Effect of an Integrated Healthcare Program for Korean Rural Older Adults: A Quasi-Experimental Study

Studies have been conducted on the development of healthcare programs for older adults in rural areas, not only in Asia but also in Europe and the United States. However, these reports have been limited by largely non-comprehensive results, lack of demand surveys, or programs with no systematic development. The purpose of this study was to develop an integrated healthcare program for rural older adults and investigate the effects of the program. A nonequivalent control group pretest–posttest design was used. Subjects were aged over 65 and lived in the rural community. The integrated healthcare program involved 12 three-hour sessions over 12 weeks. Compared with the control group, the experimental group demonstrated significant differences in both upper extremities strengths (t = 2.74, p = 0.008; t = 2.03, p = 0.047), static balance (z = −2.38, p = 0.017), dynamic balance (t = −4.82, p < 0.001), loneliness (t = −3.02, p = 0.003), and role self-efficacy (t = 2.39, p = 0.020), but no differences for ego integration (t = 1.51, p = 0.137). To improve physical, mental, and social health of the rural older adults, we developed an integrated healthcare program. The program improved physical functions, loneliness, and role self-efficiency of the rural older adults. Therefore, it is recommended that healthcare professionals actively apply this program in primary healthcare institutes and elsewhere.

Download Full-text

COMPASSION-BASED ENVIRONMENTAL VOLUNTEERISM AMONG OLDER ADULTS: A CASE STUDY OF TZU CHI RECYLING PROGRAM

Innovation in Aging ◽

10.1093/geroni/igz038.2690 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S734-S734

Author(s):

Hsinyi Hsiao ◽

Chiu-Tien Hsu ◽

Lei Chen ◽

Jinli Wu ◽

Pao-Sheng Chang ◽

...

Keyword(s):

Older Adults ◽

Environmental Sustainability ◽

Rural Areas ◽

Intervention Group ◽

Well Being ◽

Control Group ◽

Long Term Effects ◽

Social Good ◽

Quasi Experimental ◽

Environmental Volunteering

Abstract To promote environmental sustainability and mitigate climate change that causes numerous families to suffer from natural disasters, a group of older residents’ volunteer to recycle usable materials by setting up recycling stations in their communities and transform recycled bottles into eco-friendly blankets for disaster survivors globally. This study examined long-term effects of the peer-led Tzu Chi Recycling Program (TCRP) on older adults’ compassion, psychological and physiological well-being. Using a quasi-experimental design, 1-year longitudinal data were collected from older adults at recycling stations (intervention group n = 36) and community centers (control group n = 36) in rural areas in Southern Taiwan. Findings from two-way repeated analysis of variance show that TCRP significantly improved older adults’ self-compassion, compassion for others, depression, hostility, happiness, and hypertension. Older adults built resilience through environmental volunteering in the TCRP as an environmental sustainability model for health promotion and social good

Download Full-text

Environmental Volunteerism for Social Good: A Longitudinal Study of Older Adults’ Health

Research on Social Work Practice ◽

10.1177/1049731519892620 ◽

2019 ◽

Vol 30 (2) ◽

pp. 233-245 ◽

Cited By ~ 2

Author(s):

Hsin-Yi Hsiao ◽

Chiu-Tien Hsu ◽

Lei Chen ◽

Jinli Wu ◽

Pao-Sheng Chang ◽

...

Keyword(s):

Older Adults ◽

Environmental Sustainability ◽

Rural Areas ◽

Repeated Measures ◽

Longitudinal Design ◽

Intervention Group ◽

Control Group ◽

Design Data ◽

Social Good ◽

Quasi Experimental

Natural disasters and aging societies are increasingly prevalent globally. To improve environmental injustice and contribute to social good, the Tzu Chi Recycling Program engages older adult volunteers in recycling usable materials into eco-friendly blankets for disaster survivors. Drawing on life span and ecological systems theories, this study examined the longitudinal effects of this program on older adults’ mental and physical health. Using a quasi-experimental longitudinal design, data were collected from older adults at recycling stations (intervention group, n = 36) and community centers (control group, n = 36) in rural areas in Southern Taiwan. Findings from two-way repeated measures analysis of variance show that the program significantly improved older adults’ self-compassion, compassion for others, depression, hostility, happiness, and hypertension. Older adults built resilience and contributed to environmental sustainability and social good, which suggest a new avenue for social work practitioners and policy-makers to address social and environmental challenges.

