Perceptions Of Older Adults Research Articles

Older Adults' Perceptions of Sedentary Behavior: A Systematic Review and Thematic Synthesis of Qualitative Studies.

Reducing sedentary behavior contributes to healthy aging. In order to develop sedentary behavior interventions, insight is needed into older adults' perceptions of (reducing) sedentary behavior. Therefore, this systematic review aims to synthesize qualitative evidence of older adults' perceptions towards (a) the concept of sedentary behavior, (b) barriers and facilitators of sedentary behavior, and (c) solutions and strategies to reduce sedentary behavior. A systematic search was conducted in four electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies investigating the perceptions of older adults (mean age: ≥60 years) towards (reducing) sedentary behavior. Quality of the included studies was rated using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist. Relevant data on older adults' perceptions were extracted and imported into NVivo. Two independent reviewers analyzed the data by means of thematic synthesis (line-by-line coding, constructing descriptive (sub)themes, developing analytical themes). Fifteen studies were included. Four analytical themes were developed to be considered when aiming to reduce sedentary behavior in older adults: the lack of knowledge on/awareness of sedentary behavior, the habitual nature of sedentary behavior, the importance of enjoyment and convenience, and the key role of aging. The reduction of older adults' sedentary behavior will likely be challenging as sedentary behavior seems to be firmly incorporated into older adults' daily routines, and strongly linked with positive reinforcement. Both aspects deserve thoughtful attention by intervention developers and health care professionals who aim to promote healthy aging by reducing sedentary behavior.

Grados de resiliencia que perciben adultos mayores durante su estancia en un hospital mexicano

A lo largo de la vida el adulto mayor se encuentra inmerso en diversas problemáticas derivadas de aspectos sociales, culturales, físicos y familiares, entre otros, esto conlleva a que desarrolle factores protectores que lo vuelvan resiliente: la resiliencia se define como “un factor de protección que nos favorece el desarrollo de recursos y cualidades que se ponen en marcha ante los eventos estresantes para poder afrontar las situaciones desagradablesque van ocurriendo”. El objetivo fue valorar la percepción que tienen los adultos mayores (AM) con base en la escala de Connor y Davidson en relación a los factores protectores que favorecen la resiliencia. Como hipótesis, existe interrelación entre los factores protectores con el grado de resiliencia de los AM. Este estudio cuestiona ¿Cuáles son los principales factores protectores presentes en el desarrollo de la resiliencia del AM? Se trata de una investigación observacional, realizada en un hospital de tercer nivel. La muestra fue de conveniencia conformada por 120 AM sin deterioro cognitivo, que se encontraron hospitalizados al momento de la aplicación del cuestionario. Donde 62% son viejos ancianos con base en la clasificación de la OMS. De esta muestra el 68% son mujeres, un factor social predominante para el desarrollo de la resiliencia es la posición económica en donde se encontró que el 61% cuenta con un nivel de ingreso que cubre sus necesidades básicas, el 35% perciben que “son capaces de adaptarse fácilmente cuando hay cambios”. Se identificó la relación que hay entre factores protectores y grado de resiliencia que tienen los adultos mayores hospitalizados de acuerdo a los indicadores de Connor y Davidson.

Hand asymmetries of tactile attention in younger and older adults

ABSTRACTBackground/Objectives: The allocation of attention can alter the perception of magnitude. When performing line bisections, young adults deviate leftward (pseudoneglect), a bias thought to be induced by right hemisphere dominance for allocating spatial attention. However, when performing body bisections young adults deviate rightward, suggesting left hemisphere dominance for allocating body-centered attention. With aging, there is a reduction of pseudoneglect thought to result from either an age-related decrease in right hemispheric functions (right hemi-aging) or from hemispheric asymmetry reduction in older adults (HAROLD). The goal of this study was to learn if there are tactile body-centered perceptual-attentional right-left asymmetries in that change with aging.Methods: The participants were younger and older healthy adults. Semmes-Weinstein Monofilaments were used to test for differences in the perceived magnitude of pressure differences between a reference stimulus and test stimuli applied to the right and left palmar thenar eminence.Results: Young adults perceived the magnitude of difference in the lightest pressure stimuli applied to the right hand as being greater than the older adults. Young adults perceived the magnitude of difference between the lightest pressure and reference applied to the right hand to be greater than the left hand, but older adults perceived a lighter stimulus greater on the left compared to the right.Conclusions: Whereas the right hemisphere appears to be dominant in mediating spatial attention, the left hemisphere may play a dominant role in the allocation of body-centered attention. Like the aging-related reduction of the visual perception of the magnitude (length) of the left side of a line, this tactile reduction in magnitude (pressure) perception in older adults suggests that with aging, there is a reduction of left-hemispheric mediated allocation of tactile attention, and this result is not fully consistent with either the HAROLD or hemi-aging models.

