scholarly journals Mediation Role of Health Service Use and Depression on Multimorbidity and Self-rated Health in Home-based Long-term Care Residents: a Cross-sectional Study

2021 ◽  
Author(s):  
Huosheng Yan ◽  
Wenjia Peng ◽  
Mengying Li ◽  
Xinghui Li ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Health Service ◽  
Service Use ◽  
Long Term Care ◽  
Health Service Use ◽  
Term Care ◽  
Self Rated Health ◽  
Home Based

Abstract Background: Multimorbidity is common among older people and a major cause of reduced quality of life. The study aim was to investigate the relationship between multimorbidity and self-rated health and its mediators in home-based long-term care residents.Methods: Participants were 1067 home-based long-term care residents covered by long-term care insurance in Shanghai. Stratified sampling was used to select participants from six Shanghai districts. Data were collected using face-to-face interviews. Multimorbidity was defined as co-occurrence of ≥2 chronic diseases in the same person. The 30-item Geriatric Depression Scale was used to assess depressive symptoms. Structural equation modeling was used for data analysis.Results: The findings showed that 59.4% of participants had multimorbidity and 67.7% reported depressive symptoms. The mean self-rated health score was 1.97 (standard deviation [SD] = 0.861) and mean health service use frequency was 1.61 (SD = 3.406) per month. Compared with participants with no multimorbidity, those with multimorbidity were more likely to report low self-rated health (β = −0.141, p<0.001), more severe depressive symptoms (β = 0.100, p<0.001), and more health service use (β = 0.121, p<0.001). Low self-rated health may be caused by depression and health service use (β = −0.280, p<0.001). The effect of multimorbidity on self-rated health was significantly mediated by depression (β = −0.024, p<0.001) and health service use (β = −0.034, p<0.001).Conclusion: Multimorbidity is associated with self-rated health, and depression and health service use mediate this association. Prevention and proper management of multimorbidity and depression in long-term care residents may help to maintain and improve quality of life.

scholarly journals Gender Differences in Self-Rated Health among University Students in England, Wales and Northern Ireland: Do Confounding Variables Matter?

2016 ◽  
Vol 8 (11) ◽  
pp. 168 ◽  
Author(s):  
Walid EL-Ansari ◽  
Christiane Stock
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Physical Health ◽  
Service Use ◽  
Health Behaviours ◽  
Well Being ◽  
Health Service Use ◽  
Health Complaints ◽  
Self Rated Health

<p><strong>INTRODUCTION:</strong> We assessed gender differences in self-rated health (SRH) while considering physical health, health complaints, health service use, wider wellbeing, and health behaviours.</p><p><strong>METHODS:</strong> 3706 undergraduates at 7 Universities in the United Kingdom completed a self-administered questionnaire (2009–2008). Logistic regressions with excellent/very good SRH as dependent variable assessed the variables that explained the SRH sex difference. </p><p><strong>RESULTS:</strong> Females had more health complaints, illness periods, lower quality of life, more burdens, and took medication/s more often. The crude (unadjusted) odds ratio (OR) proposed that females were less likely to report excellent/very good SRH than males [OR 0.79, 95% CI 0.68-0.94]. Adjusting only for physical health and health service use, females’ OR increased considerably, and the association between female sex and SRH was no longer significant. Also, when adjusting only for wider well-being or when adjusting only for health behaviour, the negative association between females and SRH was no longer significant. Adjusting for all the variables simultaneously (physical health, health service use, wider well-being, health behaviours) resulted in considerable increase of females’ OR indicating now a positive association between female sex and SRH [OR 1.33, 95% CI 1.04-1.74].  </p><p><strong>CONCLUSION:</strong> Females’ lower SRH found in the crude analyses was confounded by their higher stress level, lower quality of life, lower physical activity and by more illnesses or health complaints when compared with males. Gender-related SRH research should control for many potential confounders to prevent overestimation of the gender effect. Health promotion programs should consider these factors when tackling gender health disparities.</p>

scholarly journals Factors Affecting Quality of Home Based Long-term Care Provision for the Bedridden Patients in Chandigarh, North India

2015 ◽  
Vol 49 (3) ◽  
pp. 126-131
Author(s):  
Tarundeep Singh ◽  
Amarjeet Singh Minhas
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
North India ◽  
Care Provision ◽  
Term Care ◽  
Factors Affecting ◽  
Home Based ◽  
The Subject

