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CASP-19 special section: how does chronic disease status affect CASP quality of life at older ages? examining the WHO ICF disability domains as mediators of this relationship
- Authors:
- SEXTON E., et al
- Journal article citation:
- Aging and Mental Health, 19(7), 2015, pp.622-633.
- Publisher:
- Taylor and Francis
Objectives: The effect of chronic disease status on quality of life (QoL) has been well established. However, less is known about how chronic diseases affect QoL. This article examines impairment in three domains of the WHO International Classification of Functioning, Health and Disability (ICF) – body function, activity and participation, as well as affective well-being, – as potential mediators of the relationship between chronic disease and QoL. Method: A cross-sectional sample (n = 4961) of the general Irish community-dwelling population aged 50+ years was obtained from the Irish Longitudinal Study of Ageing (TILDA). The CASP measure of QoL was examined as two dimensions – control/autonomy and self-realisation/pleasure. Structural equation modelling was used to test the direct and indirect effects of chronic disease on QoL, via variables capturing body function, activity, participation and positive affect. Results: A factor analysis showed that indicators of body function and activity loaded onto a single overall physical impairment factor. This physical impairment factor fully mediated the effect of chronic disease on positive affect and QoL. The total effect of chronic disease on control/autonomy (−0.160) was primarily composed of an indirect effect via physical impairment (−0.86), and via physical impairment and positive affect (−0.45). The decomposition of effects on self-realisation/pleasure was similar, although the direct effect of physical impairment was weaker. The model fitted the data well (RMSEA = 0.02, TLI = 0.96, CFI = 0.96). Conclusion: Chronic disease affects QoL through increased deficits in physical body function and activity. This overall physical impairment affects QoL both directly and indirectly via reduced positive affect. (Publisher abstract)
Moderating effects of psychosocial attributes on the association between risk factors and disability in later life
- Authors:
- JANG Y., et al
- Journal article citation:
- Aging and Mental Health, 7(3), May 2003, pp.163-170.
- Publisher:
- Taylor and Francis
This study examined the roles of psychosocial attributes in the associations between potential risk factors (age, gender, marital status, education, and chronic conditions) and disability in later life, and in particular how neuroticism and social resources (social network, received support, and satisfaction with support) modify the linkages between risk factors and disability. The main and moderating effects were empirically tested using a sample of 444 community-dwelling older adults in Florida( M age1/472.3) who were cognitively intact. The likelihood of disability increased with advancing age, more chronic conditions, higher levels of neuroticism, more received support, and less satisfaction with support. In addition to the main effects, neuroticism and received support interacted with age and chronic conditions, strengthening the associations between risk factors and disability. Results suggested that personality and social support deserve greater attention as factors that can alter the disability process.
Factors associated with frailty in chronically ill older adults
- Author:
- HACKSTAFF Lynn
- Journal article citation:
- Social Work in Health Care, 48(8), November 2009, pp.798-811.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
An ex post facto analysis of a secondary dataset examined relationships between physical frailty, depression and the self-perceived domains of health status and quality-of-life in older adults. The randomised sample included 992 community-dwelling, chronically ill and functionally impaired adults age 65 and older who received care from a Southern California Kaiser Permanente medical centre between 1998 and 2002. The purpose of the study was to identify possible intervention junctures related to self-efficacy of older adults in order to help optimise their functionality. Multivariate correlation analyses showed statistically significant positive correlations between frailty level and depression (r = .18; p = < .05), number of medical conditions (r = .09; p = < .05), and self-rated quality-of-life (r = .24; p = < .05). Frailty level showed a statistically significant negative correlation with self-perceived health status (r = -.25; p = < .05). Notably, no statistically significant correlation was found between age and frailty level (r = -.03; p = < .05). In linear regression, self-perceived health status had a partial variance with frailty level (part r = -.18). The significant correlations found support further research to identify interventions to help vulnerable, older adults challenge self-perceived capabilities so that they may achieve optimum functionality through increased physical activity earlier on, and increased self-efficacy to support successful adaptation to ageing-related losses.
Escape loneliness by going digital: a quantitative and qualitative evaluation of a Dutch experiment in using ECT to overcome loneliness among older adults
- Authors:
- FOKKEMA T., KNIPSCHEER K.
- Journal article citation:
- Aging and Mental Health, 11(5), September 2007, pp.496-504.
- Publisher:
- Taylor and Francis
This study evaluates the outcomes of an Internet-at-home intervention experiment that intended to decrease loneliness among chronically ill and physically disabled older adults through introducing them to the use of an electronic communication facility. To determine the effectiveness of the experiment in terms of reducing loneliness, 15 older adults were interviewed three times: shortly before the start, two years later and immediately after termination of the experiment, while their loneliness scores at zero and post-measurement were compared with those of a control group. Both the participants and the control persons experienced a reduction in loneliness over time. However, the reduction was only significant for the intervention participants. Moreover, the changes in loneliness were significantly greater among the participants compared to the control persons. When looking more in detail, the effect of the experiment was only significant regarding emotional loneliness and among the highest educated. Findings of the qualitative research enabled us to understand the mechanisms through which the intervention helped alleviate loneliness. E-mail was found to facilitate social contact. Furthermore, the computer and Internet were often used to pass the time, taking people's minds off their loneliness. Unexpectedly, the intervention also improved people's self-confidence. The decline in loneliness is likely to be greater if persons under more favourable circumstances are selected and if more social functions of the Internet are used.