Resilience, not frailty: A qualitative study of the perceptions of older adults towards "frailty".

Despite increasing importance placed upon the identification of frailty among the older population, scholarship is limited around the perception of older adults towards the term. This qualitative study aimed to investigate the perceptions of older adults in a New Zealand setting towards the term "frail". Twelve participants identified as frail based on unrelated comprehensive geriatric assessment were approached and interviewed in their own homes. Interviews were transcribed ad verbatim and analysed by general inductive approach. There was a diverse conceptualisation of frailty among the participants, across physical, cognitive and social dimensions, which differed from professional definitions of frailty. Participants maintained a neutral stance towards the concept of frailty and, however, reject its application to themselves. They also highlight the importance of independence and resilience in the staving off of frailty and the maintenance of quality of life. This study suggests health professionals should shift focus on clinical encounters with the older patient, away from the deficits of frailty and towards independence, resilience and autonomy. Frail older adults often reject the term frailty when used about themselves, therefore using this term in communication with older adults may have negative consequences.

Community size and perception of older adults in the Cook Islands.

Attitudes towards aging are often negative, a phenomenon known as ageism. However, personal contact with older adults and intergenerational exchange in the context of close families may mitigate such negative tendencies. So far, these effects have been studied in Western and industrialized contexts. The present study extended this work to the Cook Islands archipelago, a group of islands in the South Pacific characterized by low levels of industrialization and relative isolation from foreign influences. We tested the hypothesis that attitudes toward aging in the Cook Islands would be more positive than in the world at large, and that, within the archipelago, attitudes towards aging would be more positive in smaller, less industrialized communities with closer family ties. Participants (n = 70), were recruited from three islands varying in community size and strength of the family ties among inhabitants. They rated their aging attitudes on four dimensions. Contrary to our hypotheses, attitudes in the Cook Islands did not differ from those reported in industrialized nations and did not vary significantly across islands, even after controlling for personal contact to older adults. Potential limitations and implications for future research are discussed.

Experiences and Perceptions of Hospitalization and Recovery of Older Adults and Their Caregivers Following Traumatic Brain Injury: "Not Knowing".

The purpose of the current study is to describe the experience and perceptions of older adults and their caregivers following hospitalization for mild or moderate traumatic brain injury (TBI). Qualitative analysis of data obtained in individual semi-structured interviews with older adults and their caregivers (N = 11, five dyads and one individual) was performed to capture the perceptions and experiences of the survivor and their caregivers about the acute injury, hospitalization, and recovery. Data were collected over a 2-month period following discharge from the hospital. Open coding and constant comparative analysis generated codes that were revised throughout the analysis and reformulated into thematic descriptions. As a result, seven interrelated themes were identified. These findings can be used to implement interventions focused on recovery, communication, teaching, patient outcomes, and satisfaction. [Res Gerontol Nurs. 2019; 12(5):227-238].

Improper Communication Makes for Squat: A Qualitative Study of the Health-Care Processes Experienced By Older Adults in a Clinical Trial for Back Pain.