Download Full-text

Effects of a Physical Exercise Program on Physiological, Psychological, and Physical Function of Older Adults in Rural Areas

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168487 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8487

Author(s):

Sunmi Kim ◽

Eun-Jee Lee ◽

Hyeon-Ok Kim

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Physical Function ◽

Psychological Health ◽

Rural Areas ◽

Exercise Program ◽

Control Group ◽

Exact Test ◽

Chi Squared ◽

Quasi Experimental

With the increase in the older population, there is a concern for health in older adults. This study aimed to develop a physical exercise program that combined walking and gymnastics for older adults residing in rural areas and to evaluate its effect on their physiological and psychological health and physical function. A quasi-experimental design was adopted. Participants were aged 65 years or older, with 94 and 130 participants in the experimental and control group, respectively. The program was implemented for seven months, from April–October 2016. Walking and gymnastics were performed once a week each, for about 60 and 50 min, respectively. Data were analyzed using the Chi-squared test, Fisher’s exact test, independent t-test, or Mann–Whitney U test. Results revealed that the experimental group participants displayed improved waist circumference (t = 1.70, p = 0.045), body mass index (U = 4691.00, p = 0.002), depressive symptoms (t = −2.94, p = 0.002), upper limb strength (t = 2.27, p = 0.012), and lower limb strength (t = 3.86, p < 0.001). Therefore, it can be presumed that the physical exercise program was effective and beneficial for older adults living in rural areas. This program is expected to contribute to maintaining and improving their health if implemented regularly in the future.

Download Full-text

Walking for Better Outcomes and Recovery: The Effect of WALK-FOR in Preventing Hospital-Associated Functional Decline Among Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glz025 ◽

2019 ◽

Vol 74 (10) ◽

pp. 1664-1670 ◽

Cited By ~ 13

Author(s):

Yaniv Cohen ◽

Anna Zisberg ◽

Yehudit Chayat ◽

Nurit Gur-Yaish ◽

Efrat Gil ◽

...

Keyword(s):

Older Adults ◽

Group Intervention ◽

Functional Decline ◽

Intervention Group ◽

Control Group ◽

Community Mobility ◽

Steps Per Day ◽

Quasi Experimental ◽

Activity Survey

Abstract Background In-hospital immobility of older adults is associated with hospital-associated functional decline (HAFD). This study examined the WALK-FOR program’s effects on HAFD prevention. Methods A quasi-experimental pre-post two-group (intervention group [IG] n = 188, control group [CG] n = 189) design was applied in two hospital internal medical units. On admission, patients reported pre-hospitalization functional status, which was assessed again at discharge and 1-month follow-up. Primary outcome was decline in basic activities of daily living (BADL), using the Modified Barthel Index. Secondary outcomes were decline in instrumental ADL (Lawton’s IADL scale) and community mobility (Yale Physical Activity Survey). All participants (75.1 ± 7 years old) were cognitively intact and ambulatory at admission. The WALK-FOR included a unit-tailored mobility program utilizing patient-and-staff education with a specific mobility goal (900 steps per day), measured by accelerometer. Results Decline in BADL occurred among 33% of the CG versus 23% of the IG (p = .02) at discharge, and among 43% of the CG versus 30% in the IG (p = .01) at 1-month follow-up. Similarly, 26% of the CG versus 15% of the IG declined in community mobility at 1-month follow-up (p = .01). Adjusted for major covariates, the intervention reduced the odds of decline in BADL by 41% (p = .05) at discharge and by 49% at 1-month follow-up (p = .01), and in community mobility by 63% (p = .02). There was no significant effect of the intervention on IADL decline (p = .19). Conclusions The WALK-FOR intervention is effective in reducing HAFD.

Download Full-text

Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

Journal of Aging Research and Lifestyle ◽

10.14283/jarlife.2021.4 ◽

2021 ◽

pp. 1-7

Author(s):

J.J. Aziz ◽

K.F. Reid ◽

J.A. Batsis ◽

R.A. Fielding

Keyword(s):

United States ◽

Older Adults ◽

Grip Strength ◽

Muscle Weakness ◽

Rural Areas ◽

Gait Speed ◽

The United States ◽

Cross Sectional ◽

Comorbidity Burden ◽

Urban Rural

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.

