Functional health and the health stock

Keyword(s):  
BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049944
Author(s):  
Sarah K Schäfer ◽  
Robert Fleischmann ◽  
Bettina von Sarnowski ◽  
Dominic Bläsing ◽  
Agnes Flöel ◽  
...  

IntroductionStroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke.Methods and analysisThe study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models.Ethics and disseminationThe study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives.Trial registration numberNCT04704635.


Author(s):  
Maria Chiara Fastame ◽  
Ilaria Mulas ◽  
Valeria Putzu ◽  
Gesuina Asoni ◽  
Daniela Viale ◽  
...  

AbstractThe effect of the COVID-19 on the physical and mental health of Italian older individuals displaying signs of cognitive deterioration has not been deeply investigated. This longitudinal study examined the impact of COVID-19 lockdown measures on the psychological well-being and motor efficiency of a sample of Italian community-dwellers with and without cognitive decline. Forty-seven participants underwent instrumental gait analysis performed in ecological setting using wearable sensors, and completed a battery of tasks assessing cognitive functioning and psychological well-being, before and after the full lockdown due to the COVID-19 spreading. A series of Multivariate Analyses of Variance (MANOVAs) documented that the superior gait performance of the cognitively healthy participants exhibited before the COVID-19 spread, vanished when they were tested at the end of the lockdown period. Moreover, before the outbreak of the COVID-19, cognitively healthy participants and those with signs of cognitive decline reported similar levels of psychological well-being, whereas, after the lockdown, the former group reported better coping, emotional competencies, and general well-being than the participants displaying signs of cognitive decline. In conclusion, the full COVID-19 outbreak had a significant impact on the mental and motor functioning of older individuals with and without signs of cognitive deterioration living in Italy.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth A. Salerno ◽  
Neha P. Gothe ◽  
Jason Fanning ◽  
Lindsay L. Peterson ◽  
Graham A. Colditz ◽  
...  

Abstract Background Supervised physical activity interventions improve functional health during cancer survivorship, but remain costly and inaccessible for many. We previously reported on the benefits of a DVD-delivered physical activity program (FlexToBa™) in older adults. This is a secondary analysis of the intervention effects among cancer survivors in the original sample. Methods Low active, older adults who self-reported a history of cancer (N = 46; M time since diagnosis = 10.7 ± 9.4 years) participated in a 6-month, home-based physical activity intervention. Participants were randomized to either the DVD-delivered physical activity program focused on flexibility, toning, and balance (FlexToBa™; n = 22) or an attentional control condition (n = 24). Physical function was assessed by the Short Physical Performance Battery (SPPB) at baseline, end of intervention, and at 12 and 24 months after baseline. Results Repeated measures linear mixed models indicated a significant group*time interaction for the SPPB total score (β = − 1.14, p = 0.048), driven by improved function from baseline to six months in the FlexToBa™ group. The intervention group also had improved balance (β = − 0.56, p = 0.041) compared with controls. Similar trends emerged for the SPPB total score during follow-up; the group*time interaction from 0 to 12 months approached significance (β = − 0.97, p = 0.089) and was significant from 0 to 24 months (β = − 1.84, p = 0.012). No significant interactions emerged for other outcomes (ps > 0.11). Conclusions A DVD-delivered physical activity intervention designed for cancer-free older adults was capable of eliciting and maintaining clinically meaningful functional improvements in a subgroup of cancer survivors, with similar effects to the original full sample. These findings inform the dissemination of evidence-based physical activity programs during survivorship. Trial registration ClinicalTrials.govNCT01030419. Registered 11 December 2009


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 423-423
Author(s):  
Meredith Troutman-Jordan

Abstract Aging presents change in the form of opportunities and challenges, from common physical alterations, to major life events. Perception of such events is greatly shaped by one’s mental health, and is a major influence on gerotranscendence, a positive kind of aging involving redefinition of self, relationships, and proposed to be a precursor to successful aging. A mixed-methods cross-sectional descriptive design was used to study 50 older adults. Life Events Checklist, Gerotranscendence Scale, Herth Hope Index, and Successful Aging Inventory were administered. Mean participant age was 70.78 years; there were 9 males (18%), 41 females (82%), 13 were Black (26%), and 37 were White (74%). Participants reported a number of stressful events, most frequently transportation accidents, followed by other very stressful events or experiences, and sudden unexpected death of someone close. Gerotranscendence scores ranged from 0-10 (µ 6.88, a moderate score). Successful aging scores ranged from 40-79 (µ 62.33, a moderate score). A sub-sample of 6 participants engaged in semi-structured interviews, which were transcribed verbatim and subject to content analysis. Faith, displaced longing, temporal anticipation, proactive problem-solving/coping, and concern for future generations were emergent qualitative themes. Findings highlight opportunities for providers from multiple disciplines to target risks and possibilities for aging successfully and to promote hope, optimism, problem-solving skills, and gerotranscendence in all older adults, regardless of physical or functional health status.


2021 ◽  
pp. 105477382110068
Author(s):  
Luis Angel Cendejas Medina ◽  
Renan Alves Silva ◽  
Magda Milleyde de Sousa Lima ◽  
Lívia Moreira Barros ◽  
Rafael Oliveira Pitta Lopes ◽  
...  