Background:The study focused on perceptions of older adults toward the healthcare processes they experienced during a clinical trial for back pain that involved family medicine residents and licensed chiropractors.Methods:Individual semi-structured interviews were conducted with 115 older adults after a 12-week, 3-arm, randomized controlled trial. Two researchers conducted thematic analysis with inductive coding using qualitative software to identify participants’ salient experiences of the doctor–patient relationship, healthcare process, and collaboration between study providers. Investigators categorized thematic codes within an existing framework of clinical excellence in primary care.Results:Participants emphasized provider communication and interpersonal relationships, professionalism and passion for patient care, clinical and diagnostic acumen, and skillful negotiation of the health-care system. Older adults also described the importance of interdisciplinary collaboration and their preferences for receiving hands-on treatments for musculoskeletal conditions.Conclusion:These older adults valued doctors who communicated clearly and spent time listening to their concerns. Many participants appreciated clinicians who supported an active role for patients in their health-care and who provided touch-based care for musculoskeletal conditions.

A Qualitative Pilot Study of the Perceptions in Older Adults with End-Stage Kidney Disease on Hemodialysis.

BackgroundLittle is known about the perceptions of older adults with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) even though this could potentially influence how treatment is received. This study explores the perceptions of older adults with ESKD on HD, specifically their decision to initiate HD, preconceptions and expectations of HD, perceived difficulties with HD, and coping strategies.DesignCross–sectionalSettingOutpatient chronic dialysis unitsParticipantsOlder adults with ESKD on HDInterventionOpen-ended interviews were conducted with 15 participants. Inclusion criteria were age 60 years and older, HD duration of at least three months, and ability to consent and participate in the interview process.ResultsWe report on four identified domains: decision to initiate HD; preconceptions and expectations of HD; drawback of HD; and coping strategies. All participants were reluctant to initiate HD, but made the decision on advice from their physicians for varying reasons. Trust in physicians’ opinions also played a role for some. Some participants had positive preconceptions of HD, while a few had negative preconceptions or unrealistic expectations. Even though the majority of participants identified several difficulties with being on HD, they also had positive coping strategies, and the majority indicated that they would make the same decision to initiate HD.ConclusionAs clinicians are turning more to patient-centered medicine, understanding patients’ perceptions of HD is of crucial importance. Our study highlights the importance of improving pre-hemodialysis education to ensure that patients’ expectations are realistic, as well as identifying individualized coping strategies by patients.

Potential Effects of Mediators on Health Perception in Older Adults

Several aspects could influence mental and physical components of subjective quality of life perceptions. In particular, healthy diet and physically active lifestyles could play a crucial role for successful aging and sustainable quality of life in advancing years. PURPOSE: To determine the mediating effects of energy expenditure (EE) and intake (EI), body composition (BC) and dissatisfaction (BD) on the relation between age and health and quality of life perception. METHODS: 42 senior athletes, 55 physically active, and 61 sedentary adults (aged 55-85 years) were submitted to anthropometric (body mass, height - Body Mass Index [BMI]), weekly energy expenditure (EE), and dietary intake (EI) evaluations, and administered Body Image Dimensional Assessment (BDI), Short Form Health Survey - Physical (PCS) and Mental Component Summary (MCS) questionnaires. Two serial multiple model mediation analyses were applied to assess whether mechanisms involving diet-related and physical activity-related personal characteristics and behaviors (4 mediators: EE, EI, BMI, BDI) mediated the relation between age and PCS or MCS health-related quality of life perception. RESULTS: Only for MCS the mediation analysis showed: a) a direct effect of age on MSC (c’=0.31, p=0.002; CI(95%)=0.12; 0.50); b) a mediation path by EE, EI, BMI, and BDI (-0.0027, Bootstrap CI(95%)=-0.0105; -0.0002); and c) a positive total effect (c=0.22, p=0.02; CI(95%)=0.04; 0.39). CONCLUSIONS: The combination of positive and negative effects throughout the mediation path of mental health perception of older individuals underlined that the maintenance of adequate level of physical activity could influence the body image and, in turn, positively impact mental health with advancing age. Supported by MIUR Grant 2010KL2Y73

Perceptions of older adults in Ontario, Canada on the implementation and impact of a primary care programme, Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY): a descriptive qualitative study

ObjectivesThe aim of the study was to explore the perceptions of older adults on the implementation and impact of Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY), a multicomponent...

