Chronic Illness In Later Life Research Articles

FAITH AND HEALTH: THE INTRICATE INTERPLAY OF MARITAL QUALITY, RELIGIOSITY, AND DIABETES

Abstract Although chronic illness in later life can negatively affect marital quality and life satisfaction through increased stress and burden, religiosity and spirituality are known robust protective factors in relational and psychological outcomes. Stress theory suggests that religious behaviors can help moderate this negative relationship by providing patients with a sense of meaning in illness, external social support, and healthy coping mechanisms. Using data from the Life and Family Legacies Study, we analyzed cross-sectional data from 1,210 married participants around age 70 in 2016. Using an OLS linear regression model, we found main effects which showed that type 2 diabetes among older adults was predictive of lower positive marital quality and lower life satisfaction. When religious behaviors were included in the model as a moderator, religious behaviors interacted significantly with diabetes such that individuals with type 2 diabetes who reported high religiosity had high positive marital quality, while those with low religiosity reported significantly lower positive marital quality. Findings suggest that when persons with type 2 diabetes participate regularly in church services, prayer, and scripture study they experience more positive marital quality. This indicates that religiosity may be a significant protective factor and coping tool for marital quality when chronic illness is present.

Reconstructing leisure in adapting to chronic illness in later life: emotional and behavioral strategies

Although the idea of “constraint negotiation” is quite common in the leisure studies literature, relatively little of this work has focused on aging or the strategies used to overcome health-related constraints to leisure activity participation. This article explores how older people with chronic illnesses adapt to constraints to leisure. Semi-structured in-person interviews were conducted with 18 community-dwelling older adults with a variety of chronic conditions. Analysis of narrative data indicated a range of emotional and behavioral responses to constraints. Emotional responses grouped into: (a) allowing for mourning, (b) appreciating what one still has, (c) realizing that things can be worse, (d) welcoming the constraint, and (e) all or nothing. Behavioral reactions included: (a) substitution, (b) compensating to overcome constraints, and (c) seizing opportunities for self-validation in disability-relevant volunteer work and becoming someone “new”. Findings are discussed in terms of the models of constraint negotiation and selective optimization. Findings also indicate that health constraints require a process of ongoing negotiations, which often result in positive changes.

Could the Baby Bonus be a bonus for babies?

Closing the gap in life expectancy between Indigenous and non-Indigenous Australians needs to start in the womb. Rates of perinatal mortality, preterm birth and low birthweight are two to three times greater among the babies of Indigenous women than among those of non-Indigenous women; low birthweight predisposes infants to greater risks of chronic illness in later life. Indigenous women in Australia tend to present for antenatal care later in pregnancy than do non-Indigenous women. There are many barriers for Indigenous women seeking to access antenatal care - geographical, social, cultural, financial and in some cases a lack of service provision. Many of these problems are being addressed within the public health system and by Indigenous community-controlled health services. However, more needs to be done. While antenatal care cannot solve all medical and social problems, commencing such care as early as possible in pregnancy has the potential to improve maternal health and hence pregnancy outcomes. Changes in the way the government Baby Bonus is paid to new mothers could act as an incentive not only to service providers but also to women themselves to initiate antenatal care in the first trimester of pregnancy. Such a system has been well established for many years in France. Any changes to the Baby Bonus scheme should provide incentives and not be punitive in nature.

Reflections on End of Life: Comparison of American Indian and Non-Indian Peoples in South Dakota

During the past century, dramatic changes have occurred in the way death is experienced in the United States. A death in 1900 typically occurred as a result of sudden illness and injury among the young at home. Today, Americans are more likely to die from long-term, chronic illness in later life, often in institutional settings. In addition to the many cultural transformations and medical advances that occurred during the last century, new philosophies and responses to end of life (EOL) have also evolved. From a review of the literature, only four articles address Indian perspectives on EOL. Joseph Carrese and Lorna Rhodes examined sharing negative information (including EOL diagnoses) with Navaho patients. Christine DeCourtney et al. described the creation of a culturally sensitive palliative care program in rural Alaska, and Emmanuel Gorospe and James Hampton offered commentary on palliative care for Indians. This dearth in the literature is especially critical, given that more than one thousand tribes inhabit the United States. Variations pertaining to EOL wishes among these populations have not been addressed. LifeCircle Dakota: Partners Improving End-of-Life Care is a statewide collaboration among health care and academic institutions. The statewide research, South Dakota's Dying to Know (SDD2K), provided an understanding of Dakotans' knowledge, attitudes, and preferences about EOL care. In the prairie state of Dakota (population 754,844), the largest minority population is Indian (8%). About 5 percent of Dakota households are headed by persons self-identifying as American Indian only. Most Indians in Dakota are of the Lakota, Nakota, or Dakota tribes of the Sioux Nation. This study brings into greater clarity the EOL wishes of Indians residing in Dakota and compares those perspectives with non-Indian residents. (Contains 5 tables, 1 figure and 20 notes.) Language: en

A Comparative Analysis of Graphical Interaction and Logistic Regression Modelling: Self-care and Coping with a Chronic Illness in Later Life

Quantitative research especially in the social, but also in the biological sciences has been limited by the availability and applicability of analytic techniques that elaborate interactions among behaviours, treatment effects, and mediating variables. This gap has been filled by a newly developed statistical technique, known as graphical interaction modelling. The merit of graphical models for analyzing highly structured data is explored in this paper by an empirical study on coping with a chronic condition as a function of interrelationships between three sets of factors. These include background factors, illness context factors and four self--care practices. Based on a graphical chain model, the direct and indirect dependencies are revealed and discussed in comparison to the results obtained from a simple logistic regression model ignoring possible interaction effects. Both techniques are introduced from a more tutorial point of view instead of going far into technical details.

Lay explanations of chronic illness in later life.

This study explores lay explanations of chronic illness in later life. More specifically, perceived causes, treatment strategies, and perceived outcomes of arthritis and heart/circulatory problems from the perspective of older adults who have such problems are examined. Variations in these explanations according to selected sociodemographic and health status characteristics are explored. Among the arthritis sufferers, the most prevalent explanations were physical work/working conditions, age, and injury, whereas those with heart/circulatory problems most often explained the cause as due to tension/stress, physiology, or heredity. A variety of treatments were identified, including doing nothing, seeking or continuing medical treatment, altering lifestyle, and using folk remedies. Selected sociodemographic and health status characteristics appear important for understanding explanations about arthritis, although it is primarily health status indicators that emerge for heart/circulatory problems. Directions for future research are highlighted.