People dependent of support in daily activities perceives reduced self-determination – a cross-sectional study with community-dwelling older people

2015 ◽  
Vol 16 (4) ◽  
pp. 208-221 ◽  
Author(s):  
Isabelle Ottenvall Hammar ◽  
Synneve Dahlin-Ivanoff ◽  
Katarina Wilhelmson ◽  
Kajsa Eklund

Purpose – The purpose of this paper is to explore the relationship of self-determination with degree of dependence in daily activities among community-dwelling persons aged 80 years and older. Design/methodology/approach – This cross-sectional study focused on community-dwelling people 80 years or older with varied degree of dependence in daily activities. Self-determination in daily life was assessed with the statements from the Impact on Participation and Autonomy-Older persons (IPA-O), and degree of dependence in daily activities was assessed with the activities of daily living (ADL) staircase. Data were analysed using Fisher’s exact test, and the relative risk with a 95 per cent confidence interval was used to explore the risk of perceiving reduced self-determination in daily life. Findings – Compared to the independent persons, the perceived self-determination was significantly lower among persons dependent in instrumental activities of daily living (I-ADL), and persons dependent in personal activities of daily living (P-ADL). Reduced self-determination was most pronounced in persons requiring help with P-ADL. Practical implications – Following key features could be applied to strengthen the community-dwelling older people’s self-determination; incorporating a dialogue where self-determined questions are raised; adopting a person-centred approach between the persons involved; acknowledging older people’s capabilities – what they are able to do and to be, and what they value. Originality/value – This study highlights the need of integrating a self-determined dialogue into healthcare where the older person and the professional focus on self-determined questions.

2014 ◽  
Vol 40 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Mohammad H Ebrahimzadeh ◽  
Ali Moradi ◽  
Shahram Bozorgnia ◽  
Mohammad Hallaj-Moghaddam

Background:Long-term consequences and the activities of daily living of bilateral lower limb amputation are not well documented.Objectives:The aims of our study were to identify the long-term effects of bilateral lower extremity amputations on daily activities and understand how these amputees cope with their mobility assistive devices.Study design:Cross-sectional study.Methods:A total of 291 veterans with war bilateral lower limb amputations accepted to participate in a cross-sectional study.Results:The average of follow-up was 25.4 years. A total of 152 amputees (54%) were involved in sports averagely 6.7 h per week. Bilateral amputees walk 10 m by the average of 15 ± 33 s, and they could walk continuously with their prosthesis 315 ± 295 m. They wore their prosthesis 6.8 ± 1.7 days per week and 7.9 ± 8.1 h per day. Of these, 6.7% of bilateral lower limb amputees needed help to wear their prosthesis; 88.3% of amputees used assistant device for walking. According to this survey, 73 (42%) prostheses in right limb were appropriate, 95 (54.6%) needed to be replaced, and 6 (3.4) needed to be fixed. On the left side, it was 76 (42%), 92 (52.0%), and 9 (5.1%), respectively. A total of 203 (74.9%) amputees reported limitations in at least one domain of the activities of daily living. The most common single item that affected the patients was ascending and descending stairs by the score of 66% of normal population.Conclusion:Veterans with bilateral lower limb amputations suffering from vast categories of daily problems.Clinical relevanceThis study and its results confirm that bilateral lower limb amputees have major progressive disabilities in daily activities and their social performance. This should attract the attention of amputees’ administrative organizations, social workers, health-care providers and caregiver providers.


Author(s):  
Júlia Cristina Leite Nóbrega ◽  
Juliana Barbosa Medeiros ◽  
Tácila Thamires de Melo Santos ◽  
Saionara Açucena Vieira Alves ◽  
Javanna Lacerda Gomes da Silva Freitas ◽  
...  

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.


2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Masoud Hatefi ◽  
AmirHosein Meisami ◽  
Alalleh Dalvand ◽  
Milad Borji

Background: Spinal cord injuries (SCI) are a variety of chronic diseases that various causes such as trauma may contribute to its onset. One of the problems in these patients is the problem of physical activity and, consequently, daily activities. Objectives: This study aimed to assess daily living of patients with SCI. Methods: In this descriptive cross-sectional study in 2019, 120 patients with SCI in Kermanshah were included in the study using purposive sampling. The instruments used in this study fell into two parts. One part included the demographic characteristics of the SCI patients, and the other part was a questionnaire of the rate of the Impact on Participation and Autonomy questionnaire (IPA-P). Data were analyzed by SPSS software version 16 using descriptive tests such as mean and standard deviation. Results: The result showed there was a significant relationship between demographic characteristics such as education (P < 0.007), time of spinal cord injury (P < 0.01), and income (P = 0.000). Also, the results showed there was a relationship between Autonomy and Participation, and the age of patients and their autonomy and participation decreased with age (P = 0.000, R = 0.72). Most of the patients had severe problems with daily activities. Also, most patients had very poor scores in relation to daily living activities. Conclusions: Considering the low rate of participation and autonomy in patients with SCI, it is suggested to conduct studies aimed at improving their self-care and social participation.


2015 ◽  
pp. 1-6
Author(s):  
C. SIORDIA ◽  
H.T. NGUYEN

Background: Within the assessment of frailty, self-rated health (SRH) questions remain frequently used in survey research attempting to quantify a subjective and global measure of health. Studies have largely ignored the fact that SRH questions may differ in their ability to predict level of difficulty with performing activities of daily living (ADLs)—a variance partially influenced by whether a comparative frame of reference in used in the SRH question. Specific Aim: Investigate if a Comparative-SRH (C-SRH) question with response options ranging on an adjectival scale ranging from 0 to 3; and a Non-Comparative-SRH (NC-SRH) question with an adjectival response scale from range 0 to 5; differ in their ability to predict level of difficulty in performing ADLs after accounting for demographic, psychosocial, and related health factors. Setting & Design: Cross-sectional study of community-dwelling adults (n=275; x age=68; female=54%; x BMI=31) from North Carolina participating in the Hispanic Aging Survey (HAS) were used in multivariable linear regressions to predict a granular measure of level of difficulty performing ADLs. Results: Only C-SRH has a statistically significant relationship with ADLs—where each increase in C-SRH (i.e., more positively self-rated health) is associated with a decrease in ADL level of difficult. Conclusions: Using a comparative frame of reference in SRH questions may have important implications when attempting to understand the statistical relationship between self-rated global health and physical function in the assessment of frailty in older adults.


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.


2012 ◽  
Vol 13 (3) ◽  
pp. 741-750 ◽  
Author(s):  
Reza Amini ◽  
Robab Sahaf ◽  
Alireza Kaldi ◽  
Hamid Haghani ◽  
Keyvan Davatgaran ◽  
...  

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