Bridging the brain structure—brain function gap in prosodic speech processing in older adults

Age-related decline in speech perception may result in difficulties partaking in spoken conversation and potentially lead to social isolation and cognitive decline in older adults. It is therefore important to better understand how age-related differences in neurostructural factors such as cortical thickness (CT) and cortical surface area (CSA) are related to neurophysiological sensitivity to speech cues in younger and older adults. Age-related differences in CT and CSA of bilateral auditory-related areas were extracted using FreeSurfer in younger and older adults with normal peripheral hearing. Behavioral and neurophysiological sensitivity to prosodic speech cues (word stress and fundamental frequency of oscillation) was evaluated using discrimination tasks and a passive oddball paradigm, while EEG was recorded, to quantify mismatch negativity responses. Results revealed (a) higher neural sensitivity (i.e., larger mismatch negativity responses) to word stress in older adults compared to younger adults, suggesting a higher importance of prosodic speech cues in the speech processing of older adults, and (b) lower CT in auditory-related regions in older compared to younger individuals, suggesting neuronal loss associated with aging. Within the older age group, less neuronal loss (i.e., higher CT) in a right auditory-related area (i.e., the supratemporal sulcus) was related to better performance in fundamental frequency discrimination, while higher CSA in left auditory-related areas was associated with higher neural sensitivity toward prosodic speech cues as evident in the mismatch negativity patterns. Overall, our results offer evidence for neurostructural changes in aging that are associated with differences in the extent to which left and right auditory-related areas are involved in speech processing in older adults. We argue that exploring age-related differences in brain structure and function associated with decline in speech perception in older adults may help develop much needed rehabilitation strategies for older adults with central age-related hearing loss.

Attitudes towards deprescribing among multi-ethnic community-dwelling older patients and caregivers in Malaysia: a cross-sectional questionnaire study.

Background Deprescribing describes a process of medication regimen optimization with the aim to reduce adverse events and improve quality of life. There is limited research on perceptions of older adults, defined as those 60years of age and older, about their willingness to cease a medication in developing countries. Objective To ascertain patients' attitudes, beliefs, perceptions, and experiences regarding the number of medications they were taking and their opinions regarding deprescribing. Setting A primary care health clinic and three community pharmacies in Malaysia. Method A multicenter cross-sectional study was conducted by administering the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire to older adults aged 60years and over or caregivers attending a health clinic and three community pharmacies in Malaysia. Descriptive results were reported for participants' characteristics and questionnaire responses. Analysis of correlation between participant characteristics and their responses was performed using Spearman's correlation. Main outcome measure Patients' and caregivers' attitudes and beliefs towards reducing medications and characteristics of patients such as age, gender, education level, number of medication taken and number of medical center managing the patient. Results 650 participants were approached and the response rate was 85.2%. A total of 554 participants completed the questionnaire (502 older adults and 52 caregivers). Older adults in the study were taking a median of three medications and/or supplements compared to four in caregiver recipients. 88.1% of older adults were satisfied with their current medication regimen and 67.7% would like to try stopping or reducing the dose of their medicines when their doctor recommended. 82.7% of caregivers were satisfied with their care recipient's current medications and 65.4% were willing to stop taking or reduce the number of drugs taken by their care recipient's upon doctor's recommendation. Older adults (p = 0.003) and those with lower education level (p < 0.001) were more willing to have their medications deprescribed. Other demographic characteristics such as gender, number of medication taken or number of doctors managing patient were not found to be correlated with willingness to stop a medication. Conclusion Older adults taking multiple medications for various medical conditions were largely accepting of a trial of cessation of medication.

Effects of free weights and machine training on muscular strength in high-functioning older adults.