To analyze the correlation between functional health literacy (FHL) and self-efficacy (SE) in people with type 2 Diabetes Mellitus. Cross-sectional study was conducted among September and October 2019, with 196 people with type 2 diabetes. Data were collected using the Functional Literacy in Health instrument (B-TOFHLA) and the Diabetes Management Self-Efficacy Scale for Patients with Type 2 Diabetes Mellitus (DMSES). Bivariate analysis was used to verify the relationship among the constructs. Most diabetics showed an average B-TOFHLA score of 74.75, considered adequate, and self-efficacy of 4.07, high. The association between SE and FHL in the bivariate analysis found no statistical significance ( p > .05), in the same sense as the B-TOFHLA score and the DMSES domains ( p > .05). Constructs were not related to each other in terms of skills arising from judgments and decisions with motivational confidence by the investigated audience.


2021 ◽  
pp. 003022282110009
Author(s):  
Li Ping Wong ◽  
Sik Loo Tan ◽  
Haridah Alias ◽  
Thiam Eng Sia ◽  
Aik Saw

The COVID-19 pandemic has put a hold on the Silent Mentor Programme (SMP); this pause has not only caused unprecedented challenges for the delivery of medical education but has forced changes in the programme ceremony sessions. We aimed to describe the psychological impact and experiences of family members of silent mentors during the COVID-19 pandemic using qualitative interviews. Many expressed feelings of remorse and unrest about the unprecedented delay of the SMP. The delay increased negative emotions particularly among some elderly family members; however, there was no prominent negative effect on their functional health and well-being. Several participants relayed the belief that the soul cannot rest until the body receives a proper burial while some worried about the deterioration of the physical condition of the mentors. In conclusion, findings provide insights into the importance of not overlooking the mental health implications of delaying the SMP in future outbreaks or crises.


2021 ◽  
Vol 7 ◽  
pp. 237796082110058
Author(s):  
Ronald L. Hickman ◽  
John M. Clochesy ◽  
Marym Alaamri

Introduction Hypertension is a life-limiting, chronic condition affecting millions of Americans. Modifiable factors, quality of the patient-provider interaction and functional health literacy, have been linked to effective hypertension self-management. However, there has been limited interventional research targeting these modifiable factors. Electronic hypertension self-management interventions, in particular those incorporating virtual simulation, may positively influence the quality of the patient-provider interaction and functional health literacy status of adults with hypertension. Yet there is a dearth of evidence examining the efficacy of eHealth interventions targeting these modifiable factors of hypertension self-management. Objective Evaluate the effects of two electronic hypertension self-management interventions on the quality of the patient-provider interaction and functional health literacy in adults with hypertension. Methods A convenience sample of community-dwelling adults (>18 years) with hypertension were recruited and randomized to an avatar-based simulation (eSMART-HTN) or a video presentation on hypertension self-management (attention control). Participants were administered questionnaires to capture demographic characteristics, the quality of the patient-provider interaction, and functional health literacy. Questionnaire data were collected at baseline, and then monthly across three months. Two separate repeated measures analysis of covariance models were conducted to assess the effects of the interventions across the time points. Results The sample included 109 participants who were predominately middle-aged and older, nonwhite, and female. Scores for the quality of the patient-provider interaction demonstrated significant within-group changes across time. However, there were no significant differences in the quality of the patient-provider interaction or functional health literacy scores between experimental conditions while adjusting for covariates. Conclusion An avatar-based simulation (eSMART-HTN) intervention proved to have a positive effect on patient-provider interaction compared to an attention control condition. Although the results are promising, future research is needed to optimize the effectiveness of eSMART-HTN and enhance its efficacy and scalability in a larger cohort of adults with hypertension.


Author(s):  
Matthew J. Leach ◽  
Sue Nichols ◽  
Sven Trenholm ◽  
Martin Jones

Background Supporting a child’s healthy development is determined, in part, by a parent’s ability to seek, access, interpret and effectively utilize health information. This aspect of parenting draws on a set of skills referred to as health literacy. Objective To assess the level of health literacy among parents/carers in a regional South Australian community. Methods Parents/carers of primary school-aged children, residing in Whyalla, South Australia, were invited to complete the 13-item All Aspects of Health Literacy Survey. Results 155 parents/carers completed the survey (79% mothers). Most participants were English-speaking (97%), employed (62%) and had 2–3 children (62%), with 52% completing tertiary education. Median total health literacy scores were mostly in the moderate-high range (median 27, IQR 26,27), as were critical health literacy scores (median 7, IQR 6,8). Higher scores were reported for functional health literacy (median 8, IQR 7,9), communicative health literacy (median 9, IQR 8,9) and empowerment health literacy (median 4, IQR 3,5). Conclusions Our findings reveal modest levels of health literacy among a sample of parents/carers of primary school-aged children in a regional South Australian community. Further work is needed to understand the differential effect of parental health literacy on child health outcomes, and the types of strategies that may mitigate the impact of these barriers on a child’s healthy development.


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