The Status and Associated Factors of Doctor-Patient Communication from Older Adult's Perspective in the City of Tehran in 2023

The current study investigated balanced time perspective (BTP) in adults across the life span (N = 400, 43.3% males). Boniwell and Zimbardo (2004) defined BTP as the flow and flexibility of connecting to the past, living in the present, and looking forward to the future and argued that is an optimal time perspective associated with happiness and well-being. Using Time Attitude Scale (Mello & Worrell, 2012), younger (M = 26.09 years), middle-aged (M = 46.72 years), and older (M = 64.25 years) adults subjective ratings of their positive and negative attitudes towards the past, present, and future were used to identify individuals who had a BTP.;Construct validity of the measure of BTP, Time Attitude Scale (Mello & Worrell, 2012) firstly used in BTP literature, was addressed by examining convergent validity and discriminant validity. The past and future (positive and negative) subscales demonstrated convergent and discriminant validity. However, the present (positive and negative) subscales did not demonstrate convergent validity, as the subscales were weakly correlated with other co-construct measures, (e.g., present hedonistic subscale in Zimbardo Time Perspective Inventory, Zimbardo & Boyd, 1999). Also, the present subscales did not demonstrate discriminant validity as the subscales were strongly correlated with other cross-construct measures (e.g., subjective well-being, Diener, Emmons, Larsen, & Griffin, 1985, r = .85 with present positive, and -.83 with present negative subscales). The present time attitude subscales appeared to correspond to subjective well-being.;Since Time Attitude Scale (Mello & Worrell, 2012) was adapted from prior research on adolescents, the current study investigated the measurement invariance of the measure across age groups of young, middle-aged, and older adults. A multi-group analysis indicated that the Time Attitude Scale (Mello & Worrell, 2012) was invariant across age groups at the weak (factor loading) level, suggesting that the Time Attitude Scale could be used in adult across the life span sample. Age differences in time attitude were found in positive and negative attitudes towards the future when each subscale was examined separately. Older adults viewed their future as more negative and less positive, compared to younger and middle-aged adults, in accord with prior research. A cluster analysis using the six (3 time frame---past, present, future x 2 valence---positive, negative) subscales indicated four distinct time attitude profiles: balanced (52%), negative past (15%), uncertain (22%), and negative (11%). Age differences were not found in membership in any of the four profiles. Associations between BTP and indicators of positive

Background: Older adults account for 25% of all Emergency Department (ED) attendances and experience high rates of adverse outcomes after being discharged from the ED. Internationally, health policy is promoting Integrated Care for older adults where, ED visits are considered as an integral part of the older adult’s continuum of care. Evidence suggests that by bridging care interventions before and after ED discharge it, can lead to better outcomes for older adults. Currently, it is not known if these bridging care interventions respond to the needs of older adults transitioning from the ED. A comprehensive understanding of older adults’ experiences of transition home from the ED is required. Therefore, a systematic review and synthesis of qualitative studies was completed to describe older adult’s experiences of transition from the ED. Who is it for? Policy Makers, Health Care Professionals, Older Adults, Stakeholder Groups, Non-Profit Organisations, Researchers (Older Adults and Integrated Care). Who did you involve and engage with? The topic was identified as a priority by an Older Person Panel and the study was conceived by an interdisciplinary group of health researchers. Analysis is on-going currently. Preliminary findings of the qualitative synthesis will be shared and identified themes discussed and refined with this Older Person Panel. Further meetings will be convened to discuss key implications of the findings and to develop a lay summary of the findings for dissemination to relevant stakeholders. What did you do? The research question was developed and a protocol for a Qualitative Evidence Synthesis (QES) was registered on PROSPERO. This QES included qualitative studies of older adults (65+) experiences and perspectives of transition from the ED. A full database search was completed using three key search terms: Qualitative Research, ED, and Older Person. 4373 articles were retrieved and 9 articles were included after screening. Included articles were quality assessed using the CASP quality appraisal checklist. Data from the included studies was synthesized using the six-stage approach to meta-ethnography described by Noblit and Hare. Findings and Impact: Key findings/themes of this study include: Fragmented Care when transitioning from the ED, the value of communication, risk of readmission to the ED and symptom management. These findings are relevant for those developing interventions for this population. Learning for International audience: Address ways to improve the delivery of care for the complex needs among older persons when transitioning between Emergency Department and Integrated Care. Assist with the Clinical Pathway Development of older persons between ED and Integrated Care/Community. What are the next steps? A Qualitative Descriptive study using semi structed interviews with older adults to examine their experiences and perspectives of GP Integrated Service i