Resistance training is assumed to be a key player in counteracting the age-related decline of functional capacity as well as the incidence of falls in older adults. Functional training using free weights is presumed to mimic daily activities, but there is a lack of studies comparing free weight training with barbells and machine training in older adults. The purpose of this study was to evaluate the development of muscle strength for high resistance training in high functioning older people for machines as well as free-weights as well as testing the feasibility of free weight training for this target group. Thirty-two fitness trained women and men aged 60 to 86 years (mean: 66.9, SD: ±5.5) participated in this study. Machine exercisers (n = 16; chest press, leg press, upper row, biceps cable curls, triceps cable extension) vs. free weight exercisers (n = 16; squat, bench press, bent-over rowing, biceps curls, lying triceps press) participated twice à week for a total of 26 weeks. They trained the same five muscle groups for three sets with 10 to 12 repetitions at the 10-Repetition-Maximum, followed by 20 min of endurance training over six months. Three measurements (dynamic, isometric strength and endurance) were taken at the beginning, after 10 weeks and again after 26 weeks. Repeated measures MANCOVA analysis revealed significant increases in the free weights training group (FWT) as well as in the machine training group (MT) over the period of 6 months. However, only for leg strength (113 vs. 44%) and triceps (89.0 vs. 28.3%) the free-weights group exhibited significant differences for the percentage increase over a period of 26 weeks compared to the machine group. A detraining period revealed the decline of the dynamic strength without training. The analysis of the follow-up questionnaire resulted in higher demands for safety, but also higher values for fun, motivation, future, and benefit for daily life for the FWT group compared to the MT group indicating an overall better evaluation of their training specific regime. Our results demonstrate that especially free-weight training has benefits in improving leg and triceps strength as well as in the subjective perception in older adults. Nevertheless, our results do not overall indicate that free-weight training is superior to machine training for increasing strength.

Abstract 282: Race and Gender-Based Perceptions of Older Adults

Background: Racial and gender bias affects decision-making in cardiovascular disease, with bias strongest particularly in older patients. Culture shifts often initiate in younger generations. With increased awareness of bias, it is unknown whether racial and gender bias of older individuals persist among the younger general public. Methods: From June through July 2018, we identified how an individual’s race and gender are associated with perceptions of photographed older Whites and Blacks using Amazon’s Mechanical Turk, a crowdsourcing marketplace for electronic surveys. Photos were preselected by study team to include individuals with similar facial features, age, and clothing. An international population of adult participants was randomly provided 16 out of 32 photos of White or Black women or men aged 65+ years, with or without stated heart failure. Using Likert scale 1-10, participants were asked to rate photos for health, attraction, intelligence, trustworthiness, and facial expression (happy, sad, neutral, and threatening). Mixed effect models were used to assess the interactions between participant and photo race and participant and photo gender with delta representing rating differences for White and Black photos or women and men photos. Results: Among 1563 participants, 63% were Non-Hispanic White, 71% US, 61% women, and average 35 years ± 12. Compared to White photos, both minority (MP) and White participants (WP) perceived Black photos as more trustworthy [Delta WP -0.59 (95%CI:-0.87,-0.32); Delta MP -0.50 (-0.78,-0.22), participant race-by-photo race interaction p=0.05] and less threatening, particularly among WP [Delta WP 0.79(0.24,1.33); Delta MP 0.60 (0.05,1.15), interaction p&lt;0.001]. WP perceived Black photos more favorably for attraction and intelligence compared to MP who perceived no racial differences (interaction p&lt;0.001). Both genders perceived photos of women as more trustworthy, but differences in trustworthy ratings between women and men photos were greater among women participants (WmP) [Delta WmP 0.50(0.23,0.78); Delta men Participants (MnP) 0.31(0.03,0.59); participant gender-by-photo gender interaction p&lt;0.001]. Both genders perceived men as more threatening [Delta WmP -0.84(-1.39,-0.29), Delta MnP -0.77(-1.32,-0.22), interaction p=0.93]. Only WmP perceived women as more happy [(Delta WmP 0.80 (0.07,1.52); Delta MnP 0.42(-0.31,1.14), interaction p&lt;0.001)]. Other ratings were not significant by race nor gender. Conclusions: Among a younger international generation, older Blacks were perceived more favorably than Whites, particularly by White participants. Perceptions based upon gender followed many gender norms. This suggests that explicit bias against minorities may be decreasing, but gender biases persist. Future work should investigate whether similar patterns are observed in healthcare professionals.

Perception of Older Adults Toward Smartwatch Technology for Assessing Pain and Related Patient-Reported Outcomes: Pilot Study.