ABSTRACT Objective To determine the factors affecting the quality of home based long-term care (LTC) provision for the adult bedridden patients in Chandigarh, India. Materials and methods This cross-sectional study was conducted on 100 bedridden patients in Chandigarh. Disability was assessed using the Katz index and an interview schedule based on Craig handicap assessment and reporting technique (CHART) was used to assess the care provision to the bedridden patients. Available medical records and brief medical examination were also conducted on the spot. Quality of care was assessed based on the Donabedian model. Factors associated with the quality of care provision, based on literature, were examined for association in the study cases. Results Mean age of the bedridden patients was 69 years. Sixtyeight patients lived in joint families. All had total dependence in the domains of bathing, dressing, toileting and transfer. The commonest cause of disability was neurological diseases. Mean duration of being bedridden was 16.4 months. Though the rates of complications like urinary infections (89%), bedsores (54%) were quite high, 57% patients reported satisfaction with the quality of care they were receiving. However, only 18 males and 6 females subjects were receiving good quality care according to our evaluation. Ownership of property/money by the subject was the only factor found to be associated with good quality of care. Gender of the subject, degree of disability, type of family in which the subject was living in and whether the patient is currently married or not did not seem to significantly affect the quality of care received by the subjects. Conclusion Though more than half of the study subjects reported subjective satisfaction with the quality of care being received, objective evaluation based on the study criteria showed that only a quarter were actually receiving good quality care. Furthermore, the economic worth seemed to positively influence the quality of care being received by the subjects. How to cite this article Singh T, Minhas AS. Factors Affecting Quality of Home Based Long-term Care Provision for the Bedridden Patients in Chandigarh, North India. J Postgrad Med Edu Res 2015;49(3):126-131.

scholarly journals Depressive symptoms and associated factors in residents living in long-term care facilities from the metropolitan area of Belo Horizonte

2020 ◽  
Vol 14 (4) ◽  
pp. 252-258
Author(s):  
Poliana Fialho de Carvalho ◽  
Claudia Venturini ◽  
Tatiana Teixeira Barral de Lacerda ◽  
Marina Celly Martins Ribeiro de Souza ◽  
Lygia Paccini Lustosa ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Long Term Care ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Cross Sectional ◽  
Term Care ◽  
Self Rated Health ◽  
Care Facilities

OBJECTIVE: To identify the presence of depressive symptoms and its association with self-rated health among older adults living in Long-term Care Facilities. METHODS: This is a cross-sectional study in which institutionalized older adults were screened by using the Mental State Mini Exam. Standard questionnaires were used to collect the following data: 1) sociodemographic variables, 2) depressive symptoms, and 3) self-rated health. The descriptive statistical analysis by measures of central tendency and dispersion was performed to characterize the sample. The multinomial logistic regression analysis was performed to associate the variables. In all tests, the alpha value of 0.05 was considered. RESULTS: A total of 127 older adults living in 47 long-term care facilities were evaluated. Among those who presented depressive symptoms, 32.3% were classified as having mild symptoms and 13.4% had severe symptoms. Regarding self-rated health, 46.5% considered it poor/very poor. In the analysis of the association between mild and severe depressive symptoms and self-rated health, statistical significance (p = 0.004 and p = 0.001, respectively) was found. CONCLUSIONS: The results of this study suggest that more attention should be directed to institutionalized older adults who have symptoms of depression and to their impacts on the negative self-rated health.

scholarly journals Do home-based exercise interventions improve outcomes for frail older people? Findings from a systematic review

2011 ◽  
Vol 22 (1) ◽  
pp. 68-78 ◽  
Author(s):  
Andrew P Clegg ◽  
Sally E Barber ◽  
John B Young ◽  
Anne Forster ◽  
Steve J Iliffe
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Frail Older People ◽  
High Quality ◽  
Term Care ◽  
Exercise Interventions ◽  
Home Based ◽  
Secondary Outcomes

SummaryFrailty is common in older age, and is associated with important adverse health outcomes, including increased risk of disability and long-term care admission.This study aims to evaluate whether home-based exercise interventions improve outcomes for frail older people.We searched systematically for randomized controlled trials (RCTs) and cluster RCTs, with literature searching to February 2010.All trials that evaluated home-based exercise interventions for frail older people were eligible. Primary outcomes were mobility, quality of life and daily living activities. Secondary outcomes included long-term care admission and hospitalization.Six RCTs involving 987 participants met the inclusion criteria. Four trials were considered of high quality. One high-quality trial reported improved disability in those with moderate but not severe frailty. Meta-analysis of long-term care admission rates identified a trend towards reduced risk. Inconsistent effects on other primary and secondary outcomes were reported in the other studies.There is preliminary evidence that home-based exercise interventions may improve disability in older people with moderate, but not severe, frailty. There is considerable uncertainty regarding effects on important outcomes including quality of life and long-term care admission. Home-based exercises are a potentially simple, safe and widely applicable intervention to prevent dependency decline for frail older people.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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