10.7, 95% CI: 9–12.7). There were significant interactions with age on all three disability measures and with the gender on one (domestic life), although they were small. SRH was also strongly associated with all three disability measures, but to a lesser extent than the GALI. Conclusions The GALI reflects well and better than SRH, disability in self-care, domestic life and work activity. It is unknown whether the GALI performs equally in other living contexts such as social relations and community life.


Author(s):  
Julio Cabrero-García ◽  
Juan Ramón Rico-Juan ◽  
Antonio Oliver-Roig

Abstract Purpose The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). Methods We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. Results GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53–31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42–17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. Conclusions GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017946 ◽  
Author(s):  
Shino Bando ◽  
Yasutake Tomata ◽  
Jun Aida ◽  
Kemmyo Sugiyama ◽  
Yumi Sugawara ◽  
...  

ObjectivesTo assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss.DesignA 5.7-year prospective cohort study.SettingOhsaki City, Japan.Participants12 370 community-dwelling individuals aged 65 years and older.Primary outcome measuresIncident functional disability (new long-term care insurance certification).ResultsThe 5.7-year incidence rate of disability was 18.8%. In comparison with participants who had ≥20 teeth, the HRs (95% CIs) for incident functional disability among participants who had 10–19 and 0–9 teeth were 1.15 (1.01–1.30) and 1.20 (1.07–1.34), respectively (p trend<0.05). However, the corresponding values for those who brushed their teeth ≥2 times per day were not significantly higher in the ‘10–19 teeth’ and ‘0–9 teeth’ groups (HRs (95% CI) 1.05 (0.91–1.21) for participants with 10–19 teeth, and 1.09 (0.96–1.23) for participants with 0–9 teeth), although HRs for those who brushed their teeth <2 times per day were significantly higher (HRs (95% CI) 1.32 (1.12–1.55) for participants with 10–19 teeth, and 1.33 (1.17–1.51) for participants with 0–9 teeth). Such a negating association was not observed for other forms of oral self-care.ConclusionsTooth brushing may partially negate the increased risk of incident functional disability associated with having fewer remaining teeth.


2019 ◽  
Vol 46 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Jacqueline Jones ◽  
R. Turner Goins ◽  
Mark Schure ◽  
Blythe Winchester ◽  
Vickie Bradley

Purpose The purpose of this qualitative descriptive study was to examine the National Standards for Diabetes Self-Management Education and Support (DSMES) defined diabetes self-care behaviors (healthy eating, being active, taking medication, monitoring, problem solving, reducing risk, and healthy coping) in the context of older community-dwelling American Indians (AIs). Methods Secondary theme analysis of transcribed semistructured qualitative interview data from 28 participants in the Native Elder Care Study aged >60 years identified factors that influence the DSMES self-care behaviors in the context of community-dwelling AIs. Results Four themes that characterized barriers, facilitators, and opportunities for DSMES to support self-care behaviors included community food security, care partners in self-care, community opportunities for diabetes support, and blending of both health worlds. Conclusion Tribal communities have contemporary strengths and cultural traditions that can be activated to enhance diabetes self-management education and support. Diabetes educators can work in tandem with community health representatives to strengthen the social and community support within which individual AIs with type 2 diabetes mellitus live. Community-based participatory research with AI caregivers, dyads, families, youth, and Indian Health Service clinicians may help to improve tribal food policy and school health initiatives, as well as develop intergenerational interventions for modeling effective diabetes self-management.


2020 ◽  
Vol 9 (3) ◽  
pp. 885
Author(s):  
Ted Kheng Siang Ng ◽  
David Bruce Matchar ◽  
Rehena Sultana ◽  
Angelique Chan

Background: Population aging poses unprecedented demands on the healthcare system. There is also a scarcity of evidence on self-care intervention to improve objective measures of morbidity and aging-associated functional and physiological measures in a low-income multi-ethnic population setting. Methods: We conducted a cluster randomized controlled trial (ClinicalTrials.gov Identifier: NCT01672177) to examine the effects of the Self-Care for Older PErsons (SCOPE) program. We randomized 14 Senior Activity Centers and randomly selected older adults within these centers. Functional and physiological measurements were performed at baseline, 10-month, and 18-month periods. The primary outcome was a composite of three morbidity-specific measures, which include hemoglobin A1c (HbA1C), peak expiratory flow, and systolic blood pressure. Aging-associated functional and physiological measures were examined as secondary outcomes. Repeated-measure mixed models were employed to examine the effects of SCOPE on these measures. Results: 378 community-dwelling older adults participated in either the treatment (n= 164) or the control arm (n = 214). The primary outcome was not significantly improved. For the secondary outcomes, SCOPE participants demonstrated slower oxygen desaturation at an 18-month period (p = 0.001), improved time to complete the chair-stand test (p < 0.001) at a 10-month period with the effect persisting at the 18-month period (p < 0.001). SCOPE participants also had significantly improved vitamin B12 levels at the 18-month period (p < 0.001), increased hemoglobin concentration (p < 0.001), decreased mean corpuscular volume (p = 0.001), and decreased creatinine (p = 0.002) at the 10-month period. Conclusions: SCOPE did not improve morbidity-specific measures. However, it improved several aging-associated measures implicated in geriatric syndromes. This study highlights the potential of a self-care program in the prevention of geriatric syndromes in community-dwelling older adults, while emphasizing self-management to manage existing morbidities.


2020 ◽  
Vol 10 ◽  
pp. 2235042X2097452
Author(s):  
Philippa JA Nicolson ◽  
Esther Williamson ◽  
Hopin Lee ◽  
Alana Morris ◽  
Angela Garrett ◽  
...  

Objective: To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities on mobility or self-care limitations among older adults. Methods: We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle (OPAL) study. Participants were community-dwelling adults aged 65 years or older who completed a postal questionnaire. Participants reported demographic information, hip/knee OA, comorbidities and mobility and self-care limitations. We used modified Poisson regression models to estimate the independent and combined relative risks (RR) of mobility or self-care limitations, the relative excess risk due to interaction (RERI) between hip/knee OA and comorbidities, attributable proportion of the risk due to the interaction and the ratio of the combined effect and the sum of the individual effects, known as the synergy index. Results: Of the 4,972 participants included, 1,532 (30.8%) had hip/knee OA, and of them 42.9% reported mobility limitations and 8.4% reported self-care limitations. Synergistic effects impacting self-care limitations were observed between hip/knee OA and anxiety (RR: 3.09, 95% Confidence Interval (CI): 2.00 to 4.78; RERI: 0.93, 95% CI: 0.01 to 1.90), and between hip/knee OA and depressive symptoms (RR: 2.71, 95% CI: 1.75 to 4.20; RERI: 0.58, 95% CI: 0.03 to 1.48). The portion of the total RR attributable to this synergism was 30% and 22% respectively. Conclusions: This study demonstrates that synergism between hip/knee OA and anxiety or depressive symptoms contribute to self-care limitations. These findings highlight the importance of assessing and addressing anxiety or depressive symptoms when managing older adults with hip/knee OA to minimize self-care limitations.


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