Do it yourself
- Author:
- HOCKING Josephine
- Journal article citation:
- Community Care, 3.5.07, 2007, pp.36-37.
- Publisher:
- Reed Business Information
Online self-assessment for of need by older and disabled people is being piloted in Kingston upon Thames. The pilot offers older and disabled people to assess themselves for small items of daily living equipment. The author looks at progress so far, and lessons learned.
Health in old age: myth, mystery and management
- Author:
- SIDELL Moyra
- Publisher:
- Open University Press
- Publication year:
- 1995
- Pagination:
- 198p.,bibliog.
- Place of publication:
- Buckingham
Looks at myths surrounding health in older age. Includes chapters on: patterns of health and illness among older people; understanding chronic illness and disability; maintaining health with physical illness and functional disability; maintaining health with mental malaise; health care and the management of health; personal resources and social support; and a healthy future for old age.
Facilitators and barriers to autonomy: a systematic literature review for older adults with physical impairments, living in residential care facilities
- Authors:
- van LOON Jolande, et al
- Journal article citation:
- Ageing and Society, early cite 30 October 2019,
- Publisher:
- Cambridge University Press
Autonomy is important in every stage of life. However, little is known about how autonomy is enhanced for older adults living in residential care facilities (RCFs). This leads to the research question: which facilitators and barriers to autonomy of older adults with physical impairments due to ageing and chronic health conditions living in RCFs are known? The results will be organised according to the framework of person-centred practice, because this is related to autonomy enhancement. To answer the research question, a systematic literature search and review was performed in the electronic databases CINAHL, PsycINFO, PubMed, Social Services Abstracts and Sociological Abstracts. Inclusion and exclusion criteria were derived from the research question. Selected articles were analysed and assessed on quality using the Mixed Methods Appraisal Tool. Facilitators and barriers for autonomy were found and arranged in four themes: characteristics of residents, prerequisites of professional care-givers, care processes between resident and care-giver, and environment of care. The established facilitators and barriers are relational and dynamic. For a better understanding of the facilitators and barriers to autonomy for older adults with physical impairments living in RCFs, a description is based on the 35 included articles. Autonomy is a capacity to influence the environment and make decisions irrespective of having executional autonomy, to live the kind of life someone desires to live in the face of diminishing social, physical and/or cognitive resources and dependency, and it develops in relationships. The results provide an actual overview and lead to a better understanding of barriers and facilitators for the autonomy of older adults with physical impairments in RCFs. For both residents and care-givers, results offer possibilities to sustain and reinforce autonomy. Scientifically, the study creates new knowledge on factors that influence autonomy, which can be used to enhance autonomy. (Edited publisher abstract)
Valuing older people: positive psychological practice
- Author:
- STIRLING Elspeth
- Publisher:
- Wiley-Blackwell
- Publication year:
- 2010
- Pagination:
- 213p., bibliog.
- Place of publication:
- Chichester
A global guide to positive psychological practice when dealing with older and very old people. The author, previously a clinical psychologist, champions social role valorisation (SRV) in relation to older people and ageing. SRV theory is based on opposing society’s tendency to devalue particular groups of people because they are ‘different. The author applies it, not only to counteract stereotyped attitudes that older people are valueless, but to promote beneficial effects of having our elders active in society and observing and learning from, for example, their coping behaviour. Chapters cover: the psychology and ecology of ageing; preventive psychology in later life; assessment in the new paradigm; new paradigm principles for intervention; older people and cognitive disabilities; new paradigm principles of service design; and psychological therapies with older people.
A textbook of social work
- Authors:
- SHELDON Brian, MACDONALD Geraldine
- Publisher:
- Routledge
- Publication year:
- 2009
- Pagination:
- 429p., bibliog.
- Place of publication:
- London
This publication is a comprehensive, evidence-based guide to social work practice. It strikes a balance between the need for social workers to understand the social, economic, cultural, psychological and interpersonal factors which give rise to clients' problems, and the need for them to know how best to respond with practical measures. Divided into three accessible parts, the text covers context and theory in the first part and social work skills and methods in the second part. The final part looks at the major specialisms, including, among others, chapters on: children, people with mental health problems; older people; chronic illness and physical disability; learning disability; juvenile and adult offenders; substance misusers.
Better care, higher standards: a charter for long-term care; a summary for users and carers
- Authors:
- GREAT BRITAIN. Department of Health, GREAT BRITAIN. Department of the Environment, Transport and the Regions
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 1999
- Pagination:
- 10p.
- Place of publication:
- London
Charter for anyone in England who is eighteen or over and has difficulties associated with old age, long term illness or disability; and carers who support people in these circumstances. The Charter tells anyone who needs care or support over the long term where they can expect local housing, health and social services to set standards for the services they provide and what to do if these expectations are not met.