BackgroundChronic pain, including arthritis, affects about 100 million adults in the United States. Complexity and diversity of the pain experience across time and people and its fluctuations across and within days show the need for valid pain reports that do not rely on patient’s long-term recall capability. Smartwatches can be used as digital ecological momentary assessment (EMA) tools for real-time collection of pain scores. Smartwatches are generally less expensive than smartphones, are highly portable, and have a simpler user interface, providing an excellent medium for continuous data collection and enabling a higher compliance rate.ObjectiveThe aim of this study was to explore the attitudes and perceptions of older adults towards design and technological aspects of a smartwatch framework for measuring patient report outcomes (PRO) as an EMA tool.MethodsA focus group session was conducted to explore the perception of participants towards smartwatch technology and its utility for PRO assessment. Participants included older adults (age 65+), with unilateral or bilateral symptomatic knee osteoarthritis. A preliminary user interface with server communication capability was developed and deployed on 10 Samsung Gear S3 smartwatches and provided to the users during the focus group. Pain was designated as the main PRO, while fatigue, mood, and sleep quality were included as auxiliary PROs. Pre-planned topics included participants’ attitude towards the smartwatch technology, usability of the custom-designed app interface, and suitability of the smartwatch technology for PRO assessment. Discussions were transcribed, and content analysis with theme characterization was performed to identify and code the major themes.ResultsWe recruited 19 participants (age 65+) who consented to take part in the focus group study. The overall attitude of the participants toward the smartwatch technology was positive. They showed interest in the direct phone-call capability, availability of extra apps such as the weather apps and sensors for tracking health and wellness such as accelerometer and heart rate sensor. Nearly three-quarters of participants showed willingness to participate in a one-year study to wear the watch daily. Concerns were raised regarding usability, including accessibility (larger icons), notification customization, and intuitive interface design (unambiguous icons and assessment scales). Participants expressed interest in using smartwatch technology for PRO assessment and the availability of methods for sharing data with health care providers.ConclusionsAll participants had overall positive views of the smartwatch technology for measuring PROs to facilitate patient-provider communications and to provide more targeted treatments and interventions in the future. Usability concerns were the major issues that will require special consideration in future smartwatch PRO user interface designs, especially accessibility issues, notification design, and use of intuitive assessment scales.

(313) Association between Measures of Function and Pain Perception in Older Adults with Chronic Low Back Pain

This investigation examined the association between measures of function and pain perception in older individuals with chronic low back pain (CLPB). Data from eight subjects older than 65 were analyzed. Measures of function included the 2-minute walk test (2-MWT) and the Oswestry Disability Index (ODI). Pain perception was examined by pressure pain threshold (PPT). Clinical pain was obtained with the visual analogue scale (VAS). PPT was assessed bilaterally at T12, L5, and S2. Values obtained during PPT were averaged together to quantify local PPT. Descriptive statistics were collected and Pearson correlation moment was performed to identify correlations. A stepwise regression model was used to identify the stronger predictor of PPT, (PPT was used as the dependent variable and ODI and 2-MWT were entered as the independent variables). Results showed that local PPT was significantly correlated with both objective and subjective measures of function (2-MWT r2=0.800, p=0.017, ODI r2=-0.866, p=0.005). Correlation analysis showed that clinical pain measured with the VAS scale was not associated with measures of disability used in this study (p>0.05). Stepwise regression model revealed that ODI alone was responsible for 70% of the variability in PPT (r2=0.708, β=-0.866, p=0.005). 2-MWT explained an additional 22% of the variability in PPT (r2=0.923, β=0.502 p=0.008). Results from this modest sample of participants with CLBP suggest that perception of disability and level of activity as evaluated by the 2-MWT have a strong influence in experimental pain perception. Surprisingly, clinical pain was not associated with measures of disability which indicates that the use of the VAS alone may not be enough to assess pain in older individuals with CLBP. Moreover, the 2-MWT could be a simple and easy way to assess changes in physical activity in older individuals.

