Factors Related to the Dignity of Older People in Tehran in 2020

The elderly are the fastest growing segment of the population globally. This is also the case in developing countries such as Iran. The fear of aging and the refusal to accept older adults into the mainstream of society affects the dignity of older people. This study was conducted to describe factors and dignity of older people in Tehran, Iran. This descriptive, correlational study was conducted on a sample of 215 older people above age 60 in 10 public parks in five regions of Tehran in 2020. A socio-demographic questionnaire and patient dignity inventory were used for data collection. Content validity and Cronbach’s alpha were used for evaluating the validity and reliability of questionnaires. Data were analyzed with SPSS. 60% of subjects were male and 40% female with a mean age of 68(± 5.05) year. The mean scores for dignity domains ranged from 67.30 (±17.56) for symptom distress, to 93.01(± 10.90) for dependency on a 100-point scale. The scores of dignity domains were significantly associated with job status, housing status, income source, health insurance, chronic diseases, annual physician referral rates, and hospitalization in last year. The best predictors of dignity were health insurance and annual physician referral rates. The findings of this study showed that the dignity of older people is related to a number of factors. Monitoring modifiable factors such as health insurance and annual physician referral rates and non-modifiable factors such as chronic diseases will help us to preserve or improve the dignity of older people.

Impact of Physician Referral to Health Coaching on Patient Engagement and Health Risks: An Observational Study of UPMC’s Prescription for Wellness

Purpose: Evaluate impact of physician referral to health coaching on patient engagement and health risk reduction. Design: Four-year retrospective, observational cohort study with propensity-matched pair comparisons. Setting: Integrated delivery and finance system in Pittsburgh, Pennsylvania. Sample: 10 457 adult insured members referred to health coaching by their physician; 37 864 other members identified for health coaching through insurer-initiated outreach. Intervention: Practice-based, technology-supported workflow and process for physician prescribing of health coaching during regular office visit, with follow-up on patient’s progress and implementation supports. Measures: Patient engagement based on completion of pre-enrollment assessment, formal enrollment in health coaching, completion of required sessions, health risk levels, and number of health risks pre- and post-health coaching referral. Analysis: Difference-in-difference analysis to assess change in health risk levels and number of health risks pre- and post-health coaching and probability weighting to control for potential confounding between groups. Results: Members referred by a physician were significantly more likely to enroll in a health coaching program (21.0% vs 6.0%, P < .001) and complete the program requirements (8.5% vs 2.7%, P < .001) than when referred by insurer-initiated outreach; significant within group improvement in health risk levels from baseline ( P < .001) was observed for both the groups. Conclusions: Patients are significantly more likely to engage in health coaching when a referral is made by a physician; engagement in health coaching significantly improves health risk levels.