Representations of older adults in COVID-related newspaper articles: A comparison between the perspectives of older and younger adults

There is a consensus that the aging population is beginning to impact on many facets of our life. They have more medical problems and the potential to "drain" the focus of the medical community, as well as national budgets with their accompanying medical bills. Personal strategies related to active aging will help us to better understand and identify how older adults in Europe prepare themselves for the natural process of aging and what are their personal approaches to active aging. The objective of this review was to synthesize the best available evidence regarding the older adult's perspective on the personal strategies related to active aging among older adults in Europe. This review considered studies that included older adults (age over 55 years) who live in Europe. This review considered studies that investigated older adults' perspectives on (any) personal strategies related to active aging. Europe (considering "some similarity" in health care systems and retirement policies). This review considered any qualitative designs. A three-step search strategy was used to identify published and unpublished studies. The extensive search process was conducted in October 2014 and considered published and unpublished studies from the inception of databases until October 2014. Studies published in any language which had an abstract in English, Czech and Slovak languages were considered for inclusion in this review. Studies were appraised for methodological quality by two independent reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from the papers included in the review by two independent reviewers using the standardized JBI-QARI data extraction tool. Data synthesis was performed using the meta-aggregation approach of meta-synthesis recommended by the Joanna Briggs Institute. Fourteen studies were included in this systematic review. From these 14 studies, 42 findings were extracted; findings were synthesized into four categories: (1) positive approach to life, (2) mental, social and physical activities, (3) adaptation, and (4) financial independence. Categories were synthesized into two synthesized findings: (1) if older adults adapt to changing situations and choose a positive attitude, they can find an active way to live and also a mission and meaning in their lives, (2) if older adults learn new activities, participate in exercise, keep balanced relationships and manage their financial resources, they will stay mentally, socially and physically active, and also financially responsible. If older Europeans learn new activities, participate in exercise, keep balanced relationships and manage their financial resources, they will stay mentally, socially and physically active, and also financially responsible.

About me but without me? Older adult's perspectives on interpersonal communication during care transitions from hospital to seniors' residence

Advanced age, comorbidity and the risk of mortality in COVID-19 infection

The purpose of this pilot project was to explore the experience of an intergenerational learning environment focused on healthy aging for nursing students and older adults. Intergenerational learning experiences provide opportunities for individuals from different age groups to communicate and participate in learning activities together. The growing population of older adults calls for increased geriatric nursing expertise. Nursing students’ attitudes toward older adults are often negative though, and result in decreased interest in geriatric nursing. The opportunity to transform nursing students’ perspectives on older adults has the potential to improve nursing care for older adults, and the number of nurses focused on geriatric nursing care. This qualitative inquiry used a convenience sample of 10 participants from a cross-listed university course on healthy aging for baccalaureate nursing students and older adult members of a lifelong learning institute. Semi- structured focus group interviews were conducted. Narrative transcripts were analyzed using an inductive approach. Analysis illustrated improved nursing students’ perspectives of older adults and aging. A similar theme was noted for older adults’ perspectives of younger adults. The importance of social interaction within an intergenerational learning environment and the need for opportunities to challenge ageist perspectives was illustrated. Increased exposure to healthy older adults, personally and professionally, may increase nursing students’ interest in geriatric nursing and improve nursing care for older adults. Future research should examine more specifically how intergenerational learning experiences can decrease ageism, improve nursing students’ and nurses’ perspectives on older adults, and improve nursing practice for older adults.