Download Full-text

Effects of water aerobics on posture alignment and risk of falls of older adults: an intervention study

Revista Brasileira de Ciências do Esporte ◽

10.1590/rbce.43.e011020 ◽

2021 ◽

Vol 43 ◽

Author(s):

Camila Costa Ibiapina Reis ◽

Marcos Antônio Pereira dos Santos ◽

Camila Feitosa da Costa ◽

Edna Maria Silva Araújo ◽

Luiz Roberto Ramos

Keyword(s):

Older Adults ◽

Fall Risk ◽

Intervention Study ◽

Intervention Group ◽

Control Group ◽

Body Segments ◽

Experimental Intervention ◽

Quasi Experimental ◽

Risk Of Falls ◽

Falls In Older Adults

ABSTRACT Considering that aging leads to losses in postural control and balance, our objective was to analyze the effects of water aerobics on posture alignment and risk of falls in older adults. A quasi-experimental intervention study included 49 older adults in the Intervention Group (IG) and 34 in the Control Group (CG). A plumbed symmetrograph assessed posture alignment, while a Time Up & Go test determined the fall risk. The IG performed water aerobics twice a week for three months. Posture alignment significantly improved in most body segments assessed for the IG, and worsened in the CG. The low risk of falls in the IG increased by 28% in relation to the CG. We concluded that water aerobics improved posture alignment and reduced fall risk in older adults.

Download Full-text

Proprioceptive Training to Improve Static and Dynamic Balance in Elderly

International Journal of Statistics in Medical Research ◽

10.6000/1929-6029.2021.10.18 ◽

2021 ◽

Vol 10 ◽

pp. 194-199

Author(s):

Giovanni Esposito ◽

Gaetano Altavilla ◽

Felice Di Domenico ◽

Sara Aliberti ◽

Tiziana D’Isanto ◽

...

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Dynamic Balance ◽

Step Test ◽

Control Group ◽

Static Balance ◽

Post Intervention ◽

Proprioceptive Training ◽

Risk Of Falls ◽

Experimental Group

Background: The risk of falls is a major cause of disability in older adults. A single fall, for the elderly, increases the risk of frequent falls and often causes an increased fear of falling again, which can become debilitating. Objectives: The purpose of the present study was to test the effects of 12 weeks of proprioceptive training on the static and dynamic balance of older adults who have experienced at least one fall without compromising consequences. Method: The sample consisted of older adults, aged 60 to 80 years, randomly divided into two groups: an experimental group, which followed a proprioceptive training protocol at a physiotherapy studio, and a control group, which did not observe any treatment. Static and dynamic balance assessment was performed pre-and post-intervention. The tests administered were the Berg Balance Test for the evaluation of static balance, and the Four-Square Step Test, for dynamic balance. A questionnaire to assess confidence and fear of falling was administered at the end of the protocol. Independent sample t-test was performed to analyze differences between groups and two-way ANOVA to test the null hypothesis of no change different over time between groups (interaction intervention × time). A Chi-Square was performed to analyze perceptions. Conclusions: The results showed that 12 weeks of proprioceptive training effectively improved dynamic and static balance in older adults. The perceptions of the experimental group were more positive than the other one, in terms of the importance of physical activity to prevent the risk of falls, fear of falling again, and experience of falls during the last 12 weeks.

Download Full-text

Challenges with Pain Treatment for Rural Older Adults: Family Caregivers' Views

Innovation in Aging ◽

10.1093/geroni/igab046.3220 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 893-894

Author(s):

Hyunjin Noh ◽

Cho Rong Won ◽

Zainab Suntai

Keyword(s):

Older Adults ◽

Health Insurance ◽

Family Caregivers ◽

Rural Areas ◽

Pain Treatment ◽

Financial Burden ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Thinking Skills ◽

Rural Older Adults

Abstract Family caregivers face various challenges in assisting older adults experiencing pain and difficult symptoms. Living in rural areas poses additional obstacles to their caregiving. The purpose of this study was to explore family caregivers’ lived experiences in caring for older adults with pain and discomfort in rural communities. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 18+, have good thinking skills, resident of Alabama, provide unpaid assistance to a family/relative who has chronic/serious health conditions and experienced pain/discomfort in the last 3 months. Ten participants were recruited from rural counties of Alabama. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Inductive, thematic analysis of the data revealed themes in five categories: 1) impact of pain (physical and psychological/emotional toll), 2) coping strategies (faith/contentment with life/logistical adaptation), 3) impact of Covid-19 (physical health/social interaction/mental health/added caregiving), 4) challenges in pain treatment (transportation (time/distance/driver/cost) and non-transportation related problems (healthcare provider issues/health insurance/financial burden)), and 5) suggestions (transportation-related (more transportation options/tailored services) and non-transportation-related support (home-based services/better health insurance coverage)). Findings of this study highlight rural family caregivers’ unique experiences in assisting older adults’ access to pain treatment, particularly during the Covid-19 pandemic. Policy- and program-level intervention is called for to increase individualized transportation options, improve health insurance coverage, and expand financial support for rural older adults experiencing pain and their caregivers.