Community-based interventions to enhance healthy aging in disadvantaged areas: perceptions of older adults and health care professionals

BackgroundThe number of older adults with different ethnic and socioeconomic background is steadily increasing. There is a need for community-based health promotion interventions for older adults that are responsive to ethnic and socioeconomic diversity among target populations. The aim of this study is to explore encounters between older adults living in disadvantaged areas and health care professionals in the context of community-based health promotion.MethodsQualitative methods were used involving interviews and focus groups with older adults (n = 22) and municipal health care professionals (n = 8), and multiple observations were conducted. Data were analyzed thematically.ResultsFindings show a gap between health promotion services and older adults due to a perception of services as being neither accessible nor acceptable in the context of complex health and psychosocial needs. Health care professionals reported trust, proximity and presence as fundamental factors for improving acceptability and accessibility of health promotion services.ConclusionsThere is a need to develop participatory approaches to engage older adults who live in disadvantaged areas in municipal health promotion services and to ensure that these services are relevant to these groups.

Intergenerational Programs: Breaking Down Ageist Barriers and Improving Youth Experiences

LINKages, a nonprofit organization, aims to bridge the gap between older and younger generations by building intergenerational programs for youth and older adults. The objective of this project was to explore the influence of the LINKages intergenerational program on: a) older adults’ affect and levels of engagement, and b) youth volunteers’ experiences of engagement and perceptions of older adults. An exploratory case study design was used to address the study objectives. Sixty-five residents from four residential care homes and 87 youth volunteers in the LINKages program participated. Data were collected over 7 months. Statistically significant improvements in students’ perceptions of older adults and their experiences of engagement were found following their participation in the LINKages program. Participation also resulted in positive benefits for residents based on their observed levels of engagement and positive affect.Subscribe to TRJ

高齢者の自己身体知覚:ラバーハンド/フット錯覚を用いた検討

高齢者の自己身体知覚:ラバーハンド/フット錯覚を用いた検討

Evaluating the Use of Mobile Health Technology in Older Adults With Heart Failure: Mixed-Methods Study.

BackgroundHeart failure (HF) is associated with high rates of hospitalizations, morbidity, mortality, and costs. Remote patient monitoring (mobile health, mHealth) shows promise in improving self-care and HF management, thus increasing quality of care while reducing hospitalizations and costs; however, limited information exists regarding perceptions of older adults with HF about mHealth use.ObjectiveThis study aimed to compare perspectives of older adults with HF who were randomized to either (1) mHealth equipment connected to a 24-hour call center, (2) digital home equipment, or (3) standard care, with regard to ease and satisfaction with equipment, provider communication and engagement, and ability to self-monitor and manage their disease.MethodsWe performed a pilot study using a mixed-methods descriptive design with pre- and postsurveys, following participants for 12 weeks. We augmented these data with semistructured qualitative interviews to learn more about feasibility, satisfaction, communication, and self-management.ResultsWe enrolled 28 patients with HF aged 55 years and above, with 57% (16/28) male, 79% (22/28) non-Hispanic white, and with multiple comorbid conditions. At baseline, 50% (14/28) rated their health fair or poor and 36% (10/28) and 25% (7/28) were very often/always frustrated and discouraged by their health. At baseline, 46% (13/28) did not monitor their weight, 29% (8/28) did not monitor their blood pressure, and 68% (19/28) did not monitor for symptoms. Post intervention, 100% of the equipment groups home monitored daily. For technology anxiety, 36% (10/28) indicated technology made them nervous, and 32% (9/28) reported fear of technology, without significant changes post intervention. Technology usability post intervention scored high (91/100), reflecting ease of use. A majority indicated that a health care provider should be managing their health, and 71% reported that one should trust and not question the provider. Moreover, 57% (16/28) believed it was better to seek professional help than caring for oneself. Post intervention, mHealth users relied more on themselves, which was not mirrored in the home equipment or standard care groups. Participants were satisfied with communication and engagement with providers, yet many described access problems. Distressing symptoms were unpredictable and prevailed over the 12 weeks with 79 provider visits and 7 visits to emergency departments. The nurse call center received 872 readings, and we completed 289 telephone calls with participants. Narrative data revealed the following main themes: (1) traditional communication and engagement with providers prevailed, delaying access to care; (2) home monitoring with technology was described as useful, and mHealth users felt secure knowing that someone was observing them; (3) equipment groups felt more confident in self-monitoring and managing; and finally, (4) uncertainty and frustration with persistent health problems.ConclusionsmHealth equipment is feasible with potential to improve patient-centered outcomes and increase self-management in older adults with HF.