Introduction: Participation in leisure activities is greatly associated with the health and well-being of older adults. This study investigated the role of leisure activities in predicting the quality of life of community-dwelling older adults. Methods: In this descriptive and cross-sectional study, 141 older adults were selected by cluster sampling method from public places. Data were collected through demographic characteristics, leisure time activities, and Lipad QoL questionnaires. The questionnaires were completed through face-to-face interviews. A regression model was used for data analysis. Results: The mean age of older adult participants was 70.36 years (standard deviation = 8.99; range: 60–100 years) and 63.8% were male. The results also showed a low level of leisure time engagement and high level of QoL among older adults. The results of the current study indicated that education level and leisure time activity engagement were associated with a better QoL. Conclusion: According to the results of this study, engagement in leisure activities is related to improvements in the QoL of community-dwelling older adults. It is recommended that policymakers and families plan for and implement leisure time activities for older adults.

This study aims to know the factors that determine the interest in circular migration of the population to the city of Sumbawa. These factors include age, income, occupation, education level, marital status and land ownership. Type of this study was associative. The type of data used in this study was quantitative data. The data used in this study were primary that obtained directly from its source through questionnaires and secondary data were collected through documentation. Data analysis were used multiple linear regression analysis techniques, t and F statistical tests and the coefficient of determination (R2). To do data analysis was done through application of SPSS version 16.0 for windows application. The results showed that income and occupation variables had a significant effect on interest in circular migration of the population to the city of Sumbawa, while the variables of age, education level, marital status and land ownership had no effect on circular migration interest of the population to the city of Sumbawa. Simultaneously, the variables of age, income, occupation, education level, marital status and land ownership have a significant effect on the interest in circular migration of the population to the city of Sumbawa. The ability of the variables of age, income, occupation, education level, marital status and land ownership to influencing the variation of changes the interest in circular migration of the population to the city of Sumbawa was 95.9%, while the remaining of 4.1% was influenced by other variables outside the model research.

To determine the acceptability of a pre-consultation checklist for older adults who attend medical visits with an unpaid companion and to evaluate its effects on visit communication. Randomized controlled pilot study. Academic geriatrics ambulatory clinic. Thirty-two individuals aged 65 and older and their unpaid companions. A self-administered checklist was compared with usual care. The checklist was designed to elicit and align patient and companion perspectives regarding health concerns to discuss with the doctor and stimulate discussion about the companion's role in the visit. ratio of patient-centered communication, coded from visit audiotapes. checklist acceptability; visit duration; patient-companion verbal activity; patient- and physician-reported perspectives of the visit. All intervention patients and companions (n = 17) completed the checklist, and all participants (n = 32 dyads) completed the study. Patients and companions stated that the checklist was easy to complete (88%) and useful (91%), and they uniformly (100%) recommended it to other patients. Communication was significantly more patient-centered in intervention group visits (ratio of 1.22 vs 0.71; P = .03). Visit duration (35.0 and 30.6 minutes; P = .34) and percentage of total verbal activity contributed by patients and companions (58.2% and 56.3% of visit statements; P = .50) were comparable in the intervention and control groups, respectively. Physicians were more likely to indicate that intervention companions "helped them provide good care to the patient" (94% vs 60%; P = .02). Intervention patients were more likely to indicate that they "better understood their doctor's advice and explanations" because their companion was present (82% vs 47%; P = .03). A checklist to elicit and align perspectives of older adults and their companions resulted in enhanced patient-centered medical visit communication.

Leisure is essential to support quality of life following retirement. In India, there is limited research on the leisure participation of older adults. In collective cultures such as India, family members may also influence older adults’ leisure participation. Therefore, the present study aimed to understand the experiences and perspectives of Indian older adults and their family members regarding leisure participation following retirement. The present study used an interpretative phenomenological approach with in-depth interviews. The participants were eight dyads of older adults and their family members residing in Mumbai, an Indian metropolis. The findings suggest that older adults described activities that gave them satisfaction as leisure, such as preretirement hobbies, work-related activities, volunteering, and activities for and with family, including household chores. The study also identified personal, familial, and contextual factors influencing older adults’ leisure participation. The findings of this study can inform the provision of contextually relevant interventions to support meaningful leisure participation in older adults and healthy aging.