Download Full-text

The Six-Month and One-Year Outcome of a Chronic Disease Self-Management Program Among Older Adults in Macao: A Quasi-Experimental Study

SAGE Open Nursing ◽

10.1177/2377960820958231 ◽

2020 ◽

Vol 6 ◽

pp. 237796082095823

Author(s):

Sok Man Leong ◽

Wai In Lei ◽

Un Wa Chan

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Healthcare Services ◽

Management Program ◽

Self Management ◽

Control Group ◽

Study Group ◽

Health Related ◽

Quasi Experimental ◽

One Year

Introduction Promoting older adults to self-manage their chronic conditions is a major focus of the Macao government and healthcare professionals since more than 80% of older adults have suffered chronic conditions. Objectives This study evaluated the effect of the Chronic Disease Self-management Program (CDSMP) on self-management behaviors, self-efficacy, health status, and healthcare services utilization among Macao older adults with chronic disease over six months, and assessed whether the intervention effect persisted for one year. Methods A longitudinal and quasi-experimental design was used in this study. A total number of 158 older adults with at least one chronic disease were recruited from three Macao community centers. Participants in the study group engaged in a six-session CDSMP in the community centers and participants in the control group received usual care. The Chronic Disease Self-management Questionnaire was used to assess the outcome measures for baseline, six-month and one-year assessment. Results The age of subjects ranged from 60 to 88, 64.6% had three or more chronic diseases. The results showed that the subjects in the study group had significant improvement in self-management behaviors, self-efficacy, and some health-related indicators at the point of six months, and these improvements were still observable at the point of one year when comparing to the control group. The results also showed that the study group had a decrease in healthcare services utilization, but there was no significant difference between the two groups. Conclusion This study confirmed that the community-dwelling older adults in Macao can acquire positive outcomes in self-management and health-related indicators from the CDSMP. Hence, it is worth promoting this program as a health promotion activity in community.

Download Full-text

Motivating rural older residents to prepare for disasters: moving beyond personal benefits

Ageing and Society ◽

10.1017/s0144686x15000914 ◽

2015 ◽

Vol 36 (10) ◽

pp. 2117-2140 ◽

Cited By ~ 10

Author(s):

SATO ASHIDA ◽

ERIN L. ROBINSON ◽

JANE GAY ◽

MARIZEN RAMIREZ

Keyword(s):

Older Adults ◽

Social Relationships ◽

Rural Areas ◽

Process Model ◽

Service Providers ◽

Social Groups ◽

The United States ◽

Adverse Outcomes ◽

Medical Needs ◽

Increased Risk

ABSTRACTIn the United States of America (USA), older adults in rural areas are at increased risk for adverse outcomes of disasters, partly due to medical needs, limited or long geographic distances from community resources, and less knowledge and motivation about preparedness steps. Older residents and ageing service providers in a rural community in the USA were interviewed regarding their perceptions about disasters and preparedness, and their reactions to the preparedness training programme using the concepts of the Extended Parallel Process Model. Participants generally indicated low motivation to engage in preparedness behaviours despite perceptions of personal risk and beliefs that preparedness behaviours were easy and could improve disaster outcomes. A theme of social relationships emerged from the data, with participants identifying social relationships as resources, barriers and motivators. People surrounding older adults can support or deter their preparedness behaviours, and sometimes elicit a desire to protect the wellbeing of others. Findings suggest two potential strategies to facilitate preparedness behaviours by moving beyond personal benefits: highlighting older adults' increased ability to protect the wellbeing of younger generations and their community by being prepared themselves, and engaging family, friends and neighbours in preparedness programmes to enhance the resilience of their social groups. Older adults in many cultures have a desire to contribute to their society. Novel and effective approaches to increase preparedness could target their social groups.

Download Full-text