BackgroundAge associated cognitive decline or normal cognitive aging is related with lower levels of functioning in real life, and may interfere with maintaining independence and health related quality of life (HRQL).ObjectiveIn this study, health related quality of life and cognitive function in community-dwelling older adults were evaluated with the aim of exploring the association between them by adjusting for potential confounders.MethodsThis cross-sectional study, was implemented on 425 community-dwelling older adults aged 60 and over, between August 2016 and October 2016 in health centers of the municipality of Tehran, Iran, using Mini Mental State Examination (MMSE) to assess cognitive function and Short Form-36 scales (SF-36) to assess HRQL. The relation between HRQL and cognitive function was evaluated by Pearson’s correlation coefficient, and the impact of cognitive function on HRQL adjusted for potential confounders was estimated by linear regression model. All analyses were done using SPSS, version 22.0.ResultsA positive significant correlation between cognitive function and quality of life (r=0.434; p<0.001) and its dimensions was observed. Two variables of educational level (B=2.704; 95% CI: 2.09 to 3.30; p<0.001) and depression (B=2.554; 95% CI: 2.00 to 3.10; p<0.001) were assumed as potential confounder by changing effect measure after entering the model. After adjusting for potential confounders in regression model, the association between MMSE scores and quality of life persisted (B=2.417; 95% CI: 1.86 to 2.96; p<0.001).ConclusionThe results indicate that cognitive function was associated with HRQL in older adults with age associated cognitive function. Two variables of educational level and depression can affect the relation between cognitive decline and HRQL.

Chronic pain and aging trigger different plastic changes in pain processing; however, their combined effects on electroencephalographic correlates remain unexplored. This study aimed to examine these neural processing alterations in older adults with chronic pain, comparing them with pain-free older and younger adults. We compared pain-related evoked potentials (Pain ERPs) of 26 older adults with chronic pain (69,15 ± 4.63 years; 11 males), 26 pain-free older participants (69,65 ± 4.08 years; 12 males), and 27 pain-free younger adults (21,37 ± 1.92 years; 14 males). Participants received 30 painful and 30 non-painful electrical stimuli to the dorsum of the non-dominant hand individually calibrated using intra-epidermal electrical stimulation (IES) delivered via a concentric needle WASP electrode. EEG data were analyzed using cluster-based permutation test. Older participants with chronic pain showed enhanced pain ERPs from 150 to 500 ms in comparison to healthy older adults. Younger adults showed higher amplitudes than both older participants' groups except in late potentials (350-500 ms). No differences between younger and older adults with chronic pain were found. We found a similar amplitude reduction in early (linked to sensory processing), but increased amplitude in late (linked to evaluative and attentional mechanisms) evoked potentials to pain in older adults with chronic pain in contrast to pain-free older adults. This pattern may reflect an age-related sensory coding decline combined with chronic pain-related enhancement of affective-attentional processing. Altogether suggest that plastic changes driven by suffering from long-lasting pain outweigh those resulting from the normal aging process when both coexist.

Management of aggressive B-cell NHLs in the AYA population: an adult vs pediatric perspective

Objective: to identify scientific evidence regarding the care of frail older adults in the community, from the perspective of the older adults themselves. Method: a descriptive, integrative review study was performed. The search for articles was carried out in the Medline, Lilacs, Web of Science, Scopus and SciELO databases. The inclusion criteria were complete available articles; published between 2014 and 2019; written in Portuguese, English, Spanish or French; which had older adults as participants. Results: four categories of analysis emerged from the results: frailty from the perspective of frail older adults; priorities from the perspective of the older adults; the older adults’ perspectives on care by services; and interpersonal relationships in the care of frail older adults. The perception of the older adults has specific characteristics, has maintaining their independence as a focus of care, signals the need to maintain interpersonal relationships, improve communication, and for actions of health education and people-centered services. Conclusion: these points demand the attention of care providers and policy services to improve care delivery and provide actions that are welcomed by this public.